Rosedale Nursing Home

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant people were safe and protected from avoidable harm.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider had a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

The provider encouraged an open culture of continuous learning. Accidents and incidents were well documented by staff. Managers ensured action was taken to reduce future risk and identify any lessons that could be learned to improve the service.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services.

Managers and staff worked closely with health and social care professionals to ensure people received the care and support they needed. This included sharing information when people transferred back to their own homes or other care facilities.

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect.

Staff had received training in safeguarding people from abuse and knew how to raise any concerns. Managers shared any concerns quickly and appropriately. People said they felt safe with the staff and living at the home. A person told us, “I’m extremely safe; security is paramount to me and it’s very safe in here.”

DoLS applications had been made where required. Staff were aware of DoLS authorisations that were in place, and any conditions attached to these.

The provider worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

The provider worked with people to understand and manage risks. Risk assessments were person‑centred, and ensured people were supported in a way that kept them safe and respected things that were important to them.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. Risks within the home were identified and well managed. Regular health and safety checks and maintenance of the building and equipment were undertaken.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs.

There was a robust system of safe staff recruitment in place. There were sufficient staff deployed to meet people’s needs. Staff received effective training, support and supervision. Staff were very positive about the training and support. A staff member said, “The training is great. It keeps us and the people who live here safe.” A person told us, “The staff are well trained, and you often hear the seniors guiding the younger ones in the correct procedures.”

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.Risks associated with infections were assessed and well managed. Staff had access to appropriate personal protective equipment (PPE). People told us the home was always kept clean.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. They involved people in planning, including when changes happened.

Medicines, including controlled drugs were stored safely and securely, and temperature monitoring was in place for areas where medicines were stored, including medicines fridges. There was restricted access to controlled drugs and records were completed accurately. There were good stock management processes in place.

Electronic medication administration records (eMAR) were completed appropriately and there was a process in place to ensure people received their medicines. Allergies were well documented and where medicines had specific administration requirements, these were administered accordingly.

Care plans for people were detailed, person centred and had sufficient information for care givers on how to support people to manage their conditions. Written protocols for medicines that are administered ‘when required’ were also available and provided details on how to support peoples’ needs. However, we found that some care plans required updating and some written protocols required more information. Managers confirmed the information had been updated following our inspection.

Where people had specific needs, such as the use of thickener to prevent choking or were unable to swallow medicines in a solid form, staff had good knowledge of service user requirements. There was detailed information available to support this and record keeping was in place. For people with diabetes who required their blood sugars to be monitored, this was done and recorded in line with individual requirements and there was detailed information to manage their condition in care plans.

The application of medicated patches was recorded, and daily checks were made to ensure they were still in place. Body maps and site codes were used to support application and document the rotation of patches in accordance with manufacturers guidelines; however, this was sometimes unclear. Managers updated the systems during our inspection.

Staff communicated effectively and used a multidisciplinary approach to support people’s needs. Homely remedies were available in the service and the appropriateness of these were assessed and reviewed for individual people to ensure safe administration.

Detailed risk assessments were in place and specific to each individual on the use of prescribed creams where they had been prescribed flammable emollients. Other risk assessments specific to service user needs were also in place such as those for choking, pain and the use of medicines that were blood thinners.

Training and competency assessments were up to date for all staff administering medicines and there was a training matrix in place to identify when training was due.

Medicines related errors and incidents were recorded thoroughly with details of the incident, investigations, actions, and lessons learned. Learning from medicines related incidents were shared and discussed with staff to prevent future occurrences. Audits were conducted monthly and were comprehensive. Any areas for improvement identified through auditing were acted upon and reviewed to ensure the expected outcome had been achieved.