Rosevale

We found the following examples of good practice.

People’s rights were promoted and upheld as people were supported to have regular visitors, though the flexibility of visits was not always effectively communicated. The manager confirmed they would ensure all visitors were aware of visiting availability. People could choose where they wanted their visits to take place based on their preference.

Staff appropriately wore personal protective equipment (PPE) to reduce the risk of spreading infection. Guidance was available for staff and visitors on how to use PPE.

The building was tidy and well maintained with regular cleaning of the service throughout the day.

The risk of infection for people was assessed on admission to the service and people were regularly monitored for signs and symptoms of infection. Isolation processes were implemented when required to control the risk of infection.

At our last inspection we rated the service Good. At this inspection we found the evidence continued to support the rating of Good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

This inspection took place on 22 and 24 May 2018 and was unannounced. 34 people were using the service at the time of our inspection.

There was a registered manager in post. Staff spoke positively about the management and leadership of the home.

Risks to people were assessed and action taken to reduce them. There were systems and processes in place to protect people from the risk of harm. Staff were able to tell us about different types of abuse and were aware of action they should take if they had any concerns.

Medicines were stored, administered and recorded safely. The premises were clean and well maintained.

There were enough staff to meet people’s needs. Appropriate checks had been undertaken before staff began work to ensure they were suitable to work in a care setting. Staff received training, supervision and appraisal to give them the skills and knowledge they needed to meet people's needs.

People were provided with a varied and nutritious diet. Staff sought advice from healthcare professionals when they had any concerns about people’s health, and people had access to healthcare professionals and services.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

Staff treated people with dignity and respect. We observed warm, friendly interactions between staff and people who used the service and it was evident staff knew people well. Relatives and visitors spoke positively about how caring staff were.

Care plans were in place to give staff the information they needed to support people in line with their preferences and needs. People were able to take part a good range of activities and entertainment at the home. They were also supported to go out locally and could make use of the pleasant gardens at the home.

The provider had a policy in place for responding to people's concerns and complaints. People and staff were asked for their views in meetings and surveys. There was a quality assurance system and audits to identify any issues and drive improvement.

Further information is in the detailed findings below.

Rosevale is a care home service without nursing. They provide long term accommodation for up to forty four older people who require nursing or personal care, some of whom may be living with dementia. At the time of our inspection there were thirty five people receiving a service. Rosevale Residential Care Home is located a short drive from the city of York, in the village of Wigginton and has enclosed mature landscaped gardens. Off road parking is available at the front of the building for visitors.

Rosevale has a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People and their relatives spoke positively about the care they received. It was clear from talking to people and looking at care plans that care was person centred. People told us they felt safe and we found that staff knew how to protect people from avoidable harm. Staff knew how to recognise different signs of abuse and they were clear about what action to take if they suspected abuse was taking place. The registered provider had a safeguarding policy in place updated within local authority guidelines.

People were encouraged to live as independently as possible and we saw detailed risk assessments and risk management plans were in place to enable people to live independently and undertake a variety of daily activities in a safe way.

Rosevale Care Home demonstrated a high awareness for people’s safety. We saw risk assessments for the environment which included personal emergency evacuation plans [PEEPs] for each individual person. PEEPs are documents which advise of the support people need in the event of an evacuation taking place.

We looked at monthly checks on emergency lighting, fire extinguishers, room and water temperatures and pressure mats and saw that these were all up to date. The registered manager showed us maintenance certificates for electrical wiring, gas safety and portable appliance checks. These were also up to date and helped to ensure the safety of the premises for people.

There were enough competent staff on duty and staffing levels were regularly reviewed to ensure that there were sufficient numbers of qualified staff to meet people’s changing needs. Care workers told us there was adequate staffing; one care worker told us “The rotas work really well, staffing is well managed.”

Recruitment of staff was robust with checks undertaken by the provider ensuring that only people considered suitable to work with vulnerable people had been employed. New employees were enrolled on an induction and shadowing process ensuring they had the required skills to undertake their duties and provide person centred care.

Medicines were stored safely and securely. Policies and procedures were in place for storing, administering, recording and, where applicable, returning medication. We saw these were strictly adhered to. Only team leaders administered medication and we saw they had undertaken appropriate training. In addition, competency checks had been carried out so that the registered manager could monitor that staff remained competent to administer medication safely.

Management and staff had received training in and understood the requirements of the Mental Capacity Act 2005 [MCA]. The MCA provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. Where people may have lacked capacity the registered provider ensured that the MCA was followed and we saw that prompt application for deprivation of liberty safeguards [DoLS] had been completed. DoLS were regularly reviewed and evaluated. Where an individual had capacity to make decisions in other areas of their lives we saw that they were encouraged by staff to provide their consent.

We saw there was a choice of menu and the chef told us that all meals were homemade. We saw this included a vegetarian option. The registered service had an environmental health officer food hygiene rating [FHRS] award of 5.

People told us that they were well cared for and had access to a range of health professionals. The local general practitioner [GP] attended on the day of our inspection. People told us they could see a GP when they wanted to. We saw records of professional contacts with healthcare services documented in peoples care plans. These included GP, district nurse, community psychiatric nurse, and mental health practitioner.

There was an activities coordinator employed. We saw a variety of activities and seasonal events were organised in line with people’s requests and feedback. These were well advertised on notice boards and one person had a verbal update each day to ensure they did not miss out.

People and their relatives were involved in the assessment and planning of their care and support. Peoples care plans showed how they were involved in making decisions about their care, treatment and support. Care plans were detailed and included information about peoples likes and dislikes. One person said “I like to use my own toiletries and the staff know this because they have it written down.”

We saw staff providing information and explanations before carrying out care to people. They were sensitive and warm and we saw people smiled in response to staff approaching. It was evident that staff knew and understood people’s individual communication skills preferences and needs.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

The home had proper policies and procedures in relation to the Mental Capacity Act and Deprivation of Liberty Safeguards although no applications had needed to be submitted. All staff had received training in this area and the staff we spoke with confirmed that they understood when an application should be made, and how to submit one. This meant that people were safeguarded as required.

People received an assessment which helped to ensure that the home was able to meet their needs. We saw care plans and risk assessments were in place to help ensure people's safety and welfare. Information was reviewed regularly to ensure that it was up to date and reflected any changes. People told us that they were consulted about their care. Comments included 'I can choose what I want to do and I am well cared for. I could tell someone if I had any concerns.'

The home had systems in place to make sure that managers and staff learnt from events such as accidents, incidents, complaints, concerns and whistleblowing. This helped to reduce the risks to people and helped the service to continually improve.

Is the service effective?

The home had appropriate arrangements in place for gaining people's consent. People's health and care needs were assessed with them, and they were involved in decisions regarding their plans of care. This meant that staff were able to deliver care in a way that supported people.

Is the service caring?

People were supported by kind and attentive staff. We saw that care workers showed patience and gave encouragement when supporting people. A relative commented 'My relative is well looked after, nice food, nice everything. The staff are great.'

People's preferences, interests, aspirations and diverse needs had been recorded and care and support was being provided in accordance with people's wishes. We identified some concerns with one person's medication which the home agreed to address.

Is the service responsive?

Since our last visit the service had reviewed their care records and quality monitoring systems to ensure the care being delivered was appropriate for those who lived there. We saw that the home had responded to suggestions made within questionnaires and people were confident that the home would respond to any concerns if they were unhappy. We had received some concerns regarding the food. The home had employed a new chef and they were taking appropriate action to address these concerns.

Is the service well-led?

The service worked well with other agencies and services to make sure people received their care in a joined up way. Staff confirmed that the management were supportive. Meetings were held so that people could air their views. All of the people we spoke with said that they felt able to raise any concerns and were confident that these would be addressed.

People's needs were assessed and care and treatment was planned and delivered in line with their individual care plan. One person told us "I am here for a short stay, I enjoyed the exercise class this morning. It's very nice."

People who use the service were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening. The staff we spoke with had received training in safeguarding adults and said that they would tell someone if they saw or heard anything inappropriate.

The home had effective recruitment systems in place which helped to protect people and they provided staff with a range of training which helped staff to meet the needs of the people accommodated. One person told us "The staff are lovely, they are all very caring."

There were a range of effective quality management systems in place to assess and monitor the quality of service that people received. Both relatives and people living at the home said that they were able to express their views and opinions and would raise concerns if they had them.