Archived: Rosegarland Residential Home Limited

We undertook the inspection on the 19 October 2017 and it was unannounced. We last inspected the service on 19 November 2014 and rated the service as ‘Good’ overall with the effective domain rated as ‘Requires Improvement’ as the home was not meeting the requirements of the Deprivation of Liberty Safeguards (DoLS) and training was not fully up-to-date. At this inspection, although these specific concerns had been addressed we rated the service as ‘Requires Improvement’ overall. We noted the registered manager had made recent improvements to some areas such as increasing night time and domestic staffing levels and undertaking work to the environment. However we identified shortfalls around the management of risk and care plan documentation. Due to this, we were unable to rate the service better than ‘Requires Improvement.’

There was a registered manager in place. 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.

We identified some risks that had not been effectively assessed and mitigated, for example around the provision of bed rails and some care plans did not contain sufficient detail to describe how risks were to be managed.

People said they felt safe and secure within the home. Safeguarding procedures were in place and we saw they had been followed to help keep people safe.

The premises was warm and homely. There were sufficient communal spaces for people to spend time. Safety checks were undertaken on the building to keep it safe.

There were enough staff deployed to ensure safe and prompt care. Recruitment procedures were in place, although documentation needed to better demonstrate why some recruitment decisions had been made.

Staff received a range of training and support. They said they felt well supported and received regular supervision and annual appraisal.

People received a varied diet. Most people spoke positively about the food. We found a pleasant atmosphere at lunchtime, although one person could have been provided with more assistance to help them eat their meal.

The service had made appropriate DoLS applications which were awaiting assessment by the local authority. Whilst we concluded the service was acting within the legal framework of the Mental Capacity Act (MCA), documentation needed improving to ensure this was evidenced in a clear way.

The service worked with a range of healthcare professionals to help ensure people’s healthcare needs were met.

People said staff were kind and caring and this was confirmed by our observations of care and support. Staff were patient with people and took the time to help reduce any distress people were experiencing.

The service helped people maintain their independence for example by encouraging them to mobilise independently around the home.

People’s care needs were assessed and plans of care developed. Staff knew people well which gave us assurance plans of care were followed. People’s cultural and religious preferences were sought and arrangements made to ensure they were met.

People had access to activities which were provided by the home. Staff spent time with people talking to them to help meet their social needs.

People spoke positively about the way the home was run. They said the management team was approachable. Staff said the service was well run and they would recommend the service to their own relatives. We found an open and inclusive atmosphere within the home.

Systems were in place to assess and monitor the quality of the service but some of these needed improving to ensure they captured the shortfalls that we identified. People said they were able to complain and found the management team approachable.

People’s feedback was sought and used to make improvements to the service.

We identified two breaches of the Health and Social Care Act 2008 (Regulated Activities) 2014 Regulations. You can see what action we asked the provider to take at the back of the report.

We looked around the environment to see if infection control measures are in place and found areas to be clean and tidy and cleaning schedules were place and being followed.

We spoke with staff and looked at the rota system and the manager said they are in the process of recruiting one more staff member to the team. Additional staff member should provide adequate cover to meet peoples needs.

During our inspection we saw people were well groomed and smartly dressed. A person who used the service told us "If I need support with anything I ask the staff and they sort it out for me." A relative of a person who used the service told us, "I like it because it's not big; it's like a small community."

All the staff we spoke with told us they were aware of the need to safeguard people from harm and were able to explain their role in protecting vulnerable people. Staff we spoke with were able to explain how they would report and escalate concerns.

We looked at all areas of the home, lounge, bedrooms, kitchen, bathrooms and laundry. We found the home had been cleaned and maintained to a good standard. One visitor to the home said, "The home is always clean and tidy."

We looked at the staff files for four staff members. We saw evidence checks had been made to ensure people recruited were of good character. We saw evidence of the qualifications of care staff, and training certificates for courses they had attended.

The two people who used the service told us they were involved in discussions and decisions about their care needs and were kept informed about any changes.

People who lived in the home said the food was good and the home was clean, homely and comfortable.