Archived: Roseway House

We carried out this unannounced inspection on 28 September, 5 October and 19 November 2015. We last inspected the service on 28 June 2013, the service was meeting the legal requirements we inspected at that time.

Roseway House is a purpose built care home providing nursing and residential care for up to 49 older people, some of whom are living with dementia. At the time of our inspection there were 41 people using the service.

The home had 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.

We found the provider had breached Regulations 12 and 15 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This was because medicines were not always handled safely. Staff were not consistently recording the date the medicines were opened. A discontinued bottle of liquid paracetamol hadn’t been disposed of and was still available in the medicines trolley. The home did not have a dedicated treatment room and the room used to store medicines was consistently too hot. The registered provider had plans to develop a dedicated treatment room but this work had not started at the time of our inspection. Fridge temperature checks had not been recorded consistently. Guidance for staff about when to give ‘when required’ medicines had either not been written for these medicines or lacked sufficient detail.

We also found some areas classed as ‘high priority’ which had been identified during the last fire risk assessment were still outstanding at the time of the inspection. Evacuation and business continuity plans required updating as some information was out of date.

You can see what action we told the provider to take at the back of the full version of the report.

We saw staff using moving and assisting equipment safely. Up to date assessments were in place to help protect people from a range of potential risks, such as skin damage, poor nutrition and the environment. However, risk assessment evaluation records lacked detail.

Regular health and safety checks were carried out, including fire safety checks, emergency lighting checks, portable appliance testing (PAT) testing and servicing of equipment. The home had an up to date gas and electrical safety certificate.

Staff demonstrated they had a good understanding of safeguarding and whistle blowing. They knew how to report concerns. One staff member said, “I would report [concerns] to the manager and if I got no joy go higher.”

We received mixed feedback about staffing levels in the home. One person said, “She [registered manager] could do with more staff. One extra girl would make all the difference.” One staff member commented, “Staffing levels are getting better.” Another staff member said, “There was enough staff, there are some days when we are short staffed.” Following our inspection we received concerns about night time staffing levels being inadequate to meet people’s needs. Staff rotas showed the home was regularly running with four staff rather than the usual five overnight. During our unannounced, out of hours, visit we found five staff were on duty.

The registered provider’s recruitment and selection procedures were followed, including requesting and receiving references and Disclosure and Barring Service (DBS) checks.

People and family members gave us positive feedback about the care given at the home. One person said, “Nothing is perfect. The staff look after me the best they can. I am fine.” Another person told us, “The staff are lovely. If I need anything, they do something about it. I have no complaints. Everything is fine. I am quite happy.” One family member said, “The staff are so very helpful. They are a friendly bunch.” People, family members or staff did not raise any concerns with us about safety in the home.

People were treated with dignity and respect. There was a good rapport between people and staff. We observed staff were available in communal lounges to check on people’s safety and wellbeing. People were supported to be as independent as possible with staff encouraging people to do things for themselves.

Staff told us they were well supported. One staff member said, “Quite supported, I can talk to the nurse or other carers. The manager’s door is always open.” Another staff member said, “I feel really well supported.” Most training was up to date, apart from moving and assisting refresher training which was in the process of being updated. One staff member said, “All my training is up to date. It’s moving and handling [training] tomorrow.”

The registered provider was following the requirements of the Mental Capacity Act 2005 (MCA). 38 out of 41 people had a DoLS authorisation in place. Staff had a good understanding of MCA. Staff said they always asked people for permission before providing care and respected people’s decisions. We observed throughout the inspection that staff consistently asked people for their consent. Staff knew how to support people’s behaviours that challenged.

We saw people were supported to have enough to eat and drink. People told us the meals were good. One person said, “The food is good and you get a choice”. One family member told us the registered provider had followed advice from a dietitian to improve their relative’s pureed diet.

Staff said they supported people to meet their healthcare needs through attending doctors’ appointments or contacting the doctor if they were unwell. People’s care records showed they had regular access to a range of health care professionals, such as GPs, community nurses and dietitians. The nurse on duty told us a nurse practitioner came into the home on a regular basis.

People had their needs assessed before and shortly after admission into the home. Care records included a life history and information about people’s preferences. Care plans were detailed and up to date.

Activities were provided for people to participate in. These included chats, manicures, parties, entertainers and ball games. One staff member commented, “There are loads of things [activities].” A Church service was planned for the last Friday in every month. Activities for people living with dementia needed improving. We have made a recommendation about this.

People we spoke with told us they knew how to complain. They said they had no complaints. There had been no complaints made about the home in the past 12 months. People and family members could give their views at quarterly ‘relatives meetings.’ However, these had not been very well attended.

We received positive feedback about the registered manager from people, staff and visitors. One person said, “The manager is a canny [nice] lass. She could do with more staff. One extra girl would make all the difference.” One staff member said, “I can go to the manager with anything. I think most [staff] would do that.” The home had a good, friendly atmosphere. One staff member commented, “I love it here and the residents.” They added, “Nice atmosphere, we have a good team at the moment.”

There were opportunities for staff to give their views through attending staff meetings. Staff said these were regular and staff felt able to give their views. The registered provider consulted with visiting healthcare professionals in April 2015 to gather their views about the care provided at the home.

The registered provider undertook a range of quality audits to check on the quality of people’s care, including checks of care plans, infection control procedures and health and safety measures. Care plan audits had been successful in identifying areas for improvement and ensuring action was taken. Medicines audits were completed regularly. These had been successful in identifying gaps in MARs but had not identified the areas that we had found during the inspection.