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Rosewood Lodge Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

Updated 7 April 2018

This comprehensive unannounced inspection took place on the 5 February 2018. Rosewood Lodge is a 'care home'. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service has single and shared accommodation for a maximum of 20 older people, some of whom may be living with dementia. On the day of the inspection there were 17 people living at the service. The service had a registered manager in post. 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 and associated Regulations about how the service is run.

At the last inspection the service was rated 'Requires Improvement' overall. We issued one requirement notice for a breach in Regulation 12, safe care and treatment. People’s risk assessments and support plans were not always up to date and reflective of people care needs. They were not being followed to prevent people receiving unsafe care. You can read the report from our last inspection, by selecting the ‘All reports’ link for Rosewood lodge, on our website at www.cqc.org.uk.

The provider completed an action plan to show what they would do to meet the requirement of the regulation they had breached. They had prioritised some areas that needed immediate attention including: updating care plans and risk assessments and quality assurance systems. During this inspection, we saw evidence to confirm that the service had improved.

The registered manager and staff had worked to introduce new systems and procedures. Systems had been reviewed and changed; infection control practices had been improved; care plans and associated risk assessments had been updated; quality monitoring of the service had been developed. The registered manager told us this work was on going and during this inspection, we found this was the case.

Whilst improvements had been made with risk assessments and the guidance for staff to support people was now in place, we still found some shortfalls in the recording and storage of medicines and the associated audits.

Staff we spoke with knew how to provide the care and support that people needed.

People, their relatives and staff told us that the service had improved and that the registered manager, head of care and deputy manager were supportive and approachable. The registered manager had begun to seek feedback from people and their relatives. We saw people being encouraged to share their views about the service each day.

We found improvements had been made and people now had the opportunity to take part in a range of activities in-house.

We saw some improvement had been made to the environment to support people living with dementia.

People told us they were happy with the care they received.

Staff were observed to be kind and attentive and demonstrated a caring approach to people.

Staff were trained in adult safeguarding procedures and knew what to do if they considered people were at risk of harm or if they needed to report any suspected abuse.

There were sufficient numbers of staff to meet people's needs. Staff recruitment procedures ensured only those staff suitable to work in a care setting were employed.

People's capacity to consent to care was considered and the service worked in accordance with current legislation relating to the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards.

Throughout our inspection, we saw that people who used the service were able to express their views and make decisions about their care and support. We observed staff seeking consent to help people with their needs.

People's health care needs were assessed, monitored and recorded. Referrals for assessment were made when needed and people received regular health checks.

There was a system in place for recording complaints which captured the detail and evidenced steps taken to address them. The registered manager told us, and we reviewed records, that demonstrated they had acted promptly when concerns were raised.

We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of this report.

Inspection areas

Safe

Requires improvement

Updated 7 April 2018

Some aspects of the service were unsafe.

Medicines were not always managed safely.

Recruitment systems were in place.

People were protected from the risk of harm by staff who had been trained in safeguarding adults at risk.

People's risks were identified, assessed and managed appropriately.

Staffing levels were sufficient to meet people's needs.

Effective

Good

Updated 7 April 2018

People's needs and choices had been assessed when they started using the service.

Staff were trained and their skills and competencies checked by the registered manager.

People were supported to maintain a balanced diet.

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.

Caring

Good

Updated 7 April 2018

People who used the service and their relatives were complimentary about the standard of care at Rosewood Lodge.

The staff knew the care and support needs of people well and took an interest in people and their relatives to provide individual personal care.

People were treated with respect and the staff understood how to provide care in a dignified manner and respected people's right to privacy.

Responsive

Good

Updated 7 April 2018

The service was responsive.

People and their loved ones had planned their care with staff.

People received their care and treatment in the way they preferred.

People participated in a variety of activities and told us they enjoyed these.

Any concerns people had were resolved to their satisfaction.

People were supported to plan the care they preferred at the end of their life.

Well-led

Requires improvement

Updated 7 April 2018

The service was not always well-led.

Not all systems in place and were being utilised in order to monitor the quality of the service and demonstrate improvement.

The registered manager promoted a person centred approach to help make sure people's needs and preferences were met.

People who used the service, their relatives and staff spoke positively and expressed their confidence in the way the service was now being managed.