Archived: Rosedale Care Home

We found the following examples of good practice:

The provider adapted the way visitors and external professionals entered and exited the building to minimise the risk of spread of infection. Visitors were directed to enter the service via the ground floor fire door or through the garden. This avoided any unnecessary movement of external visitors through people’s living areas.

The provider had a detailed contingency plan and risk assessments to ensure staff knew what to do to minimise the spread of infection in the event that a person tested positive for COVID-19 or displayed COVID-19 symptoms.

The provider continued to facilitate daily activities and entertainment for people living at the service. For example, on the day of our visit, the local sixth form college social care students were leading a chair exercise session. The provider adhered to the regular COVID-19 testing regime, this included visiting professionals who visited frequently and had close contact with people, such as the hairdresser.

Rosedale Care Home provides accommodation with personal care for people over age of 65. The service is registered to accommodate up to 18 people, and was providing personal care to 18 people at the time of the inspection. Any nursing needs were provided by community nursing services.

People’s experience of using this service:

• People received care and support that was safe. The provider had a robust recruitment programme which meant all new staff were checked to ensure they were suitable to work with vulnerable people. All staff had received training in safeguarding vulnerable people.

• There were risk assessments to identify any risk to people and staff understood the actions to take to ensure people were safe. There were sufficient staff to support people with their daily living and activities.

• People received effective care and support. Staff demonstrated a clear understanding of people's needs and received training relevant to their role and the needs of people living in the home. People enjoyed a healthy balanced and nutritious diet based on their preferences and health needs.

• 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.

• People received care from staff who were kind and caring. Staff respected people's privacy and dignity always. Staff supported people to be fully involved in their care planning and reviews. People were supported to express an opinion about the care provided and the day to day running of the home.

• People received responsive care and support which was personalised to their individual needs and wishes and promoted independence. There was clear guidance for staff on how to support people in line with their personal wishes, likes and dislikes. People were supported to access health care services and to see healthcare professionals when necessary.

• People were supported by a team that was well led. The registered manager demonstrated an open and positive approach to learning and development. Staff said the registered manager was open to suggestions and approachable. Everybody spoken with said they felt the management team was open, approachable and the home was well led.

• There were systems to monitor the quality of the service, ensure staff kept up to date with good practice and to seek people's views. Records showed the service responded to concerns and complaints and learnt from the issues raised.

• The registered and deputy managers worked professionally with agencies outside of the service and ensured a transparent, honest and open approach to their work which was valued by others.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk.

Rating at last inspection:

At the last inspection in August/September 2017 the service was rated Requires Improvement (report published on 14 March 2018). At that inspection we found two breaches of Regulations. They related to safe care and treatment and quality monitoring systems.

Why we inspected:

This was a planned inspection based on the rating at the last inspection. The provider is no longer in breach of the two Regulations identified at the last inspection. At this inspection the service has made sufficient improvements to be rated Good.

Follow up:

We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.

At the last inspection the service was rated Good.

Medicines were not always managed safely and we found areas of concern in relation to the handwritten Medication Administration Records (MAR), some medicines which were out of date but not disposed of, the temperature of the room where medicines were stored and the administration of medicines. We discussed these issues with the registered manager. By the second day, the registered manager had begun to take steps to address our concerns.

A system of audits was in place to measure and monitor the service delivered. However, these audits were not effective in identifying the areas of concern we found at inspection. Care records were not kept securely at the time of our inspection. This was raised with the registered manager during the inspection, who arranged for locks to be installed on the drawers before we returned for our second day, thus keeping people’s personal information confidentially.

Staff were protected from avoidable harm by staff who had been trained in safeguarding adults at risk. People felt safe living at the home and their risks were identified, assessed and managed in a way to mitigate risks. Staffing levels were sufficient to meet people’s needs. Staff had been recruited safely. Premises were cleaned to an acceptable standard.

Staff completed a range of training to enable them to have the skills and knowledge required to care for people in an effective way. Staff received regular supervision with their line managers and attended staff meetings. 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. People were happy with the food on offer at the home and had a choice of what they would like to eat. Healthcare professionals supported people to maintain good health. We identified some issues in relation to the bathing facilities and general upkeep of the home. After the inspection, the registered manager informed us of actions that would be taken to address these.

Staff were warm, kind and caring with people. People spoke highly of the caring nature of the staff. They were involved in decisions relating to their care, as were their relatives. People were treated with dignity and respect. The home had achieved Platinum status for the Gold Standards Framework in relation to their end of life care.

Care plans contained detailed, personalised information about people and how they wished to be supported by staff. People and their relatives were involved in reviewing their care plans. An activities co-ordinator arranged activities for people which were individual and reflected people’s preferences. People were happy with the activities on offer. The provider had a complaints policy in place. No formal complaints had been recorded since October 2015.

People and their relatives spoke positively about the care provided at the home and held the registered manager and staff in high regard. Feedback was obtained from people and their relatives about the quality of care provided and the home overall. Staff felt supported by management and enjoyed working at the home. The registered manager worked in partnership with other agencies.

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

We spoke with the home manager and three staff members. They all told us that they actively enjoyed working at the home and felt that they were treated as valuable team members. One staff member told us, "We all get on really well here and everyone is really supportive. The manager is a great leader". Another said, "Lots of us have been here a long time and I think that speaks volumes".

We spoke to five people, the manager and three staff. Our observations provided evidence that people's individual wishes and needs were considered and met. The manager and staff were aware of people's likes, dislikes and abilities. Through observation, discussion and review of individual records we saw how these were appropriately supported.

We looked at five care records that provided information on people's assessment of needs, preference's, how their care should be delivered and their daily activities.

People told us that they 'feel safe and secure' at the home and felt happy to speak to the manager or staff if they 'felt they had a problem.'

People told us that the staff were 'extremely caring.' Records confirmed that staff were appropriately trained and skilled to meet the needs of people living at the home.

The home had systems in place to review the quality of the care provided. The business plan for the period August 2012 to July 2013 set out the schedule for reviews such as the physical environment, incident records and surveys by people living at the home in order to review and inform the quality of the service provided. People told us that the home should 'get an A rating.'