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The Old Roselyon Manor Nursing Home Good

Inspection Summary


Overall summary & rating

Good

Updated 29 June 2018

We carried out an unannounced inspection of The Old Roselyon Manor Nursing Home on 30 May 2018. The Old Roselyon Manor is a ‘care home’ that provides care for a maximum of 30 adults. 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. At the time of the inspection there were 27 people living at the service. The service is on two floors with access to the upper floor via stairs or a passenger lift. Some rooms have en-suite facilities and there are shared bathrooms, shower facilities and toilets. Shared living areas include two lounges, a dining room, garden and patio seating area.

There was a registered manager in post who was responsible for the day-to-day running of the service. 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.

As part of this comprehensive inspection we checked to see if the provider had made the required improvements identified at the inspection of 10 April 2017. In April 2017 we found the registered manager/provider had not kept up-to-date with changes in legislation in relation to the recruitment of staff and protecting people’s rights. Some audits, carried out by nurses to monitor the nursing care, had fallen behind due to nurse vacancies and sickness. We found there were missing risk assessments, incorrect air mattress settings, lack of analysis of falls and gaps in charts for when people needed to be re-positioned.

At this inspection we found improvements had been made in all the areas identified at the previous inspection. This meant the service had met all the outstanding legal requirements from the last inspection and is now rated as Good.

Since the last inspection the service’s recruitment systems had been updated to ensure all the relevant recruitment processes, including Disclosure and Barring Service (DBS) checks, had been completed before new staff started to provide care for people. This helped to ensure new staff were suitable and safe to work in a care environment.

People’s legal rights were protected because management understood the legal requirements of the Deprivation of Liberty Safeguards (DoLS). Some people lacked the mental capacity to recognise the decline in their physical capabilities, which potentially put them at risk of harm, such as sustaining injuries from falls. These people were subject to restrictive practices or continuous supervision to protect them from the risk of harm and keep them safe. DoLS applications had been made to the local authority to seek the legally required authorisation to have these restrictions in place.

There were effective quality assurance systems in place and audits were routinely completed. This included the introduction of new audits to check air mattress settings, the dating of creams on opening and the completion of re-positioning charts. A system had also been put in place for the analysing of incidents, such as falls, and where necessary changes were made to learn from events or seek specialist advice from external professionals.

Care records were personalised to the individual and detailed how people wished to be supported. They provided clear information to enable staff to provide appropriate and effective care and support. Risks were clearly identified and included guidance for staff on the actions they should take to minimise any risk of harm. In particular risks in relation people’s skin care and nutrition were being effectively monitored.

Staff supported people to be involved in and make decisions about their daily lives. Where people did not have the capacity to make certain decisions the service acted in accordance with legal requirements under the Mental Capacity Act 2005.

People told us they were happy with the care they received and believed it was a safe environment. Comments included, “I feel safe, I’ve used my call bell and they come quite quickly”, “I feel safe because staff know what they are doing”, “I know my relative is safe, I see it every time I come in. The staff know what they are doing great respect for them all”, “There’s laughter here and that’s important” and “It’s a happy atmosphere everyone is very cheerful.”

There were enough suitably qualified staff on duty and additional staff were allocated if peoples’ needs increased, such as when someone was unwell. Staff were supported by a system of induction, relevant training, one-to-one supervision and appraisals. Staff knew how to recognise and report the signs of abuse.

Staff supported people to access to healthcare services such as occupational therapists, GPs, chiropodists, community nurses and dentists. A visiting healthcare professional said, “The way staff have worked with me to support one person to have a bath and the communication with the home has been fabulous.” Relatives told us staff always kept them informed if their relative was unwell or a doctor was called.

People had a choice of meals and staff were knowledgeable about people’s likes, dislikes and dietary needs. People told us they enjoyed their meals. Comments included, “We get given a choice of things and can always get a salad if we don’t want what is offered”, “The food is very good, it’s different every day”, “I have a choice of what I would like”, “The food is good, they give me a choice of two or three things.”

Staff ensured people kept in touch with family and friends. Relatives told us they were always made welcome and were able to visit at any time.

People were able to take part in activities supported by staff and external entertainers. These included, singing sessions, music entertainers, bingo, pamper sessions and visiting therapeutic animals from a local farm.

People and their families were given information about how to complain. People and their families were all positive about the management of the service and told us they thought the service was well run. Comments included, “One of the managers is always available to talk to”, “The manager is here every day”, “The girls know what they are doing, they get on with the job, very competent. It’s runs well here”, “It runs like clockwork and very well. Everyone appears to be cheerful and very competent” and “If you mention something they try to do it. The manager does what he can and the girls are very willing and always cheerful.”

Staff told us they felt supported by the management commenting, “The management is very good”, “The rotas are good, the manager tries to take each staff’s circumstances into account”, “Lovely management”, “The manager is very approachable” and “The manager always supports you if you have any personal problems, you know you can trust him as he keeps what you tell him private.”

The environment was clean and there were no unpleasant odours. Some areas of the premises were in need of re-furbishment, particularly two bathrooms. Work to build a single storey extension, to provide additional shared living areas, was planned to start shortly after the inspection. The two bathrooms were due to be upgraded as a part of the extension work. There was an on-going programme to re-decorate people’s rooms. Appropriate safety checks were completed to help ensure the building and utilities were safe.

Inspection areas

Safe

Good

Updated 29 June 2018

The service was safe. There were sufficient numbers of suitably qualified staff on duty to keep people safe and meet their needs.

Staff completed a thorough recruitment process to ensure they had the appropriate skills and knowledge. Staff knew how to recognise and report the signs of abuse.

People were supported with their medicines in a safe way by staff who had been appropriately trained. Risks were identified and appropriately managed.

Effective

Good

Updated 29 June 2018

The service was effective. Staff had a good knowledge of each person and how to meet their needs. Staff received on-going training so they had the skills and knowledge to provide effective care to people.

People saw health professionals when they needed to so their health needs were met. Specialist advice was appropriately sought from external healthcare professionals.

People’s rights were protected because staff understood the legal requirements of the Mental Capacity Act 2005 and the associated Deprivation of Liberty Safeguards.

People were supported to maintain a balanced diet in line with their dietary needs and preferences.

Caring

Good

Updated 29 June 2018

The service was caring. Staff were kind and compassionate and treated people with dignity and respect.

People and their families were involved in their care and were asked about their preferences and choices.

Staff respected people’s wishes and provided care and support in line with those wishes.

Responsive

Good

Updated 29 June 2018

The service was responsive. People received personalised care and support which was responsive to their changing needs.

Care plans gave direction and guidance for staff to follow to meet people’s needs and wishes.

Staff supported people to take part in some social activities.

People and their families told us if they had a complaint they would be happy to speak with the registered manager and were confident they would be listened to.

Well-led

Good

Updated 29 June 2018

The service was well led. The management provided staff with appropriate leadership and support. There was a positive culture within the staff team with an emphasis on providing a good service for people.

People and their families told us the management were approachable and they were included in decisions about the running of the service.

There were effective quality assurance systems in place to make sure that any areas for improvement were identified and addressed.