An unannounced inspection took place on 15 and 19 April 2016. It was carried out by two inspectors.
Rose Lodge provides accommodation for up to 34 people who require personal care; 32 people were living at the home during our visit, including a person who had been admitted to hospital. The service provides care for older people, who are living with the early stages of dementia. They also care for people who have more complex care needs because of the progression of their illness.
The bedrooms are on the ground and first floors, which can be accessed by two passenger lifts. Work was taking place to provide an increased number of en suites in the original building called The Lodge. The Cottage, which is attached to The Lodge, is purpose built with rooms that include en-suite facilities. There are two communities living at Rose Lodge, who interact with one another. A person centred approach meant some people moved between the two communities to suit their personal preferences. For example, one person told us they chose to engage in some activities with one community but benefited from the environmental changes in The Cottage which was where their room was based.
There was 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’. The service is owned by a provider, who is a registered person. 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.
The Care Quality Commission (CQC) is required to monitor the operation of the Mental Capacity Act (2005) (MCA) and Deprivation of Liberty Safeguards (DoLS) and to report on what we find. DoLS are put in place to protect people where they do not have capacity to make decisions, and where it is considered necessary to restrict their freedom in some way, usually to protect themselves or others. We discussed DoLS with the registered manager and looked at records. We found the provider was following legal requirements in the DoLS. At the time of the inspection, an application had been made to the local authority in relation to people living at the service. This meant people’s legal rights were protected.
People praised the atmosphere of the home. People felt safe and well cared for. Staff were attentive to people’s changing moods and calmly intervened if people became unhappy with each other. Staff consistently demonstrated affection and warmth in their relationships with people. People praised the standard of the food and the cleanliness of the home. People took a pride in their surroundings and several people commented on feeling part of a community. People were supported to eat and drink in a relaxed and supportive manner by staff who worked to promote a pleasant meal time experience.
The atmosphere of the home was one of constant stimulation whether on a one to one basis or through group activities. However, the atmosphere was calm. Staff were well-organised, working as a team while maintaining a relaxed and unrushed manner. Music and singing featured as an everyday part of people’s daily life. We saw this activity formed bonds between people and staff enabling them to build relationships and participate as equals.
The registered manager and our conversations with the provider clearly demonstrated their commitment, both financially and ethically, to provide an innovative environment that enabled people to be as independent as possible. They had sought specialist advice on the selection of colours, lighting, flooring and furniture, and made changes based on specialist recommendations. The gardens were laid out to provide an interesting and stimulating area to garden, with hens, rabbits and fish to watch, or a place to relax and entertain friends and family.
People visiting the home praised the way it was run and the commitment of the staff. They recognised the range of activities and the investment into the building to maximise people’s independence. An ethos had been created by the providers, the registered manager and staff to ensure people’s diagnosis of dementia was not a barrier to them leading full and active lives.
People told us about the skills of the staff who cared for them. They commented on their friendliness and positive approach. People were consulted about their care, and their wishes were respected. Staff were consistently smiling and looked happy to be at work. Staff said they were well supported and had access to a range of training and supervision. Staff morale was high with staff enthusiastically describing their roles and responsibilities. They were clear about the ethos and values of the home which they demonstrated in their actions and interactions with the people living in the home and their teamwork.
There were sufficient numbers of staff on duty in order to meet the needs of people using the service. Staff were attentive and the atmosphere was unrushed. There was an effective recruitment and selection procedure in place and the registered manager carried out robust checks when they employed staff.
People were confident complaints and concerns would be addressed; they said the registered manager and staff were approachable. The service is well-led and the registered manager provides a strong role model for good practice.