Roseside

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. At our last assessment we rated this key question inadequate. At this assessment the rating has changed to good. This meant people were safe and protected from avoidable harm.

At the last inspection, the provider was in breach of regulation, due to a lack of knowledge of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty (DOLs) frameworks. At this inspection we found the provider was no longer in breach of regulation.

At the last inspection the provider was in breach of regulation in relation to the safe administration of medicines. At this inspection we found the provider was no longer in breach of regulation.

This service scored 72 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider had a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

Systems and processes were in place to identify and manage risks and safety concerns effectively, meaning opportunities to make the necessary improvements could be made in a timely way. Lessons were learned via various forums such as staff handovers and daily ‘huddle’ meetings.

Clinical governance boards and clinical communication files were in place which helped analyse any complaints and/or issues to help staff with learning from actions that had been taken in response.

Staff told us they understood the process for reporting and recording incidents and felt any incident sand safety events were discussed as part of their learning.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services.

Risk assessment tools and care plans helped to ensure people’s safety was properly managed and/or monitored. This meant correct and up to date information could be shared with other medical and health and social care professionals involved in the person’s care.

Since the last inspection, people’s care records were maintained electronically which made it easier to keep records accurate and up to date, meaning when records were shared, they contained current information.

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider shared concerns quickly and appropriately.

Staff had a clear understanding of safeguarding and how to keep people safe. Staff knew what action to take should they suspect or witness potential abuse.

People and their relatives told us they felt safe living at Roseside. One person told us, “Yes, I feel safe. ”A relative confirmed, “I don’t worry when I leave the home, my mind is at ease as I know [Name] is safe and getting well looked after."

The provider worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

Safety concerns were identified and addressed. Risks analysis tools were used to assess and manage the severity of risks to people. Tools were also used to help determine staff dependency levels, to help ensure people received the correct support from staff.

People’s care plans and risk assessments contained consistent information to guide staff on how to mitigate risks specific to them. However, some care plans contained some repetitive information about people’s conditions, we spoke to the provider about condensing information in care plans where appropriate, to help ensure they were easier for staff to follow.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

People had emergency evacuation plans in place to assist staff and emergency services to evacuate them safely, in the event of an emergency such as a fire.

We observed call bells in people’s rooms were present and accessible and sensor equipment were in operation where required. Regular health and safety checks took place to ensure the environment and equipment complied with health and safety requirements.

Staff received training in fire safety, health, safety and welfare. Fire drills were practiced with staff.

Although we were assured the provider made sure there were enough qualified, skilled and experienced staff and staff received effective support, supervision and development, they did not always work together well to provide safe care that met people’s individual needs.

Some people told us their preferred gender of staff wasn’t always readily available, and another person told us they felt night staff were not always available to talk to. Comments from people included, “They need more female staff of a night, sometimes they have to go to another floor to get a female member” and “There’s only 2 staff of a night and sometimes when I go out, they just tell me to go back to bed.”

We spoke to the registered manager about this who confirmed they would directly act on people’s feedback to ensure people had the support they required from staff at any time of the day or night.

We observed a lack of staff presence on one of the communal lounges during our inspection, but on checking the rotas, there was enough staff deployed. We spoke to the registered manager about this who thought staff may have been a little unsettled due to the inspection process.

Feedback from people and their relatives was mixed in terms of availability and continuity of staff. Comments from people included, “Yes [enough] I think so” “Yes, other than of a night time,” “I think they [staff] are all the same” and “There is a lot of agency [staff].”

People’s relatives told us, “Sometimes there seems to be loads and other times not enough,” “Yes, there is a consistent staff team and that includes the same agency staff” and “A lot of change [to staff], no continuity of care.”

We spoke to the registered manager about the use of agency staff. They told us although agency staff were sometimes used, the same staff were utilised to help ensure they had knowledge and experience of people and their care and support needs.

Staff had competed all their mandatory training and were supported with supervision and appraisal processes to help ensure they had the skills they needed for their role. One member of staff told us, “I feel well trained and have had all my training.”

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

Staff had completed appropriate training in infection prevention and control, food hygiene and were aware of safe hygiene practices. Personal protective equipment (PPE) was available for staff to wear when providing support.

Regular audits of the home’s environment and equipment were completed to ensure it was clean and well maintained. We spoke to the domestic staff who told us they felt they needed more support due to the heavy workload. We spoke with the provider about this who confirmed they would liaise with domestic staff to ensure they received the additional support they needed.

People and their relatives told us they thought the home was kept clean. One person confirmed, “Yes, it’s clean all the time. ”Relatives told us, “Yes, always spotless” and “The home is so clean, as is [Name’s] room, immaculate."

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened.

Some people were prescribed medicines to be taken ‘when required’. The protocols to support the safe administration of these medicines were personalised meaning staff had sufficient guidance to follow to help them decide the most appropriate way to give these medicines. We saw positive examples of how staff had helped support people to lessen their reliance on these types of medicines by supporting them in other ways, such as via therapeutic intervention.

For people who took their medicines covertly (hidden in food and drinks) due to their refusal to take medicines, guidance was in place to help direct staff, this guidance had been approved by both the GP and the pharmacist.

People received their medicines consistently and at the time they were needed.