Rosekeys

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

Well-led – this means we looked for evidence that leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture.

This key question was previously rated requires improvement. At this assessment the rating remains requires improvement. This meant there were shortfalls in leadership. Inconsistent leadership did not assure the delivery of high-quality care.

The provider was previously in breach of legal regulation in relation to the governance of the service. At this assessment they are no longer in breach of legal regulation.

This service scored 61 (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 shared vision, strategy and culture. This was based on transparency, equity, equality and human rights, diversity and inclusion, engagement, and understanding challenges and the needs of people and their communities.

Staff told us the culture at Rosekeys had improved recently and there was a more positive culture of engagement. One staff member we spoke with explained about the team values and gave the acronym “CHOICE” which stood for the organisations value of caring, honest, one team, innovative, courageous and equal.

We observed practice which evidenced the culture at Rosekeys ensured each individual person was at the centre of their support. However, the cultural changes need to be embedded to ensure they are sustainable as people move into the home, and the staff team grows.

Not all leaders understood the context in which the provider delivered care, treatment and support. Not all leaders had the skills, knowledge, experience and credibility to lead effectively.

The homes registered manager was currently on leave and was being covered by the registered manager from another nearby home as an interim measure to support people and staff with continuity and progress work on improvements at the home. The home has had a number of management changes which has impacted the delivery of the organisational vision and professional management of risks.

Staff told us there was an open culture. The covering registered manager and staff team spoke positively about improved communication.

Whilst we didn’t see evidence of consistent regular engagement with people and their representatives we observed positive engagement between the management team, staff and people supported, and relatives knew who to speak to about any concerns. We saw a strong focus on supporting people to thrive, have new experiences and live the life they choose.

The provider fostered a positive culture where people felt they could speak up, and their voice would be heard.

People were seen to be able to openly communicate with staff and management and had positive relationships with them. Relatives told us they felt confident speaking with management about any concerns.

There was a current policy and procedure to support staff to speak up and staff told us they felt able, and had opportunity, to discuss concerns. One staff member told us, “We have regular team meetings and talks with the management. There is openness and genuine interest [from the management team] in what is going on.”

People feeling able to speak openly about concerns meant issues could be identified and addressed quickly.

The provider valued diversity in their workforce. They worked towards an inclusive and fair culture by improving equality and equity for people who worked for them.

The provider had policy and procedure in place to support an inclusive and fair workforce culture.

Staff had no concerns regarding equality, inclusion and diversity and spoke about ensuring overseas staff were included and supported as well as organisational policy in place to support staff. One staff member told us, “They [provider] do flexible working like if you have family and things. A lot of the guys might come in an hour later cause of school. Only a certain amount can do it, or we would have no staff here, but they will try and help you as much as possible.”

Supporting staff and valuing their diversity and what this brings to the team promotes staff wellbeing and a positive work/home life balance, and an inclusive culture.

The provider did not always have clear responsibilities, roles, systems of accountability or good governance. They did not always act on the best information about risk, performance and outcomes.

We raised concerns with the provider over the lack of medicines trained staff working on night shift as we were advised at the time of the assessment that there was only one staff member working on night shift who was trained and competent to administer medicines. A lack of good governance, in this instance ensuring a suitable number of staff were always available to administer medicines, had been overlooked meaning there could be a delay to people receiving as required medicines.

There was no clear management oversight of processes meaning tasks carried out were not always sufficiently followed up by the leadership team to ensure they were completed to a high standard, for example in the case of the business continuity planning document.

A lack of oversight had also meant required documentation, for example risk assessments, had not been identified as missing from care planning documentation.

Improved ways of working, for example improvements in infection prevention and control processes in the kitchen, were not sufficiently monitored to ensure they were completed consistently and embedded ways of working.

The provider was able to give examples of processes they were about to implement at Rosekeys to improve governance and management including bringing in an interim registered manager with a proven track record of service improvement.

Failure to consistently apply effective governance processes and management oversight could result in a reduction in the quality of care and support people experience.

The provider understood their duty to collaborate and work in partnership, so services worked seamlessly for people. They shared information and learning with partners and collaborated for improvement.

Management and the staff knew what stakeholders were available to the service and how to access support. For example, we saw evidence of the occupational therapist being involved to support with accessing the right equipment for the person. Staff were able to give examples of when they had engaged with external stakeholders including people’s relatives. One staff member told us, “I work closely with [name] [relative]. If they have a problem they will say can you sort this please. I will say I can sort it yeah. We work with social workers, advocates, doctors, hospitals which are the usual.”

Leaders and staff worked with people, their representatives and external professionals to build a culture that focused on enabling people to enjoy their lives.

The provider did not always focus on continuous learning, innovation and improvement across the local system. They did not always encourage creative ways of delivering equality of experience, outcome and quality of life for people.

Staff we spoke with were able to identify areas for improvement that would positively impact people’s quality of life but had not been addressed. For example, one staff member told us, “A new bathroom for [name] would be fantastic. [Name] loves a bath and it’s a coping thing for them when they get agitated. I know some things take time, best interests and things but it is in their best interests to have a bath.” However, staff did also identify areas that had improved and positively impacted people’s care including additional funding or one person.

Areas for improvement were not consistently identified and acted upon at service level to improve peoples lived experience of care at Rosekeys. The provider was keen to address this and told the inspection team during feedback about planned improvements, including the use of artificial intelligence (A.I.) technology to identify positive practice and areas for improvement in care planning documentation to support further improvement in this area.