The Care Quality Commission
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Archived: Roseneath Care Home

Overall: Requires improvement read more about inspection ratings

163-165 Hamstead Road, Handsworth Wood, Birmingham, West Midlands, B20 2RL (0121) 523 8280

Provided and run by:
Linkline Care Limited

All Inspections

2 March 2015 and 4 March 2015

During a routine inspection

This inspection took place on 2 and 4 March 2015. Both days were unannounced so no one knew we would be inspecting. We last inspected the home in 6 June 214. At that inspection we found that the provider was not meeting regulations relating to the monitoring of the quality of the service. We did not receive an action plan about how the issues were going to be addressed and some of these issues were found to be ongoing at this inspection.

Roseneath provides care and accommodation for up to 30 people who have needs relating to mental health, old age and frailty. The premises are not purpose built and as such there are a variety of bedroom sizes.

There was no registered manager in post at the time of our inspection. 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.

We found that there were some quality monitoring systems in place but they were limited and did not show that the provider was monitoring the quality of the service provided. Some improvements were being made to the fabric of the building but there was no time scale in which this would be completed.

Some people were not able to make decisions for themselves and required close supervision to keep them safe. How people who did not have the ability to make decisions for themselves were supported to make decisions was not always recorded. We saw that some applications had been made under The Mental Capacity Act Deprivation of Liberty Safeguards (MCA/DoLS) to ensure that their human rights were protected. Some applications had expired and not been reviewed, evidence was not available for others to indicate whether they had been approved or that the appropriate applications had been submitted. This meant that people’s Liberty may have been restricted without the correct authorisations in place.

This is a breach of three regulations and you can see what action we have asked the provider to take at the end of this report.

We saw that interactions between staff and the people who lived at the home were friendly, polite and helpful to people. All the relatives and people spoken with were happy about the care their relative received.

All the staff we spoke with understood their responsibilities to protect people from harm and abuse. Staff told us that they were provided with the training that they required to carry out their role and keep people safe but safeguarding alerts were not always raised so that their responsibilities were not always fulfilled.

Our observations and conversations with staff and relatives confirmed that staffing numbers and the skill mix of staff was adequate to meet people’s needs and to keep them safe. Staff had been appropriately checked before they started their employment in the home.

The management of medicines was not always safe because medicines were not stored and recorded appropriately and not all staff were knowledgeable about the systems for the safe management of medicines.

All the people spoken with told us they enjoyed their meals.

People knew who to speak with if they had any concerns. Relatives told us the provider was available to speak with if needed.

Some surveys had been sent out and a meeting had been held to get the views of people about the service.

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

6 June 2014

During a routine inspection

There were 25 people that lived at the home at the time of our inspection. During our inspection we spoke with eight people that used the service, five staff, the manager, two relatives and a visiting healthcare professional. The majority of people living in the home had dementia so were not always able to tell us what they thought about the service provided. We observed how people were cared for and how staff interacted with them during our visit to get a view of the care they experienced. We considered all of the evidence that we had gathered under the outcomes that we inspected. We used that information to answer the five questions that we always ask.

Is the service safe?

We saw that people's individual needs had been assessed and that there were enough suitably trained staff to meet people's needs.

We saw that medicines were generally managed safely so that people received their medication as prescribed. One person told us that they received their medicines on time.

CQC monitors the operation of the Deprivation of Liberty Safeguards (DOLS) which applies to care homes and hospitals. We saw that staff were knowledgeable about the need to assess people's ability to make decisions for themselves. Systems were in place and actions were taken to ensure that where restrictions were placed on people's liberty these were authorised by the appropriate professionals to ensure this was in the person's best interest.

Staff were alert to the signs of or potential, abuse of vulnerable adults and procedures were in place, which were reviewed regularly to prevent abuse.

We saw that the provider carried out regular health and safety audits and equipment was regularly maintained. However, we saw that the premises were not adequately maintained to ensure the premises were safe and comfortable for people.

Is the service effective?

People's care and health needs were assessed and plans put in place to ensure they were met. This meant that people's care was planned and delivered in line with their individual needs. One person told us, "It's nice (referring to the food.)". Another person told us that they went out to their place of worship.

People's needs were met because the appropriate adaptations were in place to support people to move around freely and for their needs to be met appropriately.

There were sufficient staff on duty to meet people's needs. Staff had the skills and knowledge to ensure that people's needs were met safely. We saw that staff were able to speak to people in their preferred language.

Is the service caring?

Staff responded to people's needs in a caring and appropriate way. Staff told people what they were doing to reassure them people. Staff spoke with people in a tone that expressed friendship and support and offered people choices throughout the day.

We saw that people were supported to join in in meaningful activities. People were supported to dress in styles that reflected their individual personalities. People were supported to maintain relationships that were important to them.

Is the service responsive?

We saw that people's care plans and risk assessments were reviewed on a regular basis to ensure that their changing needs were planned for. We saw that actions were taken to protect people's health as needed.

We saw that there were systems in place for people to raise concerns however, records did not show how they had been addressed. We saw that meetings were organised for relatives to attend so that they could give their views about the service. One relative told us that the meetings were not held at an appropriate time for people who worked. We saw that a weekend meeting was planned but had not yet been arranged. We saw that some repairs within the home had been identified at the beginning of 2014 but they had not been addressed at the time of our inspection. This showed that actions were not always taken in a timely way.

Is the service well led?

There had not been a registered manager in post for two years. This meant that the provider was in breach of their condition of their registration. This condition was imposed at the time of their registration with us.

The manager supported staff to provide care and support to people. Improvements could be made in the way the home was run. There were some audits in place to monitor the quality of the service but they did not always ensure that actions were taken in a timely manner to improve the service.

Staff were supported to meet the needs of people through the provision of training, supervision and staff meetings. Staff told us the manager was supportive and available for advice.

8 October 2013

During an inspection in response to concerns

Our inspection was unannounced, which meant that no one knew that we would be visiting. There were 25 people living there on the day of our inspection. We spoke with two relatives, three of the people living there and spent time observing how staff supported people. We spoke with three members of staff and the manager and looked at three people's records.

All staff spoken to was able to tell us about people's needs and records seen confirmed the that staff were knowledgeable about the people they cared for. We saw positive interactions between staff and people that lived at the home. One person said, 'We lovely carers and care is genuinely given to us.'

Systems were in place to ensure that people were safeguarded from harm. People told us they felt safe living there. One person said, 'I feel safe here.'

The provider had arrangements in place that ensured that people's prescribed medication was managed safely.

Staff spoken with told us they felt supported by the manager, and had regular training so they knew how to support the people living there. One staff said, 'There are lots of training opportunities here.'

28 June 2013

During a routine inspection

There were 24 people living at the home on the day of our visit, no one knew we would be visiting. We spoke to four people who lived at the home, two relatives, three staff, and the manager.

Some of the people who lived at the home had dementia care needs. People with dementia are not always able to tell us about their experiences so we looked at records relating to their care and observed staff caring for them.

People told us and we saw that that people's views were sought and acted upon. All the staff that we spoke to was able to tell us about people's needs so that they received care in a way that they preferred. Both relatives told us they were consulted about their relative's care and kept informed about their relative's health so they felt involved in their care. One relative said, 'I am told what is happening and my views are asked for about my relatives care.'

We saw that people's consent was always sought before any care and treatment was carried out. Staff said, 'I always check that people are ok with what I am doing with them.'

We saw that systems were in place to keep people safe from harm. A relative told us about their relative and said, ''She is very safe.'' Staff received a range of training so that they were able to support the people who lived in the home. One person told us, ''Staff are very to me.''

There were systems in place to monitor how the home was run, to ensure people received a safe and quality service.

25 July 2012

During an inspection looking at part of the service

At our last two visits to the home we found that improvements were needed to people's care files, management of medicines and the environment.

On the day of our visit, there were 22 people living at the home. One person was in hospital and no one knew we would be visiting that day. A pharmacist inspector came to look at the management of medication. The manager was on holiday and we were assisted by the senior carer on duty. We looked at three people's files and the pharmacist looked at seven people's files. We spoke with two staff and three people who live at the home. We sat with a group of people who live at the home in the lounge. We found that a number of improvements had been made.

People told us that they were happy living at the home and we saw good interactions between the staff and people who live there. There was a good atmosphere in the home and people were laughing and singing. One person said 'We get on and have a laugh together'.

People who lived at the home were supported to take part in activities that were interesting and stimulating so that they have a meaningful lifestyle.

We saw that people's care plans had been reorganised and updated so that staff knew how to assist people to meet their needs. One person said 'They will help me if I want them to, I can manage myself but they do my bed for me'.

There had been numerous improvements to the management and administration of medication to ensure that people received their medication in a safe way.

We saw that the environment had improved and that things had been repaired to ensure that people had a homely, safe and comfortable environment in which to live.

There were systems in place to monitor how the home is run, to ensure people receive a quality service. One person had written in the comments book 'I have noticed a vast improvement in the organisation of the home in recent months'.

25 May 2012

During an inspection in response to concerns

The safe handling of medicines was assessed by a pharmacist inspector. There were 23 people living at the home on the day of our visit. No one knew we would be visiting. We spoke with the manager, provider and a member of care staff. We looked at the storage of medicines, seven people's medicine records and one person's care plan.

We did not speak with people who lived at the home about their medication. Many of the people who live there have dementia care needs.

1 May 2012

During a routine inspection

This was our third visit to the home since November 2011. Our inspection of 5 January 2012 found that improvements needed to be made in relation to the number of qualified cooks, choice of meals and the checking of information when new staff were employed. We met with the provider following this visit who gave us assurances that these concerns would be addressed. We reviewed these areas again during this visit to the home.

Prior to our current inspection we had received information of concern about the care of people and the environment in which they lived. These concerns have been reviewed as part of this visit. They have also been reviewed by Birmingham local authority contracts team.

A new manager had been appointed and was only in her second day when we visited. The new manager had identified a number of areas where improvements were needed and had arranged meetings with the staff, relatives and people who live at the home and the chefs to discuss improvements needed. The manager was aware of the previous concerns at the home and had read the last inspection reports. The manager was enthusiastic about the potential for improvements at the home and was keen to address the issues as quickly as possible to ensure that people received quality care.

There were 22 people living at the home on the day of our visit. No one knew we would be visiting. We spoke to two care workers and partially looked at three people's care files. We spoke to four people who lived at the home and they told us that they were happy living there. One person said 'They are a nice bunch here'.

The majority of the people who live at the home have dementia care needs. Because people with dementia are not always able to tell us about their experiences, we used a formal way to observe people during this visit to help us understand. We call this a Short Observational Framework for Inspection (SOFI). We completed two observations so that we could spend time in two lounges. This involved us observing four people for 20 minutes and three people for 20 minutes recording their experiences at regular intervals. This included their state of well being, how they interacted with staff members, other people who live at the home and the environment.

We spent time sitting in the lounge area and observed the care that people received. We saw good interactions between the staff and the people who live at the home and we saw that people were offered choices.

Staff spoken to were able to tell us about people's individual care needs but we saw that people's care files did not always contain information about their individual needs and risks.

We saw that there were not many activities for people to engage in so that they had an interesting and meaningful lifestyle.

People are offered a choice of meals and drinks and are assisted to eat a balanced diet. One person said 'They keep feeding you, whenever you sit down you get something to eat and its good'.

The atmosphere was relaxed and friendly. We saw that people were at ease with the staff and confident within their home environment. People had a good rapport with staff.

We saw that there were some areas of the home that needed to be repaired to ensure that people lived in a safe environment.

Records showed that checks were completed on staff before they started to work at the home so that people were cared for by appropriate staff. A training matrix showed what training staff had received.

5 January 2012

During an inspection in response to concerns

Most people living in Roseneath Care Home have dementia or other mental health conditions. Not all people living in the home could tell us of their experiences.

Some people said that they were unhappy with the quality of the food provided at Roseneath Care Home. Others found it hard to tell us about this.

Prior to our visit we received information that the Christmas meal was not appropriately cooked and people had upset stomachs. We found that some people had complained of stomach upsets over Christmas period. Records did not indicate the causes of people's ill health.

We were told that care workers were employed without enough checks to ensure that they were safe to work with vulnerable people. We found that the latest care workers employed needed further checks.

Care workers were seen to have good relationships with people that lived in the home. They responded when people asked for or appeared to need help.

18 November 2011

During a routine inspection

People living at Roseneath were very positive about the home and the care they received. 'I'm well-looked after here"; "I love it here". We found all areas of Roseneath to be clean and welcoming. We saw that people appeared comfortable in their home environment. There was a cheerful atmosphere. Cultural diversity is celebrated at Roseneath. People with dementia are supported by care workers who understand their needs.