Rosewood Care Home

Rosewood Care Home is a residential care home providing personal care and accommodation for up to 35 people. The service provides support to older people and those who may be living with dementia. At the time of our inspection there were 32 people using the service. The home is a single storey accommodation, purpose-built building.

People’s experience of using this service and what we found

At this inspection we found some improvements had been made. We were still not assured there was sufficient oversight of the management and monitoring of legionella and safe water systems. Monitoring of staff recruitment processes had also remained inconsistent.

The provider had systems to manage people’s medicines safely. Staff were trained in how to recognise and respond to abuse and understood their responsibility to report any concerns. There were sufficient numbers of experienced staff to meet people’s needs.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People and their relatives, staff and external professionals, gave positive feedback about the registered manager and staff team. For example, a person and their relative spoke very positively about the care provided and about the registered manager. They told us, “Nothing is too much trouble” and the care was “Excellent.” The relative said, “All his needs are met” and told us, “He is safe, so I am safe.” They said the home was kept very clean and tidy. There were plenty of activities offered to people. Staff asked for permission to give care and support and always closed the door for privacy when providing personal care.

Staff we spoke with felt the team was well led. They told us the registered manager was, “Very approachable and accommodating” and worked ‘hands on’ with the team when needed. A health professional told us, “It is so refreshing to go into Rosewood knowing that the residents are receiving excellent care from the staff.”

The provider and registered manager were promoting an open, empowering and inclusive culture within the service. There were a range of systems in place to assess and monitor the quality and safety of the service and to help ensure people were receiving appropriate care and support. The service worked well in partnership with external professionals.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was requires improvement (published 12 August 2022) and there was a breach of regulations. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found the provider remained in breach of the regulation. The service remains rated requires improvement. This service has been rated requires improvement for the last 2 consecutive inspections.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

This report only covers our findings in relation to the key questions Safe and Well-led. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has remained requires improvement based on the findings of this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Rosewood Care Home on our website at www.cqc.org.uk.

Enforcement and Recommendations

We have identified a continuing breach of the regulations in relation to managing the risk of legionella and a new breach in relation to assessing and monitoring the quality and safety of the service at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Rosewood Care Home is a residential care home providing personal care and accommodation for up to 35 people. The service provides support to older people and those who may be living with dementia. At the time of our inspection there were 31 people using the service. The home is a single storey accommodation, purpose-built building.

People’s experience of using this service and what we found

People told us they were happy and safe living at Rosewood Care Home. We were told by people living in the service and their relatives that they felt included, safe and well cared for. The service was clean and well maintained. However, risks related to legionella had not been fully assessed and mitigated.

Processes and procedures were in place to store and administer medicines safely, although we did observe poor hygiene practice on our first day. This was rectified on our second visit. We were somewhat assured appropriate infection prevention and control measures were in place to protect people against the risk of COVID-19 and other infections. However, recording of exactly what had been cleaned could have been more robust.

People were supported safely and appropriately by sufficient staff who were competent and knew people well. Risks to individuals were assessed and well managed. The registered manager worked well with other health care professionals to ensure that learning took place and necessary changes were made to continually improve.

The service was well led. The staff team told us they felt supported by the registered manager. People who used the service and staff were involved in how the service was managed. The registered manager had processes in place to monitor and improve the quality of the service people received.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 28 February 2020)

Why we inspected

We undertook this inspection as part of a random selection of services rated Good and Outstanding.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

This report only covers our findings in relation to the key questions Safe and Well-led. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from good to requires improvement. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Rosewood Care Home on our website at www.cqc.org.uk.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified a breach in relation to managing the risk of legionella at this inspection. We found that the two areas reviewed were now rated as Requires Improvement.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect. We have requested an action plan from the provider to show what they will do and by when to manage the risk of legionella.

Rosewood Care Home is a residential care home providing personal care and accommodation for up to 35 people. There were 35 people living at the service at the time of the inspection. The home is a single storey, purpose-built building.

People’s experience of using this service and what we found

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

The registered manager and staff team consistently went above and beyond what they needed to do to provide good care and support. This had led to outstanding outcomes in promoting people’s wellbeing and helping them avoid the risks of becoming socially isolated.

People felt well cared for and were treated well. People and their relatives spoke in glowing terms of how compassionate and kind the registered manager, staff and the provider were.

The provider had policies and procedures in place designed to protect people from the risk of suffering harm and abuse. Risk assessments were in place which identified possible risks to people living at the home. These included risk assessments of equipment used to support people move around the home.

People’s needs were met by suitable numbers of staff. People received their medicines as prescribed. The provider had processes in place to reduce the risk of the spread of infection. Staff received training in infection control and food hygiene.

People’s needs were assessed before they were offered a room in the home. People were supported by staff who had the appropriate training and skills.

People were supported to eat and drink enough to meet their needs and had access to healthcare. People expressed their views and were involved in making everyday decisions about their care. Staff respected people’s privacy and dignity and promoted independence. People were supported to develop and maintain relationships with people important to them. Where people received end of life care, this was based on best practice and personal preferences.

The registered manager and staff worked with other agencies. The registered manager had considered how the environment met the needs of people living with dementia and made changes since the last inspection.

The provider had a complaints procedure in place. The registered manager sought the views of people using the service and their relatives. The registered manager and provider ensured there was a person-centred, open and inclusive environment for people to live and staff to work.

There was a clear leadership structure in place which included the registered manager and senior staff. The registered manager was open to learning and development should anything go wrong. The registered manager had a quality assurance system in place to ensure the quality of the service continued to improve.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 28 July 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

The home provides accommodation and care for up to 35 older people, some of whom were living with dementia. There were 29 people living at Rosewood when we visited. The home is on one level with all the bedrooms having en-suite facilities. Communal areas include a sitting and dining room as well as a new conservatory. There is an outdoor courtyard area for people to enjoy sitting outside if they wish.

The inspection took place on 14 and 20 June 2017 and was unannounced.

There was a registered manager in place. 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 and associated Regulations about how the home is run.

People and their friends and relatives spoke extremely highly of the staff, registered manager and provider. Care plans were extremely person centred and were written as a narrative which enabled staff to read and assimilate the care plan easily and were reviewed regularly. This ensured that care plan detail was embedded within staff knowledge and working practice. The service was flexible and responsive to people’s individual needs and preferences, finding creative ways to enable people to live as full a life as possible. The arrangements for social activities were innovative in that they were adapted to different needs and abilities. Staff and volunteers supported people to enjoy activities at a level which met their needs.

Staff had received training in safeguarding and the registered manager knew how and when to use safeguarding procedures appropriately. People’s needs were met by suitable numbers of staff. The registered manager took people’s changing needs into account when deciding the staffing levels. Some people’s needs had increased so staffing levels were increased. Appropriate recruitment procedures were in place when new staff were needed. Risks to people’s wellbeing had been identified and risk assessments were in place to minimise risks. People received their medicines as prescribed by staff who were trained and assessed as competent.

People were supported by staff who had received relevant training to enable them to support people they worked with. New staff completed an induction to the home and all staff were supported with a variety of training, supervision and appraisal. Staff had training in and followed legislation designed to protect people’s rights and ensured they offered people choices and sought consent. People enjoyed their meals and had access to healthcare professionals when necessary.

There was a positive atmosphere within the home and people were very much at the heart of the service. People and their relatives valued their relationships with the staff team. People were supported to express their views and be involved in making daily decisions about their care and support. Staff supported people with their personal care whilst being mindful of their privacy and dignity.

The registered manager had systems in place to monitor the quality of the service provided, including a range of audits. The provider and registered manager sought the views of people living at Rosewood and their friends and relatives and acted upon them to improve the service.

People living in the home commented the staff were, 'really lovely, helpful and kind' and 'the treatment I get is excellent'. They also said they could rely on the staff 'completely' and they always responded quickly when they pressed the call bell. People told us they received their medication when they needed it.

We found staff spoke with people respectfully and gave them choices. People's decisions were accepted and their individual care needs were met. Care plans were detailed and staff were aware of people's assessed needs. Medication procedures were in place which meant people received their medication as prescribed. The provider had a recruitment process in place which ensured the relevant checks were completed before new staff started work. The manager completed regular audits of procedures and practice which ensured the quality of the service provision.