Archived: Rosemary Lodge Rest Home

Updated 25 December 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This unannounced comprehensive inspection took place on 20 November 2018. The inspection team consisted of one inspector, one assistant inspector and an expert by experience. We also contacted other health and social care organisations such as representatives from the local authority commissioning team and Healthwatch to ask their views about the service provided. Their views helped us in the planning of our inspection and the judgements we made. Commissioners are people who work to find appropriate care and support services which are paid for by the local authority. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England.

During our inspection visit, we met and spoke with eight of the people who lived at the home. Some of the people who lived at the home were not able to tell us in detail, about how they were cared for and supported because of their complex care needs. We therefore used the short observational framework tool (SOFI) to help us assess whether people's needs were appropriately met and to identify if people experienced good standards of care. SOFI is a specific way of observing care to help us understand the experience of people who could not talk to us.

We observed staff providing care and support to people in the communal areas of the home. We spoke with three relatives of people and one visiting health professional to get their views. In addition, we spoke at length with the nominated individual, the registered manager, the deputy manager, one senior care assistant, three care assistants, one domestic worker and the cook.

We sampled a range of records about people’s care and how the service was managed. This included plans of care for five people using the service and associated documents including risk assessments. We looked at two staff files including their recruitment record. We sampled other records relating to the management of the service including audits, quality monitoring systems and action plans; accident and incident records; surveys; meeting minutes and complaint records.

Updated 25 December 2018

This unannounced comprehensive inspection took place on the 20 November 2018. The inspection team consisted of one inspector, one assistant inspector and an expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of service.

Rosemary Lodge Rest Home is a 'care home'. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Rosemary Lodge Rest Home can accommodate up to 29 people. At the time of our inspection 21 people were using the service. Some people living at the home were living with Dementia.

At our last inspection in March 2017 we identified improvements were needed to improve the quality and safety of the service provided. We judged the provider to be in a continued breach of Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 Good governance. Following the inspection, we asked the provider to complete an action plan to show us what they would do and when by to improve the key question(s) of safe, responsive and well-led to at least "good." The provider sent us their action plan in and we looked at their action plan as part of this inspection.

This inspection took place on 20 November 2018 to follow up on our previous findings. We returned on this occasion to check that the provider was taking the necessary action to improve the quality of care and reducing the risks to people. During this inspection the service demonstrated to us that improvements have been made and the service was no longer in breach of regulations. Systems for the governance of the service were more robust and the action plan we received from the provider following our previous inspection had been addressed.

There was a registered manager in post at the time of this 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.

Despite the noted improvement in the management of the home we were made aware of some issues that needed to be addressed or considered further from talking to people and sampling records. People and staff were positive about the leadership skills of the registered manager. Audits and quality checks were undertaken on a regular basis and any issues or concerns addressed with appropriate actions. The registered manager led by example and encouraged an open and honest culture within their staff team. People were supported to express their views. The registered manager and their staff team worked together with other organisations to ensure people's wellbeing.

People received care that made them feel safe. People were cared for by staff who were trained in recognising and understanding how to report potential abuse. Potential risks to people had been assessed and were being managed by staff. Recruitment checks had been carried out to ensure staff were suitable to work in a care setting with vulnerable people. At the time of our inspection there were sufficient staff to respond promptly to people's needs. People received medicines safely and as prescribed. The environment was clean and systems were in place to audit infection control practices.

All feedback that we received from people about the staff was that they had the knowledge and skills to deliver effective care and that relevant training was provided. People told us they saw their GP and health specialists whenever necessary. People told us they were satisfied with the food provided and we saw suitably prepared meals being served. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible.

People were happy with the care they received and staff were seen treating people with dignity and respect. People's independence was promoted by staff and they were encouraged to express their views and make choices about their daily living. People's contact with relatives and friends was promoted.

People receive cared and treatment that was responsive to their needs and provided in a person-centred way. People were supported to be involved in the planning and reviewing of the care they received. People had some opportunities for social interests. People told us they felt confident to raise a complaint. People could be confident that their wishes during their final days and following death were respected.