Rose Cottage Nursing Home

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Responsive – this means we looked for evidence that the provider met people’s needs.

At our last assessment we rated this key question good. At this assessment the rating has remained good.

This meant people’s needs were met through good organisation and delivery.

This service scored 68 (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 did not always make sure people were at the centre of their care and treatment choices and they did not always work in partnership with people, to decide how to respond to any relevant changes in people’s needs.

During lunchtime, we observed all people seated in the communal lounge were provided with plastic aprons to protect their clothing from food spills. Whilst people did not object to wearing the aprons, staff did not always offer people a choice or seek their views before applying them. We heard staff routinely say, "Let's put your apron on ready for lunch." The registered manager told us people were asked on admission whether they were happy to wear an apron at mealtimes; however, this was not documented within care records. As a result, the provider could not demonstrate that people’s individual wishes had been considered and respected. This approach reflected a task-focused practice rather than one tailored to each person’s preferences. Following the assessment, the registered manager completed reflective practice discussions with staff and issued guidance reminding them that people should be asked at each mealtime whether they wished to wear a protective apron.

We also observed one occasion where a person who became unwell did not receive prompt emotional reassurance or comfort from staff. This meant the person's immediate emotional needs were not fully considered at that time.

However, people and their relatives told us they were involved in developing and reviewing care plans, which reflected people's preferences and assessed needs. One person told us, “We did the care plan, and we get a monthly update email.” This demonstrated that people were generally given opportunities to contribute to planning their care and to discuss changes in their needs.

The provider understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.

Relatives told us the service kept them up to date on any scheduled health appointments and changes in people’s needs. They told us the service accommodated support from staff to attend hospital appointments with people when they were unable to do so. People felt the service made appropriate external referrals for them and followed this up.

Information was available where the service had worked collaboratively with other service and healthcare professionals. During the assessment we saw professionals visiting the service to provide healthcare services.

Professionals provided positive feedback. One commented, “My experience is that the service acts promptly when residents' needs increase and seeks additional professional input when required. On several occasions, I have found the service goes above and beyond in coordinating care and ensuring recommendations are implemented.”

The provider supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

We observed people had access to hearing aids and glasses to help with their communication. We also observed staff adapting their approaches with people. For example, we saw staff speak clearly and position themselves close to people with hearing impairments to ensure they could be understood, rather than raising their voices from a distance.

People’s communication needs were outlined in their care plans and an Accessible Information Standards (AIS) policy available.

The provider made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff involved people in decisions about their care and told them what had changed as a result.

Feedback was positive about the responsiveness of the management team. Comments included, "I spoke with them about my concerns and they resolved it," and "The manager has been very helpful and lets me know what's happening."

The service provided regular opportunities for people, relatives, staff and professionals to share their views and experiences. We reviewed feedback records and found comments were overwhelmingly positive. Where suggestions or concerns were identified, these were acted upon and followed up appropriately. This demonstrated the provider's commitment to listening to people and using feedback to support improvement.

The provider did not always make sure that people could access the care, support and treatment they needed when they needed it.

We identified 1 person’s bedroom door did not have a handle on the outside. Whilst there was a handle on the inside, the door was heavy and could only be opened from the outside by pushing against it. This meant a person wishing to access their room independently may have been unable to do so without physical effort or support from staff. The registered manager told us the person occupying the room required staff assistance to access the room. However, the environment had not been adapted in a way that maximised the person's independence or ensured unrestricted access to their own room. The provider subsequently acted and sent us pictures to confirm door handles had been put in place. Access to the secure garden area was also locked, which did not give people opportunities to access outdoor spaces if required.

However, people had access to independent advocacy services when they required support to express their views and wishes. People were also supported to access a range of healthcare services, including GPs and podiatry services. One relative told us, “They have been really good at helping me get [Person] to hospital appointments, they send a staff member with me, free of charge, which is great because I couldn't manage alone.”

For people who were mobile we observed them walking around the service and there were 3 separate sitting room areas for people to access, if they required.

People who were independently mobile were able to move freely around the service and had access to a choice of communal areas. We observed people using the different lounge areas throughout the day. Care plans also contained information about barriers people may experience in relation to their mobility, personal care and decision-making, which helped staff understand their support needs.

Staff and leaders actively listened to information about people who are most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this.

People and their relatives told us they were able to access the treatment when they needed it. People commented about achieving positive outcomes such as, “The nurses are dressing my legs, they are very gentle and careful, I feel much better than I did in hospital.”

Staff and leaders demonstrated a good understanding of people’s individual needs and described how support was adapted to promote their wellbeing and safety.

People were supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life.

They were people living at the service on end-of-life care. We observed that although some people were confined to the beds, they were clean and well looked after.

Staff regularly checked on people in their rooms and food had been modified to include smaller portions and pureed where needed. Staff showed a compassionate approach to people on end-of life, where dignity and respect was at the forefront of their practices. We were given an example of where a person and their relatives did not want the person to go into hospital and instead remained living in the service, with people they knew and staff they were familiar with until the end.

Documents contained details of people wishes at the end-of-life.