You are here

Inspection Summary


Overall summary & rating

Outstanding

Updated 7 June 2017

The inspection visit at Rossall was undertaken on 08 and 09 March 2017and was unannounced.

Rossall currently provides nursing care and support for a maximum of 33 people who live with dementia, physical disability, alcohol/drug dependency or mental health conditions. As part of the planned, staged expansion by the provider, an additional 13 bedrooms were registered following our inspection. At the time of our inspection there were 32 people living at the home. Rossall is situated next to the promenade in Fleetwood. Accommodation is provided on the ground floor within separate units. There are multiple lounges, rest spaces, dining areas and themed rooms, including a cinema. Every bedroom is for single occupancy, spacious and contains a wet room, toilet and sink.

Rossall was newly registered on 18 March 2016. Consequently, this was their first inspection.

During this inspection, we found the provider had thoughtfully redesigned the building and deployed cohesive staff teams in an exceptional manner. A member of the commissioning team told us the systems in place were ‘amazing’ and care was ‘exceptional’. A relative said, “I know you give a rating on homes now. We are incredibly happy.”

We corroborated this when we toured the building and talked with people and relatives. Outstanding features included automatic bedroom lights to illuminate the path to the ensuite toilet and discreet bed safety strips to reduce the risk of falls. The provider had funded a member of staff to commence a degree in physiotherapy as an advanced way of supporting people’s mobility. We saw the management team completed an in-depth risk assessment matrix to monitor the efficiency of risk evaluation and related processes. We saw this had consequently reduced falls and serious injuries resulting in reduced hospitalisation.

Staff worked within a highly trained team and had ample time to support individuals in a meaningful way. This was because very high staff numbers and skills mixes were deployed to provide a holistic approach to care and people’s safety. We found excellent, consistent recordkeeping, systems related to the recruitment of suitable staff. A newly recruited staff member told us, “It’s in my best interest because I’m new in care and want to learn as much as possible.”

We found care records contained detailed, personalised and specific medicines management care plans. We observed staff followed these in their exceptionally safe and caring approach to people’s related support. The provider was the only service in the region to train their nurses to deliver intravenous fluids and antibiotics. These safe systems meant staff maintained people’s related care to a very high degree.

Staff recorded best interest meetings and transparently documented mental capacity assessments and decision-making practices. We saw this followed the Code of Practice in relation to the Mental Capacity Act 2005 (MCA) and associated Deprivation of Liberty Safeguards (DoLS). We observed staff treated people as equals, offering them options whenever they engaged with them. Local commissioners said they found staff were very knowledgeable about the MCA and tried everything to help people make their own decisions.

Food standards were enhanced by a very high level of organisation of the kitchen. The provider utilised inventive processes to support people with their nutritional requirements. When we discussed the quality of meals with people and their relatives, they said food was of a very high quality.

People and their representatives said staff worked collaboratively with them to ensure they received high standards of care. One relative said other services had never involved them in their family member’s care planning. They added, “They involved me right from the start and focused on what my [relative] was like. What did he use to do? What was family life like? His food likes and dislikes. To me, that’s where Rossall goes above and beyond.”

We found Rossall had a particularly tranquil, warm and welcoming atmosphere throughout. We saw people were relaxed and staff had an exceptionally caring attitude. A relative commented, “Each person matters and they have a meaningful and high quality of life.”

Relatives told us they felt extremely well supported and encouraged to maintain their important relationships with those who lived at Rossall. They said the management team was extremely good at keeping them informed about people’s care. One relative said, “As soon as we arrive, they give us an update. In between times they contact us just to reassure us [our family member] is fine. It’s fantastic.”

We saw staff were responsive to each person’s changing needs and adopted revised care planning to improve upon assistance. One relative said, “As a result of the staff’s care, [our relative] has improved beyond believe. We can talk with her now, she washes herself and dresses smartly, just like the way she used to be many years ago.” We found care planning enabled staff to work in a highly personalised and holistic approach. A member of the commissioning team said they found Rossall was a wonderful home and would rate it as outstanding in all areas.

The management team provided excellent opportunities to optimise people’s social and stimulation requirements. A relative told us, “I go home not feeling anxious because I know the quality of care is exceptional and [my relative] is fully occupied and never bored.”

We found staff, people and relatives were at the heart of Rossall’s quality assurance programme. The management team had a wide range of systems to gain their feedback. This included multiple meetings and a variety of satisfaction questionnaires. Staff, people, their relatives and visiting professionals told us the home was highly organised and exceptionally well-led.

The provider and registered manager regularly completed multiple auditing systems and acted swiftly to address any identified issues. They had remarkable oversight of care provision, service quality and everyone’s safety.

Inspection areas

Safe

Outstanding

Updated 7 June 2017

The service was exceptionally safe.

The building design optimised innovative systems, which maximised the safety of people who lived there.

Care files held thorough risk assessments to mitigate each hazard to people’s safety and welfare. Staff had an excellent awareness and approach of safeguarding principles.

We found Rossall had very high staffing levels and skill mixes to enhance people’s safety and welfare. The provider deployed additional staff to adapt to people’s changing needs. They also had vigorous recruitment procedures to safeguard vulnerable people from the employment of unsuitable staff.

We found staff followed clear processes to meet high standards of the management of people’s medicines.

Effective

Outstanding

Updated 7 June 2017

The service was highly effective.

The provider had an appreciation of high standards of training and created an ongoing programme.

The management team and staff viewed consent processes as pivotal in providing an inclusive environment where people mattered. Staff received MCA and DoLS training and when we discussed this with them, we found they had exceptional awareness.

The provider had innovative systems to protect people from the risks of malnutrition and related medical conditions.

The adaptation of the building meant staff had excellent scope to protect people who lived with dementia.

Caring

Outstanding

Updated 7 June 2017

The service was exceedingly caring.

We observed multiple examples of the exceptionally caring and highly efficient staff approaches.

End of life care plans we reviewed were very detailed, person-centred and had the person and their relatives at the heart of their support.

We saw evidence of staff working collaboratively with people and their relatives about their care planning. They exhibited the same respect, care, empathy and kindness to relatives that they showed to people who lived at Rossall.

Responsive

Outstanding

Updated 7 June 2017

The service was exceptionally responsive.

We found multiple examples of the exceptional responsiveness of staff and management to people who lived at Rossall. The registered manager developed personalised care plans to guide staff to provide highly responsive, holistic support.

The provider went to great lengths to ensure people were supported to engage in activities they enjoyed and their known interests and hobbies.

The provider had arrangements to manage complaints and concerns.

Well-led

Outstanding

Updated 7 June 2017

The service was extremely well-led.

The management team set up multiple, extremely efficient forums to involve people and visitors and gain their feedback.

The management team worked with other agencies in the oversight of Rossall’s quality and safety. They found the management team skills were exceptional, which reassured them in placing people at the home.

We found the provider had high standards and a great desire to involve staff in service development and improvement of their working experiences.

The management team monitored the home as a high priority to ensure excellence in care and quality assurance.