Rosedale Care Home

Rosedale Care Home residential care home providing personal and nursing care to up to 20 people in one adapted building. The service provides support primarily to older people, many of whom are living with dementia. At the time of our inspection there were 20 people living in the service.

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

People were cared for safely. They were protected from the risk of abuse by a management and staff team who knew how to follow safeguarding procedures and did so when required. Risk assessments were in place and reviewed regularly and as people’s needs changed. People were supported to use equipment to help keep them safe.

When people lacked or had fluctuating capacity to make decisions, mental capacity assessments and best interest decision making processes were followed. Staff knew how to support people make choices about their daily care. 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.

Safe recruitment practices were followed to ensure staff were suitable for their roles. There were consistently enough staff to meet people’s care needs and when people needed assistance, this was provided promptly. People were supported safely with their medicines. Good infection control practices were followed including use of personal protective equipment (PPE) when supporting people with personal care and at mealtimes.

Accidents and incidents were recorded and followed up appropriately. Lessons were learned when things went wrong, and measures put in place to reduce the risk of the same thing happening again.

An open and positive culture was embedded in the service. People, relatives and staff spoke positively about the approach and availability of the registered manager and the management team.

There were clear and well organised systems in place to support the registered manager's effective oversight of all key areas of the service. A comprehensive range of quality assurance audits were undertaken to monitor the quality and standard of care provision.

People and their representatives were involved in people's care and had opportunities to provide feedback at care reviews and regular meetings. Feedback was acted upon when areas for improvement were identified.

Staff were supported through team meetings and one to one supervision. Positive feedback was received about good teamwork amongst staff which benefited everyone living and working in the service.

The staff team worked in partnership with health and social care professionals involved in people's care and treatment, to support people achieve good outcomes.

The registered manager was aware of their legal responsibilities and worked in an open and transparent way.

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 01 December 2018). A targeted inspection took place on 08 December 2020 which only looked at infection prevention and control during the COVID19 pandemic period. No rating was awarded at that time.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

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.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Rosedale Care Home on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

We found the following examples of good practice.

The home had purchased handheld two way portable radios to enhance communication during window visits. In addition, a further two computer tablets had been purchased to support people in maintaining contact with family and friends.

A room sanitising machine was used daily to deep clean all rooms and communal areas.

Staff used equipment to help identify symptoms of the National Early Warning Signs tool, (NEWS2). This tool detects early deterioration in people and supports requests for medical intervention and advice.

Rosedale Care 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. Rosedale Care Home is registered to accommodate 20 older people, some of whom are living with dementia. At the time of our inspection there were 20 people living in the home.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the overall rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns.

This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

There was a registered manager in post. 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.

Staff had a good understanding of abuse and the safeguarding procedures that should be followed to report abuse and incidents of concern. Risk assessments were in place to manage potential risks within people’s lives, whilst also promoting their independence.

The staff recruitment procedures ensured that appropriate pre-employment checks were carried out to ensure only suitable staff worked at the service. Good staffing levels were in place. Staffing support matched the level of assessed needs within the service during our inspection.

Staff induction training and on-going training was provided to ensure they had the skills, knowledge and support they needed to perform their roles. Specialist training was provided to make sure that people’s needs were met and they were supported effectively.

Staff were well supported by the registered manager and senior team, and had regular one to one supervisions. The staff we spoke with were all positive about the senior staff and management in place, and were happy with the support they received.

People's consent was gained before any care was provided. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice

Staff treated people with kindness, dignity and respect and spent time getting to know them and their specific needs and wishes. Care plans reflected people’s likes and dislikes, and staff spoke with people in a friendly manner. Our observations during inspection, were of positive and friendly interactions between staff and people.

People were involved in their own care planning and were able to contribute to the way in which they were supported. People and their family were involved in reviewing their care and making any necessary changes.

A process was in place which ensured people could raise any complaints or concerns. Concerns were acted upon promptly and lessons were learned through positive communication.

The provider had systems in place to monitor the quality of the service. Actions were taken and improvements were made when required.

Rosedale is a residential home in Luton providing care and support to older people, some of whom are living with dementia and physical disabilities. At the time of our inspection there were 20 people using the service.

There was a registered manager in post. 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.

People were kept safe and protected from risk of avoidable harm. Staff understood the process to follow if they needed to report any concerns or suspected abuse. Risk assessments were robust and detailed and included control measures to minimise and manage risk effectively. There were enough staff available to meet people’s needs and keep them safe. A robust recruitment policy was in place so that staff employed to the service had the skills and character required for the role. People’s medicines were managed and administered safely by trained members of staff.

Staff received a range of training that was relevant to their role and supported them to develop their skills and competencies. They received a regular programme of supervision and performance review from management and had opportunities to pursue professional qualifications. Staff understood the principles of the Mental Capacity Act 2005 and associated Deprivation of Liberty Safeguards (DoLS). People gave consent to receiving support from the service and consideration had been given to the ways in which people could consent to different aspects of their care. People’s healthcare needs were identified and the service worked with other healthcare professionals to support people’s health and well-being. People’s dietary needs were identified and the service offered them a choice of food and drink based on their individual preferences.

Staff demonstrated a kind and caring attitude towards people and provided care that was consistent and person-centred. The service created a pleasant atmosphere where friends and relatives were encouraged to visit and spend time with people in their home. People were treated with dignity and respect and had their right to privacy observed.

People had care plans in place which detailed their needs, choices and preferences. These were subject to regular review and created with the involvement of the person and their relatives. Where people’s needs changed, these were reflected in their care plans. There was an activities co-ordinator in the service who arranged a variety of activities and events in the home. People understood how to make complaints, and their grievances were handled and resolved effectively.

People, their relatives and staff were positive about the management of the service and felt supported and listen to. The manager had robust systems in place for quality monitoring and identifying improvements that needed to be made across the service. Questionnaires were sent out to all those involved with the service to gain their feedback and views. Regular staff meetings took place to give staff the opportunity to contribute towards the development of the service.

During our inspection we found that the provider had made improvements to the systems designed to prevent, detect and control the spread of infection. This meant we found that appropriate standards of cleanliness were being maintained within the home. In addition, we found that areas of the home that had been in need of attention had been repaired and/or replaced.

Staff training records we looked at during the previous inspection showed that staff had not completed or were not up to date with essential training within the timeframe set by the provider. The staff training records that we looked at during this inspection showed that all staff had either completed or were booked to complete essential training such as health and safety, first aid, safeguarding of vulnerable adults, moving and handling and medication administration.

We observed that people were offered support at a level which encouraged independence and assured their individual needs were met.

Care plans showed that people and their families had been involved in the development of their care plans. This was confirmed in discussions we had with people using the service.

We found that although most areas of the premises were clean there were some areas that were not being cleaned properly. We found that some processes designed to prevent and control the risk of infection were lacking. Some areas of the home were in need of attention and repair.

Training records showed that essential training for some staff needed to be updated to ensure people were not at risk of unsafe or inappropriate care and treatment.