Archived: Roselands Residential Home Limited

At our last inspection we rated the service good overall, although we found one breach of the Health and Social Care Act. This was because care records did not provide enough information to guide staff on the care and support people required. At this inspection we found improvements had been made and the service was no longer in breach of the regulations. We found the evidence continued to support the 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.

Systems remained in place to help safeguard people from abuse. Staff understood what action they should take to protect vulnerable people in their care. 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 to the needs of people living at the home.

The home was well-maintained, clean and decorated to a good standard. Maintenance checks on services and equipment were up-to-date. Procedures were in place to prevent and control the spread of infection. The management of medicines was safe. The service plans to introduce more detailed documentation around the administration of ‘when-required’ medicines.

Staff encouraged people to make choices where they were able. The service was working within the principles of the Mental Capacity Act (MCA) 2005 and the Deprivation of Liberty Safeguards (DoLS).

People were supported by staff who had the knowledge and skills to undertake their duties. Staff completed a programme of training and received regular supervision and an annual appraisal.

Warm and caring relationships had been encouraged at the service and staff were polite and friendly when engaging people. People's privacy and dignity were respected. People had good access to other health professionals for advice and support, when needed. Care plans, which were reviewed regularly, reflected the needs of each individual.

There was strong, committed leadership from the registered manager and home owner and staff told us they felt supported by the management team. Audits and quality checks were undertaken on a regular basis and any issues or concerns addressed with appropriate actions. The service was committed to partnership working and had developed links with other healthcare professionals and the local community.

Roselands Residential Care Home is located in an old vicarage, which has been adapted and extended to accommodate up to 19 older people. There were 14 people using the service at the time of the inspection; this was due to three of the shared rooms being used for single accommodation. Accommodation is provided on two floors with a passenger lift providing access to the first floor. There are 13 single and three double bedrooms, some of which have en-suite facilities. There is adequate parking to the front of the home and well maintained gardens to the rear and side of the building. The home is located between Royton and Oldham and is within easy reach of local transport.

The home had a manager registered with the Care Quality Commission (CQC) who, due to extended leave, was not present on the day of the inspection. A registered manager is a person who has registered with CQC 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 service is run. The Responsible Person is also the co-owner of the home.

We found a breach in the Health and Social Care Act (HSCA) 2008 (Regulated Activities) Regulation 2014. We found that although the care records contained some information, there was not enough information in place to guide staff on the care and support required for some aspects of people’s care. You can see what action we have told the provider to take at the back of the full version of the report.

We found people were cared for by sufficient numbers of suitably skilled and experienced staff. Staff received the essential training and support necessary to enable them to do their job effectively and care for people safely. People who used the service told us they felt the staff had the skills and experience to meet their needs.

People were happy with the care and support they received and spoke positively of the kindness and caring attitude of the staff. During our inspection we saw staff treating people with respect and dignity. Social and recreational activities were provided and interactions between staff and the people who used the service were friendly and relaxed.

Staff we spoke with had a good understanding of the care and support that people required. We saw people looked well cared for and there was enough equipment available to promote people’s safety, comfort and independence.

We saw that suitable arrangements were in place to help safeguard people from abuse. Guidance and training was provided for staff on identifying and responding to the signs and allegations of abuse. Staff were able to demonstrate their understanding of the whistle-blowing procedures (the reporting of unsafe and/or poor practice).

The system for managing medicines was safe and we saw how the staff worked in cooperation with other health and social care professionals to ensure that people received timely, appropriate care and treatment.

All areas of the home were clean and procedures were in place to prevent and control the spread of infection. Risk assessments were in place for the safety of the premises and systems were in place to deal with any emergency that could affect the provision of care, such as a failure of the electricity and gas supply.

We saw that appropriate arrangements were in place to assess whether people were able to consent to their care and treatment. We found the provider was meeting the requirements of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS); these provide legal safeguards for people who may be unable to make their own decisions.

Food stocks were good and people were offered a choice of meal. People we spoke with told us they enjoyed the food, there was always enough and they could have second helpings if they wished.

To help ensure that people received safe and effective care, systems were in place to monitor the quality of the service provided. The complaints procedure was displayed in each person’s bedroom and in the hall. People told us that the staff were approachable and felt confident they would listen and respond if any concerns were raised.

Is the service safe?

Is the service effective?

Is the service caring?

Is the service responsive?

Is the service well led?

This is a summary of what we found -

Is the service safe?

A personal emergency evacuation plan (PEEP) was in place which meant all people had received an assessment of their needs in the event of a fire emergency. We also saw emergency procedures were in place in the event of a hospital admission. This helped to minimise risks to the health and safety of people who used the service.

The store room for cleaning materials was kept locked when not in use which ensured the safety of people who used the service. We spoke with the domestic staff member who explained the procedure for dealing with an infectious outbreak at the care home. We were told, "We have dealt with it in the past without a problem."

Deprivation of Liberty Safeguards (DoLS) become important when a person is judged to lack the capacity to make an informed decision related to their care and treatment. The provider told us no applications for DoLS had been made but knew the procedure to be followed if an application needed to be made. On the day of our inspection, no person who used the service was subject to a DoLS.

Is the service effective?

The care plans we looked at contained relevant information related to the care needs of the person who used the service. People had undergone a pre-admission assessment. We saw their likes, dislikes and their choices and preferences had been recorded.

A recreational area had been provided so people and visitors could make their own drinks and spend some private time if they wished to.

Is the service caring?

During our inspection, we spent time in communal areas. Staff members interacted well with people and gained consent before providing any care or support to people who used the service.

During our inspection, we spoke with two people who used the service and two family members who were visiting the care home. One person told us, "It`s just champion here. We get really well looked after."

Is the service responsive?

General Practitioner and professional visits and appointments had been recorded. This showed the provider had a multi-disciplinary approach to providing care. This helped ensure people received support in accordance with their care needs when they required it.

A complaints procedure was displayed on the wall at the care home and a copy was also available within the service user`s handbook in people`s rooms. The last complaint was recorded in July 2014, and we saw it had been managed appropriately with a satisfactory outcome.

Is the service well led?

Roseland`s care home had procedures in place that monitored the quality of service being provided to people who used the service. We saw evidence that care plans, infection control procedures and medication audits were regularly completed.

Annual surveys were held for people who used the service and family members. We looked at the results of the last survey and saw positive comments had been recorded. Most feedback we observed had been rated between good and excellent.

People confirmed that they were able to access services such as GPs and chiropodists when they needed to. We saw that the provider liaised with other healthcare professionals in identifying and providing appropriate care and support for people, for example, dieticians.

One person living there described the home as "comfortable". Another said they had "all I need" in their bedroom. The home was odour free, clean and tidy. Furnishings and decor throughout were adequate and reasonably well maintained.

The provider had systems in place to support staff with regular training and individual supervision sessions. We saw that a complaints policy was in place and accessible to people using the service.

We observed that staff interacted with people who use the service in a positive manner. They offered support to people in a kind and considerate way ensuring their dignity was respected. We observed staff talking sensitively and involving people in decisions about their support so that their wishes and preferences were taken into consideration. Staff were visible at all times and responded promptly to people's requests.

During our discussion with a visitor to the home, we asked if they felt able to raise any issues or concerns they may have. They told us; 'I'd have no hesitation in asking for anything or speaking to them if there are any issues' and 'They are very approachable'. They also told us; 'The carers are smashing' and 'They care for [my relative] very well'. They also told us that they were always made welcome.

Staff spoken with told us they 'Feel supported' and 'Loved working at the home'. They said they had requested training in an area, which interested them and this had been provided.