This was an unannounced inspection which took place on 24 and 25 June 2015. We had previously carried out an inspection on 12 September 2013 when we found the service had complied with all the regulations we reviewed.
Rose Court provides accommodation for up to eighty seven people who have nursing and personal support needs. Rose Court is a purpose built home that has recently been extensively refurbished with the aim of becoming a centre of Excellence for Dementia Care. The home is on three floors. Clarence Unit on the ground floor is a residential unit, Windsor Unit provides both nursing care and personal support to people while Wilton Unit on the 2nd floor provides nursing care and support to people living with dementia. However there are people who use the service on all units who may have a diagnosis of dementia.
The service had a manager who was registered with us. 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 and associated Regulations about how the service is run.
People told us they felt safe at Rose Court, “Yes I feel very safe here. Better than where I was before. Staff are like good friends. Make sure I am safe and keep an eye on me. Take me the shop for my cigarettes”, “I feel very safe with all the staff. You can talk to any of them and they will listen” and “No trouble at all with feeling safe. The staff are all very nice. If I was worried I would tell my son and he would speak to them about it.”
Staff had received training in safeguarding adults and whistleblowing. They were able to tell us of the correct action to take should they have any concerns about people who used the service.
People who were able to mobilise safely and independently were free to walk about and go out into the securely fenced garden areas where there are marked paths, rails and ample seating areas with protection from the weather. One relative said, “[My relative] has been in three homes and this best by far as she can walk about and go outside. Staff will go and find her when we come if she is not about.”
There were systems for managing medicines, infection control, risks and health and safety.
The home had recently been fully refurbished and had fully taken into account the needs of people who live with dementia in the design.
People who used the service and their relatives thought that staff had the necessary knowledge and skills to provide the care that was needed and that there was sufficient staff to meet people’s needs. We spoke with two new members of care staff who had previous experience of working in other homes. They said, “I love it here. The training is amazing. They throw it at you and I will take it. It’s properly run” and “It’s a fantastic team. All good.”
Staff understood their responsibility to support people to make their own decisions wherever possible and always asked for consent before carrying care tasks.
People told us that they enjoyed the food provided by the home. We saw that drinks and snacks were always available to people who used the service
A person who used the service said, “No messing if I am not well they call the GP straight away here.” Relatives told us that if the person who used the service needs changed or there were any concerns and that they were good at seeking professional health care advice.
People who used the service told us that staff were kind and caring. This was confirmed by our observations during the inspection. The atmosphere was calm and relaxed.
Systems were in place to help ensure people received the care they wanted at the end of their life.
People told us that they are given choices about everyday things and that staff respect their choices. This included when to get up, go to bed, what to wear, what to eat, how and where to spend their time. People told us, “Lots of choices. I can come and go to my room as I like.” “Go out in the garden for a smoke. Staff look after cigarettes but only have to ask. Choose whether I have shower or bath and when I want to have it.”
There was a wide range of activities for people to get involved in they wanted to which included people living with the advanced stages of dementia.
People we spoke with told us they thought the home was well-led and that unit managers and seniors as well as the registered manager were readily available and approachable at all times. The registered manager promoted a whole team approach to the running of the home.
Systems were in place to monitor the day to day running of the home and review the quality of the service provided.