Rosenmanor 1

Updated 7 December 2022

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

Inspection team

The inspection was carried out by one inspector.

Service and service type

Rosenmanor 1 is a 'care home'. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This 2 day inspection was unannounced on the first day.

What we did before the inspection

We reviewed all the information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke in-person with 5 people who lived at the care home about their experiences of using this service, the registered manager and 4 care workers. We also received telephone and/or email feedback from 2 relatives and 2 care workers about their experiences of either using or working for this service.

In addition, we looked at a range of records including 5 people’s electronic care plans, staff files in relation to their recruitment, training and supervision, and multiple medicines records. A variety of other records relating to the overall management of the service, including policies and procedures were also examined.

Updated 7 December 2022

Rosenmanor 1 is a residential care home providing accommodation and personal care for up to a maximum of 9 people in one adapted building. The service provides support to women with mental health care needs. At the time of our inspection 9 women aged 50 and over were living at the care home.

People’s experience of using this service

People were not suitably protected from harm because the risks they might face were not always properly assessed and managed. This meant staff did not always have access to enough sufficiently detailed guidance to help them keep people they support safe.

The provider had established governance and monitoring systems in place however, these were not always operated effectively. This meant the provider had failed to always identify and take appropriate action to prevent people living in the care home being placed at risk of harm. This included staff working excessively long hours without taking sufficient time off to rest and recuperate, staff not always wearing personal protective equipment (PPE), and not always respecting the privacy of people living in the care home.

In addition, records the provider is meant to keep and make available to the CQC on request were not always made immediately accessible on request.

Furthermore, staff were not always adequately supported and supervised by their line managers. This was because staff did not have sufficient opportunities to routinely reflect on their working practices and professional development.

People were kept safe from abuse. The provider ensured there were always sufficient numbers of suitably trained staff to support people and keep them safe. People received personal care and support from staff whose fitness to work in adult social care had been checked. People received their medicines as they were prescribed.

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.

People were supported to access food and drink that met their dietary needs and wishes. People were supported to stay emotionally and physically healthy and well, and to access relevant community mental health and social care services as and when they needed to.

People were treated equally and had their diversity respected, including their cultural and spiritual needs and wishes. People typically described staff as “kind”. People were encouraged and supported to maintain their independent living skills and to do as much for themselves as they were willing and capable of doing safely.

People's care plans were person-centred, which helped staff provide them with the individualised care and support they needed. Staff ensured they communicated and shared information with people in a way they could easily understand. People were encouraged to make decisions about the care and support they received at the care home and staff respected their informed choices. Where appropriate, people's end of life wishes and contacts were known and recorded for staff to refer to.

The registered manager promoted an open culture which sought the views of people, their relatives and staff. The provider worked in close partnership with other health and social care professionals and agencies to plan and deliver people's packages of care.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at the last inspection

The last rating for this service was good (published 26 August 2021).

Why we inspected

The inspection was prompted in part due to concerns received about staffing, building maintenance, food and social activities. A decision was made for us to inspect and examine those risks.

We have found evidence that the provider needs to make improvements.

You can see what action we have asked the provider to take at the end of this full report.

Enforcement and Recommendations

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified 3 breaches at this inspection in relation to how the provider assessed and managed risk, operated their oversight and scrutiny systems and ensured records they were expected to keep were always easily accessible, and supported and supervised staff.

We have also made some recommendations in relation to how the provider manages ‘as required’ medicines and arranges meaningful social activities for people to participate in.

In addition, we discussed issues we found in relation to the way the provider managed the premises and dealt with outstanding maintenance issues.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.