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Reports


Inspection carried out on 13 December 2017

During a routine inspection

Rosebery House 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. They are registered to provide accommodation for up to fourteen people for older people including people with dementia. At the time of our inspection there were twelve people using the service.

At the last inspection on 16 October 2015 we rated the service Good. At this inspection, we found that the service remained Good.

There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (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 2008 and associated Regulations about how the service is run.

People told us they felt safe living at Rosebery House. Staff knew how to report concerns and keep people safe.

Staff received training and support that enabled them to carry out their roles effectively. Risk to people`s wellbeing were identified and managed safely

People`s medicines were managed safely by staff who had their competencies assessed.

People had choices about the food they ate. Staff met people’s nutritional needs.

There were enough staff employed by the provider to meet people`s needs effectively.

People were involved in planning their care and support .People had opportunities to pursue their hobbies, interest and socialise at the home and in the community.

People`s feedback about the service they received was regularly sought and people felt listened to by staff and the provider..

People and staff were positive about the management of the service. The provider had systems to ensure the quality of the service was monitored and improved.

Inspection carried out on 16 October 2015

During a routine inspection

The inspection took place on 16 October 2015 and was unannounced. At our last inspection on 09 October 2014, we asked the provider to take action to make improvements for medicines, staff training and recruitment. When we inspected Rosebery on 16 October 2015 we found the required improvements had been made. Rosebery House provides accommodation and care for older people including people with dementia. At the time of our inspection 14 people lived at the home.

There was a manager in post who had registered with the Care Quality Commission (CQC). A registered manager is a person who has registered with the 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 CQC is required to monitor the operation of the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS) and to report on what we find. DoLS are put in place to protect people where they do not have capacity to make decisions and where it is considered necessary to restrict their freedom in some way, usually to protect themselves or others. At the time of the inspection we found that people’s freedoms had not been restricted and so DoLS authorities were not required.

People told us that they felt safe, happy and well looked after at the home. Staff had received training in how to safeguard people from abuse and knew how to report concerns, both internally and externally. Safe and effective recruitment practices were followed to ensure that all staff were suitably qualified and experienced. Arrangements were in place to ensure there were sufficient numbers of suitable staff available at all times to meet people’s individual needs.

The environment and equipment used were regularly checked and well maintained to keep people safe. Trained staff helped people to take their medicines safely and at the right time. Risks to people’s health and well-being were reviewed and managed positively.

Relatives and people were positive about the skills, experience and abilities of staff who worked at the home. They received training and refresher updates relevant to their roles and had regular supervision meetings to discuss and review their development and performance.

People were supported to maintain good health and had access to health and social care professionals when necessary. They were provided with a healthy balanced diet that met their individual needs.

Staff made considerable efforts to ascertain people’s wishes and obtain their consent before providing personal care and support, which they did in a kind and compassionate way. Information about local advocacy services was available to help people and their family’s access independent advice or guidance.

Staff had developed positive and caring relationships with the people they cared for and clearly knew them very well. People were involved in the planning, delivery and reviews of the care and support provided. The confidentiality of information held about their medical and personal histories was securely maintained throughout the home.

Care was provided in a way that promoted people’s dignity and respected their privacy. People received personalised care and support that met their needs and took account of their preferences. Staff were knowledgeable about people’s background histories, preferences, routines and personal circumstances.

People were supported to pursue social interests and take part in meaningful activities relevant to their needs, both at the home and in the wider community. They felt that staff listened to them and responded to any concerns they had in a positive way. Complaints were recorded and investigated thoroughly with learning outcomes used to make improvements where necessary.

Relatives, staff and people very were complimentary about the manager how the home was run and operated. Appropriate steps were taken to monitor the quality of services provided, reduce potential risks and drive improvement.

Inspection carried out on 9 October 2014

During a routine inspection

This inspection took place on 9 October 2014 and was unannounced. The service was found to be meeting the required standards at their last inspection in August 2013.

Rosebery House is a residential care home which provides accommodation and personal care for up to 14 older people. At the time of our inspection there were 12 people living at the home. There is a registered manager. 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. The registered manager and the provider for this service is the same person.

CQC is required to monitor the operation of the Mental Capacity Act (MCA) (2005) and Deprivation of Liberty Safeguards (DoLS) and to report on what we find. DoLS are in place to protect people where they do not have capacity to make decisions and where it is considered necessary to restrict their freedom in some way, usually to protect themselves or others. At the time of the inspection no applications had been made to the local authority in relation to people who lived at Rosebery House.

People were supported by staff who knew them well, however, they did not always have the necessary skills to support them appropriately. Staff had not always received training in advance of providing care to people. In addition, specific training to meeting individual people’s needs such as pressure care management was not provided. Staff had a good understanding of how to promote people’s safety in regards to protecting people from the risk of abuse. Staff numbers were appropriate to meet the needs of the people they were supporting. The recruitment procedure was under review to ensure it was consistent.

People, and their relatives, told us that care was delivered in accordance with their preferences. People had regular access to health care professionals and had been involved in the development of their plan of care

People, their relatives and visiting professionals were positive about the staff. We were told that they were kind, caring and responsive. Our observations and discussions with staff supported their comments. People enjoyed their food and there were opportunities to maintain hobbies and interests. Work was being done to ensure these met people’s individual needs and preferences.

Staff were clear on what their roles were and shared the manager’s view of the type of service they wanted people they supported to receive. There were systems in place to gain people’s feedback and monitor the quality of the service, however, issues were not always addressed. We also found that other issues, in relation to training, supervision, and pressure care provision were not identified. We also identified shortfalls in relation to the management of medicines in relation to the recording and dispensing of medicines were not identified.

At this inspection we found the service to be in breach of Regulations 9, 10, 13, and 23 of the Health and Social care Act 2008 (Regulated activities) Regulations 2010. You can see what action we told the provider to take at the back of the full version of the report.

Inspection carried out on 23 August 2013

During a routine inspection

The people who lived at Rosebery House told us that they liked living there. They said that it was in a central location and was convenient for going out and about. The people told us that the staff were �tip top� and that the manager was �such a support�. All of the people we spoke with were very positive about living in the home and the care and support that was offered to them.

At the last inspection carried out in June 2013 there were areas of concern in relation to how the people who lived in the home were involved in determining how their care was carried out, the quality of the care plans, how infection was prevented, the training levels of the staff and how the home was monitored. At this inspection we found that all of these areas had been addressed and we found the home to be well run in the best interests of the people who lived there.

Inspection carried out on 12 June 2013

During a routine inspection

We carried out the inspection in response to concerns raised with us about care provided to people who used the service.

Overall we found the home to be visibly clean on the day of our inspection and people appeared to have had their personal care needs met.

Staff told us how they enjoyed working at the home and had felt supported by the manager. Staff told us that they thought there were sufficient numbers of staff to meet peoples� needs. However, not all staff had attended training which was of relevance to their role, this may mean they do not have adequate skills to care for people.

We found that there were no activities provided for people who used the service and that people spent most of their time in their bedroom.

Care plans had not been regularly reviewed and updated and some people did not have a care plan in place. This meant that staff may not know how to care for people correctly.

The people we spoke with told us that they were satisfied with the care they had received. They told us that in general they found the staff to be friendly and helpful.

We found that the home did not have suitable arrangements in place to monitor the quality of the service. We also found that people were not consultant on how the home was managed or how their care was provided. This may mean that people did not receive the care and treatment they would like to receive.