Rosegarland Residential Care Home

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. At our last assessment we rated this key question requires improvement. At this assessment the rating has changed to good. This meant people were safe and protected from avoidable harm.

This service scored 72 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider had a positive approach to learning, with a culture based on openness and willingness to learn. People and relatives told us they knew how to raise concerns and felt confident appropriate action would be taken to address them.

Accidents and incidents were reported by staff and action was taken to mitigate the risk of events taking place again. Complaints and concerns were recorded and appropriate action taken. The registered manager and the provider demonstrated an open approach and told us about recent examples where lessons had been learned. For example, there had been a recent review of recruitment processes in order to strengthen the service’s value based approach. Improvements could be made to how overarching themes and trends were reviewed and monitored. However, due to the size of the service the registered manager demonstrated they had effective oversight.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, maintaining continuity of care when moving between services. The provider had a pre-assessment process in place which enabled them to gather relevant information prior to care being provided.

People’s needs were robustly assessed before they started to use the service. Care records evidenced the involvement of a range of health and social care professionals. Where people’s needs changed referrals were made for specialist support and advice, including tissue viability nurses and the palliative care team. The service had good working relationships with the local pharmacy and nursing teams, which supported people to have good continuity of care.

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider shared concerns quickly and appropriately.

There was a safeguarding file in place and referrals had been made to the local authority when required. Staff had received safeguarding adults training and they understood how to raise concerns. Comments included, “I would raise it straight away if I saw poor care or abuse.” People and relatives told us they felt safe living at Rosegarland.

The provider worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

Risks to people’s health, safety and well-being were assessed and regularly reviewed. Key risks relating to areas such as falls, nutrition and skin integrity had been reviewed but individualised risks had also been assessed and monitored in detail. For example, one person had a specialist chair and there was a detailed assessment in place. Where people’s care required monitoring records were generally well completed by staff. Some people needed staff to monitor how much they drank and we found checks had not always been well completed. However, we did not identify any concerns about people’s level of hydration, and the registered manager acted straight away. Staff told us they got good information about how to support people safely through handover and having access to people’s care plans and risk assessments.

People and relatives told us care was provided safely. Comments included, “I would score them 10 plus. They are brilliant.”

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

The service was safe and well maintained. Regular health and safety checks were completed. Window restrictors were in place to support people’s safety but they did not all adhere to best practice standards. The provider assured us they would be replaced promptly. Dementia friendly signage supported people to orientate safely. The service had an accessible and attractive patio area and we observed people enjoying using the outside space. People’s bedrooms were personalised with accessories of their choice.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs.

Safe staffing levels were in place and were regularly reviewed when numbers or people’s needs changed. Staff were attentive and responded to people promptly when they needed care and support.

The provider used a dependency tool to assess the numbers of staff required. The most recent assessment had not been fully completed as there was no evidence recent events, such as falls, had been considered. In addition, in the afternoon staff’s role included maintaining the cleanliness of the service and preparing and serving the evening meal. It was not clear how this was factored into the calculations to ensure safe staffing levels were in place. We discussed this with the provider and they confirmed they would review this fully.

Staff recruitment was managed safely and the required checks were in place and completed. Staff received face to face and online training they required to carry out their role. Staff told us the training supported them to carry out their role fully.

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

Processes were in place to ensure people were protected from the risk of infection. Over the course of the assessment the service was clean, tidy and free from malodours. Staff received training in infection, prevention and control and understood what action they needed to take to keep people safe. People and relatives gave good feedback about the cleanliness of the service. Comments included, “The home never has an odour and their bedroom is always spotless.”

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened.

Overall, medicines were managed safely. Records were clear and people were receiving their medicines on time and in their preferred way. Some people’s topical medicines were stored in their bedrooms and detailed risk assessments were not always in place. We discussed this with the registered manager and we were assured this would be addressed.

Where people had complex medical issues requiring high risk medication, detailed care plans were in place.

Staff had received training in how to administer medication safely. Good practice guidance highlights staff should have their competency to administer medicines assessed annually. Staff competency assessments were slightly out of date, but the registered manager was aware of this and plans were in place to ensure refresher checks were carried out.