Rosemount Care Home

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

This key question was previously rated inadequate. This key question has improved to good. This meant people’s outcomes were consistently good, and their feedback confirmed this.

People’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

This service scored 71 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People and their relatives were confident in the provider’s oversight of their needs. The registered manager had ensured reviews of people’s needs were more regular, and had regard to their input, and that of families.

One relative told us, “They listened to how the room [person] was in wasn’t a good fit for them in terms of noise and business nearby. They really listened and here we are, it’s much quieter and more suitable. Within reason, they are receptive to suggestions and ideas.”

Another said, “We sat down and talked through all the bits of the care planning.”

The provider used a range of recognised tools to help assess people’s needs and make changes if and when necessary, For instance, Waterlow and Malnutrition Universal Screening Tool (MUST). The Waterlow score is a means of assessing people’s risk of developing skin pressure damage. These records were consistently filled in and up to date, helping to inform the provider’s level of response to the risk people faced.

Staff clearly understood people’s current needs and communicated with them effectively on an ongoing basis.

External professionals expressed confidence in the effectiveness of care delivered at the service. One said, “The relationships with families have been a notable improvement and meant that they can now have ongoing open conversations.”

The registered manager reviewed a range of data on a monthly basis that helped indicate where more focus or change might be required in terms of people’s care needs. For instance, people’s weight fluctuations, number/type of falls, and skin integrity issues.

They were able to do this reliably because staff kept the electronic records system up to date and made alerts at the right time.

Leaders sought advice from external professionals when required. At times this information needed to be more accessible for care staff to ensure they had it at a glance, but they demonstrated good knowledge.

Accurate records were kept so patterns and trends could be identified and addressed. For instance, turn charts and nutrition and hydration records.

The registered manager and regional operations manager were keen to learn about new and innovative approaches to improve the way their service delivers care. They recognised the service had first to ensure it embedded the improvements made across core aspects of care monitoring and delivery.

The registered manager had attended a significant number of handovers to ensure the appropriate level of information was shared between shifts, and to ensure staff understood any changes in practice or process.

Staff worked well together. One staff member said, “We work as a team, and I feel like whatever the day throws at us we can manage it because we have good staff and a good manager.”

The registered manager had built effective working relationships with the local GP surgery through the frailty nurse. This working relationship allowed the opportunity for additional challenge/scrutiny when needed, to the benefit of people using the service. The relationship was a developing one and clearer boundaries needed to be agreed to ensure the relationship continued to be a positive one.

One external professional said, “I used to talk to different people on a daily basis and there were often different stories about what had happened. It’s so much better know with clear accountabilities, and I am a lot more confident.”

The registered manager recognised the importance of team working and communication with external partners. For instance, in ensuring people who came to the service for a short time had their needs supported with a view to their returning home (in the case of respite care).

People felt better empowered and supported to manage their own health, care and wellbeing needs by staff who understood their needs and preferences. One person said, “They give me a range of choices, and I know what’s on the information boards.”

The provider ensured relevant referrals were made when there may be underlying health issues that needed additional support. For instance, referring to the dietitian and the speech and language therapy team.

We observed two meals and for the most part the experience was positive. More needed to be done to explore why some people, who were not able to vocalise, may be leaving their food. The registered manager agreed to review this with relatives and to try different approaches. Drinks were plentiful and the mealtime environment had seen significant improvements. Where people’s enjoyment of mealtimes was impacted by a dental issue, we saw a referral and follow-up had been made.

The registered manager recognised the importance of stimulation, both physical and mental. They had brought in a second activities co-ordinator to help in this area. There were now weekly trips out for people on a minibus, which was proving popular.

One person said, “I get out more now, which I really enjoy.” One person’s relative felt there needed to be more inclusive and immersive activity experiences for people living with more advanced dementia. We fed this back to the registered manager, who was keen to incorporate more aspects of dementia friendly best practice into the home.

People and relatives were happy with the service provided, and felt staff monitored people’s needs well. The registered manager stayed in touch with people and families regularly to ensure needs were well monitored. Staff confirmed they had sufficient time to update records and were clear on the expectation regarding detailed, person-centred care notes. The registered manager regularly reviewed the systems and processes in the service to determine if improvements could be made. There were daily logs in place so staff and families could share pertinent information. This worked well for people and staff. One relative said, “The communication is excellent – always getting updates on my phone, and there was a communication book we used to update the carer and vice versa.” The registered manager planned to introduce electronic record keeping in the future but the systems in place at the time of inspection worked well. Where improvements could be made, for instance in relation to oral healthcare, the provider recognised the shortfalls and committed to further improvements.

People were supported to have control over day-to-day choices. Staff respected people’s independence and rights. People and families were involved in core decisions about their care from the outset.

The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. Staff had received training regarding the MCA and policies were in line with the principles of the MCA.

Some processes had not always adhered to the principles of the MCA. For instance, when people required medicines covertly, or when a medicine was used as a last best option to help someone who was experiencing anxiety. The registered manager was able to demonstrate that the people who knew people’s needs best had been involved in these considerations, but best interests decision making records were not always in place. They took action to improve this during the inspection.