Rosemount Care Home

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• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

This key question was previously rated inadequate. This key question has improved to good. This meant the service was consistently managed and well-led. Leaders and the culture they created promoted high-quality, person-centred care.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Staff delivered compassionate care to people they respected and treated with dignity. They were expected and enabled to provide timely, good quality care, by a registered manager who had recognised the need for significant changes and implemented them. The registered manager had brought staff with them in terms of staff being committed to shared goals. There was a positive atmosphere and an open culture within which staff were supportive of each other.

The stability of a year of consistent management arrangements and a clear focus on putting outcomes for people first, had contributed to significant improvements in the service. One staff member said, “They have completely changed things. They really listen and they are always available.”

Relatives consistently told us the service had dealt transparently with concerns and had worked with them to address the areas of risk identified at the last CQC inspection. One relative said, “You can see them working as a team.”

Equality and diversity amongst staff were respected.

Policies and procedures were up to date and had regard to person-centred care principles, equality, diversity, human rights and inclusion.

At our last inspection staff had not always felt supported. At all levels of staffing improvements were noted during this inspection. Staff were supported individually and as teams. When mistakes were made, they were supported to learn from these.

Standards and expectations from the registered manager were high, and staff understood and responded to this. Leaders modelled high standards and were knowledgeable regarding people’s needs and good practice. They had the right experience and support in place. Leaders acted with integrity and compassion for the people they were responsible for providing high standards of care to.

Staff support and wellbeing was consistently supported through planned supervision meetings and a recognition that leaders were available to discuss ad hoc matters when required.

Policies and procedures supported the delivery of a person-centred approach at the service.

At our last inspection, there were concerns regarding the opportunity for people to speak up. The current registered manager had made significant changes and everyone we spoke with found them to be open, approachable and proactive in dealing with any issues.

Staff all felt they could raise concerns with the registered manager or deputy (in a way that they had not felt able to do previously).

One staff member said, “I’ve got confidence now. The manager is very supportive with non-work things as well, for instance if you are not feeling 100% - they can spot this and have a little word.” Another said, “They are really firm but that’s what’s been needed.”

One relative said, “They listened, and they looked into all the alternatives, without jumping to conclusions.”

The provider had policies and systems in place to support people, relatives and staff to speak up if they needed. Concerns and complaints had been dealt with promptly. One concern had not been appropriately recorded – the registered manager agreed to rectify this immediately.

The registered manager understood the strength in a diversity of experience.

Staff from different backgrounds were working effectively as a team. The registered manager focussed on values and skills during recruitment to ensure an equity of experience for prospective staff.

The registered manager was mindful of the potential disparities in the experience of staff with protected equality characteristics, or those from excluded and marginalised groups. They were enabled to support staff fairly with the support of a robust set of policies and procedures.

Staff were well supported and there was no evidence of discrimination or bullying.

There were much clearer lines of accountability and staff knew their responsibilities. In terms of sustainability, the provider had recently employed a deputy to support the registered manager. They demonstrated a sound knowledge of people’s needs and were being supported to build their leadership strengths.

There still needed to be some improvements in the link between auditing arrangements and outcomes. For instance, the medicines issues we identified should reasonably have been identified and actioned by the provider. Likewise, the improvements needed to some details in care planning documentation should have been identified and improvements made through auditing and governance processes. The registered manager reflected on this and demonstrated the suite of auditing tools they had in place. They gave assurances that the service had rectified the vast majority of the issues identified at the previous inspection and were confident in sustaining the improvements made. External professionals and relatives shared this confidence.

Systems and resources were available to ensure the registered manager, deputy manager and regional operations manager had the time and resources to review practice and make improvements.

Relevant notifications had been made to external partners, including CQC, as required. The registered manager recognised the importance of the duty of candour and had applied this consideration when reviewing incidents.

Leaders collaborated openly with external professionals and agencies, to meet people’s changing needs and to explore improving practice. They shared information and sought to make contacts with local organisations to ensure people had access to their community. The registered manager had organised a summer fete to encourage family and friends’ participation, and to build more community links.

The recruitment of an additional activities co-ordinator meant people had access to more activities in the service, from a wider range of visitors. People benefitted from weekly visits out in the provider’s minibus to local places of interest.

People we spoke with were comfortable, safe and happy in their home.

There had been a lack of demonstrable learning and improvement at our last inspection. This had improved significantly during this inspection, with stronger governance and accountability arrangements in place. The registered manager ensured wider safety and other messages were shared appropriately with staff. When incidents occurred in the service and learning needed to be shared, this was done through daily handovers, team meetings and individual and group supervisions.

Care records were greatly improved, making for easier and more effective auditing. This also meant external health and care professionals could access people’s records and contribute to their ongoing support more easily.

Staff felt they had the opportunity to develop their careers within a much more supportive environment.

The registered manager had developed some positive external relationships and hoped to build on these (and develop more) as the culture grew.