Archived: Rosemary Care Home

Updated 7 May 2020

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 Care Act 2014.

Inspection team

The team consisted of three inspectors, two of which were present on each day of the inspection.

Service and service type

Rosemary Care Home 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. The service had a manager registered with the Care Quality Commission. 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.

Notice of inspection

This inspection was completed over two days. The first day of the inspection was unannounced.

What we did before inspection

We reviewed 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. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We spoke with five people who used the service. We also spoke with two relatives about their experience of the care provided. We spoke with the registered manager, a senior member of staff, the housekeeper and three care staff. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

We reviewed a range of records. This included five people’s care records and multiple medication records. We looked at records in relation to staff supervision and a variety of records relating to the management of the service.

Updated 7 May 2020

About the service

Rosemary Care Home is a residential care home providing personal and nursing care for up to 24 older people. At the time of the inspection, the service was supporting 22 people across three floors. The upper floor was dedicated to accommodation while the other two floors housed accommodation, lounges and dining areas.

People’s experience of using this service and what we found

Medicines were not always safely managed in accordance with best practice. Risks associated with the building were not always managed safely. The service was in breach of regulation regarding Safe Care and Treatment.

Quality assurances processes had not been effective in identifying and rectifying concerns found during this inspection. We made a recommendation regarding this.

Systems and processes were in place to safeguard people from the risk of abuse. Individual risks to people were assessed. There were enough staff to meet people's care needs. Arrangements were in place to keep premises clean and hygienic to protect people from the risk of infections. Additional measures had been introduced to reduce risk associated with COVID-19 (Coronavirus). However, areas of the building and the grounds needed refurbishment and some furniture needed replacing.

Notifications to the Care Quality Commission (CQC) had been submitted as required. The service had a positive learning culture where people were supported to reflect on performance and improve practice. The provider regularly engaged people using the service, their relatives and staff through meetings and informal discussions. People said communication with the registered manager was good.

People were given a good choice of nutritious food and drinks in accordance with their needs and preferences. Their healthcare needs were met through effective working with a range of healthcare professionals. The service operated in accordance with the principles of the Mental Capacity Act 2005 (MCA). 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.

Staff treated people with kindness, compassion and respect. People’s faith and cultural needs were recorded and understood by staff. People were encouraged to be as independent as possible. Staff understood the need to protect people’s privacy and dignity when providing care.

Care records were personalised for each individual. Care plans were reviewed regularly to ensure they remained accurate and reflected people’s needs. Staff adapted the way in which they communicated with people to engage them and to ensure important information was shared. People were supported to engage in a range of activities and to maintain important relationships. However, recent changes in personnel meant activities hadn’t always taken place as planned. People’s end of life wishes were considered as part of the assessment and care planning process.

We have found evidence that the provider needs to make improvement. Please see the Safe and Well-Led sections of this full report.

The provider has acted to reduce the risk posed by the issues we identified during this inspection.

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

Rating at last inspection

The last rating for this service was good (published 24 August 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

We have identified a breach in relation to the management of medicines and the safety of the environment at this inspection.

Please see the action we have told the provider to take at the end of this report.

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 with the 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.