All inspections: Rosedale Residential Home

This unannounced inspection took place on 14 July 2015. This service provides personal care for up to 17 older people some of whom were living with dementia. There were 17 people living at the home at the time of our inspection.

When we inspected the home in September and October 2014 we identified a number of areas where the provider needed to make improvements to the way in which care was delivered, monitored and to the staffing arrangements in place to support people. At this inspection we found that these improvements had been completed and that the required improvements had been made.

A number of changes in management had occurred since the last inspection. Staff spoke positively of the changes the new manager had made. The manager that had driven the changes to improve the service had left. Arrangements had been made for the deputy manager to act up as the registered manager for the service and they were in the process of applying to the Care Quality Commission for registration. 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 2008 and associated Regulations about how the service is run.

Quality monitoring of the service had been carried out, and improvements had been made to the environment as a result of this. People and their family members had been asked for feedback on the service and changes had been made as a result of feedback.

Care plans and activities had been developed with people and their relatives so that they were individualised. Staff knew the people who used the service very well and they were familiar with their requirements and had a good understanding of people’s needs and preferences. People received personalised care and support. People felt safe and comfortable in the home.

Safe recruitment practices were followed and staff were clear on their roles and responsibilities to safeguard people.

People were encouraged to make decisions about how their care was provided and their privacy and dignity were protected and promoted. Staff demonstrated their understanding of the Mental Capacity Act, 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS).

Peoples physical health needs were kept under regular review and people were supported by relevant health and social care professionals. People were supported to engage in activities that reflected their interests and supported their physical and mental well-being.

There were positive interactions between people living at the home and staff. People were listened to, their views were acknowledged and acted upon and care and support was delivered in the way that people chose and preferred. People using the service and their relatives knew how to raise a concern or make a complaint.

The inspection took place over four days, 23 and 30 September and 6 and 8 October 2014. The inspection was unannounced. At the last inspection on 3 April 2013 the provider was found to be meeting the regulations.

Rosedale Residential Home provides accommodation for people requiring personal care. The service can accommodate up to 19 people. At the time of our inspection there were 17 people using the service.

There was a registered manager in post at the time of the inspection. 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 2008 and associated Regulations about how the service is run.

People told us that they felt safe living at the home and there were systems in place to safeguard people from the risk of abuse. However, the provider and the registered manager did not always ensure all agencies involved in the safeguarding of adults were appropriately informed of safeguarding incidents.

The provider had a recruitment system in place and staff had received a Disclosure and Barring service (DBS) check. The DBS helps an employer make safer recruitment decisions and prevents unsuitable people from being employed. However, recruitment procedures had not been consistently applied and the provider had not checked some staff member’s previous work history or performance.

We observed that there were not enough staff on duty to ensure people received appropriate support and assistance with eating their lunchtime meal.

The provider had systems in place to ensure people received their medicines in a safe way.

There was a system of staff training and development in place; however this did not always ensure staff were suitably trained to meet people’s needs.

The registered manager and staff were aware of their responsibilities under the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS). The registered manager was in the process of submitting DoLS applications to the local authority for people who needed these safeguards.

People did not always receive care that maintained their dignity and human rights.

People received support to maintain their health and wellbeing and staff worked well with health professionals to ensure people were cared for. However, support to ensure people’s social needs were not always provided and there was an inconsistent approach to ensuring all people received support to undertake their hobbies and social interests.

Complaints were not always recorded appropriately. This made it difficult to evidence how people’s and relatives complaints were fully investigated and resolved, so far as practical to the satisfaction of the complainant.

The registered manager and the provider reacted positively to concerns raised with them about people and the service provided. There were systems in place to assess the quality of service provided; however risks were not always identified to improve the service people received.

The systems in place to gain the feedback from people using the service had not been fully implemented to make improvements in line with people’s views.

We found a number of breaches 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.

We spoke with two people who used the service. Both told us that they liked living at the home. One person, with whom we talked with at length, told us, "I'm happy here. I wouldn't want to be anywhere else. I'm well looked after. I choose when I get up and get ready in the mornings and I go to bed when I want to." They added, "There could be a few more interesting things to do, I don't always want to play board games. I'd like to do more things that stimulate me."

We found that staff were attentive to people's needs when they requested help with personal care. Staff spoke with people who used the service politely and with a reassuring manner. We saw four people spending time reading, watching or listening to television and having conversations. One person had been supported to attend a local community centre. Other people relaxed in one of two lounges or in their rooms.

The home was in the process of being redecorated.

The provider was registered to provide diagnostic and screening procedures and treatment of disease, disorder or injury but those activities were not in fact provided. The provider may therefore wish to deregister those activities.

We spoke to three people who used the service and relatives of another person. People's comments conveyed that they had a positive experience of the home. One person told us, "I wouldn't want to be anywhere else." They told us that they had been well cared for and that they had been supported to be as independent as they wanted to be. Another person who used the service told us that they were "well looked after", that they enjoyed the food that the home provided and that they were able to spend their time how they wanted. A third person told us, "The carers are good. Other residents seem to be happy." That person told us that they received all the help they required with personal care. Relatives told us that, "People seem quite happy here" and that their relation was well looked after and "always nice and clean."

We talked with people about how they spent their time. Some people were able to decide themselves what they wanted to do. One person told us, "I don't always want to be in a group. I want to do interesting things. Sometimes I'd like to have a ten minute conversation with a carer but they don't have time." Another person told us, "I think they could do with more staff sometimes." We saw people reading or watching television and one person played dominoes. People spent time in one of two lounges, a dining room or in their bedrooms.

People we spoke with told us that staff helped them with personal care and maintained their privacy and dignity. They told us the staff were very nice and helped them. They told us the food was nice and they had choices, and the menus were displayed on the dining room tables. One person told us if they did not feel well, they told the manager and staff, and they got the doctor out to see them.

There were 14 people living at the service when we visited on 3 October 2011. We spoke with five residents and two staff to ask for their comments and observations. We spent time in the company of residents. Some of the residents' communication skills had been affected by dementia. We observed their experience of care and assessed the quality of support they received.

We were told that residents felt involved in decisions made about their care and support. We were told that staff were very helpful and would always try to respond to residents' wishes. Three residents told us that they were happy but they would like more staff led activities such as board games and outings.

Archived: Rosedale Residential Home

All Inspections

14 July 2015

During a routine inspection

23, 30 September and 6, 8 October 2014

During a routine inspection

3 April 2013

During a routine inspection

17 October 2012

During a routine inspection

6 February 2012

During an inspection looking at part of the service

3 October 2011

During an inspection in response to concerns