Rosebank

On this page

• 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

We assessed 8 quality statements in the safe key question and found areas of good practice. Our rating for this key question is good. The provider promoted a culture of learning and improvement, not only amongst staff but also with people. Best practice guidance was used to help further improve standards in the safety and quality of the care being provided. Leaders were capable, transparent and compassionate and were well thought of by people and staff alike. Leaders were visible in the service and adopted a hands on approach to people’s care and support. Roles of responsibility and governance processes were in place to help identify current areas of risk. Any shortfalls in practice were identified and actions put in place to help drive-up improvements in the quality of care and support being delivered. Policies and practices were in place to ensure the voices of staff and people were heard, helping to ensure input from both was valued and acted on. The provider worked in collaboration with both in-house and external health care providers to ensure people received the support they required and to help improve the quality of people’s experiences and outcomes. The provider was aware of potential impact of their activities on the environment and were making a positive contribution to help reduce it. There had been a significant reduction in the use of paper by the introduction of electronic record keeping.

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.

Feedback from leaders confirmed staff understood a shared vision and strategy which had been developed through a structured planning process in collaboration with people who used the service, staff and external partners. The registered manager described the culture and the ethos of the service as being, “The person is at the centre of their care and their care and support is considered with them, nothing is done to them, it's done with them, we provide all the information they need for them to make the best possible decision.” Staff understood the vision and values of the service and they felt fully involved in decisions about the service. Staff described a positive culture and good morale across the whole team. Staff were complementary of the management team and described them as being as approachable, fair and supportive. Staff told us they felt empowered to share their views and opinions with managers at all levels. Staff also confirmed they attended regular team meetings and took an active part in them.

Processes were in place to help staff and leaders demonstrate a positive, compassionate, listening culture, focused on learning and improvement. These included the use of regular meetings to discuss any shortfalls in the safety and quality of the service, to help further enhance the positive experience of care and support people received. Policies were in place to help ensure equality and diversity were promoted. We saw how people’s protected characteristics were valued and did not act as a barrier to the accessing care and support they needed.

Feedback from leaders confirmed the organisational vision was understood and delivered by staff and managers were visible. Staff described managers as approachable, fair and supportive. Staff told us about how there had been opportunities to progress within their role and how managers supported them to work flexibly around any personal circumstances they had.

Processes were in place to recognise and reward positive staff practices, which evidenced leaders were compassionate and inclusive. The management team were visible throughout the service and adopted a hands-on approach to the care and support of the people. This helped instil a positive culture which was adopted and practised by staff. Such practices helped to ensure staff were well supported and this helped with staff retention. Many of the staff working at the service had been there since its beginning.

Managers promoted a culture of speaking up in the home. The registered manager told us, “I encourage staff to raise any concerns, I have an open door. I reach out and speak to staff every day and ask them how they are, staff can email me if needed and can ask me anything. I am visible and have a shared office with the staff.” Staff felt able to feed back their views in various formats such as written surveys and face to face meetings.

Processes were in place to help ensure concerns were raised and that leaders investigated appropriately. Lessons were shared and acted on. The managers were aware of their responsibilities under their duty of candour, meaning that when something went wrong, people received a timely apology, and actions were taken to prevent the same happening again.

Feedback from leaders confirmed action was taken to help prevent any disparities in the experience of staff with protected equality characteristics. The registered manager confirmed, “We use staff risk assessments to help assess any specific and unique needs. We have a ‘mental health first aider’ for support and staff can go to any of the management team.” Staff told us they were treated fairly and were confident their feedback was used to make positive changes to the service.

Processes were in place which helped to protect the rights of staff under the Equality Act. Risk assessments and any reasonable adjustment measures were utilised if required. This helped to create a more equitable and inclusive organisation.

Feedback from staff and leaders confirmed information was used effectively to monitor and help further improve the quality of care. Recognised standards and best practice guidance were used to help improve equity in experience and positive outcomes for people. The registered manager explained that in addition to their own checks and audits, the provider would also carry out checks to help ensure the best possible standards for people were being met. Staff told us regular audits and checks were completed by managers at all levels and areas identified for improvement were shared with them. Staff said they were made aware of any areas that needed improving and guidance on how they could contribute. Staff understood their role and responsibilities and the management structure. Staff knew of their responsibilities for ensuring people's records were well maintained and stored securely.

Processes were in place to help ensure effective governance, management and accountability. Policies and procedures helped staff understand their role and responsibilities. Managers were able to account for the actions, behaviours and performance of staff. For example, by using supervision, appraisal and competency checks. Systems to manage current and future performance and risks to the quality of the service, allowed a proportionate approach to managing risk. A thorough analysis was carried out for each person to help understand people’s risks and implement tailor made support to manage and mitigate risks as far as possible. Audits and governance processes such as the analysis of accidents and incidents, helped ensure the provider had an accurate picture of risk to the safety and quality of the service at any one time. Knowledge was shared across the staff teams. An open-door policy provided open and transparent communication, enabling staff to raise any issues or suggestions for improved practices.

People told us staff supported them to access the community including services they used to support their health and well-being.

Feedback from staff and leaders confirmed they were open and transparent, and collaborated with relevant external stakeholders and agencies. The registered manager explained how people had built up positive relationships in their local community which helped aid their independence, they told us, “Some of our people go to the local shops regularly, they have built up good and trusting relations with the shop owners. People have positive links to the community.” Staff told us they supported people to access the facilities in the local community such as shops, cinemas, cafes and pubs.

Feedback from partners confirmed managers collaborated with all relevant external stakeholders and agencies to support care provision and joined-up care for people. One external professional told us, “The team showed this by constantly attending complex and challenging meetings to ensure the needs of their service user were considered and supported. They also advocated and offered solution focused suggestions during difficult discussions.” Another professional commented, “The staff, leaders and managers are open and transparent and aim to collaborate with all relevant agencies and wider teams. The model of care is new and promoting the aims of the model is an ongoing process. However, they have demonstrated that they are working hard to collaborate and inform other agencies to their model of care.”

Processes were in place to help people receive the best possible outcome with regards to their care and support. People’s care and support records evidenced how staff worked with external partners to help ensure people received the right care and support to meet their needs in a holistic way. The provider worked closely with external professionals and any advice provided had been adopted into the care plan for staff to follow.

Feedback from leaders confirmed they had a good understanding of how to make improvement happen. The approach used was consistent and included measuring outcomes and impact. The registered manager explained how people would be involved in a share learning approach, for example, to reflect on and discuss any incidents they may have been involved in. Staff told us there were involved in discussions which focused on learning and improvements, during handovers, meetings and supervision sessions.

Processes were in place to help to ensure learning happened when things went wrong. Regular staff meetings and handovers were used to communicate important information about people and to discuss and explore any recent incidents. These meetings were also used as opportunities to learn and to consistently improve practice. Staff were supported to develop their skills around improvement and innovation, and could request additional training for topics they had an interest in or felt they required to help better meet the needs of people. Leaders encouraged staff to speak up at any time with ideas for improvement and innovation. The provider fostered strong external relationships to help support improvement and innovation. For example, the provider worked closely with professionals who were pivotal to people’s care, such as designated nurses and social workers. This collaborative working helped achieve the best possible outcomes for people.