Archived: Rosedale Residential Home

We carried out a full comprehensive inspection because we had received information of concern from people’s families, staff and the local authority.

There was no registered manager. 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.

The provider did not have sufficient oversight of the management of the home to identify that people were receiving unsafe care.

There had been multiple concerns raised by people’s families and staff to CQC. These included people not receiving their medicines, people not having enough to drink, people being moved in an unsafe way and people not receiving their personal care. These had been raised as safeguarding alerts which had been investigated and substantiated. This meant that all of the concerns had been proven to be true.

CQC worked closely with the safeguarding team and the local authority that commissioned care from the home to keep people safe. Referrals were made to other agencies to provide training, guidance and support in areas such as fire safety, food hygiene, medicines management and moving and handling. These agencies continued to provide input into the home as there was insufficient management to implement the safe systems and embed them into practice.

The local authority placed a suspension on the home, preventing any new people from being admitted whilst the care was unsafe.

The provider considered the response from the agencies involved in people’s care and decided to close the home.

CQC worked with the safeguarding team and local authority to activate the home closure procedure recommended by the department of health.

At the time of inspection the local authority were carrying out daily visits to monitor the management of people’s care including the monitoring of staffing levels, medicines management, moving and handling, food hygiene and people’s health and well-being.

People were anxious about moving to a new home. The local authority had appointed care managers to support people to find a suitable new home. People’s risk assessments and care plans did not reflect all of peoples current care needs and this meant that people’s commissioners struggled to ascertain people’s specific care needs.

Staff did not have adequate supervision and people were not always receiving their planned care. People were not always receiving enough to drink to maintain their health and well-being. Food was not always stored in a safe way. This was being closely monitored by the local authority on a daily basis.

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’.

Services in special measures will be kept under review and, if we have not taken immediate action to propose to cancel the provider’s registration of the service, will be inspected again within six months.

The expectation is that providers found to have been providing inadequate care should have made significant improvements within this timeframe.

If not enough improvement is made within this timeframe so that there is still a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve.

This service will continue to be kept under review and, if needed, could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement so there is still a rating of inadequate for any key question or overall, we will take action to prevent the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration.

For adult social care services the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.

There were nine breaches of the regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The action we have taken can be seen at the end of the full report.

There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

The quality of the service was monitored by the audits regularly carried out by the registered manager, however, the service required more oversight and prompt action by the provider in carrying out timely repairs.

People were supported by a team of staff that had the managerial guidance and support they needed to do their job.

People were safeguarded from harm as the provider had systems in place to prevent, recognise and report any suspected signs of abuse. Staff knew their responsibilities as defined by the Mental Capacity Act 2005 (MCA 2005) and Deprivation of Liberty Safeguards (DoLS) and had applied that knowledge appropriately.

Staff understood the importance of obtaining people’s consent when supporting them with their daily living needs. People experienced caring relationships with the staff that provided good interaction by taking the time to listen and understand what people needed.

People’s needs were met in line with their individual care plans and assessed needs. Staff took time to get to know people and ensured that people’s care was tailored to their individual needs.

People’s care and support needs were continually monitored and reviewed to ensure that care was provided in the way that they needed.

There were sufficient numbers of experienced staff that were supported to carry out their roles to meet the assessed needs of people living at the home. Staff received training in areas that enabled them to understand and meet the care needs of each person.

People were supported to have sufficient to eat and drink to maintain a balanced diet. Staff monitored people’s health and well-being and ensured people had access to healthcare professionals when required. Medicines were managed safely.