25 July 2018
During a routine inspection
Following concerns raised by the local authority, we carried out a comprehensive inspection in October 2017 and found continued breaches of regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 (Part 3). The service was rated ‘Inadequate’ and placed into special measures. We took immediate enforcement action to restrict admissions to the service and sent an urgent action letter regarding the seriousness of our concerns. The provider submitted an action plan to address our concerns and to ensure compliance with the regulations. We met with the provider and placed conditions on the provider’s registration to encourage improvement.
You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Rosier Home on our website at www.cqc.org.uk
We undertook this comprehensive inspection on 25, 30 and 31 July and 1 August 2018 to check that the registered provider had made the required improvements and to confirm they now met legal requirements.
This service has been in Special Measures. Services that are in Special Measures are kept under review and inspected again within six months. We expect services to make significant improvements within this timeframe. During this inspection the service demonstrated to us that improvements have been made and is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is now out of Special Measures.
Rosier Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The care home accommodates up to 16 older people who may have dementia.
Rosier Home is situated in a quiet residential area and is close to the seafront and amenities. The premises is on two floors with each person having their own individual bedroom and communal areas are available within the service. At the time of our inspection, nine people were using the service.
There was a registered manager in post. The registered manager was also the provider. 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.
Since our last inspection of the service, some improvements had been made, however, we found a continued breach of Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 (Part 3). Further improvements were still required to ensure the quality assurance arrangements were robust and effective to drive and sustain improvements; and to achieve compliance with regulatory requirements.
The managerial oversight in the service had improved and the registered manager was more pro-active. However, the auditing and monitoring systems had not been effective in identifying the concerns found during this inspection and these needed to be improved, embedded and sustained.
Staffing levels had been reviewed and there were sufficient numbers of staff on duty to support people and meet their needs and people were provided with adequate supervision, stimulation and meaningful activity.
Safe processes were in place for the administration of medicines and there were procedures and processes in place to ensure the safety of the people who used the service. However, improvements were required around cleanliness and ensuring that equipment was fit for purpose.
There were systems in place to safeguard people from abuse and the recruitment of staff was safely completed to make sure that they were suitable to work in the service. Staff were aware of their responsibilities and knew how to report any concerns, although they had not received any recent training.
Training for staff was still not managed effectively. The training that staff had received was not always recorded and some training updates were required. Staff did not demonstrate an understanding of the Mental Capacity Act (MCA) and Deprivation of Liberty Safeguards (DoLS.)
People were supported to have maximum choice and control of their lives and staff did supported them in the least restrictive way possible, although the recording of best interest decisions required improvement.
People were supported effectively with their nutritional needs and received personalised care from a staff team who respected their privacy and dignity and promoted their independence.