Archived: Rose Brae Nursing and Residential Home

We spoke with seven relatives, two people who used the service, five staff and two other professionals involved in the care of people living in Rose Brae. We looked at five care plans and three staff files, plus other documentation related to the running and management of the home.

At the time of our visit, there were 30 people using the service and living at Rose Brae.

We last inspected this service in February 2014 and found that action was needed to address issues around consent to care and treatment and to the safety and suitability of premises. During this visit, we saw evidence that the provider had addressed these issues and that the service was now compliant.

Below is a summary of what we found. The summary describes what people using the service, their relatives and the staff told us, what we observed and the records we looked at.

If you want to see the evidence that supports our summary please read the full report.

Is the service safe?

People were treated with respect and dignity by the staff. People told us they felt safe. Safeguarding procedures were robust and staff understood how to safeguard the people they supported.

Systems were in place to make sure that managers and staff learn from events such as accidents and incidents, complaints, concerns, whistleblowing, safeguarding and investigations. This reduced the risks to people and helped the service to continually improve.

The home had proper policies and procedures in place in relation to the Mental Capacity Act and Deprivation of Liberty Safeguards. Relevant staff had been trained to understand when an application should be made, and how to submit one. This meant that people were safeguarded as required.

The service was safe, clean and hygienic. Equipment was well maintained and serviced regularly, therefore not putting people at unnecessary risk. The building was generally in a good state of repair and decoration.

The registered manager set the staff rotas and took people's care needs into account when making decisions about the numbers, qualifications, skills and experience required. This helped ensure that people's needs were always met. Recruitment practice was safe and thorough.

Is the service effective?

People told us that they were happy with the care they received and felt their needs were met. It was clear from what we saw and from speaking with staff that they understood people's care and support needs and that they knew them well. One person told us, "They give me the help I need without any query at all. They are wonderful. I cannot speak highly enough of them'.

Staff had received training to meet the needs of the people living at the home. One professional said, 'Staff work with me and are very forthcoming'.

Is the service caring?

People were supported by kind and attentive staff. We saw that care workers showed patience and gave encouragement when supporting people. People commented, 'I never feel rushed by the staff that help me, they don't do everything for me and help me to do things for myself'. A relative said, 'If I were not happy he wouldn't be here, it's like a home, their own home'.

People using the service, their relatives, friends and other professionals involved with the service completed an annual satisfaction survey. Where shortfalls or concerns were raised these were addressed.

People's preferences, interests and diverse needs had been recorded and care and support had been provided in accordance with people's wishes.

Is the service responsive?

People completed a range of activities within Rose Brae, regularly. The home welcomed visitors at all times of the day and night.

People we spoke with knew how to make a complaint if they were unhappy. We looked at how complaints had been dealt with, and found that the responses had been open, thorough, and timely. This showed us that that complaints were appropriately investigated and action taken where necessary. One relative told us that he had complained and that the issue had been dealt with to his satisfaction.

Is the service well-led?

The service worked well with other agencies and services to make sure people received their care in a joined up way. One professional told us, 'The manager is very supportive'.

Staff told us they were clear about their roles and responsibilities. Staff had a good understanding of the ethos of the home and quality assurance processes were in place. This helped to ensure that people received a good quality service at all times.

The provider now had a local safeguarding policy in place for staff to refer to. Staff had completed safeguarding training and were knowledgeable about the types and signs of abuse including who to contact if abuse was suspected or alleged.

We reviewed five staff files and found evidence that appropriate checks on the staff member's identity, employment history, good character and professional registration had been undertaken where appropriate. Records relating to staff appraisal, supervision and training were available in each file.

We saw that audits of the health and safety risks posed to people who lived at the home showed evidence that issues were addressed and satisfaction surveys had been sent to each person/and or their relative to enable the provider to come an informed view of the quality of the service they provided.

On the day of our visit however we found a lack of suitable procedures in place to ensure people consented to the support provided. For example, people were taken to a communal room without being asked if they wanted to go. We also found there were a number of premises related issues that required attention for example the passenger lift was out of order and there was old furniture and equipment both inside of the home and in the garden that posed a health and safety risk to people who lived at the home.

We reviewed three care records. We found people's needs were assessed and reviewed. Care records contained relevant information in relation to personal details, individual needs and preferences. Daily records indicated people had received the care and support needed. We saw people were offered sufficient food and drink and adequate nutrition.

The home did not have an internal safeguarding policy. Staff training in safeguarding was not up to date. Staff we spoke with had a limited understanding of the types of abuse and who to report concerns to. This meant the provider did not have suitable arrangements in place to safeguard people against the risk of abuse

We reviewed five staff records. Staff were not appropriately checked for suitability prior to employment and were not properly appraised, supported or trained to care for people. This meant the provider did not have suitable arrangements in place to ensure the selection and support of staff ensured good quality care.

Quality monitoring systems were in place to safeguard the health and safety of people but there was no evidence of suitable arrangements to manage the risks identified. People's views on the quality of the service provided were sought but not analysed to gain an informed view of the standard of care.