Archived: Rosywood Care Services

The detailed evidence supporting our summary can be read in our full report.

We have taken enforcement action against Rosywood Care Services to protect the health, safety and welfare of people using this service.

Is the service safe?

People told us they felt safe with staff. Relatives also thought people were safe in the service.

Staff had been aware about care plans, and support plans had been written for people with particular needs. Some plans did not contain sufficient detail to promote people's welfare. Risk assessments for identified conditions had not been in place.

We saw evidence that all people had not always received medical treatment when they were ill.

This meant that people were not fully safe in the service. We are taking enforcement action on the agency, which aims to ensure that action will be taken to ensure people's needs are met. If the agency does not comply. We have a range of further enforcement powers which we can use to protect peoples' welfare.

Is the service effective?

People's health and care needs had largely been assessed but care plans did not always cover peoples' needs.

More detail was needed in some plans to ensure people got the right care. Some people and relatives said they could not fully communicate with some staff due to language problems.

A majority of the people and their relatives we spoke with told us that some calls had been very late time and that staff sometimes did not turn up to calls. They also said that cares had constantly changed which bothered them as they liked to have carers who they knew and who knew how to meet their needs.

We found that staff had not received comprehensive training and support to enable them to have the knowledge and skills to meet peoples' needs.

This did not confirm that the service had always been effective in meeting people's needs. We are taking action which aims to ensure that people's needs will be met.

Is the service caring?

Most people we spoke with told us that on the whole staff were friendly and caring. One person said; 'staff are friendly.' The relatives we spoke with also said that staff most were kind and caring. One relative said, 'some staff are really good.'

People told us they had been supplied with an annual satisfaction survey. This meant they were able to comment on the service provided. However, at the time of the inspection, this had not been provided to relatives, staff or relevant professionals. This meant these groups of people had not been able to make their views known and appropriate action taken as needed to help provide a better service for people.

Is the service responsive?

A number of people said they had complained, particularly about the lateness of calls or missed calls. Whist some people said some action had been taken to put this right, others said it had not improved.

Relatives told us when they told management about anything that had concerned them, it had not always been put right. This meant people were at risk of being provided with poor care when action could have been taken earlier to prevent this.

We saw no evidence of an action plan produced from surveys. This would have helped to ensure people were not at risk of receiving inadequate quality care. We are taking action which aims to ensure that the agency will be taking steps to ensure systems are in place to meet peoples' needs.

Is the service well-led?

The service had some systems to check that care was of good quality. Some important aspects of the service had not been fully checked.

Staff had only received infrequent supervision to check their competence and provide them with support. This meant staff had limited discussion about important features such as staff training, the provision of care to people and whether staff had any concerns.

There were no quality assurance systems in place to check on essential issues such as staff call times, staff training and medication. This meant that issues had not been systematically identified and acted upon. We are taking action which aims to ensure that people's needs will be met in the future.

Information we received from a whistleblower said that staff had left due to the new transport policy of the agency which incurred higher costs for staff. This was largely the reason why there were not enough staff to meet calls. The manager told us this issue would be reviewed.

The detailed evidence supporting our summary can be read in our full report.

Is the service safe?

People told us they felt safe. They said that they felt their rights and dignity were respected by staff.

Staff had been aware about care plans, and support plans had been written for people with particular needs. Some plans did not contain sufficient detail to promote people's welfare.

All essential checks had not been carried out for all staff. This did not entirely protect people from unnecessary risk of harm or promote their welfare.

A proper safeguarding system was in place to protect people from abuse. Staff had been aware of how to contact relevant agencies to report any concerns to.

Is the service effective?

People's health and care needs had been assessed and care plans were in place. However, there was no evidence in plans of people being involved in assessments of their needs and planning their care. People had not signed their care plans agreeing to the care they received.

People and their relatives told us that care workers changed a lot. They had staff that had not been fully aware of their needs. They also said that staff could be up to two hours late for calls.

Although peoples' needs had been assessed and included in care plans, more detail was needed in some plans to ensure people got the right care. Plans had not been reviewed regularly. People and their relatives told us that they had not been invited to reviews of the care of their relatives.

This did not entirely confirm that the service had always been effective in meeting people's needs.

Is the service caring?

Five people told us that staff had supported them properly. One person said, 'I have no problem with staff. They help me in any way I ask them to.'

Some people and most relatives told us they could not remember having completed an annual satisfaction survey. This meant they were not able to comment on the service provided.

We saw no evidence of an action plan produced from surveys. This would have helped to ensure people were not at risk of not receiving good quality care.

Is the service responsive?

No one said they needed to make a complaint. People told us when they told the office manager about anything that had concerned them; the manager had tried to put it right.

Is the service well-led?

Staff told us that if they witnessed or heard of poor practice they would report their concerns to their management.

The service had some systems of a quality assurance system. We saw that staff had been spot checked to ensure care was meeting the needs of people.

Staff received supervision to check their competence and provide them with support. However, there were no specific audits in place to check that specific issues were working well such as care being on time, continuity of care for people, care plans, medication and staff recruitment. Therefore there was no evidence of shortfalls being identified and addressed. There was also no system in place to give staff the opportunity to provide feedback to management, so their knowledge and experience had not been taken into account.

We looked at the care records of three people who used the service and found care plans provided clear guidance to staff about how the persons' care should be delivered. These took into account people's individual needs and safety.

Our inspection of 8 October 2013 found that the process for recruiting care workers had not always been effective and that care workers had not been properly supported to deliver safe and effective care.

The service wrote to us to tell us about the changes they were making. At this inspection we found that the service had made sufficient improvements to achieve compliance with these standards. Staff had been appropriately screened to ensure they were suitable to work with vulnerable people. We also found that the provider now had appropriate arrangements in place to ensure staff received adequate training and support to enable them to carry out their roles effectively.

We spoke with several people who used the service and their relatives. People told us they were satisfied with the care they were receiving. People were complimentary about the carers and felt comfortable with the care being provided.

We looked at the records of five people who used the service and found care plans provided clear guidance to staff about how the persons' care should be delivered.

We found that there were enough staff to meet the needs of people who used the service. However, staff had not always been appropriately screened to ensure they were suitable to work with vulnerable people. We also found that the provider did not have suitable arrangements in place to ensure staff received adequate training and support to enable them to carry out their roles effectively.