Roop Cottage Residential Home

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• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

This key question has been rated requires improvement. Improvements were required to ensure risks to people's health, safety and welfare were consistently updated. There were updated systems for learning lessons went things went wrong but further improvements were required to ensure these were fully embedded. Robust procedures were in place to recruit staff and there were enough trained and skilled staff to support safely. Medicines were managed safely. The home was clean, accessible and well maintained.

This service scored 59 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We did not receive any specific feedback on this subject from people and relatives. Overall their feedback about the quality and safety of the service was positive.

The provider demonstrated a commitment to learning and improvement. They acknowledged the shortfalls in the current processes and plans were in place to address this.

Improvements were required to the provider's systems to investigate and evidence lessons were learned in order to improve good practice and embed learning. Accidents, incidents and complaints were reported. Whilst we found evidence they were reviewed by the management team, documentation was not always clear and not all accidents had been reviewed promptly. There was no overarching summary of events which meant wider themes and trends had not always been analyzed in order to learn lessons.

We did not receive any specific feedback on this quality statement from people and relatives. Overall feedback about the quality of the service was good.

Staff understood their role in supporting people to access appointments. One staff member said, “Depending on the needs of the resident, staff contact the professionals about any concerns and where necessary staff attend the appointment with the person and relatives. Staff put information of the outcome of the appointment in people’s care plan, inform family and share the information with staff members." The manager told us they had developed a new Admissions Policy and assessment to support future admissions to the home.

We received some positive feedback from partners about recent improvements at the home.

Processes were in place to support people transferring safely between services, including health appointments and admissions to hospital.

People and relatives told us they felt safe living at Roop Cottage. Comments included, "I feel safer here than at home" and, "My relative is very safe here. It is like home from home."

Staff said they had completed safeguarding training. Staff understood what action to take if they observed abuse or poor care. The manager told us they checked out staff knowledge and understanding through supervisions and regular discussions in flash and handover meetings.

We did not observe any safeguarding events over the course of our site visits. Observations indicated care and support was provided safely.

Processes were in place to identify and monitor safeguarding referrals. A safeguarding log was maintained but improvements were required to ensure details about any actions taken to mitigate any future risks were clearly recorded. Systems were in place to ensure people's personal finances were managed safely.

People and relatives told us they felt supported safely with their care, including those who needed staff support with moving and handling. One person said, "Staff are very good and I always feel safe when they are helping me." A relative told us staff were kind and gentle when using the hoist to support their relative. They said, "They [staff] always said what they were going to do, checking [name of relative] understood and was happy with everything."

Staff were able to demonstrate a good understanding of the risks people were exposed to and how to support them safely. They told us communication was good and they were able to access information they needed in people's care plans and risk assessments.

We observed staff provided care and support safely. Where people required support with moving and handling safe techniques were used and staff supported people patiently and kindly. Staff ensured the communal areas and people's bedrooms were clean and free from hazards. Where people were assessed to need sensor mats and utensils for eating and drinking these were in place.

Processes were in place to manage risks to people's health and welfare. Key risk assessments were in place to covers areas such mobility, skin integrity and nutrition and hydration and there was evidence they were regularly reviewed. We identified some minor gaps and inconsistencies. For example, one person's risk assessments indicated they were cared for in bed but we observed they were in the communal areas of the home on both days of our assessment. The manager was aware further improvements were required and we were assured this would be addressed. On the second day of the assessment areas we had highlighted had been fully addressed.

People and relatives did not raise any concerns about the environment and the safety of the home. One relative told us they had seen improvements and the communal areas had been recently decorated.

The provider told us there were ongoing improvements planned to improve the environment including making Roop Cottage more homely and dementia friendly. There were also plans to improve the outdoor space with an upgraded summer house.

We observed overall the home was maintained safely. There was a maintenance worker on site who responded promptly to minor repairs and refurbishment jobs. Equipment such as wheelchairs and bathing and shower facilities were well maintained. Some areas of the home required redecoration but this was part of the refurbishment plan which was ongoing.

The provider had systems in place to ensure the building was maintained safely, including regular checks and audits. There was an ongoing programme of refurbishment.

Most people and relatives told us there were enough staff on duty to support them safely. Comments included, "If I press the call bell staff seem to be with me very quickly." One family member said they thought there could be more staff on duty at night but did not raise any specific concerns. There were no concerns raised about staff having the appropriate training to carry out their role. One relative said, "I do not know what training the staff are given but there has been never anything to suggest the staff do not know what they are doing."

Staff told us there were enough staff on duty to support people safely.

We observed there were enough skilled staff to support people safely. People received support from staff in a timely way and staff did appear rushed when they were offering care and support to people. Where people were being cared for in their rooms staff responded promptly when support was requested. There was a good presence in the communal areas of the home. We did not have any concerns about staff's knowledge and skills during our observations.

The provider followed robust staffing processes to ensure staff were recruited, inducted and trained to carry out their roles safely. The provider used a recognised dependency tool to identify staffing levels. This was reviewed regularly to ensure there were enough staff on duty to meet people's needs.

Most people told us their rooms were kept clean and tidy. One relative said, " The room was spotless, as was [name of relatives'] clothing and bedding." One person said their room was not always kept clean. People and relatives reported staff wore personal protective equipment when required.

Staff were able to tell us about good infection, prevention and control practices. The manager confirmed they carried out regular observations to highlight compliance and good practice.

We observed staff followed safe infection, prevention and control measures. This included wearing uniforms and personal protective equipment (PPE) when required. PPE was readily available in strategic areas of the home. We also observed staff supporting people to clean their hands with wet wipes before being offered meals and snacks.

Processes were in place to ensure compliance with infection, prevention and control standards. There was an up to date policy and staff had relevant training to support their knowledge and practice. Regular audits were carried out and action taken to address any issues identified. There were detailed cleaning schedules in place and regular housekeeping and cleaning of people's bedrooms and communal areas. .

People and relatives told us they received their medication at the right time. One relative told us they always visited in a morning and their relative received their medication at the same time every day.

Staff said they received good training and support in relation to their role in administering medicines safely.

Overall medicines were managed safely and medication records were generally clear to support safe administration. People received their medication on time. Where people were prescribed medicines to be administered 'as required' clear guidance and protocols were in place. Some instructions for topical medicines were not clear but the manager spoke with the GP during our assessment in order to address this. Rotation charts were in place to monitor the positioning of patches but they did not always follow the required guidance. We discussed this with the manager and were assured they would address this. Staff had received up to date medication training and had regular assessments to demonstrate their competence.