Background to this inspection
Updated
8 March 2017
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was carried out to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
This inspection was carried out on 18 January 2017 and was unannounced. The inspection was carried out by two inspectors and an expert by experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
We did not ask the registered provider to complete a Provider Information Return (PIR) before this inspection. As part of our planning for this inspection we looked at records that were sent to us by the registered provider and the local authority to inform us of significant changes and events. We spoke with the local safeguarding team and commissioning team to obtain their feedback about the service.
We looked at four people’s care plans, risk assessments and associated records. We reviewed documentation that related to staff management and recruitment. We looked at records of the systems used to monitor the safety and quality of the service, menu records and the activities programme. We also sampled the services’ policies and procedures.
We spoke with five people who lived in the service and one person’s relative to gather their feedback. We spoke with the registered manager, head of care, four care staff, and catering staff as part of our inspection.
Updated
8 March 2017
Rosset Holt is a residential care home offering personal care and accommodation to older people and people who are living with dementia. The service is registered to accommodate a maximum of 18 people. The service does not provide nursing care. There were 13 people using the service at the time of the inspection. Rosset Holt is part of a charitable organisation that operates within Christian values. The registered manager told us that people of all faiths and of no faith were welcome to use the service.
This inspection was carried out on 18 January 2017 and was unannounced. The inspection was carried out by two inspectors and an expert by experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
There was a manager in post who was registered with the Care Quality Commission (CQC). A registered manager is a person who has registered with the 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.
At our inspection on 5 January 2016 we found breaches of regulation relating to personalised care, medicines, managing risks and governance. At this inspection we found that improvements had been made and sustained and the regulations were being met.
People told us they were very happy using the service and felt safe and well cared for. The registered manager had ensured the culture of the service was person centred and flexible to meet people’s needs and wishes. People’s spiritual and cultural needs were met. The values of the service were based on Christian beliefs, but people were supported to practice their own beliefs.
People were protected by staff that understood how to recognise and respond to signs of abuse. Risks to people’s wellbeing were assessed and staff knew what action they needed to take to keep people safe. Accidents and incidents were recorded and monitored to identify how the risks of recurrence could be reduced. The premises were safe, clean and hygienic. People had individual evacuation plans outlining the support and equipment they would need to safely evacuate the building. Staff understood how to reduce the risk of infection spreading in the service and they followed safe practice.
There was a sufficient number of staff on duty at all times to meet people’s needs in a safe way. We saw that staff had time to chat with people and support them with social activities in addition to meeting their health and care needs. The registered provider had systems in place to check the suitability of staff before they began working in the service. People and their relatives could be assured that staff were of good character and fit to carry out their duties. Staff had completed training and qualifications relevant to their role. The registered manager monitored staff training needs to ensure that staff were skilled and competent to meet people’s needs.
Staff identified and met people’s health needs. Where people’s needs changed they sought advice from healthcare professionals and reviewed their care plan. Records relating to the care of people using the service were accurate and complete to allow the registered manager to monitor their needs. People had enough to eat and drink and were supported to make choices about their meals. Staff knew about and provided for people’s dietary preferences and restrictions. Medicines were stored, administered, recorded and disposed of safely and correctly.
Staff communicated effectively with people and treated them with kindness and respect. They knew people well and understood what was important to them. People’s right to privacy was maintained. Staff promoted people’s independence and encouraged people to do as much as possible for themselves. Personalised care and support was provided at an appropriate pace for each person so that they did not feel rushed. Staff were responsive to people’s needs and requests.
Staff sought and obtained people’s consent before they helped them. People’s mental capacity was assessed when necessary about particular decisions. Meetings were held, when needed, to make decisions in people’s best interest, following the requirements of the Mental Capacity Act 2005. The requirements of the Mental Capacity Act 2005 had been followed in respect of depriving people of their liberty. However, the registered manager had not informed us when authorisations had been granted and not all staff were clear when these were in place. We have made a recommendation about this.
People were involved in making decisions about their care and treatment. Clear information about the service and how to complain was provided to people and visitors. The registered provider sought feedback from people and used the information to improve the service provided. People were involved in developing and improving the service through residents meetings, quality surveys and being involved in the recruitment of new staff. It was evident that people’s opinions were valued.
There was a system for monitoring the quality and safety of the service to identify any improvements that needed to be made. Staff felt supported in their roles.