Background to this inspection
Updated
1 December 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 planned 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.
The inspection was carried out on 19 October 2017 and was unannounced. The inspection team consisted of one adult social care inspector 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. In this case the expert-by-experience was experienced in the care of older people and people living with dementia.
During the inspection we spoke with six people who lived at the home, two visitors and two people’s relatives. We spoke with the provider, the registered manager, three care workers and the cook. We also spoke with a health professional who worked with the service.
We observed people being supported in the communal rooms and observed meal service at breakfast and lunch time. We looked at two people’s care records and other records such as medication records, meeting notes, accident and incident reports, training records and maintenance records. We looked around the home.
Before visiting the home we reviewed the information we held about the service which included notifications sent to us by the provider. We contacted the local authority commissioning and safeguarding teams to ask for their views of the service.
We asked the provider to complete a Provider Information Return (PIR). This is a document which gives the provider the opportunity to tell us about their service and any planned improvements. All this information was taken into consideration when we rated the service.
Updated
1 December 2017
Rosegarland is a large semi-detached property on the main Thornton Road approximately three miles from Bradford City centre. It is registered as a care home and accommodates up to eighteen older people in both single and twin bedrooms. Communal areas including the lounge and dining room are located on the ground floor of the premises. On the day of the inspection 14 people were living in the home.
We undertook the inspection on the 19 October 2017 and it was unannounced. We last inspected the service on 19 November 2014 and rated the service as ‘Good’ overall with the effective domain rated as ‘Requires Improvement’ as the home was not meeting the requirements of the Deprivation of Liberty Safeguards (DoLS) and training was not fully up-to-date. At this inspection, although these specific concerns had been addressed we rated the service as ‘Requires Improvement’ overall. We noted the registered manager had made recent improvements to some areas such as increasing night time and domestic staffing levels and undertaking work to the environment. However we identified shortfalls around the management of risk and care plan documentation. Due to this, we were unable to rate the service better than ‘Requires Improvement.’
There was a registered manager in place. 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.
We identified some risks that had not been effectively assessed and mitigated, for example around the provision of bed rails and some care plans did not contain sufficient detail to describe how risks were to be managed.
People said they felt safe and secure within the home. Safeguarding procedures were in place and we saw they had been followed to help keep people safe.
The premises was warm and homely. There were sufficient communal spaces for people to spend time. Safety checks were undertaken on the building to keep it safe.
There were enough staff deployed to ensure safe and prompt care. Recruitment procedures were in place, although documentation needed to better demonstrate why some recruitment decisions had been made.
Staff received a range of training and support. They said they felt well supported and received regular supervision and annual appraisal.
People received a varied diet. Most people spoke positively about the food. We found a pleasant atmosphere at lunchtime, although one person could have been provided with more assistance to help them eat their meal.
The service had made appropriate DoLS applications which were awaiting assessment by the local authority. Whilst we concluded the service was acting within the legal framework of the Mental Capacity Act (MCA), documentation needed improving to ensure this was evidenced in a clear way.
The service worked with a range of healthcare professionals to help ensure people’s healthcare needs were met.
People said staff were kind and caring and this was confirmed by our observations of care and support. Staff were patient with people and took the time to help reduce any distress people were experiencing.
The service helped people maintain their independence for example by encouraging them to mobilise independently around the home.
People’s care needs were assessed and plans of care developed. Staff knew people well which gave us assurance plans of care were followed. People’s cultural and religious preferences were sought and arrangements made to ensure they were met.
People had access to activities which were provided by the home. Staff spent time with people talking to them to help meet their social needs.
People spoke positively about the way the home was run. They said the management team was approachable. Staff said the service was well run and they would recommend the service to their own relatives. We found an open and inclusive atmosphere within the home.
Systems were in place to assess and monitor the quality of the service but some of these needed improving to ensure they captured the shortfalls that we identified. People said they were able to complain and found the management team approachable.
People’s feedback was sought and used to make improvements to the service.
We identified two breaches of the Health and Social Care Act 2008 (Regulated Activities) 2014 Regulations. You can see what action we asked the provider to take at the back of the report.