Archived: Roseworth Lodge Care Home

Updated 16 October 2015

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 was 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 took place on 25 August 2015 and was unannounced. This meant the staff and the registered provider did not know we would be visiting.

The inspection team consisted of two adult social care inspectors, one specialist professional advisor and an expert by experience. A specialist professional advisor is someone who has a specialism in the service being inspected such as a nurse. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service. The expert by experience had experience in caring for older people living with dementia.

Before we visited the home we checked the information we held about this location and the service provider. For example, inspection history, safeguarding notifications and complaints. No concerns had been raised. We also contacted professionals involved in caring for people who used the service, including commissioners, safeguarding staff and district nurses. No concerns were raised by any of these professionals.

We did not ask the registered provider to complete a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make.

During our inspection we spoke with 12 people who used the service and five family members. We also spoke with the regional manager, the manager, three nurse’s, four care workers, the head cook and the activity coordinator.

We undertook general observations and reviewed relevant records. These included three people’s care records, four staff files, audits and other relevant information such as policies and procedures. We looked around the home and saw some people’s bedrooms, bathrooms, the kitchen and communal areas.

Updated 16 October 2015

This inspection took place on 25 August 2015 and was unannounced inspection, which meant the staff and registered provider did not know we would be visiting.

Roseworth Lodge provides care and accommodation to a maximum number of 48 people. Accommodation was provided over two floors. Bedrooms are single and have ensuite facilities which consist of a toilet and hand wash basin. On the first floor of the home there is a designated unit for 12 people who are living with a dementia type illness. There are communal lounge areas on both the ground and first floor of the home. The home is close to shops, pubs and public transport.

The home had a manager in place who had been working there as the manager for two weeks and was going through the registration process with the Care Quality Commission (CQC) to become a registered manager. 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 the last inspection in October 2014 we found the registered provider did not meet regulations related to the management of medicines and consent to care and treatment. The registered provider sent us an action plan that detailed how they intended to take action to ensure compliance with these two regulations.

At this inspection we found that since the inspection of the service in October 2014, appropriate systems were now in place for the management of medicines so that people received their medicines safely, some minor issues still needed addressing and consent to care and treatment was sought.

We found that supervisions and appraisals had only taken place for some staff members and training was not fully up to date. The new manager had already recognised this and put an action plan in place.

We saw that people were involved in activities.

People nutritional needs were met and their individual preferences and wishes adhered to.

Staff we spoke with understood the principles and processes of safeguarding, as well as how to raise a safeguarding alert with the local authority. Not all staff had received training in safeguarding but said they would be confident to whistle blow [raise concerns about the home, staff practices or provider] if the need ever arose.

Assessments were undertaken to identify people’s health and support needs and any risks to people who used the service and others. Plans were in place to reduce the risks identified. Care plans provided evidence of access to healthcare professionals and services.

There were sufficient numbers of staff on duty to meet the needs of people using the service on the day of inspection but the manager felt that one more member of staff on a morning and evening was needed. Recruitment and selection procedures were in place and appropriate checks had been undertaken before staff began work.

All of the care records we looked at contained written consent for example consent to photographs and the care provided.

Any accidents and incidents were monitored by the manager to ensure any trends were identified. This system helped to ensure that any patterns of accidents and incidents could be identified and action taken to reduce any identified risks.

The home was clean, spacious and suitable for the people who used the service.

We saw safety checks and certificates that were all within the last twelve months for items that had been serviced such as fire equipment and water temperature checks.

The registered manager had knowledge of the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS). The manager understood when an application should be made, and how to submit one. CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. The Deprivation of Liberty Safeguards (DoLS) are part of the Mental Capacity Act 2005. They aim to make sure that people in care homes, hospitals and supported living are looked after in a way that does not inappropriately restrict their freedom. We discussed DoLS with the registered manager and looked at records. We found the provider was following the requirements in the DoLS. Not all staff we spoke with had a clear understanding of DoLS. We discussed this with the manager who said they would look into simplifying this for the staff and discussing it further at group supervision.

People who used the service, and family members, were complimentary about the standard of care. Staff told us that the home had an open, inclusive and positive culture.

Staff treated people with dignity and respect and helped to maintain people’s independence by encouraging them to care for themselves where possible..

Care records showed that people’s needs were assessed before they moved into the service and care plans were to be replaced with a new Four Seasons Care Plan which we were told would be less confusing.

The service had a comprehensive range of audits in place to check the quality and safety of the service and equipment

The registered provider had a complaints policy and procedure in place and complaints were documented on the services DATIX [computer] system. We could not get a full list of complaints due to some being documented in DATIX incorrectly.