Rosebank Lodge

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence. At our last assessment we rated this key question good. At this assessment, the rating has remained good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 67 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The service made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them. Staff completed a comprehensive assessment of each person's physical and emotional health care, dependency and communication needs either on admission or soon after. Staff completed functional assessments for people who needed them and took the time to understand people's behaviours. Care plans reflected a good understanding of people's needs, including their dependency and communication needs.

The service planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards. People received care and support from staff according to their individual assessed needs and wishes. For example, staff could recognise signs when people experienced emotional distress and knew how to support them to keep them safe. We observed staff supporting people with compassion when they were distressed. Staff were aware of what triggered an emotional response from people and tried to minimise these triggers as much as possible. In addition, the service ensured people remained in contact with people who were important to them and facilitated visits.

The service worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services. The provider worked in partnership with various health and social care professionals and agencies, both internally and externally, who regularly liaised with the care home. This included the providers own positive behavioural support and wellbeing teams and external community-based GPs, district nurses, local authority social workers and speech and language therapists. We found recorded evidence of guidance and advice various external health and social care professionals and bodies described above had provided staff to help them meet the needs of people living or staying at the care home.

The service supported people to manage their health and wellbeing to maximise their independence, choice and control. The service supported people to live healthier lives and where possible, reduce their future needs for care and support. People were supported to access external health care professionals in a timely manner, this included supporting them when they expressed that they were in pain or discomfort or showing signs of an infection. People had health actions plans and hospital passports in place which were used by health and social care professionals to support them in the way they needed. People were supported to attend annual health checks, screening and primary care services. Staff ensured people routinely attended scheduled health care appointments and had regular check-ups with a range of community health and social care professionals including GP’s and district nurses. In addition, people received support to eat and drink enough to maintain a balanced diet.

The service did not always routinely monitor people’s care and treatment to continuously improve it. They did not always ensure that outcomes were positive and consistent, or that they met both clinical expectations and the expectations of people themselves. The outcome of all the audits, monitoring checks and feedback the provider received from stakeholders were not always routinely or effectively analysed. This meant issues, themes and patterns were not always identified, lessons learnt and action plans developed to improve the quality and safely of the service people living at the care home received.

The service did not always tell people about their rights around consent and did not always respect their rights when delivering care and treatment. Managers confirmed the restrictive practice of locking a person in their bedroom to keep them safe at the request of a family member and staff routinely locking other people’s bedroom doors when they were providing personal care had been customary practice within the service. Although this unacceptable restrictive practice had now ceased, this showed a lack of understanding around consent. Managers and staff told us about the rationale behind this restrictive practice was to prevent other service users from entering people’s bedrooms uninvited. Managers and staff had clearly not considered the least restrictive option when supporting people to keep them safe and used restrictive practices in an unjustified, disproportionate and illegal way. However, staff knew about people's capacity to make decisions through verbal or non-verbal means and this was well documented. For people that the service assessed as lacking mental capacity for certain decisions, staff clearly recorded assessments and any best interest decisions. The service had liaised with the appropriate authorities to deprive people of their liberty to ensure their safety under the Deprivation of Liberty Safeguards (DOLs) process. Staff organised for these arrangements to be regularly reviewed to ensure they remained appropriate for each person.