Archived: Rose Court

We found the following examples of good practice.

The risks associated with Covid-19 were considered and plans were in place to mitigate these risks. At the entrance to the home there was clear guidance in place requesting staff and visitors to adhere to government guidance with respect to personal protective equipment (PPE).

Staff had received training on infection control and COVID- 19, and they understood the signs and symptoms that might indicate ill health which would require medical attention.

Staff took part in regular testing for COVID-19 and were vaccinated. They appropriately wore (PPE) to minimise the risk of infections spreading.

The layout of the building allowed for clear zoning if someone needed to self-isolate in their own room if they received a positive test result. Staff provided additional support and activities in people’s rooms if a person was self-isolating.

We found the following examples of good practice.

¿ Measures were in place to help reduce the risk of visitors catching or spreading infections. The provider was only allowing essential visitors into the building and relatives visits were conducted via a separate entry and exit point. The garden area had been arranged for socially distanced visits and the internal environment was also arranged for social distancing among people using the service. The provider arranged for relatives to sanitise their hands and wear masks before they met people. These measures had been communicated to relatives in writing and tablets were available for virtual meetings where relatives could not attend in person.

¿ The provider ensured there was enough Personal Protective Equipment (PPE) available for staff and visitors and there was a separate area available for the donning and doffing of PPE. All staff had received training in infection control procedures.

¿ Appropriate systems were in place when people were admitted to the home. All residents were assessed virtually or on the phone and were required to undertake a test for Covid 19 before moving into the home. Upon entry they were also required to undertake a period of isolation as a further precautionary measure before undertaking a further Covid 19 test to ensure they were free from infection before interacting with other people.

¿ The provider had implemented a programme of testing for both people using the service and staff which all parties participated in. At the time of our inspection, nobody using or working at the service had tested positive for Covid 19. Staff were restricted to the same area of the building to minimise the risk of spreading infections.

Further information is in the detailed findings below.

At the last inspection on the 2 June 2015 the service was rated Good.

This inspection took place on 15 and 28 September 2017. At this inspection we found the service remained Good and the registered provider continued to meet all of the fundamental standards.

There was not a registered manager in post. Since the last inspection, the registered manager of the service had left the service. The Care Quality Commission was informed of this change. The registered provider has identified a new home manager, who will transfer from one of the registered provider’s other locations and register with CQC. 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.

Staff understood how to protect people from harm and abuse. The registered provider had an embedded safeguarding process in place that supported actions staff took to protect people at risk.

Risks to people’s health and wellbeing were identified. A plan of action was developed, implemented and followed by staff to reduce risks occurring and to keep people safe.

The management of medicines for people continued to be safe. Staff administered medicines to people as prescribed. People’s medicines were ordered, stored, administered and disposed of in a safe way.

There continued to be enough safely recruited staff employed. Staff rotas showed enough staff were deployed during the day and night to meet people’s needs.

Staff continued to receive regular training, supervision, and appraisals. This provided staff with opportunities to become familiar with expectations of working at the service and with people, and to identify and improve their skills and knowledge in their roles.

People are supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. Staff supported people in line with the Mental Capacity Act 2005, and carried out mental capacity assessments and applied for Deprivation of Liberty Safeguards authorisations as appropriate.

Staff continued to meet people’s nutritional needs because they provided enough food and drink for them. People on specialist diets were supported with these as required.

Staff continued to provide support to people in a caring and compassionate way. Staff respected people in a way that protected their privacy and dignity.

People were supported by heath care professionals when required. When people’s healthcare needs changed staff sought support and advice from health care professionals to ensure they continued to meet people’s needs.

People’s needs were assessed to ensure these could be met at the service. Care and support was appropriately planned for people. People had a care plan in place that provided staff with guidance to help them meet people’s needs.

People and their relatives continued to be encouraged to make a complaint about the service where they were dissatisfied. The registered provider had a complaint process that people understood. People and their relatives were supported to make comments about the quality of care received.

The registered provider had an effective system in place to monitor, review and improve the service.

On 10 July 2013 the provider submitted an updated action plan in response to the June 2013 inspection and four further updates up to 27 August 2013. During this period the provider continued to provide additional management support to the home in improving service delivery. The provider also informed us that they had been successful in recruiting to the business manager and care manager positions. The local authority commissioners reported to us from their monitoring visits carried out at the service that there had been dramatic improvement in the areas of concern previously identified at the home. On 25 July 2013 they lifted the voluntary embargo on placements to the home that had been in place since May 2013.

At our inspection on 12 September 2013, we found the provider had made significant progress in implementing actions to address the concerns identified at our previous inspections. The planning and delivery of care now took account of people's individual needs and ensured their welfare and safety. There were appropriate arrangements in place to ensure that people were protected against the risks associated with the unsafe management of medicines. Suitable arrangements were now in place to support staff through appropriate training, supervision and appraisal.

The provider had met the requirements of the warning notices we issued after the previous inspection and now complied with the three regulations these related to.

People we spoke with were happy with the care and support they received and felt staff met their needs. One person said, 'Staff treat me very well, there is enough to do and we go on trips out. The food is nice and the laundry service is very good.'

In February 2013 the provider submitted an updated action plan in response to the January 2013 inspection and two further updates to the plan in March and May 2013. Since the previous inspection there have been further changes in the management of the home and an interim manager has been appointed pending the recruitment of a permanent appointment. The provider was also continuing to provide additional management support to the home in improving service delivery. In addition the provider had agreed with the local authority commissioners a temporary embargo on new placements at the home to allow time for improvements to be made.

At our inspection on 11 June 2013, we found for all three standards which did not meet our standards previously that action to address the concerns identified was still on-going or incomplete. Despite some improvement seen, we found continuing non-compliance for all three regulations. For two other standards we inspected we found the provider was meeting the standard: the service worked in co-operation with other providers and there were appropriate arrangements in place to protect people from abuse.

The six people we spoke with told us they were satisfied with their care. One person said, 'I know they are not family but they treat me alright.' Another said, 'When you are ill, they (the staff) try and make you well again.' However, the continuing non-compliance we identified meant that people were not sufficiently protected against the risks of receiving inappropriate or unsafe care and support.

In response to our previous inspection the provider had put in place a comprehensive action plan to address the concerns identified. We found that the provider had made some progress in implementing this action. The provider had also put additional management support into the home and had recently appointed a new care manager to lead on implementing service improvements. However, for all three regulations we inspected, action was ongoing or incomplete and despite some improvement seen, we found continuing non-compliance for all three regulations.

The three people we spoke with told us they were satisfied with their care. One person said, 'The staff are nice and all of my needs are being met at the moment.' Another said, 'I can't fault the home and was pleasantly surprised when I came here.' However, the continuing non-compliance we identified meant that people were not sufficiently protected against the risks of receiving inappropriate or unsafe care and support.

People we spoke with were mostly content with the care and support they received, although two people were unhappy about some of the activities they took part in. Two visitors said that they were happy with the way the home looked after their relatives. People's comments included:

'It's an OK place to live and the staff are helpful.'

'The food is OK and you get a good choice at breakfast. The carers are good'

This was a scheduled inspection but we took the opportunity to check that the provider had made improvements following our last inspection 23 September 2011. We also reviewed some additional standards not covered in our last inspection.

Although people told us they were satisfied with their care, we found other evidence that people were not always protected against the risks of receiving inappropriate or unsafe care and support.