28 November 2016
During a routine inspection
Roseway House is a purpose built care home providing nursing and residential care for up to 49 older people, some of whom are living with dementia. At the time of our inspection there were 34 people using the service. In July 2016 a new provider took over management responsibility for the home.
Since our last inspection the home had a new registered manager. 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.
Following our last inspection the provider had made progress to improve the management of medicines in the home. We found there were accurate records to confirm medicines were administered and stored correctly. All of the high priority areas identified in the fire risk assessment had been actioned and completed since we last visited the home.
The current gas safety certificate and legionella assessment were overdue. These had been arranged and would be completed by the end of December 2016. We have asked the provider to confirm what action they plan to take to protect people from risks posed by uncovered radiators in the home. We are dealing with this issue outside of this inspection.
Relatives and care workers told us the home was safe. They also gave us positive feedback about their care and the care workers providing this care. Risk assessments had been carried out to help keep people safe. For example, people were assessed against the risk of poor nutrition, skin damage and falling.
Care workers had a good understanding of safeguarding and the whistle blowing procedure. They knew how to raise concerns and said they did not have concerns about people’s safety. Safeguarding concerns had been dealt with in line with the agreed local procedures.
There were enough care workers to support people’s needs in a timely manner. People and relatives told us care workers responded quickly to their requests for help. Care workers also said there were enough staff.
The provider had effective recruitment checks in place. These included requesting references and Disclosure and Barring Service (DBS) checks.
Incidents and accidents had been logged, fully investigated and action taken to help keep people safe from harm.
Care workers were well supported in their role. One to one supervisions were on track following a period where opportunities for care workers to meet with their line manager had lapsed.
The provider followed the requirements of Mental Capacity Act 2005 (MCA). DoLS authorisations had been approved for all relevant people. Decisions made in people’s best interests were only made following a MCA assessment. Care workers had a good understanding of the MCA and knew how to support people with decision making.
People received support in line with their needs. Personalised care plans described the support people needed with meeting their nutritional needs including their preferences and any special dietary requirements.
People received regular input from external health professionals when required. A visiting health professional gave us positive feedback about the care people received at the home.
People’s needs had been assessed both before and after admission to the home. Not all people had a life history in their care records to help care workers better understand their needs. The registered manager said life histories and one page profiles were to be developed for each person.
Most care plans we viewed were personalised and included information about people’s specific needs and preferences. Care plans had been evaluated regularly to keep them up to date.
Relatives gave us mixed views about the activities provided. In particular they commented that people living on the first floor did not always have opportunities to take part in activities. They also commented that people sat for long periods in front of the television. We also observed this on a number of occasions during the inspection. The registered manager advised a second activity co-ordinator was due to start and the activity programme was to be reviewed. Activities were on-going during our visit such as ball games. Other activities available included playing cards, chatting, watching TV and looking at memory cards. Some people were supported to do small daily living tasks. We have made a recommendation about the provision of activities.
Meetings for people and family members were being re-launched as these had previously been infrequent. A meeting was to take place on the evening of the day we inspected the home.
Relatives knew how to complain if they had concerns about their family member’s care. Previous complaints received had been thoroughly investigated and resolved.
Relatives and care workers gave us positive feedback about the approachability of the registered manager. They also told us about the improvements made to the home, such as new flooring, the re-decoration programme, better support for care workers and improvements to the meals provided at the home.
We have asked the provider to send us the findings from the most recent consultation with people and relatives. This was not available when we inspected.
There was an effective quality assurance system in place. This included checks on medicines management, the quality of care plans and a nutritional audit. The audits had been successful in identifying areas for improvement and action had been taken to deliver these improvements.