Archived: Roseville Care Centre

Updated 24 March 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.

This inspection took place on 24 and 25 January 2017. The visit commenced at 6am so we could meet the night staff and look at nightshift practices. At the time of our inspection 93 people were using the service.

The inspection team consisted of two adult social care inspectors, an inspection manager, a pharmacist inspector and two experts 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.

We reviewed information we held about the service, including the notifications we had received from the registered provider. Notifications are changes, events or incidents the provider is legally obliged to send us within required timescales.

We contacted external healthcare professionals to gain their views of the service provided at the service. We spoke with relatives who had contacted us previously about the operation of the service.

We spoke with 18 people individually and a group of 12 people who used the service; seven relatives during the inspection and two relatives who contacted us following the visit. We spoke with 27 members of staff, including the director of operations, the registered manager, the deputy manager, a unit leader, two nurses, clinical lead, four senior carers, ten care staff, the head of housekeeping, an activity coordinator, the cook, assistant cook, kitchen assistants and three maintenance staff. We looked at ten care records, Medicine Administration Records (MARs), six staff files, including recruitment records, as well as records relating to the management of the service.

We looked around the service and went into some people’s bedrooms (with their permission), all of the bathrooms and the communal areas. We observed how staff engaged with people during activities.

Updated 24 March 2017

We inspected Roseville Care Centre on 24 and 25 January 2017. This was an unannounced inspection which meant that the staff and registered provider did not know that we would be visiting.

We last inspected the home in November 2015 and found people had limited access to activities; evidence that people had consented to their care was not always available; the dining experience required improvement; there were gaps in staff training and supervision; there were insufficient staff; the management of cleaning products needed to be improved; medication administration arrangements needed to be enhanced; and the performance management and audit systems needed to be improved. We found that the home was breaching regulation 12 (Safe care and treatment), regulation 17 (Good Governance) and regulation 18 (Staffing). We rated Roseville Care Centre as requires improvement in four domains.

Roseville Care Centre is a large residential and nursing home situated in Ingleby Barwick. It has a three storey building and two storey annexe which are currently divided in to five units. All floors are accessible by lift. There are lounges, dining rooms and bathrooms on all floors and bedrooms are en suite. The service provides care and support for people with nursing care needs, dementia and those who require residential support. It is registered to provide care and support for 103 people. At the time of the inspection 93 people used the service.

The home has had a registered manager since October 2010. 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 registered provider sent us information, in the form of an action plan, which detailed the action they would take to make improvements at the service.

At this inspection we found the action the registered provider and registered manager had taken had made significant improvements to the way the service was run. The registered provider had increased the support provided to the registered manager by creating more deputy manager roles and reviewing the clinical lead role. The team had worked collaboratively to ensure all of the previous breaches of regulation were addressed.

The registered manager with the support of the registered provider had introduced a full and comprehensive assessment and monitoring system. They were in the process of delegating some of the tasks within this system across the new management team. We found that the system had improved the care being provided to people, staff training and staffing levels as well as the management of cleaning products and fire risk assessments.

We found that although some improvements had been made to the management of medication, further work was needed to ensure all medication was administered in line with people's prescriptions.

People told us they were happy with the service and felt the staff did a good job. We heard how people felt the service was well-run and that the registered manager was extremely effective.

We found that since the last inspection and feedback from relatives meetings the registered manager had sought to improve the range of activities that were available. Additional activity coordinators had been employed so people could be engaged in meaningful occupation seven days a week. People told us that in recent months stimulating and engaging activities were being provided at the home. We saw that there were enough staff to support people to undertake activities in the service and community. We saw there was a full programme of activity provided through the week at the service. During the visit we enjoyed joining people for a coffee morning and quiz.

The registered manager told us that on the nursing unit this was an area they continued to work on as people were often unable to join group activities so they had asked the activity co-ordinator to look at the one-to-one activities that could be provided. We saw the activities coordinator was already starting to work on increasing the available activities on the nursing unit and while we were there we saw people enjoying aromatic massages.

People’s care plans were tailored for them as individuals and created with them and their family involvement. People were cared for by staff that knew them really well and understood how to support them. We observed that staff had developed very positive relationships with the people who used the service. The interactions between people and staff were jovial and supportive. Staff were kind and respectful. We saw that they were aware of how to respect people’s privacy and dignity.

Staff were supported and had the benefit of a programme of training that enabled them to ensure they could provide the best possible care and support. Staff were all clear that they worked as a team and for the benefit of the people who lived at the service.

The registered manager understood the complaints process and detailed how they would investigate any concerns. The registered manager took on board the issues raised in complaints so for example had improved the care records by introducing a one-page summary sheet, as a family member pointed out this could readily assist staff to understand people’s needs.

The operations manager discussed with us how they were supporting the team to fully incorporate a reflective learning culture in the service. This type of reflection allows staff to critically review even the smallest of incident in order to determine what lessons could be learnt so improvements to staff practice can be made.

The registered manager and staff had a clear understanding of safeguarding. The registered manager had ensured staff training and supervision were up to date.

We found that there were enough staff on duty to meet people’s needs. The registered manager had closely considered people’s needs and ensured there were sufficient numbers of staff.

Where people had difficulty making decisions we saw that staff worked with them to work out what they felt was best. Staff understood the requirements of the Mental Capacity Act 2005 and had appropriately requested Deprivation of Liberty Safeguard (DoLS) authorisations.

People told us they were offered plenty to eat and we observed staff to assist individuals to have sufficient healthy food and drinks to ensure that their nutritional needs were met. The cook provided home cooked meals, including dietary specific such as vegan and vegetarian meals. They also provided a range of fortified and adapted meals for people who needed extra calories to ensure they maintained their weight. People were supported to maintain good health.

Effective recruitment and selection procedures were in place and we saw that appropriate checks had been undertaken before staff began work.

The registered manager had informed CQC of significant events in a timely way by submitting the required notifications. This meant we could check that appropriate action had been taken.