Rotherwood Care Home

Rotherwood Care Home provides residential care to older people with a range of support needs, including living with dementia. The service is registered to provide a service for up to 29 people. At the time of our inspection there were 21 people using the service.

People’s experience of using this service and what we found

People told us they felt safe. Staff knew how to raise safeguarding concerns and were aware of the processes to follow to keep people safe. Care and support plans were developed to ensure people's needs were met appropriately. Risk management strategies were in place to assist staff to help people to manage identified risks and included positive risk taking. Environmental maintenance and risks were managed appropriately.

Staff were recruited safely and staffing levels were appropriate to ensure people's needs were met in a safe, and timely way. The service was following infection prevention and control procedures to keep people safe. People received their medicines as prescribed.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

There was an effective governance system in place. People, their relatives and staff were confident about approaching the registered manager if they needed to. Their views and feedback were valued, respected, and used to support service development. A range of audits ensured the quality of the service was maintained. People had access to healthcare services where needed. There was evidence of effective communication with other professionals in the health and social care sector.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was Good (published 8 December 2022).

Why we inspected

The inspection was prompted in part to check how the provider was safeguarding people from risk of Legionella. A decision was made for us to inspect and examine those risks. We found no evidence during this inspection that people were at risk of harm from this concern.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service remains good. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Rotherwood on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

About the service:

Rotherwood Care Home provides residential care services to older people with a range of support needs, including people living with dementia. The home accommodates 27 people in 1 adapted building. At the time of our inspection there were 19 people using the service.

People's experience of using this service and what we found

People told us they felt safe and happy living in the home. Staff knew how to identify and report safeguarding concerns. Risks to people were assessed and reduced as much as possible, without overly limiting their freedom.

People's medicines were managed and administered safely. Risks relating to infection prevention and control (IPC), including in relation to COVID-19, were assessed and managed. There were thorough reviews of accidents, incidents and near misses. Lessons were learned, and action was to make sure people were safe and to prevent reoccurrence.

Staff were recruited in a safe way. People said there were enough staff to support them. We observed positive and caring staff interactions with people. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests.

People’s feedback was used to make changes and improvements to the service. There was a new manager who provided staff with leadership. They were approachable and keen to achieve high standards within the service. The new manager (supported by the provider's operations manager and the compliance manager) was clearly working hard to manage the home in an inclusive, person centred way. There were effective systems in place to monitor and review the quality of the service and to make sure improvements were carried out.

For more information, please read the detailed findings section of this report. If you are reading this as a separate summary, the full report can be found on the Care Quality Commission (CQC) website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 18 July 2019).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service remained good based on the findings of this inspection.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Rotherwood Care Home on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

We found the following examples of good practice.

The provider had a process in place to enable relatives to visit their family members in a safe way and in line with government guidance. The service booked visitors in at a time that suited people and was spaced out, to help with maintaining social distancing. People were also supported to keep in touch with their relatives by social media, video and telephone calls.

Professional visitors were required to show a negative lateral flow test and evidence of COVID-19 vaccination. Visitors had their temperature taken in the entrance area to ensure they did not show symptoms of illness.

Infection prevention and control measures were in place and staff understood how to prevent the spread of infection. Staff had completed training in hand hygiene and donning and doffing personal protective equipment. Staff wore personal protective equipment as required by the current guidance.

People using the service and staff took part in the home’s testing programme. This enabled the provider to take swift action to prevent the spread of infection if anyone tested positive for COVID-19.

Staff had access to cleaning products, and high touch areas such as door handles and handrails were cleaned regularly.

Rotherwood Care Home provides residential care services to older people with a range of support needs, including dementia. It can accommodate up to 27 people. The home is located in the East Dene area of Rotherham, and has parking and public transport access as well as local facilities nearby.

People’s experience of using this service:

At our last inspection in June 2018, we raised concerns about medicines management and consent and the service was in breach of Regulations 11 and 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations. At this inspection we found improvements had been made and the service was no longer in breach of these Regulations.

Medicines were being administered safely and people’s dietary and healthcare needs were met. Infection control procedures were being followed and the service was clean and tidy.

The registered manager provided staff with leadership. They were approachable and keen to achieve high standards within the service. Audits and checks were carried out and used to drive continuous improvements to the service people received.

People told us they felt safe living at the service and, where appropriate, safeguarding referrals had been made. Staff had received safeguarding training and understood how to keep people safe. There was a complaints procedure available which enabled people to raise any concerns or complaints about the care or support they received.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Staff were caring in their approach and knew people well. There was a culture within the home of treating people with respect and dignity. People’s feedback was used to make changes to the service.

A range of meaningful activities were on offer to keep people occupied, and this reflected their individual interests.

Care plans were up to date and detailed, setting out the care and support people wanted and needed. Risk assessments were in place which set out the steps staff should take to manage the risks people were vulnerable to or presented.

Staff were recruited safely and there were enough of them to keep people safe and to meet their care needs. Staff were receiving appropriate training which was relevant to their role and people’s needs.

Rating at last inspection and update:

The last rating for this service was requires improvement (published19 July 2018) and there were two breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected:

This was a planned comprehensive inspection based on the rating at the last inspection.

Follow up:

We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rotherwood is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Rotherwood is located in Rotherham, South Yorkshire. It is can accommodate up to 27 people who have needs associated with those of older people. There were 26 people living there at the time of the inspection.The home is in its own grounds in a quiet, residential area, but close to public transport links.

At the time of the inspection, the service did not have 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 and associated Regulations about how the service is run. A manager had been appointed prior to the inspection and had applied to register with CQC, however, at the inspection we were informed that this manager had left and work was under way to recruit a new manager.

Throughout the inspection staff spoke with people with warmth and respect, and took steps to uphold their dignity. People told us their experience of care was good, and praised the staff. People gave us positive feedback about the mealtime experience and told us they were offered a good range of options at mealtimes.

Medicines were not safely managed; people did not always receive their medication in accordance with the prescriber’s instructions, and there was insufficient information for staff about when “as required” medication should be administered.

Risks were not always appropriately assessed to ensure people were cared for safely, and sufficient numbers of staff were not always available.

The arrangements in place for obtaining and acting in accordance with people’s consent did not meet legal requirements.

Activities were available in the home, however, sometimes short staffing impacted upon activities.

The arrangements in place for monitoring the quality of the service were not robust enough to identify or address shortfalls in service quality.

At this inspection we found the registered provider had taken appropriate actions to meet the requirements of the breach. The registered provider was meeting the requirements of the Mental Capacity Act 2005. Staff gained consent from people prior to completing care tasks.

Rotherwood Care Home is situated on the outskirts of Rotherham close to local shops and public transport. It provides accommodation for up to 27 people who require personal care. Care is provided for people who have needs associated with those of older people.

At the time of our inspection there was a registered manager in post. 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.

We looked at care records and found risks associated with people’s care had been identified. Appropriate risk assessments were in place to ensure risks were minimised.

Staff we spoke with knew how to recognise and report abuse and told us they would inform the registered manager if they had any concerns. They were confident that the registered manager would take appropriate actions to ensure people were safe.

We observed staff interacting with people and found there were enough staff available to meet people’s needs in a timely way.

We found some concerns regarding the management of medicines. The service could not always evidence the medicines had been stored at the correct temperature. We also found some medicines had not been recorded correctly in line with the current guidelines for storing controlled medicines.

We completed a tour of the home with the registered manager and found the laundry/sluice area was not clean and needed further attention to ensure the area was fit for purpose. The registered manager had begun work in this area and intended to complete this action.

Staff were knowledgeable and had the skills and support to carry out their roles and responsibilities. Staff received training and support from the management team.

People received a well-balanced diet which met their needs and their preferences. Meals looked appetising and people enjoyed them. Snacks and drinks were also available throughout the day.

People had access to healthcare professionals when required.

We observed staff interacting with people who used the service and found they were kind, caring and compassionate. People and staff shared appropriate and friendly banter and there was a lot of laughter which showed people were happy. Staff respected people’s privacy and dignity and were respectful in their approach with people.

The registered manager had developed a new care planning system and had received good feedback from visiting professionals. We looked at care records and found they reflected people’s current needs.

People were supported to follow their interests and take part in social activities which were appropriate and met their needs.

The provider had a complaints procedure and people were encouraged to talk with the registered manager and staff about any concerns.

People told us the registered manager was supportive and they felt able to approach them. People felt they were listened to and their comments were acted up on. We saw evidence that people were involved in residents and relatives meetings and were able to comment about the service.

We saw regular audits took place to check the quality of service provision. Action plans were devised to follow up any issues.

Rotherwood is a 27 bed service providing residential care to older people with a range of support needs including dementia. It provides accommodation on either a long term basis, or on a short term respite basis including assisting people to rehabilitate following injury or illness before returning to their own home.

Rotherwood is located in the East Dene suburb of Rotherham, South Yorkshire. It is in its own grounds in a quiet, residential area, but close to the town centre and public transport links.

The service had a 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 and associated Regulations about how the service is run.

At the inspection, we found that staff spoke to people with warmth and respect, and day to day procedures within the home took into account people’s privacy and dignity. The home was undergoing a programme of improvements to make the environment more suitable for the needs of people with dementia.

Staff had received training to enhance their understanding, although we noted a small number of staff still required this training. Medicines were stored and handled safely, although we noted some areas for improvement, which the provider addressed immediately.

Where people were at risk of injuring themselves or others, there were appropriate risk assessments in place to guide staff in relation to caring for people safely. Recruitment procedures were sufficiently robust to ensure people’s safety.

The service was not always effective, as improvements were required in the way consent was obtained and recorded, and in the way the service responded when people did not have the capacity to consent to their care.

Mealtimes were observed to be comfortable and pleasant experiences for people, and people told us they enjoyed their food.

The home had an activities coordinator whose role involved designing and leading an activities programme for people using the service. We observed activities taking place and saw that people appeared to enjoy this.

There was a formal complaints procedure in place, and we saw that where complaints had been received the provider carried out a thorough investigation and responded to complainants in a timely manner.

The home’s manager understood the responsibilities of their role, and they were supported by an operations manager who also had a good knowledge of the home and the people living there.

The management team were accessible and were familiar to people using the service. The provider had a thorough system in place for monitoring the quality of service people received.

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, speaking with the staff supporting them and looking at records.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

Care and treatment was planned and delivered in a way that ensured people's safety and welfare. Records were in place to monitor any specific areas where people were more at risk and explained what action staff needed to take to protect them.

We saw people using the service were treated with respect and dignity by the staff who supported them. Care and support was delivered in a safe way by staff who had received appropriate training.

The home was clean and fresh throughout. We saw that since our last inspection a more effective system had been introduced to reduce the risk and spread of infection.

People were protected from unsafe or unsuitable equipment. We saw where people needed specific equipment as part of their care delivery, for example to help with their mobility, it was available. Where staff used equipment to help people they did so in a safe and appropriate manner.

We saw checks took place to ensure the service was operating safely.

Is the service effective?

People's health and care needs were assessed on a regular basis. We saw people who used the service and their relatives had been involved in planning care and these were reviewed and updated regularly.

Staff had received appropriate professional development. We saw they had access to a varied training programme that helped them meet the needs of the people they supported.

We saw most staff had received an annual appraisal of their work, which included a training and development plan. Formal staff support sessions had also been carried out on a regular basis.

Is the service caring?

People said they were supported by kind, caring and friendly staff who were aware of their needs and preferences. We saw staff interacting with people positively. They encouraged them to be as independent as they were able to be, while providing support as needed. A visitor spoke positively about the care and support provided to their relative.

People we saw looked well-presented and cared for. We spoke with seven people who used the service and a visitor who all said they were happy with the care provided and complimented the staff for the way they cared for people.

Care files contained adequate information about people's needs and preferences. Staff were aware of the content and followed the guidance.

Is the service responsive?

We saw, and were told, that people's needs had been assessed and where necessary a review of their care plan had taken place so it could be updated to reflect their changing needs. A visitor told us how they had been involved in reviewing their relatives care.

The home has a complaints procedure which was available to people using and visiting the service. No complaints had been recorded since our last inspection.

Is the service well-led?

There was a quality assurance system in place to assess if the home was operating correctly. We saw audits had been completed by the manager and where shortfalls had been noted action taken to address them. However there were some areas still needing attention.

Satisfaction surveys and meetings had been used to enable people to share their views on the service provided. This helped the provider to assess if people were receiving the care and support they needed and facilities provided were suitable.

Staff were clear about their roles and responsibilities. We saw staff had access to policies and procedure. The ones we sampled had been updated since our last inspection and reflected current best practice.

People were provided with a choice of suitable and nutritious food and drink. They told us they enjoyed the meals they received saying they provided variety and choice.

The system in place to reduce the risk and spread of infection was not always effective.

There was a system in place to ensure people received their medicines promptly and in a safe way, but records were not always completed correctly.

There were enough qualified, skilled and experienced staff to meet people's needs.

There were systems in place to gain people's views. However checks carried out to make sure staff were following company policies were not always used effectively.

Records were not always accurate or up to date. Although each person had a care plan in place they had not always been reviewed and changed as needed. We also found shortfalls in monitoring and assessment documentation.

We spoke with six people who lived at the home and four visitors. Their comments indicated that people received the care and support they needed and they were happy with how staff delivered care. When we asked one visitor about the care their relative had received they said, "It's sound." Another person told us, "The care is very good."

The premises were generally in a satisfactory state of repair and were clean and fresh. One person said they were "Thrilled to bits" with their room. We saw there were some areas that needed attention but most of these were already being addressed.

Appropriate background checks had been carried out on staff before they started to work at the home. This included ensuring staff underwent Criminal Records Bureau (CRB) checks. Although staff told us they had received an induction to the home when they started working there this had not always been thoroughly recorded.

We saw the complaints procedure was displayed in the home and people told us they felt confident taking any concerns to the manager or any of the staff.