Rosewood Lodge

Rosewood Lodge is a residential care home providing personal care to people aged 65 and over, some of whom may have dementia. The home can support up to 19 people in an adapted two floor building with facilities, including en-suite bathrooms. At the time of the inspection, there were 17 people living in the home.

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

People felt safe and happy in the care home. They had risk assessments and care plans, which were reviewed regularly to ensure their needs were met. People lived in a safe, clean environment with suitable equipment and facilities. Staff were checked so they were safe and experienced to work effectively with people and were trained and supported by the provider to do so. Feedback from people, relatives and professionals confirmed staff were kind and caring.

Staff administered, recorded and audited medicines. People were supported to access health care as and when they needed. The food provided was fresh and nutritious. People and relatives told us staff provided varied activities. Care plans were tailored to people's individual needs ensuring their preferences, wishes and equality characteristics such as ethnicity, faith and gender were recorded and taken into account for their care. 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.

The registered manager sought feedback from people, relatives and staff, and welcomed complaints and compliments. The registered manager told us they used feedback as part of their improvement plan. The registered manager audited various aspects of the home, including staff training, health and safety, and care plans. Staff worked in partnership with health and social care professionals.

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

Rating at last inspection and update

The last rating for this service was Requires Improvement (published 5 August 2021) and there was a breach of regulation.

We issued a requirement notice to the provider for breach of Regulation 17 (good governance).

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 some improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection and following concerns raised about the safety of the 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.

Follow up

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

Rosewood Lodge is a residential care home providing personal care to people aged 65 and over, some of whom may have dementia.

The home can support up to 19 people and at the time of the inspection, 17 people were living in the home. The home is an adapted two floor building with facilities, including en-suite bathrooms.

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

The provider was not always assessing, monitoring and improving the quality and safety of the service. We found procedures were not in place to ensure there was effective and safe recruitment practices and safe management of controlled drugs. We have made a recommendation for the provider to review criminal background checks of staff who had been working in the home for more than five years.

The provider had re-registered the home under a new limited company in 2020 but they had not updated or reviewed most of the home’s policies and procedures over the past four years. The manager of the home was reviewing quality assurance systems to ensure action was taken to improve the service but they had not yet identified all the shortfalls we found.

Risks to people were assessed but changes to people’s health risks were not reflected accurately in their risk management plans. People’s care plans were personalised but not always consistent with each other because some care plans contained more information than others. There was an activities programme in place but people told us they had little to do and felt unstimulated. We have made a recommendation about reviewing activities to help people avoid social isolation.

People were protected from the risk of abuse. There were suitable numbers of staff available to provide support to people. The provider ensured infection control procedures were in place and there was guidance for people, staff and visitors during the Covid-19 pandemic to keep them safe.

Premises safety was maintained to keep the environment safe from hazards but bathing equipment was not always being serviced in accordance with the provider's moving and handling policy. Incidents and accidents in the service were reviewed and analysed to prevent reoccurrence.

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.

People were treated well by staff, who were kind and respectful towards them. Staff told us they were supported by the management team and they received supervision to discuss their performance and any concerns they had. Staff received training to ensure they had the right skills to support people whose behaviour could challenge.

People maintained their health and nutrition with food and drink of their choice. Their communication needs were assessed. There was a complaints procedure for people to use. There were systems to obtain people's and relative’s feedback about the service. Meetings with staff were held with the management team to discuss important topics. The service worked with health professionals and other agencies to ensure people’s health and wellbeing were maintained.

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

Rating at last inspection

This service was registered with us on 7 April 2020 and this was the first inspection. The previous rating for this service was Good (report published 31 October 2017) under the previous provider.

Why we inspected

This was a planned inspection because the service had not been inspected since registering with us under the new provider. The inspection was prompted in part due to concerns received about staffing, recruitment and medicines. A decision was made for us to inspect and examine those risks.

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.

We have found evidence that the provider needs to make improvements. Please see the safe, responsive and well-led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report. The provider has taken some action since our inspection to improve the service.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

We found the following examples of good practice.

Restrictions had been placed upon people visiting the service. Where relatives had been unable to visit, they were encouraged to maintain contact with people electronically.

The provider had taken steps to ensure they had adequate supplies of Personal Protective Equipment (PPE). Staff had received training in the use of PPE and were seen to be wearing it during the course of the inspection.

Temperature checks were carried out on staff and visitors upon arrival to the premises. PPE was made available to visitors if required.

The provider had made appropriate arrangements to test people and staff for Covid-19 and was following government guidance on regular testing. Measures were in place to ensure the safety of staff and people should they have tested positive for Covid-19. For example, people self isolated, and staff stopped working at the service until they were no longer infected with Covid-19.

Cleaning schedules were in place and there were systems for recording completed cleaning. These were checked daily by a member of the management team. Regular infection control audits were carried out at the service.

Further information is in the detailed findings below.