This inspection took place on 6 September 2016 and was unannounced. This meant that the provider did not know we would be visiting. The service was last inspected in November 2013, and at that time was meeting the regulations we inspected. Rosebank Care Home is a 26 bedded home providing residential care to older people with a variety of support needs including those with dementia. It is located in its own grounds in a residential area, close to Sheffield city centre. At the time of our inspection 24 people were using the service, many of whom were living with dementia.
There was a registered manager in place. 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.
People were safely supported to access their medicines. However medicines were not always securely stored and there was a discrepancy in the count for one person’s medicines.
Risks to people arising from their health and support needs or the premises were not always assessed and plans were not always in place to minimise them.
A number of checks were carried out around the service to ensure that the premises and equipment were safe to use.
Staff understood safeguarding issues, and felt confident to raise any concerns they had in order to keep people safe.
The service monitored people’s levels of dependency and used this to assess staffing levels. A number of recruitment checks were carried out before staff were employed to ensure they were suitable. The service was in the process of recruiting new staff.
Staff received training to ensure that they could appropriately support people, and the service used the Care Certificate as the framework for its training.
Staff received support through regular supervisions and appraisals. Staff felt confident to raise any issues or support needs they had at these.
Staff had completed a range of training that enabled them to meet people’s assessed needs effectively.
The registered manager and staff had received Mental Capacity Act (2005) and the Deprivation of Liberty Safeguards (DoLS) training. At the time of inspection one person who used the service was subject to a DoLS authorisation. Care plans contained evidence of MCA assessments and consent. We have made a recommendation around MCA and DoLS.
The service worked closely with external professionals to support and maintain people’s health. Staff knew how to make referrals to external professionals where additional support was needed. Care plans contained evidence of the involvement of GPs, nurse practitioners, district nurses and other professionals.
The interactions between people and staff were cheerful and supportive. Staff were kind and respectful; we saw that they were aware of how to respect people’s privacy and dignity. People and their relatives spoke highly of the care they received.
Procedures were in place to support people to access advocacy services should the need arise.
Care plans were person centred and provided a lot of personal information that was relevant to that person. However care plans did not always capture people’s needs. We have made a recommendation regarding care plans.
People were supported to maintain a healthy diet, and people’s dietary needs and preferences were catered for. People told us they enjoyed the food although were not offered a choice. The cook did not fully understand how to fortify people’s meals and the picture menus did not match what food was on offer that day.
The service was in the process of employing a new activities co-ordinator. At the time of the inspection staff were arranging activities. People were happy with the activities on offer.
The service had a clear complaints policy that was applied when issues arose. People and their relatives knew how to raise any issues they had.
Staff were able to describe the culture and values of the service, and felt supported by the registered manager in delivering them.
The registered manager was a visible presence at the service, and was actively involved in monitoring standards and promoting good practice. Feedback was sought from people and their relatives to assist in this. The service had some good links with the community.
We identified one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the registered provider to take at the back of the full version of the report.