Background to this inspection
Updated
31 October 2019
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
Inspection team
One adult social care inspector and an expert by experience carried out this inspection. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Service and service type
Keychange Charity Rose Lawn Care Home 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.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
This inspection was unannounced.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service.
The provider also completed a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We used all of this information to plan our inspection.
During the inspection
We spoke with 12 people who used the service and three relatives about their experience of the care provided. We spoke with 11 members of staff including the operations manager, registered manager, deputy manager, senior care workers, care workers, activity co-ordinator, the chef and catering staff. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.
We reviewed a range of records. These included four people's care records and multiple medication records. We looked at three staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed. We looked at training data and quality assurance records. We reviewed further information about positive achievements sent to us by the registered manager. We also received emails from 11 staff and four relatives following the inspection, all with extremely positive views.
We sought and received feedback from one health and social care professional.
Updated
31 October 2019
About the service
Keychange Charity Rose Lawn Care Home is a residential care home providing accommodation and personal care for up to 29 people. At the time of the inspection 26 people were living at the home, some living with dementia or physical frailty.
The home is a large well maintained detached house close to the town centre of Sidmouth. All bedrooms are for single occupancy, although some are large enough for couples or friends/family if requested. The website states, “The care provision is based on a strong Christian ethos, while carers are trained to take a holistic approach and in achieving best practice.”
People's experience of using this service and what we found
People told us staff were, "Amazing and treated people very well" and were, "Very kind, caring and funny." People said, “‘They can’t do enough for you. Everybody just takes care of you”, “It’s like being on holiday, a lovely club. The atmosphere is rather nice” and “They are very helpful, you get to know them as real friends”. One relative said, “They are checking on [person’s name] constantly, they’re very kind’. The provider had been recommended on the national care home review website as one of the top 20 care home groups, with many positive comments.
Staff interacted with people at their pace, unrushed, and joked and laughed with each other. Staff in all roles were empowered to sit and chat to people and developed relationships that helped people feel confident to speak up. Relatives told us the service was, "Fantastic." and "The best home ever." People and their relatives were supported in a variety of ways to speak up and have a say in how the service was run. Many people, relatives and staff used the word 'family' when describing the service.
People told us of many examples of where staff had altered activities and care approaches to support individual preferences, including bucket lists, finding people’s passions to help them engage and using detailed ‘Who am I?’ folders. Staff were creative in how they engaged people and prevented people feeling isolated.
People and their relatives were supported with end of life care in a sensitive and individual way. There was a strong spiritual element and a home group to enable people to talk about their wishes, as well as be supported through bereavements and celebrating people’s lives.
People who wanted to be, were supported to have roles in the care home which they were very proud of and boosted their sense of self-worth.
People and their relatives experienced a positive and inclusive approach to care and conducted audits to give their feedback to help improve the service. The staff worked with outside professionals and communities to improve people's health and social wellbeing, including local churches and businesses.
The registered manager and staff team all had an excellent understanding of their roles and were empowered to make suggestions to keep improving the care, including sharing their knowledge through various ‘champion’ roles. These were meaningful with learning always shared and put into practice.
People told us they felt safe and secure and well cared for. People were safe because the service had excellent systems for monitoring risk whilst promoting independence and positive risk taking. Staff had excellent understanding of people's needs and how to keep them safe with a team approach.
People were able to live full lives supported by sufficient staff on duty to meet their needs and they did not need to wait when they called for support.
People were supported to take their medicines safely whilst being cared for in a way that enabled them to take minimal medication.
People told us the food was lovely and they had plenty of choice. In particular, staff ensured that people not only received food they enjoyed with opportunities to try new things but that their meal experience and environment was suitable for them using individualised ‘Dining with Dignity’ and ‘Early Bird’ schemes. The chef had been empowered to use their knowledge of catering and care combined, and was passionate in providing creative, highly person centred nutrition for people as the home’s nutrition and hydration champion.
People and their relatives were involved in planning their care and assessing their needs. People could choose the décor and personalise their rooms. 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 focus was on people’s wellbeing and maintaining people’s independence or providing discreet support in a respectful way.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last
The last rating for this service was Outstanding. (15 February 2017).
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our reinspection programme. If we receive any concerning information we may inspect sooner.