Rose Villa Nursing Home

Updated 15 October 2022

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 Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by one inspector and a medicines inspector. An Expert by Experience also spoke to relatives by telephone. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of service.

Service and service type

Rose Villa Nursing Home is a ‘care home. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Rose Villa Nursing Home is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. 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.

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

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed the 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. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with four people who used the service and eight relatives to ask about their experience of care provided. We also spoke with the registered manager, eight members of staff and two professionals. We looked at four care files along with a range of medication administration records (MAR). We looked at other records relating to the management of the service including recruitment, staff training and supervision and systems for monitoring quality.

Updated 15 October 2022

About the service

Rose Villa Nursing Home is a residential care home providing personal and nursing care up to a maximum of 36 people. The service provides support to people with dementia, older people and people with a physical disability. At the time of our inspection there were 25 people using the service.

Rose Villa Nursing home is a large Victorian house and has three floors serviced by a passenger lift. There are bedrooms for single and shared occupancy on each floor, with communal and dining space on the ground floor.

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

People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.

Staff supervision and appraisals were not consistent and did not support staff to maintain knowledge of best practice. Training was inconsistent and did not support staff to meet the needs of people in their care.

The service did not have effective safeguarding systems in place and there was not a consistent approach to safeguarding matters. Staff were not up to date with safeguarding training.

Information about risks and safety was not always comprehensive or up to date and full information about risks to people’s safety was not always communicated to the staff. People and their families or carers were not always involved in decisions about their care and treatment.

People received the care and support they required to be safe, however, staff did not always have time to respond to people’s changing needs. Staff regularly felt stretched and focused on tasks rather than person-centred care.

Governance systems were not reliable or effective. Investigations were not always completed and there was little evidence of learning from accidents and incidents.

Information to support staff to safely administer medicines was not always available. We have made a recommendation about the management of some medicines.

People were not always supported to engage in person-centred activities to help them maintain hobbies and interests. One relative told us “Activities are an issue, [person] would benefit from some activities that suited them”. We recommend the provider reviews accessibility of activities.

The provider did not always engage with people who use the service, their families and/or carers, ensuring their views were acted on to shape the service and culture. Relatives told us there had never been any invitations to attend carers meetings. We have made a recommendation around how the provider obtains the views of all stakeholders including people and their families.

Staff have access to and followed clear policies and procedures on infection, prevention and control that met current and relevant national guidance.

People had access to an outside space and a quiet area to see their visitors. People had choice and access to enough food and drink throughout the day.

For more details, please see the full report which is 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 20 March 2018).

At our last inspection we recommended that improvements continue with the recording of care plans and monitoring charts to ensure up to date information guides staff in meeting people’s needs. At this inspection we found improvements had not been made in the recordings of care plans, and care plans did not contain up to date relevant information.

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 this service has changed from good to requires improvement based on the findings of this inspection.

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

You can see what action we have asked the provider to take at the end of this full report.

Enforcement and recommendations

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified breaches in relation to person-centred care, safe care and treatment, the Mental Capacity Act 2005, safeguarding, staffing and the overall leadership and management of the service.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

We will request an action plan from 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 continue to monitor information we receive about the service, which will help inform when we next inspect.