Archived: Rose Cottage Residential Home

We undertook this focused inspection to check that they had followed their plan and to confirm that they now met legal requirements. This report only covers our findings in relation to those requirements.

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

Rose Cottage Residential Home is registered to provide accommodation and nursing care for up to 38 people. At the time of our inspection there were 35 people living at the service. The service is a single storey premises located in the village of Broughton near the towns of St Ives and Huntingdon. Most of the rooms have en-suite bathrooms. Each room has a call bell system, a telephone and TV point, and access to the internet. The service is based in a rural location, has landscaped gardens and a naturally occurring pond.

There was not a registered manager in post. However, two new managers had been recruited and they were in the process of applying to become registered. 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.

At our focused inspection on 1 September 2017, we found that the provider had followed their action plan in relation to reporting incidents. They had told us the actions would be completed by June 2017. Legal requirements had been met.

Systems and procedures had been introduced and these had been consistently applied in ensuring CQC had been notified about important events such as any serious injury to a person if this had occurred. Staff had informed external agencies such as a GP service and the local safeguarding authority where necessary.

Management and quality assurance processes that had been implemented since our previous inspection had been effective in driving improvement in the staff culture and audit records. This had resulted in accurate and appropriate reporting of all incidents that by law we needed to be informed about.

This unannounced comprehensive inspection was undertaken by one inspector and took place on 3 February 2017. At the previous inspection in January 2015 the service was rated as ‘Good’.

A registered manager was in post at the time of the inspection and had been registered since the service was registered in 2010. At the time of inspection the registered manager was on leave. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

Staff had been trained on how to keep people safe and they knew who they could report any incidents of harm to. However, we found that not all incidents of harm or potential harm had been reported or acted upon. This put people at risk of harm and meant that organisations responsible for investigating safeguarding were not able to respond in a timely manner to assure people’s safety.

Not all risk assessments were in place. This increased the risk of people being exposed to a risk of harm.

A sufficient number of appropriately recruited and suitably skilled staff were in post to safely meet people’s assessed needs.

Medicines were managed safely by staff whose competency had been assessed. Where medicines’ administration errors had occurred, action had not always been taken to assure people's safety. This put people at risk of harm.

Staff possessed the necessary care skills to meet people’s health and nutritional needs. Health care support from external healthcare professionals was requested by staff in a timely manner.

The CQC is required by law to monitor the Mental Capacity Act 2005 [MCA] and to report on what we find. The provider was aware of what they were required to do should any person lack mental capacity. Appropriate authorisations were in place to lawfully deprive people of their liberty. Staff did not always have a good understanding about the application of the MCA code of practice and how care that was in the person’s best interests was determined.

People were looked after with respect for their dignity. Staff provided care that was compassionate and in consideration of each person that was cared for.

People, their legal representative or relatives were enabled to be involved in identifying, determining and planning the review of their care.

People were supported to be as independent as they wanted to be where this was safe. People could take part in their hobbies, interests and pastimes. This stimulated people and prevented the risk of isolation.

An effective system was in place to gather and act upon people’s suggestions, concerns and complaints. Actions taken in response to people’s concerns were effective in preventing the potential for recurrence.

The registered manager was supported by a deputy, four team leaders, care staff, as well as catering and maintenance staff. Staff had the support mechanisms in place that they needed to fulfil their role effectively.

The registered manager and provider had not always notified the CQC about important events that, by law, they are required to do. People, their relatives and staff were involved and enabled to make suggestions to improve how the service was run. Quality monitoring and assurance processes were in place. Not all improvement actions identified were acted upon.

We found a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.You can see what action we told the provider to take at the back of the full version of the report.

We found that care records were current and reflected the needs of people who lived in the home. Staff demonstrated a good understanding and knowledge of the care and support people required.

A safeguarding policy for vulnerable adults was in place and staff had undertaken training in this. Information was available for people who lived in the home, their families and staff informing them of how to safeguard people from abuse and raise their concerns.

Procedures were in place to ensure that people using the service received their medication appropriately and staff had undertaken training in medication administration.

There were regular on-going training sessions in place to ensure that staff safely delivered care and support to people.

The provider had a system in place to check that people were satisfied with the service and they had various monitoring checks on a number of aspects of the service.