Rothsay Grange

Updated 6 December 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 2 inspectors a specialist advisor registered nurse and an Expert by Experience. 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

Rothsay Grange 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. Rothsay Grange 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 provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

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 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 information we already held about the service including enquiries and notifications. A notification is information about significant events in care services submitted by the provider to CQC. We used all this information to plan our inspection.

During the inspection

We looked at records about the service including audits, policies and premises safety records. We spoke with staff members including 2 registered nurses, a regional clinical trainer, a care practitioner, 4 care staff and the registered manager. We reviewed 55 medicines records, several topical medicines application records (tMAR’s) and 4 care plans.

Updated 6 December 2022

About the service

Rothsay Grange is a residential care home providing personal and nursing care to up to 60 people. The service provides support to older people, people living with dementia or physical disabilities and younger adults. At the time of our inspection there were 59 people using the service.

Rothsay Grange is a purpose-built care home providing care to people over 3 floors, 1 of which specialises in providing care to people living with dementia.

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

Improvements had been made in safe management of medicines, governance and staffing and the provider was no longer in breach of regulation.

People were safeguarded from abuse by staff trained to protect them. People felt safe at the service and regular servicing and maintenance ensured the premises were safe. Recruitment was safely completed and agency staff were used to maintain safe staffing levels. Medicines were safely managed and improvements had been made since we last inspected. We were assured the provider maintained good infection prevention and control standards and government guidance was followed both in IPC and around visiting the service.

Most people’s care records contained extensive plans to ensure they received the care they needed, in a way they were happy with. Some care plans needed additional information to enable staff to provide personalised support. Staff completed an induction on commencing in post and completed additional and refresher training to ensure they were familiar with current good practice. People were weighed at least monthly and referrals to healthcare professionals were made should they become necessary. The chef was responsive to people’s needs and wishes and prepared meals people enjoyed. The premises were in good condition and there will be a full refurbishment next year.

People and their relatives told us they were well cared for at Rothsay Grange and they were involved in making choices. They told us they received support when they needed it apart from certain busy times of the day such as first thing in the morning. People were supported to remain active and as independent as possible. 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.

Details were lacking in some clinical care plans but people were involved in devising them if possible. More consideration was needed about escalation of treatment on Recommended Summary for Emergency Care and Treatment ReSPECT forms. There were a wide range of plans addressing aspects of people’s health and well-being and daily activities. People had been supported throughout the pandemic to maintain contact with relatives and friends, and visitors had been able to access the service in line with current guidelines. People could participate in a varied activities programme.

The service was managed in a positive way and staff could access the management team when needed as they had an open-door policy. The provider understood their responsibilities under the duty of candour and informed CQC of significant events in the service. Regular meetings and quality assurance surveys ensured the provider maintained good communications with staff, people and relatives.

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 30 September 2020). 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 improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

The inspection was prompted in part due to concerns received about dementia care, lack of staffing, people living with dementia who had behaviours that put others at risk and poor infection control. 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.

The overall rating for the service has changed requires improvement to good based on the findings of this inspection.

Follow up

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