We carried out a review of the data available to us about Rose Lodge Exmouth on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Rose Lodge Exmouth, you can give feedback on this service.
This was a comprehensive inspection carried out on 14 and 20 December 2018. It was unannounced on the first day and announced on the second. At the last inspection in April 2016 the service was rated as ‘Outstanding’ in effective, caring and responsive. At this inspection we found the evidence continued to support the rating of Outstanding.
There was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.
Why the service is rated Outstanding
The service was outstanding in providing effective support. The internal and external environment was designed using best practice guidance for dementia care. This enabled people to maintain their independence and help them make choices. People were supported by exceptionally well-trained staff, whose approach had been influenced by best practice trends and policies. Excellent partnership working had been developed with other professionals, who repeatedly expressed their confidence in the service. Varied and nutritious meals were provided and all feedback about the food was very positive. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.
The service was outstanding in providing caring support. Staff promoted a person-centred culture and provided sensitive, compassionate care. They responded very promptly to people’s needs and requests with empathy and a friendly approach. They understood each individual person’s diverse requirements and ensured they were met. There was an emphasis on promoting independence and inclusion.
The service was outstanding in providing responsive support. There was an exceptional ‘Active Living Programme’ meaning people were well occupied and stimulated. People were supported to pursue their hobbies and explore new experiences. Music, singing and dancing featured as part of people’s daily life. People made choices about all aspects of their daily lives. Staff took account of people’s previous lifestyles and wishes when planning and delivering care.
People continued to feel safe. The provider had taken action during the inspection to ensure recruitment was robust. Staffing levels ensure people’s individual health, emotional and social needs were met. People were encouraged and involved to manage their risk taking wherever possible to ensure they were in control of their lives. Staff were knowledgeable about how to identify and respond to safeguarding concerns if they arose. Medicines were managed and administered safely by trained staff. The environment was safe and exceptionally clean.
The service was well-led. It had been developed and designed in line with good practice for dementia care. The provider was keen to introduce innovative models of care to improve people’s ‘lived experience’. Effective monitoring of the service ensured continued improvements and that the service provided was safe.
Further information is in the detailed findings below.
Rose Lodge provides accommodation for up to 34 people who require personal care; 32 people were living at the home during our visit, including a person who had been admitted to hospital. The service provides care for older people, who are living with the early stages of dementia. They also care for people who have more complex care needs because of the progression of their illness.
The bedrooms are on the ground and first floors, which can be accessed by two passenger lifts. Work was taking place to provide an increased number of en suites in the original building called The Lodge. The Cottage, which is attached to The Lodge, is purpose built with rooms that include en-suite facilities. There are two communities living at Rose Lodge, who interact with one another. A person centred approach meant some people moved between the two communities to suit their personal preferences. For example, one person told us they chose to engage in some activities with one community but benefited from the environmental changes in The Cottage which was where their room was based.
There was a registered manager. 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’. The service is owned by a provider, who is a registered person. 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.
The Care Quality Commission (CQC) is required to monitor the operation of the Mental Capacity Act (2005) (MCA) and Deprivation of Liberty Safeguards (DoLS) and to report on what we find. DoLS are put in place to protect people where they do not have capacity to make decisions, and where it is considered necessary to restrict their freedom in some way, usually to protect themselves or others. We discussed DoLS with the registered manager and looked at records. We found the provider was following legal requirements in the DoLS. At the time of the inspection, an application had been made to the local authority in relation to people living at the service. This meant people’s legal rights were protected.
People praised the atmosphere of the home. People felt safe and well cared for. Staff were attentive to people’s changing moods and calmly intervened if people became unhappy with each other. Staff consistently demonstrated affection and warmth in their relationships with people. People praised the standard of the food and the cleanliness of the home. People took a pride in their surroundings and several people commented on feeling part of a community. People were supported to eat and drink in a relaxed and supportive manner by staff who worked to promote a pleasant meal time experience.
The atmosphere of the home was one of constant stimulation whether on a one to one basis or through group activities. However, the atmosphere was calm. Staff were well-organised, working as a team while maintaining a relaxed and unrushed manner. Music and singing featured as an everyday part of people’s daily life. We saw this activity formed bonds between people and staff enabling them to build relationships and participate as equals.
The registered manager and our conversations with the provider clearly demonstrated their commitment, both financially and ethically, to provide an innovative environment that enabled people to be as independent as possible. They had sought specialist advice on the selection of colours, lighting, flooring and furniture, and made changes based on specialist recommendations. The gardens were laid out to provide an interesting and stimulating area to garden, with hens, rabbits and fish to watch, or a place to relax and entertain friends and family.
People visiting the home praised the way it was run and the commitment of the staff. They recognised the range of activities and the investment into the building to maximise people’s independence. An ethos had been created by the providers, the registered manager and staff to ensure people’s diagnosis of dementia was not a barrier to them leading full and active lives.
People told us about the skills of the staff who cared for them. They commented on their friendliness and positive approach. People were consulted about their care, and their wishes were respected. Staff were consistently smiling and looked happy to be at work. Staff said they were well supported and had access to a range of training and supervision. Staff morale was high with staff enthusiastically describing their roles and responsibilities. They were clear about the ethos and values of the home which they demonstrated in their actions and interactions with the people living in the home and their teamwork.
There were sufficient numbers of staff on duty in order to meet the needs of people using the service. Staff were attentive and the atmosphere was unrushed. There was an effective recruitment and selection procedure in place and the registered manager carried out robust checks when they employed staff.
People were confident complaints and concerns would be addressed; they said the registered manager and staff were approachable. The service is well-led and the registered manager provides a strong role model for good practice.
People were positive about the service or appeared comfortable in their surroundings. One person we asked about the service and the care they received said, 'I think it's excellent.' Another said 'Yes ' they do care'I am well cared for.'
Care was planned and delivered in a way that was intended to ensure people's safety and welfare. They were cared for by staff who were supported to deliver care safely and to an appropriate standard. A typical view of the staff was 'They're good, without fussing too much. They're always friendly and helpful.'
Those who use the service, staff and visitors were protected against the risks of unsuitable premises. We found ongoing adaptation and development of the environment to meet people's needs better. They were protected from infection risks, having a clean environment. They were also protected from unsuitable equipment partly because of action to maintain it.
There was an effective complaints system. Comments and complaints made by people who used the service or their representatives were responded to appropriately.
Other people had varying degrees of dementia so could not tell us what they thought about living at the home. For this reason we observed how staff and people interacted at the home. We only witnessed positive interactions. These included the use of appropriate affection, touch and reassurance. People were empowered, recognised and accepted as individuals.
The environment and wide range of activities at Rose Lodge were planned to improve the quality of life and encourage an active lifestyle.
People told us they felt safe living at Rose Lodge and liked the staff. One person said 'Oh yes, I feel very safe here' Staff understood the different types of abuse and knew the procedure to follow if they suspected or witnessed any abuse.
There were enough staff on duty to meet the needs of people, but also offer additional support, attention and work at a relaxed pace of work.
People living at the home and their families were involved in planning the care and were encouraged to feedback their views, compliments and concerns. There were systems in place to continually review the quality and safety of the service provided.