Rosemanor 2 Residential Care Home

Rosemanor 2 is a residential care home providing accommodation and personal care for to up to 9 people. The service provides support to women with mental health needs. At the time of our inspection there were 5 people using the service.

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

The provider was in the process of making changes to the service to make sure people received care and support in a safe environment. The provider carried out health and safety checks of the premises but these needed to be more detailed in some areas to make sure all relevant guidance, such as the Health and Safety Executive guidance, was considered and acted upon.

People told us they liked living at the service. There were enough staff to give people the support they needed. Risks relating to people’s care were identified and staff knew how to manage these risks to help keep people stay safe but still encourage independence. Systems were in place to safeguard people from abuse and staff knew the procedure and guidance to follow if something went wrong. The service was clean and hygienic and staff followed current infection control and hygiene practices to reduce the risk of infection. Medicines were managed safely. 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.

The registered manager also managed other services but was supported at this location by a senior staff member who coordinated the day-to day delivery of care and support. Although the registered manager was not on site all of the time they assured us they were available to support staff should they need it. The provider worked with people and staff to gather their views on how the service was run. Staff told us they felt supported and were able to make suggestions to make the service better for people. The provider worked with other healthcare professionals to make sure people received the right care and support.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published September 2019).

At our last inspection we recommended that the provider consider the guidance from the Health and Safety Executive to make sure the environment remained safe for people. During this inspection we found there had been delays in making improvements to the environment. However, the provider had identified the outstanding issues and was working, at the time of our inspection, to improve the environment for people.

Why we inspected

The inspection was prompted in part due to concerns received about the provider's other services. The concerns indicated there may be issues with the way this service was managed and we wanted to be sure the issues raised did not extend to this regulated service. A decision was made for us to undertake a focused inspection to review the key questions of safe and well-led so we could inspect and examine those risks.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.

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.

Enforcement

We have identified a breach in relation to the environmental safety at the service and the way these risks have been managed.

Please see the action we have told the provider to take at the end of this report.

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

We found the following examples of good practice.

People were kept safe from the risks of infection by staff who adhered to the infection prevention and control measures in place. The service was clean and staff were undertaking additional regular cleaning duties to reduce the risk of infection.

The provider made sure staff were available to give people the support they needed when they were isolating in their rooms. Staff were zoned to different floors to help reduce the spread of infection.

People were encouraged to self-isolate when necessary and the provider made sure people had everything they needed to remain safe, keep engaged with others and reduce social isolation.

People and staff were supported to engage with testing for COVID-19 in line with government guidance.

Staff had received regular updates about government guidance in relation to COVID-19. This included how to put on and remove Personal Protective Equipment (PPE) safely and additional hygiene measures to help stop the spread of infection.

The provider had risk assessed people and staff to make sure those who were high risk were identified. Measures had been put into place to help reduce the risk from COVID-19 infection.

Further information is in the detailed findings below.

Rosemanor 2 is a 24-hour residential care service providing rehabilitation and recovery programmes for up to nine women who are suffering or recovering from mental health problems. At the time of our inspection there were eight people using the service.

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

People told us they liked living at Rosenmanor 2 and felt comfortable with the staff working there. Staff knew how to keep people safe, they knew the risks people faced in the service and in the community and they were able to support people to reduce that risk. Some people’s bedrooms needed improvements to make them safe. The registered manager made sure these improvements were made during the inspection and we have made a recommendation to make sure the future health and safety needs of people at the service are met.

People were supported by staff who had been trained and supported to meet people’s needs. 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.

People chose what they ate and drank, and staff helped people to make healthy choices. When people needed additional help from healthcare professionals, staff made sure they supported people to have the care they needed when they needed it.

Staff were caring and worked with people to encourage their independence and meet their goals. Staff respected people and encouraged them to be involved in activities that interested them.

People were involved in their care and support plans, they met regularly with staff to talk about how they felt and what they wanted. This information was used to improve the care for people.

People said they liked the manager. The manager made sure they checked the way the service was run so people were safe and received the care they needed.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 03 March 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 re-inspection programme. If we receive any concerning information we may inspect sooner.

Our inspection took place on 17 and 19 January 2017 and was unannounced. At the end of the first day we told the provider we would be returning to continue with our inspection.

The service had a registered manager in post. 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.

We carried out an unannounced comprehensive inspection of this service on 15 and 16 December 2015. Breaches of legal requirements were found in relation to the management of medicines, safe care and treatment and governance.

After the comprehensive inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to the breach. During this inspection on 17 & 19 January 2017 we checked that they had followed their plan and confirmed that they had made improvements in all areas and now met legal requirements.

People using the service told us they felt safe at Rosemanor 2. They were encouraged to take part in some in-house activities and to continue to be part of their community. People were supported to maintain relationships with family and friends who were important to them.

There were clear procedures in place to recognise and respond to abuse and staff had been trained in how to follow these. Staffing numbers on each shift were sufficient to help make sure people were kept safe. Appropriate recruitment checks took place before staff started work. Staff told us they felt supported by the management team.

There were systems and processes in place to protect people from the risk of harm and improvements had been made to the way incidents and accidents were investigated and acted upon to help reduce the possibility of future events

People were supported to have their health needs met. Staff worked with people to access the GP and other local health services as appropriate to help make sure their individual health needs were met.

Staff received training which gave them the knowledge and skills to support people effectively. Staff had received training in the Mental Capacity Act (MCA) 2005 and the Deprivation of Liberty Safeguards (DoLS). People were asked for their consent to the care and support they received

People told us they received their medicine when they needed to. We saw improvements had been made to people’s medicine records and medicine was now being stored securely and managed safely.

People’s care records focused on their healthcare needs and the risks associated with them. The service had made improvements to how they recorded information on people’s individual needs, history, their likes, dislikes and preferences.

Improvements had been made in how the service kept and monitored its records. Care and support plans were reviewed and updated regularly and regular audits were carried out to ensure records were complete. Internal audits and reporting mechanisms were now in place and so errors and risk could be highlighted and acted upon.

Our inspection took place on 15 and 16 December 2015 and was unannounced. At the end of the first day we told the provider we would be returning the next day to continue with our inspection.

The service had a registered manager in post. 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.

People told us they received their medicine when they needed to but some records were not complete and some people’s medicines were not being stored securely and managed safely.

People’s care records focused on their healthcare needs and the risks associated with them. There was very little information on people’s individual needs, history, their likes, dislikes and preferences. This meant that staff may not know people well which could impact on how staff manage and support people when they became upset.

People’s records were not always accessible, complete or reviewed regularly. Internal audits and reporting mechanisms were weak so some errors and risk were not highlighted or acted upon.

There were systems and processes in place to protect people from the risk of harm but sometimes incidents and accidents were not investigated or acted upon to help reduce the possibility of future events.

People using the service told us they felt safe at Rosemanor 2. They were encouraged to take part in activities and to continue to be part of their community. People were supported to maintain relationships with family and friends who were important to them.

There were clear procedures in place to recognise and respond to abuse and staff had been trained in how to follow these. Staffing numbers on each shift were sufficient to help make sure people were kept safe. Appropriate recruitment checks took place before staff started work. Staff told us they felt supported by the management team.

People were supported to have their health needs met. Staff worked with the person to access the GP and other local health services as appropriate to help make sure their individual health needs were met.

Staff received training which gave them the knowledge and skills to support people effectively. Staff had received training in the Mental Capacity Act (MCA) 2005 and the Deprivation of Liberty Safeguards (DoLS). People were asked for their consent to the care and support they received.

The service was in breach of three of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. These were in relation to the management of medicines, safe care and treatment and governance. You can see what action we told the provider to take at the back of the full version of this report.