This unannounced inspection took place on 7 November 2017. At our previous inspection in January 2017 we found that the service was not always safe, effective, caring, responsive or well led and we found three breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. At this inspection we found that improvements had been made and the provider was no longer in breach of the three regulations. However further improvements were required and we found two new breaches of Regulations. This is the second consecutive time the service has been rated as requires improvement. You can see what action we told the provider to take at the back of the full version of the report.
Rosevilla provides accommodation, personal and nursing care for up to 40 people. 10 places at the service were for people who required rehabilitation following a stay in hospital. At the time of the inspection 36 people were using the service.
There was 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.
Lessons were not always learned and risks reduced following incidents and accidents which could have resulted in harm. Prompt action was not always taken to respond to people's individual changing needs.
People's medicines were managed safely, however further information was needed to inform staff as to when people may require their medication.
The principles of the MCA were not being consistently followed to ensure that people who lacked the mental capacity to agree to their treatment were supported to do so in their best interests.
People's needs and choices were assessed, however further information was required to ensure people's individual diverse needs were identified and responded to.
People's dignity was not always maintained and people were not always involved and offered choices about their care.
Statutory notifications had not always been submitted and the registered manager did not follow current legislation to support people to make decisions.
People were protected from the risk of infection as safe infection control measures were in place.
People were protected from the risk of abuse as staff and the registered managers followed the safeguarding procedures if they suspected abuse.
There were sufficient numbers of suitably trained staff to meet the needs of people who used the service. Staff received training and support to fulfil their roles.
People received health care support when they became unwell or their needs changed and they were supported to eat and drink sufficient amounts to remain healthy.
Staff worked together with other agencies to ensure that people's needs were met effectively.
The environment had been adapted to meet people's individual needs and preferences.
People were enabled to be as independent and people told us that staff were kind and caring. People felt able to raise concerns and any complaints were acted upon.
People's end of life wishes were gained and staff worked with other agencies to ensure people received dignified care at this time.
The systems the provider had in place were improving the service and there were further plans to improve the quality of care for people. People and staff liked and respected the registered manager.