Rose Cottage Nursing Home

Updated 6 April 2023

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.

Inspection team

The inspection was carried out by 2 inspectors 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

Rose Cottage 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. Rose Cottage 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 reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. 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 all this information to plan our inspection.

During the inspection

We spoke with 10 people who used the service and 3 relatives. We observed the environment and the way staff interacted with people. We looked at 4 people's care records and 2 medicine administration records (MARs). We spoke with 5 members of staff including the registered manager, carers, and support staff. Following the inspection, we also spoke with the local authority who had recently carried out their own quality checks and the local safeguarding team.

We reviewed a range of records relating to people's care and the way the service was managed. These included staff training records, 3 staff recruitment files, quality assurance audits, incidents and accidents reports, complaints records, and records relating to the management of the service.

Updated 6 April 2023

About the service

Rose Cottage is a residential care home providing accommodation for persons who require nursing and personal care for to up to 21 people. The care home accommodates 21 people in one adapted building. At the time of our inspection there were 18 people using the service.

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

People were not always protected from the risk of harm. Records did not always evidence action taken to keep people safe. Staff were not always provided with detailed guidance to follow when supporting people with complex needs.

Medicines were not always managed safely. The provider had an auditing system which included auditing medicines; however, shortfalls found during inspection were not always picked up by these audits.

Staff we spoke with understood their responsibilities to report concerns. There were enough staff to meet people's needs. Staff told us they felt they had the skills, time and support they needed to meet people's needs.

When incidents or accidents occurred, it was not always clear these were investigated, and if lessons were learnt. There were systems in place to monitor the safety and quality of the service. However, these monitoring systems were not always effective in identifying quality concerns and had not identified the concerns we found at this inspection.

People and their families gave positive feedback about being involved in the planning of their care and the care they received from staff at Rose Cottage Nursing Home.

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; however we saw that documentation around best interest decision was not always completed in full as it did not involve professionals in decision making. We were assured by the provider that this would be implemented immediately.

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 (23 January 2019).

At our last inspection we recommended that the service seeks guidance from a reputable source in relation to effective quality assurances systems to identify and manage potential risks to people. At this inspection we found that although regular audits were being carried out, these were not always effective at driving improvement or identifying concerns found on inspection.

Why we inspected

The inspection was prompted as we received concerns in relation to people’s safety, nursing care needs, management of the service and staff competency. As a result, we undertook a focused inspection to review the key questions of safe, effective, and well-led only.

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.

You can see what action we have asked the provider to take at the end of this full report.

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 have found evidence that the provider needs to make improvements. Please see the safe and well-led relevant sections of this full report.

Follow up

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