Rose Lodge

Updated 19 December 2020

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 Care Act 2014.

Inspection team

The inspection was carried out by an inspector and an assistant inspector.

Service and service type

Rose Lodge is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

We gave the service 24 hours' notice of the inspection. This was due to the COVID-19 pandemic and we wanted to make sure the management team at the service could support the inspection.

What we did before the inspection

We reviewed the information we held about the service such as when the provider told us about serious injuries or events.

The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.

We sought feedback from the local authority contracts monitoring and safeguarding adults' teams and reviewed the information they provided. We contacted the NHS Clinical Commissioning Group (CCG), who commission services from the provider, and the local Healthwatch for their feedback. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We used all of this information to plan our inspection.

During the inspection

We reviewed documentation, inspected the safety of the premises, the arrangements for infection prevention and control, and carried out observations in communal areas. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

We spoke with four people living at the service and nine members of staff including the registered manager, deputy manager, quality director and care staff.

We reviewed the care records for five people, the medicine records for nine people and the recruitment records for two staff.

After the inspection

We looked at a range of records. These included staffing rotas, training records, meeting minutes, policies and procedures, environmental safety and information relating to the governance of the service.

We continued to seek clarification from the provider to validate evidence found. We requested further assurances that issues found during the inspection were being acted upon and measures put in place to remove identified risks. The management team were proactive and provided updates throughout and after the inspection.

We emailed and telephoned relatives but did not receive any feedback from the relatives we contacted.

Updated 19 December 2020

About the service

Rose Lodge is a residential care home providing accommodation and personal care to a maximum of 54 people. At the time of inspection there were 43 people living at the home, some of whom were living with a dementia.

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

People told us they felt safe and secure living at the home. People commented that they had positive relationships with staff, but they felt that staff did not always have enough time to spend quality one-to-one time with them.

There were enough staff on duty to safely support people, but they were not always deployed appropriately. The management team took immediate action and changed the deployment areas for staff to ensure that there were enough staff on each floor to support people. Staff were recruited safely and received regular training.

Medicines management had improved, and medicines were now managed safely. Since our last inspection record keeping had improved. Risk assessments were in place for people and the environment to help keep people safe. Care records were accurate and regularly reviewed.

There was an effective infection prevention and control policy in place and staff were following this to keep people safe. This had been reviewed and updated to reflect the current pandemic relating to COVID-19 and extra steps were in place to minimise the risk to people living at the service. We did find that due to staff not being suitably deployed, there were no identified areas on the first floor for staff to change PPE to help reduce the risk of spreading infections. The management team addressed this issue as part of the staff deployment concerns.

There was a robust quality and assurance framework in place, which allowed the registered manager to monitor the safety and quality of the care provided and improve the service. Staff worked with other agencies to provide people with the support they needed.

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.

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 18 October 2019) and there were multiple breaches of regulation. 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

We carried out an unannounced comprehensive inspection of this service on 30 September 2019. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve safe care and treatment and the governance arrangements at the service.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe, Effective and Well-led which contain those requirements.

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 coronavirus and other infection outbreaks effectively.

The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Rose Lodge on our website at www.cqc.org.uk.

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.