We carried out a review of the data available to us about Rose Lodge 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, you can give feedback on this 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.
Rose Lodge is a residential care home that provides accommodation and personal care for up to 54 people some of whom are living with dementia. On the day of our visit there were 50 people using the service.
People’s experience of using this service and what we found
Records to show medicines were administered safely were not always completed or correct. People were protected from abuse by staff who understood how to identify and report any concerns. The risks to people’s health, safety and welfare had been identified. However, these were not always addressed in people's care plans. The provider had recognised that more staff were needed and were going through the recruitment process. The management team sought to learn from any accidents or incidents involving people. Some areas of the service needed cleaning. Records for bathing temperatures were very low, sometimes as low as 32 degrees.
Staff were recruited safely and received appropriate training and support to enable them to carry out their role effectively. 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. Not all people were happy with the food provided and the dining experience needed improving.
We have made a recommendation about improving the dining experience for people.
Staff were caring and treated people with kindness and respect.
People had care plans which guided staff on the most appropriate way to support them. People were confident to raise any concerns. People enjoyed the activities provided.
There was a clear management structure in place and staff were supported by the registered manager. Quality assurance systems were completed and had identified some of the concerns we raised. However, these concerns were continuing. Records were not always updated or fully completed.
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 good (published 11 April 2017).
Why we inspected
This was a planned inspection based on the previous rating.
We have found evidence that the provider needs to make improvements.
You can see what action we have asked the provider to take at the end of this report.
Enforcement
We identified breaches in relation to keeping people safe and good governance.
Follow up
We will request an action plan from the provider to show how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
Rose Lodge is a residential care home based at Cobblers Hall in Newton Aycliffe, County Durham. The home provides personal care for older people and people living with dementia. It is situated close to a wide range of local amenities and transport links. On the day of our inspection there were 52 people using the service.
The service had a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 last inspected the service in February 2015 and rated the service as ‘Good.’ At this inspection we found the service remained ‘Good’ and met all the fundamental standards we inspected against.
The atmosphere of the service was lively with lots going on but at the same time homely. Relatives told us the service was very welcoming. People who used the service and their relatives that we spoke with told us they felt the service had a friendly approach.
Without exception we saw staff interacting with people in a person centred and caring way. We spent time observing the support that took place in the service. We saw that people were always respected by staff and treated with kindness. We saw staff being considerate and communicating with people well.
We saw that people were encouraged to enhance their wellbeing on a daily basis to take part in activities that encouraged and maximised their independence and also contributed positively to the atmosphere of the service.
We spoke with a range of different team members; care, kitchen staff, activity staff, domestics and volunteers who told us they all felt well supported and that the registered manager was supportive, and they were all polite, receptive, open and approachable. We also spoke with the registered provider’s visiting quality assurance manager and a student who was on their placement at the service.
Throughout the day we saw that people who used the service, relatives and staff were comfortable, relaxed and had an extremely positive rapport with the registered manager and also with each other.
From looking at people’s care plans we saw they were written in plain English and in a person centred way and they were in the process of including a ‘one page profile’ that made use ofpersonal history and described individual’s care, treatment and support needs. These were regularly reviewed and included family members and people in the process.
Care plans contained risk assessments. These identified risks and described the measures and interventions to be taken to ensure people were protected from the risk of harm. The care plans we viewed also showed us that people’s health was monitored and referrals were made to other health care professionals where necessary, for example: their GP, community nurse or optician.
Our observations during the inspection showed us that people who used the service were supported by sufficient numbers of staff to meet their individual needs and wishes in a person centred way.
When we looked at the staff training records, they showed us staff were supported and able to maintain and develop their skills through training and development opportunities were accessible at this service. The staff we spoke with confirmed they attended a range of valuable learning opportunities. They told us they had regular supervisions and appraisals with the registered manager, where they had the opportunity to discuss their care practice and identify further mandatory and vocational training needs. We also viewed records that showed us there were robust recruitment processes in place.
We observed how the service administered medicines and how they did this safely. We looked at how records were kept and spoke with the registered manager about how senior staff were trained to administer medicines and we found that the administering process was person centred and safe.
People were actively encouraged to participate in numerous activities that were well thought out, organised, personalised and meaningful to them including the use of volunteers and regular entertainers. We saw staff spending their time positively engaging with people as a group and on a one to one basis in fun and meaningful activities. We saw evidence that people were supported to go out regularly too.
We saw people were encouraged to eat and drink sufficient amounts to meet their needs. We observed people being offered a varied selection of drinks and homemade treats and snacks. The daily menu that we saw was reflective of people’s dietary needs, likes and dislikes and offered varied choices and it was not an issue if people wanted something different.
We saw a complaints and compliments procedure was in place. This provided information on the action to take if someone wished to make a complaint and what they should expect to happen next. The compliments that we looked at were very complimentary to the care staff, management and the service as a whole. People also had their rights respected and access to advocacy services if needed.
We found an effective quality assurance survey took place regularly and we looked at the results. The service had been regularly reviewed through a range of internal and external audits. We saw that action had been taken to improve the service or put right any issues found. We found people who used the service and their representatives were regularly asked for their views about the care and service they received at meetings and via surveys.
We found that the registered manager ensured that the service made good links with the local community and public resources across the county to benefit the people who used the service.
This inspection took place on 17 December 2014 and was unannounced. This meant the staff and provider did not know we would be visiting.
Rose Lodge provides care and accommodation for up to 54 people, including people living with dementia. On the day of our inspection there were 48 people using the service.
The home did not have a registered manager in place as the registered manager had recently left the service. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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. A new manager was in post and was in the process of registering with CQC at the time of our inspection.
Rose Lodge was last inspected by CQC on 17 April 2013 and was compliant.
There were sufficient numbers of staff on duty in order to meet the needs of people using the service. The provider had an effective recruitment and selection procedure in place and carried out relevant checks when they employed staff.
Staff were aware of their responsibilities with regard to protecting vulnerable people and training records we looked at showed that staff were up to date with safeguarding training.
Training records were up to date and staff received regular supervisions and appraisals, which meant that staff were properly supported to provide care to people who used the service.
We saw in the care records consent was obtained for sharing information, photography, agreement with care plan reviews and care plan participation. All of the records we saw had been signed apart from one, which was for a person who was recently admitted to the home.
CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. The Deprivation of Liberty Safeguards (DoLS) are part of the Mental Capacity Act 2005. They aim to make sure that people in care homes, hospitals and supported living are looked after in a way that does not inappropriately restrict their freedom. We discussed DoLS with the manager and looked at records. We found the provider was following the requirements in the DoLS.
People who used the service, and family members, were complimentary about the standard of care at Rose Lodge. They told us, “It’s lovely”, “she’s been here seven years and we couldn’t be happier” and “they are very caring”.
Staff talked to people in a polite and respectful manner, were responsive to people and interacted well and treated people with care and compassion.
Care records showed people’s needs were assessed before they moved into Rose Lodge and care plans were written in a person centred way.
We saw a copy of the provider’s complaints policy and procedure and saw that complaints were fully investigated and responded to.
The provider had a robust quality assurance system in place and gathered information about the quality of their service from a variety of sources.
As part of this scheduled inspection we followed up on a compliance action set at the previous inspection in August 2012. We found improvements had been made in this area.
People who used the service were given appropriate information and support regarding their care or treatment. One person said "It's alright here, the staff are great. I've got no complaints.' Other people said they were happy to be living at Rose Lodge.
People told us they were happy with the care and support they received. One person told us "I'm very well looked after' and another person said 'I'm quite happy as it is.' Everybody we spoke with was well presented and looked well cared for.
People said their rooms were kept clean and they were happy with the standard of cleanliness throughout the home.
People were very complimentary about the staff. Comments about the staff included 'The girls (staff) are really great', 'Talking to them (the staff) is a big help. If I needed anything, they'd help me' and 'The staff's manner is great ' we have a daft carry on.'
The provider had an effective system to regularly assess and monitor the quality of service that people received.
treated by staff and their involvement in making choices about their care. They
also told us about the quality and choice of food and drink available. This was
because this inspection was part of a themed inspection programme to assess
whether older people living in care homes are treated with dignity and respect
and whether their nutritional needs are met.
The inspection team was led by a CQC inspector joined by an 'expert by
experience' (people who have experience of using services and who can provide
that perspective).