Rosclare Residential Home Limited

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Staff adhered to their responsibilities to safeguard people from avoidable harm and to report any concerns observed. People received their medicines as prescribed and there were safe medicines management processes in place. This included improvements to processes for the administration of ‘when required’ medicines. Infection prevention and control processes were adhered to and people were cared for in a clean and hygienic environment. Staff supported people to manage risks to their safety. However, we found that staff’s knowledge around risk management was not always appropriately captured in people’s care records. A safe environment was provided but required some adaptations to assist those living with dementia to navigate around the service. Staffing levels were established in line with people’s dependency needs. Staff felt there was good team working and sufficient staff to enable them to undertake their duties. However, some people felt at times staff were not easily accessible and they felt they were restricted to certain parts of the building so staff could more easily supervise them. Staff received a regular programme of training and were supported through supervision and appraisal processes. The registered manager took action to address the areas identified above following our feedback.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People were listened to by the staff team when they raised a concern. They felt heard and their feelings and thoughts were considered during care delivery.

The management team were open to change and took actions to improve as necessary. There was a learning culture within the staff team and they welcomed feedback from external reviews to ensure the best outcomes possible for the people being supported by the home.

The Duty of Candour is a regulation that all providers must adhere to. Under the Duty of Candour providers must be open and transparent if things go wrong. The staff team adhered to this duty. Processes were followed to ensure that appropriate actions were taken to address any incidents and accidents taking place. Staff were required to complete an incident form if they witnessed the incident or accident occurring. This was reviewed by the management team making sure people were protected and lessons learnt were shared with the staff team to prevent future occurrences.

Individual information about people was appropriately shared to ensure continued care delivery. For example, the service used the ‘red bag’ initiative which ensured people had all their important items, medicines and documentation in one place if they required hospital admission so that in an emergency important information was quickly and easily accessed by the medical staff.

The staff team worked together with people to ensure safe transitions between services. This also included supporting people to leave the care home and return to independent living.

Health and social care professionals working with the service felt there were safe systems in place to ensure joint working and continuity of care. One professional said, “I have found they take on any advice given. It is received and acted on to the best of their ability, ensuring continuity of care is provided for all patients.”

Systems were in place which involved people in care planning prior to moving to the home and to ensure smooth transition into the service. Information was gathered from the person, their family and any previous health or social care placement to get a holistic view of people’s needs and what was important to them, to support successful transitions.

People felt safe living at the care home. A person told us, “I do feel safe because of the staff, they’re always on the job. It gives you a safe feeling being here. It’s just a happy, safe place to be.” A family member commented, “I’m totally happy with things. It definitely feels safe. I feel relaxed that my relative is here. I think that says a lot.”

Staff were aware of the safeguarding process and received guidance on how to keep people safe from avoidable harm. Their comments included, “Safeguarding training is very good. If I saw something concerning, I have to inform my manager and she would take the steps.” The management team were clear about the safeguarding pathway they had to follow when information of concern was reported to them.

We observed good interactions between people and the staff team. We saw staff being kind, supportive, friendly, and reassuring to people. Staff took their time to listen to people’s wishes and choices and gave them time to express themselves. People seemed comfortable in staff's presence and asked for support when needed.

Processes were in place for recording, reporting and investigating any safeguarding concerns received. Safeguarding records included learning that was put in place from investigations to ensure people were cared for safely.

People were involved in making decisions about risks to their safety and wellbeing and how these should be managed. Staff used this information for guidance on actions they should take to minimise the potential risks to people’s safety.

Staff were knowledgeable about people’s individual care needs and the support they required to manage the potential risks to their safety. A staff member told us that if they observed a resident being anxious, “I try to give them time to calm down, we ask questions to understand what they want and why they are anxious. Like for example, if they want to go somewhere or eat something.”

Staff enabled people to take everyday risks and make choices about what they wanted. Staff encouraged people’s movement using mobility aids where it was assessed they required it for their safety.

There were processes in place to identify risks to people’s safety. However, we found that information about how to manage these risks continued to lack detail in some people’s written care records. Staff had this knowledge and there were processes in place to share this knowledge and learning through robust staff handovers which mitigated the risk to people’s safety. The manager informed us, following our feedback, they had updated people’s care records to include staff knowledge and provide detailed information about how to support people safely. Whilst people had mobility risk assessments in place, we found these processes did not always cover risks specific to the service. For example, in relation to steep staircases which were freely accessed by people. A person told us, “I don’t like going out in the garden as it doesn’t feel safe – too many steps.” This was discussed with the management team who took immediate action to assess the risks to people’s safety when using the stairs.

People had a choice about where to spend time in communal areas depending on their mood and how much they wanted to interact with other people. There was a quiet space for those who might be feeling anxious and wanted to have time for themselves. People spent time in the main lounge watching television, taking part in activities and socialising.

Staff were aware of their responsibly to ensure a safe environment for people to use. This included safe manual handling and movement around the service. Staff had received training and were aware of what equipment people required to keep them safe within the home’s environment. A staff member told us, “All residents have their zimmer frames with names on it and we have extra if needed.”

Premises were adapted to meet people's care and support needs safely. We saw good lighting and handrails available to support people when moving around the care home. People’s bedrooms looked well-kept and were decorated with personal items. We saw some pictorial guidance in the communal areas to support people’s orientation. However, more adaptation was required to help people stay independent for as long as possible and help to orientate people around the service, particularly for those living with dementia. This was discussed with the management team who told us that actions will be taken to improve people’s living environment.

Safety measures were undertaken to identify and manage hazards related to people's environment. Health and safety assessments and audits were undertaken to check the safety of the environment. People had Personal Emergency Evacuation Plans (PEEPS) in place to inform staff about the support they required should there be a fire in the home. Mobility equipment was checked and serviced to ensure it was in good working order.

We received mixed views from people about staffing levels. Some people told us, “I can always find a staff member, but I don’t really need them often.” And “I do feel safe – because of the staff; they’re always on the job.” Although we also heard, “It does feel safe. I suppose it is knowing that you can get help if needed, although there are not always staff around – they seem to disappear at times.” Some people also felt that due to staffing levels they were required to stay in the lounge where staff could easily observe them. People told us, "I prefer to sit in my room and [do activity], but [staff] always insist that I go to the lounge” and “[Staff] like you to go downstairs during the day.” This was discussed with the managing team who said they would review staff allocation to ensure people were able to spend time where they wished and this was not restricted due to staffing. People had access to call bells which staff responded to quickly. However, some people told us they only rang the call bell in an emergency. Records showed that the call bells were not used much by people. This was discussed with the registered manager who told us they were aware of this situation and regularly reminded people to use the call bells whenever they needed staff’s assistance with general matters such as if they wanted a cup of tea or their television to be switched on.

Staff felt they had enough time to undertake their duties effectively and safely. Comments included, “More than enough staff. We changed our policy from last year. We make sure we get occupied with the residents. We have a rota which tells us who does what, like medication and shower. We make sure everyone has a shower daily. If anyone refuses, we give a body wash and encourage the next day.” The management team told us there was a high retention of staff at the service. Shifts were covered by permanent staff as needed and currently the service was fully staffed.

Staff worked as a team, discussing issues, sharing tasks and helping each other where needed. Staff were visible and assisted people when they required support in communal areas. They were well trained and able to meet people’s care needs as necessary, which included a person being provided with appropriate support to manage their feelings when they became distressed.

Safe recruitment practices were in place which ensured people were supported by suitable staff. This included reviewing staff’s identity, their right to work in the UK, obtaining references and undertaking criminal records checks. Recognised tools were used to identify people’s dependency level and this was used to establish staffing levels, to ensure there were sufficient staff to meet people’s needs. Staff updated their skills and knowledge through regular training courses. We saw that staff were up to date with the majority of the provider’s mandatory training courses, and where this was due refresher courses had been booked. Staff were supported through regular supervision and appraisal.

People felt the home was well maintained and clean. They said, “It’s always clean. [Staff] are always polishing this and scrubbing that” and “There is a person who cleans, and they seem to do a good job.” A relative commented, “It is always clean when I visit and my relative always looks presentable.”

There was enough Personal Protective Equipment (PPE) provided and staff wore it as necessary. A staff member told us, “Yes, we have enough [of PPE]. We use masks if there is a risk of infection, but otherwise gloves and aprons at all times when providing personal care.”

Safety was promoted through the hygiene practices staff applied when supporting people at the home. The home was kept tidy and clutter-free in all areas accessed by people. We observed staff wearing PPE as necessary. Control of substances hazardous to health (COSHH) storage was maintained safely and only accessed by the staff team.

The provider’s ‘Infection control’ policy was up to date and guided staff on how to safely wear and dispose of the PPE. Monthly infection prevention and control audits were carried out by the registered manager to ensure a safe and infection free environment for the people living at the care home. Routine cleaning schedules were followed to prevent infections from spreading.

Staff supported people to manage their medicines safely and as prescribed. People’s comments included, “[Staff] usually give me my medication at breakfast,” and “The medication is perfect. I’ve never had a problem with the medication.” A relative told us, “[Staff] keep me updated about everything and any medication changes.”

Staff followed the process of checking people’s medicines against the records at the time of administration. A staff member told us, “I follow the MAR chart and I read the medication carefully - when and how I need to give it to the residents. I read the [medicines] boxes making sure it’s the right person.”

Systems and processes in place ensured people were supported to take their medicines in line with national guidance. Medicine administration records (MAR) were completed by staff after they administered the medicines to people. People now had 'as required' medicine protocols in place to guide staff on when these medicines should be given to them and staff recorded when and why these medicines were given.