Rosewood Care Home

Updated 7 July 2021

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.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was undertaken by two inspectors.

Service and service type

Rosewood 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 did not have 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

This inspection was unannounced.

Inspection activity started on 29 April and ended on 13 May 2021. We visited the service on 29 April 2021.

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 who work with the service. 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 used all of this information to plan our inspection.

During the inspection-

We spoke with nine people who used the service and four relatives about their experience of the care provided. We also spoke with eight care staff, activities co-ordinator, chef, deputy manager, and the provider and a visiting healthcare professional.

We reviewed a range of documents and records including the care records for six people, four medicine records, two staff files and training records. We also looked at records that related to the management and quality assurance of the service.

After the inspection

We continued to seek clarification from the manager to validate evidence found. We reviewed various records such as training information, care plans and quality assurance records. We also undertook telephone calls to relatives and staff to gain feedback. We had telephone discussions with the deputy manager and the provider to discuss these records and the service.

Updated 7 July 2021

About the service

Rosewood Care home is a residential care home providing personal care and accommodation for up to 43 people some of whom may live with Dementia. The service was supporting 25 people at the time of the inspection.

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

Although some improvements had been made since our last inspection the risks to people associated with their care and treatment continued to be consistently not well managed which left people at potential risk of harm. Improvements were being made to ensure people received their medicines when they needed them. Enough staff were on duty to meet people’s care needs. Systems were in place to protect people from risk of abuse. Measures were in place to prevent the spread of infection.

People were overall 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. Staff had the training they needed for their role. People were provided with choices at mealtimes but there was a lack of interaction between people and staff during meals. People accessed healthcare services to ensure their needs were met.

People were supported by staff who were caring and were supported to make daily choices about their care. People were treated with respect and dignity.

Staff knew people well and were responsive to their needs. Improvements were being made to ensure records contained personalised information about people including their end of life wishes. People knew how to raise concerns. People had opportunities to engage in activities although this could be improved for people that lived with dementia.

Improvements had been made since our last inspection, however due to changes in management and Covid-19 these has not been sustained and embedded. Systems were in place to maintain oversight of the service, but these were not always robust to ensure actions were taken in a timely manner. The culture of the service was not consistently person centred, but action was being taken to address this.

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 12 July 2019) and there were three 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 enough improvement had not been made/ sustained, and the provider was still in breach of regulations.

The service remains rated requires improvement. This service has been rated requires improvement for the last four consecutive inspections.

Why we inspected

This was a planned inspection based on the previous rating.

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.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service.

We have identified continued breaches in relation to the safe support provided to people and the overall governance of the service at this inspection. We have not issued any further enforcement actions and the conditions we imposed following our previous inspection will remain in place.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.