Roseacre

Updated 12 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

This inspection was completed by two adult social care inspectors.

Service and service type

Roseacre 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 notice of the inspection to the provider to enable appropriate Infection control arrangements to be made to enable the inspection to be safely completed during the Covid-19 pandemic. After the service had been notified of our intention to inspect, the inspection began but the site visit was delayed due to CQC resourcing issues.

What we did before 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. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We spoke briefly with five people who used the service, three staff, the registered manager and the service’s three other managers. We observed staff providing care and support to people during the lunchtime meal from a socially distanced position.

We reviewed a range of records. This included three people’s care records and multiple medication records. We looked at two staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at training data, quality assurance records and other information we had requested from the service during the site visit. We also received written feedback from five professionals who worked with the service regularly, one member of staff and two people’s relatives.

Updated 12 December 2020

About the service

Roseacre is a residential care home providing personal care to 20 people aged 65 and over at the time of the inspection. The service can support up to 22 people. The service is a detached two-story building set within its own grounds in a rural setting.

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

The service’s infection control practices had significantly improved since our last inspection. Repairs had been completed to make areas easier to clean and hand washing and drying facilities were now readily available throughout. We were assured that the additional infection control measures introduced in response to the Covid-19 pandemic were appropriate and staff used PPE effectively during our site visit.

Action had been taken to address issues identified during our previous inspection in relation to the service’s management of risk. People’s care plans now included appropriate guidance for staff on the management of risk in relation to people’s known behaviours, falls risks and risks to skin integrity. Accidents and incidents were now appropriately investigated, and locks had been removed from a fire door.

Staff had been recruited safely and had the skills necessary to meet people’s needs. Planned staffing levels had been routinely achieved. Staffing levels at the weekend were considerably lower than during the working week but staff were confident these levels were sufficient.

Medicines were generally managed safely. However, we have made a recommendation about how ‘as required’ medicines are managed.

People told us “The food is very good” and improvements had been made to the systems in place for monitoring people at risk of weight loss.

Areas of damp in a person’s bedrooms had been addressed, call bell repaired and the service’s ground floor bathroom and kitchens had been upgraded. We have recommended that repeatedly delayed improvements to the service’s outdoor space be completed before next summer.

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.

Improvements had been made to the service’s needs assessment processes and care plans were now sufficiently detailed. They provided staff with enough information to enable them to meet people’s needs and staff told us, “The care plans are all really easy to understand. They have everything we need to know”.

An activities coordinator had recently been appointed and people were now able to access a range of activities within the service. People told us, “There are plenty of things to do, games, skittles things like that” and on the day of our inspection people enjoyed playing a variety of games with staff in the lounge.

The registered manager had acted on, addressed and resolved the issues identified during our last inspection and there were now appropriate quality assurance process in place. Information was shared appropriately with people’s relatives and any complaints received were investigated and resolved.

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 29 July 2019) and there were 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 previously carried out an unannounced comprehensive inspection of this service on 04 June 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 issues identified in relation to; personal care, safe care and treatment, premises and equipment, and good governance.

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, Responsive 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 Roseacre 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.