The inspection took place on the Tuesday 15 December 2015. The inspection was unannounced. The previous inspection was completed in April 2014 and the provider was compliant with the outcomes assessed.Rosevale is a care home service without nursing. They provide long term accommodation for up to forty four older people who require nursing or personal care, some of whom may be living with dementia. At the time of our inspection there were thirty five people receiving a service. Rosevale Residential Care Home is located a short drive from the city of York, in the village of Wigginton and has enclosed mature landscaped gardens. Off road parking is available at the front of the building for visitors.
Rosevale has a registered manager. A registered manager is a person who has registered with the Care Quality Commission 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.
People and their relatives spoke positively about the care they received. It was clear from talking to people and looking at care plans that care was person centred. People told us they felt safe and we found that staff knew how to protect people from avoidable harm. Staff knew how to recognise different signs of abuse and they were clear about what action to take if they suspected abuse was taking place. The registered provider had a safeguarding policy in place updated within local authority guidelines.
People were encouraged to live as independently as possible and we saw detailed risk assessments and risk management plans were in place to enable people to live independently and undertake a variety of daily activities in a safe way.
Rosevale Care Home demonstrated a high awareness for people’s safety. We saw risk assessments for the environment which included personal emergency evacuation plans [PEEPs] for each individual person. PEEPs are documents which advise of the support people need in the event of an evacuation taking place.
We looked at monthly checks on emergency lighting, fire extinguishers, room and water temperatures and pressure mats and saw that these were all up to date. The registered manager showed us maintenance certificates for electrical wiring, gas safety and portable appliance checks. These were also up to date and helped to ensure the safety of the premises for people.
There were enough competent staff on duty and staffing levels were regularly reviewed to ensure that there were sufficient numbers of qualified staff to meet people’s changing needs. Care workers told us there was adequate staffing; one care worker told us “The rotas work really well, staffing is well managed.”
Recruitment of staff was robust with checks undertaken by the provider ensuring that only people considered suitable to work with vulnerable people had been employed. New employees were enrolled on an induction and shadowing process ensuring they had the required skills to undertake their duties and provide person centred care.
Medicines were stored safely and securely. Policies and procedures were in place for storing, administering, recording and, where applicable, returning medication. We saw these were strictly adhered to. Only team leaders administered medication and we saw they had undertaken appropriate training. In addition, competency checks had been carried out so that the registered manager could monitor that staff remained competent to administer medication safely.
Management and staff had received training in and understood the requirements of the Mental Capacity Act 2005 [MCA]. The MCA provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. Where people may have lacked capacity the registered provider ensured that the MCA was followed and we saw that prompt application for deprivation of liberty safeguards [DoLS] had been completed. DoLS were regularly reviewed and evaluated. Where an individual had capacity to make decisions in other areas of their lives we saw that they were encouraged by staff to provide their consent.
We saw there was a choice of menu and the chef told us that all meals were homemade. We saw this included a vegetarian option. The registered service had an environmental health officer food hygiene rating [FHRS] award of 5.
People told us that they were well cared for and had access to a range of health professionals. The local general practitioner [GP] attended on the day of our inspection. People told us they could see a GP when they wanted to. We saw records of professional contacts with healthcare services documented in peoples care plans. These included GP, district nurse, community psychiatric nurse, and mental health practitioner.
There was an activities coordinator employed. We saw a variety of activities and seasonal events were organised in line with people’s requests and feedback. These were well advertised on notice boards and one person had a verbal update each day to ensure they did not miss out.
People and their relatives were involved in the assessment and planning of their care and support. Peoples care plans showed how they were involved in making decisions about their care, treatment and support. Care plans were detailed and included information about peoples likes and dislikes. One person said “I like to use my own toiletries and the staff know this because they have it written down.”
We saw staff providing information and explanations before carrying out care to people. They were sensitive and warm and we saw people smiled in response to staff approaching. It was evident that staff knew and understood people’s individual communication skills preferences and needs.