Archived: Roseway House

Updated 8 February 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 28 November and 8 December 2016. The first visit to the home was unannounced.

The inspection team was carried out by one adult social care inspector and an expert by experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Before the inspection we reviewed the information we held about the home. This included the notifications we had received from the provider. Notifications are changes, events or incidents the provider is legally required to let us know about. We also contacted the local authority commissioners of the service, the clinical commissioning group (CCG) and the local Health Watch.

The provider completed a provider information return (PIR) prior to the inspection. This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make.

We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

We spoke with three people who used the service and eight relatives. Most of the feedback we received was from relatives as many people using the service had difficulties with communication. We also spoke with the registered manager, the deputy manager, a nurse, a senior care worker and three care workers. We looked at a range of records which included the care records for four people, medicines records for 34 people and recruitment records for five care workers.

Updated 8 February 2017

The inspection took place on 28 November and 8 December 2016. This was an unannounced inspection. We last inspected the service on 28 September, 5 October and 19 November 2015 and found the provider had breached the regulations relating to medicines management and suitability of the premises.

Roseway House is a purpose built care home providing nursing and residential care for up to 49 older people, some of whom are living with dementia. At the time of our inspection there were 34 people using the service. In July 2016 a new provider took over management responsibility for the home.

Since our last inspection the home had a new 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.

Following our last inspection the provider had made progress to improve the management of medicines in the home. We found there were accurate records to confirm medicines were administered and stored correctly. All of the high priority areas identified in the fire risk assessment had been actioned and completed since we last visited the home.

The current gas safety certificate and legionella assessment were overdue. These had been arranged and would be completed by the end of December 2016. We have asked the provider to confirm what action they plan to take to protect people from risks posed by uncovered radiators in the home. We are dealing with this issue outside of this inspection.

Relatives and care workers told us the home was safe. They also gave us positive feedback about their care and the care workers providing this care. Risk assessments had been carried out to help keep people safe. For example, people were assessed against the risk of poor nutrition, skin damage and falling.

Care workers had a good understanding of safeguarding and the whistle blowing procedure. They knew how to raise concerns and said they did not have concerns about people’s safety. Safeguarding concerns had been dealt with in line with the agreed local procedures.

There were enough care workers to support people’s needs in a timely manner. People and relatives told us care workers responded quickly to their requests for help. Care workers also said there were enough staff.

The provider had effective recruitment checks in place. These included requesting references and Disclosure and Barring Service (DBS) checks.

Incidents and accidents had been logged, fully investigated and action taken to help keep people safe from harm.

Care workers were well supported in their role. One to one supervisions were on track following a period where opportunities for care workers to meet with their line manager had lapsed.

The provider followed the requirements of Mental Capacity Act 2005 (MCA). DoLS authorisations had been approved for all relevant people. Decisions made in people’s best interests were only made following a MCA assessment. Care workers had a good understanding of the MCA and knew how to support people with decision making.

People received support in line with their needs. Personalised care plans described the support people needed with meeting their nutritional needs including their preferences and any special dietary requirements.

People received regular input from external health professionals when required. A visiting health professional gave us positive feedback about the care people received at the home.

People’s needs had been assessed both before and after admission to the home. Not all people had a life history in their care records to help care workers better understand their needs. The registered manager said life histories and one page profiles were to be developed for each person.

Most care plans we viewed were personalised and included information about people’s specific needs and preferences. Care plans had been evaluated regularly to keep them up to date.

Relatives gave us mixed views about the activities provided. In particular they commented that people living on the first floor did not always have opportunities to take part in activities. They also commented that people sat for long periods in front of the television. We also observed this on a number of occasions during the inspection. The registered manager advised a second activity co-ordinator was due to start and the activity programme was to be reviewed. Activities were on-going during our visit such as ball games. Other activities available included playing cards, chatting, watching TV and looking at memory cards. Some people were supported to do small daily living tasks. We have made a recommendation about the provision of activities.

Meetings for people and family members were being re-launched as these had previously been infrequent. A meeting was to take place on the evening of the day we inspected the home.

Relatives knew how to complain if they had concerns about their family member’s care. Previous complaints received had been thoroughly investigated and resolved.

Relatives and care workers gave us positive feedback about the approachability of the registered manager. They also told us about the improvements made to the home, such as new flooring, the re-decoration programme, better support for care workers and improvements to the meals provided at the home.

We have asked the provider to send us the findings from the most recent consultation with people and relatives. This was not available when we inspected.

There was an effective quality assurance system in place. This included checks on medicines management, the quality of care plans and a nutritional audit. The audits had been successful in identifying areas for improvement and action had been taken to deliver these improvements.