We carried out this inspection on 26 May 2015 and this was an unannounced inspection. During a previous inspection of this service in January 2014 we had identified concerns that people were not consistently involved in how their care was planned and provided or that care and treatment was not always planned to ensure people’s safety. We further found there were no effective systems to monitor the quality of care provided. During this inspection we found the provider had made the appropriate improvements.
Rosedale House provides personal care for a maximum of 23 people. At the time of the inspection there were 22 people living in the home.
A registered manager was in post at the time of inspection. 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 and associated Regulations about how the service is run.
Medicines were not always stored appropriately and in accordance with legal requirements.
The home was clean, however we identified areas where cross infection risks to people could be reduced. We have made a recommendation to the provider about following nationally published guidance to reduce cross infection risks.
People felt safe and staff could respond to suspected or actual abuse. Staff understood the concept of whistleblowing and were aware of external agencies they could report to.
People and their relatives told us the service met their needs quickly. Staff said there were sufficient numbers of staff on duty to enable them to perform their roles effectively and meet people’s needs.
Staffing levels set by the registered manager had been consistently achieved and staff numbers were increased when required. Safe recruitment procedures were completed when new staff were employed.
People spoke positively of the staff at the home and were happy with the standard of care they received. Staff felt they had the knowledge and skills to carry out their role. Staff received regular training. Appraisals and supervisions were completed to discuss performance.
The registered manager was aware of their responsibilities in regard to the Deprivation of Liberty Safeguards (DoLS). These safeguards aim to protect people living in care homes and hospitals from being inappropriately deprived of their liberty. These safeguards can only be used when a person lacks the mental capacity to make certain decisions and there is no other way of supporting the person safely. DoLS applications had been submitted where a need had been identified.
People were provided with sufficient food and drink and positive feedback was received on the standard of food provided. People received support if required and accurate records were maintained when food and fluid intake was being monitored.
Arrangements were made for people to see their GP and other healthcare professionals when required.
Staff had good relationships with people and we observed caring interactions throughout our inspection. People and their relatives spoke highly of the staff at the home.
Where possible, people were involved in making decisions about their care and treatment. Where people did not have the capacity to consent, the provider had acted in accordance with legal requirements.
People’s privacy and dignity was respected by staff. People received personalised care and staff knew the needs of the people they were caring for. The provider had a complaints procedure and people felt confident they could complain should the need arise.
Activities were arranged for people within the service and the activities co-ordinator ensured the activities were tailored and designed to stimulate people living with dementia.
People knew who to contact in the service and the registered manager was respected by staff and the people at the home. Staff felt they were able to approach the management of the service with ideas or concerns.
The provider had systems to monitor the quality of service provision and staff incentive schemes had been developed to encourage a high standard of care provision.
We found a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.