Roselands Residential Home

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• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

We assessed 6 quality statements in the effective key question. The assessment of these areas indicated areas of good practice and improvements since the last inspection, our rating for the key question has changed to good. An assessment of people’s needs was completed in line with best practice guidance. People were involved in planning and reviewing their care along with their loved ones. People’s care plans were relevant to their needs. Staff were knowledgeable about how best to support people and updated people’s care plans when their needs changed. Documentation evidenced that transitions into the service were done safely and effectively, and staff took time to get to know people and what was important to them. People were supported to maintain their nutrition and hydration needs and had choice over what they ate and drank. Staff worked effectively with other external bodies to help meet people’s individual needs and support them to live healthier lives. People’s rights around their consent to care and treatment were respected and decisions were made in line with the principles of the Mental Capacity Act.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People, their relative’s and health professionals were consulted with when people’s needs were assessed. People and their relatives were encouraged to get to know the home before agreeing to move in. People told us staff assessed their loved ones prior to them moving into the service to ensure they could meet their needs.

Staff told us people’s care needs were assessed before they lived at the service and were routinely reviewed as and when their needs changed. Staff told us they felt involved in the planning and updating of people’s care. One staff member told us that before someone moved into the home, they would be able to read information about the person. They said, “This helped us to know the person before they moved in.”

There were systems in place to assess, monitor, review and update care plans accordingly. Care plans were reflective of people’s needs, and were detailed of people’s wishes, likes and preferences.

People and relatives told us staff knew people’s individual health needs and followed best practice guidelines. A relative told us how their loved one had needed to gain weight due to being underweight, and gave examples of how staff had supported with this.

Staff told us they received training to ensure they had the knowledge and skills to meet people’s needs. Where people had more complex needs, such as diabetes and required insulin, staff had specific training to be able to support them safely and their dietary needs were met by the catering team.

Care plans contained all the required information to ensure peoples care and health needs were met by staff, and these were reviewed regularly. There were good systems in place to monitor people’s weight and MUST and referrals were made when required to the SALT team and dieticians. People were involved with the menu planning and people with dietary requirements could enjoy a wide variety of foods along with other people.

People told us that staff worked well with other services and health professionals. One person told us, “If you need a doctor staff will get one to come. I haven't seen one for a while. I did have an infection some time ago and staff spoke to the doctor, and he sent me some tablets. I do see the Chiropodist. They come here and are actually due this month.”

Staff told us that they work well as team and support each other whenever needed. They explained how they liaised with health care professionals to ensure people’s needs were met. The registered manager described how they had worked closely with the community dentist and identified a number of people living at the home who needed to be reviewed by the dentists, and they came in to see people.

Feedback from health professionals was positive, one health care professional told us, "I have and will continue to recommend Roselands to any of my patients who are living independently that may need more care or respite care in the future." Feedback from another community professional was that all staff at Roselands supported them when they visited, and nothing was too much trouble.

Team meetings were held regularly, to discuss people’s needs and ensure these were met and staff were positive about these. Recommendations from outside agencies were recorded in people’s care plans for staff to follow.

People told us staff encouraged them to be healthy and to make positive decisions about their care. One person said, “Staff give me my medication, they keep it locked away. I do have Insulin, and they will prep it for me as my right eye is not good and I am waiting for an operation on it. Then I will give it, but they will watch me. The Insulin they keep in my drawer. I do get a lot of headaches, but they do keep an eye on this.”

Staff understood people's needs such as their dietary requirements. The registered manager gave us examples of supporting people’s oral health care, and how they engaged with community dentists and other health care professionals, to obtain advice and guidance to promote people’s health.

There were processes and systems in place to assess and review people’s health needs, for example we saw in peoples care plans records of input from health professionals and continued assessment from staff. Information was displayed around the home of how to promote people’s health and well-being.

People told us that staff monitored their care needs to ensure they were met. One person said, “If I had any pain I would just ask, and they would get me something. They would always talk to me if there were any changes to my tablets.”

Staff were knowledgeable of how to meet peoples’ individual needs. Staff gave an example of due to someone’s agitation they were concerned about meeting their needs. Through continual monitoring and engagement with other relevant professionals the person has now settled at the home.

Up to date and sector specific information was made available for staff to expand their skill set and knowledge. There were systems in place for staff to share information around peoples needs to provide person centred care and positive outcomes.

People told us staff obtained their consent prior to receiving any care. People were encouraged to be as independent as possible. One person said, "I decide everything. I do what I want to. It's my choice what to do. Staff help me get up, they come to me and if I don't want to get up then they will come back. I'm just happy being on my own.”

Staff understood the Mental Capacity Act and ensured that people were asked to consent and offered choice before care was provided. Staff told us how they supported people who were less able to make their own choices and decisions. One staff member said, “If they are unable to make a choice, we will ask at a different time to see if they can make a choice then.” Staff also told us if people were unable to make a decision at a particular time, for example, a meal choice, then staff would make decisions with them using their knowledge of the person and their preferences. Another staff member said, “People fluctuate, and we work with them throughout each day, to help them make choices.”

Mental capacity assessments were completed, and best interest decisions made with the involvement of relevant others, when needed. Care plans provided staff with guidance about how to involve people as fully as possible in making decisions including access to advocates. Mental capacity assessments were decision specific and signed by people or those with the authority to do so.