Rosehill Care

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

This is the first assessment of this newly registered service and we therefore looked all 8 quality statements associated with this key question. Based on the findings of this assessment, our rating for this key question is good. This meant people were safe and protected from avoidable harm. However, we found potential risks people might face were not always accurately assessed or appropriate management plans developed to guide staff and help them mitigate or minimise these risks. We found no evidence that people had been harmed, but this failure had placed people at risk of harm. This represented a breach of Regulation 17 (Good Governance) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can find more details of our concerns in the evidence category findings below. The provider had a positive culture of learning lessons when things went wrong. The registered manager and staff understood their duty to safeguard people from abuse and protect them from harm. New staffs fitness and suitability to work in an adult social care setting was thoroughly assessed. Staff had the right levels of training and support to deliver safe and effective care to people. Staff followed current best practice guidelines regarding the prevention and control of infection.

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 told us the provider learnt lessons when things went wrong. They acknowledged when they should have done better. People were aware that if they wished to raise a concern or made a formal complaint they could speak to the registered manager. People were confident any concern and/or complaint they made would be taken seriously and investigated by the registered manager. A person told us, “I wasn’t happy with one carer I had coming here, so I told the [the registered manager] and she arranged for another carer to come instead.” A relative added, “There have been a few occasions when carers did not do the odd minor chore they should have done, but when I raised this as an issue with the manager [registered], she addressed it straight away to everyone’s satisfaction.”

The registered manager told us any incidents and accidents, safeguarding concerns or formal complaints involving the people they supported would always be reviewed to determine potential causes. The registered manager encouraged an open and transparent culture where people receiving a service, their representatives and staff could all raise concerns without fear.

The provider learnt lessons when things went wrong. Information about incidents, including lessons learnt, were shared and discussed with staff during regular meetings.

People were invited to participate in an assessment process prior to them receiving a home care service from this provider.

The registered manager assessed people's personal care needs before deciding whether or not they were able to safely meet those needs and offering to provide them with a home care service.

We requested feedback from external community health and social care professionals and bodies this provider worked closely with, but none was received.

The registered manager carried out an initial needs assessment for all prospective new service users. These assessments were used as the bases to develop care plans for everyone who received a home care service from this provider.

People told us they felt safe with the staff who regularly supported them at home. A person said, “I do feel absolutely safe with all the staff who come and look after me at my home.” A relative added, “I have no qualms about the staff who know how to keep my [family member] safe. I also have no doubt the [name of registered manager] knows how to report and deal with any allegations of abuse she receives.”

Staff were aware of safeguarding reporting procedures. They knew how to recognise and report abuse and were able to articulate how they would spot signs if people were at risk of abuse or harm. Staff received safeguarding adults training as part of their induction. Staff confirmed this was routinely refreshed. A member of staff told us, “I know what abuse is and what actions to take, including how to report and document it if it happens. This is because I have received safeguarding and staff whistleblowing training.” Another added, “I have had training for safeguarding and I know if such incidents were to happen I must report it to the manager [registered] straight away.” The registered manager understood their legal responsibility to immediately refer any safeguarding incidents or concerns to external agencies and bodies including, the relevant local authority, the CQC, and where necessary, the police.

Robust systems and processes were in place to protect people from the risk of abuse and harm. The provider had clear safeguarding and staff whistleblowing policies and procedures in place which were kept up to date, reflected relevant legislation and were easy for staff to access. We found the service was working within the principles of the Mental Capacity Act 2005 (MCA). MCA provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The MCA requires that, as far as possible, people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible. People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the Mental Capacity Act (MCA).

People told us staff knew how to keep them safe. A relative said, “The staff know exactly how to look after my [family member] and to minimise the risk of her being harmed.”

Staff told us they had been trained to keep people safe and prevent or minimise potential risks they might face. A member of staff said, “We’re trained to use proper moving and handling techniques to safely transfer people from one place to another. For example, when helping to move people on a bed we always use a sliding sheet, so we don’t drag and injure anyone, including ourselves. We also prevent pressure sores by constantly repositioning people to stop them lying in the same spot for too long.”

However, potential risks people might face had not always been assessed or management plans put in place to help staff prevent or safely manage identified risk. For example, risks associated with people falling and/or developing pressure sores had not always been accurately assessed. In addition, risk management plans were not always in place to help guide staff and ensure they knew how to prevent or manager these identified risks. We discussed this issue with the registered manager at the time of this assessment and they acknowledged their approach to risk assessing and management needed to be improved as a matter of urgency. The registered manager agreed staff would all benefit from having more sufficiently detailed risk assessments and management plans in place to guide and help staff have a better understanding of how to prevent or safely manage any potential risks people they supported.

People told us the registered manager and staff regularly visited them at home to check the health and safety of their home environment and to identify potential risks.

The registered manager routinely visited the home of everyone they provided personal care. This was to identify and safely manage potential risks in people’s home environment.

The registered manager carried out health and safety risk assessments on the home environments of everyone they provided personal care to.

People consistently reported that staff were punctual and would provide advance notice of any delays. A person said, “Staff are usually on time and they will let you know if they’re going to be late.” A relative added, “My [family members] carers stay the full hour as agreed with the agency, which we know happens, because we’re often here to monitor this.” Furthermore, people said they received continuity of care from a core group of staff who were familiar with their personal care needs, preferences and daily routines. A person told us, “I don’t like having lots of different staff come to my house to look after me, so I’m really pleased with this agency who make sure I always have the same staff support me.” A relative added, “My [family member] receives consistently good quality care from the same small group of carers who regularly visit us at home.” People commented that staff who supported them were well-trained and competent. A person said, “The carers that come and see me at home know what they are doing and how to look after me.”

Staff told us their home care visits were coordinated well by the registered manager. A member of staff said, “My home care visits are arranged by the manager [registered] and I know exactly when and where I have to go. I always get enough time to travel between my home care visits and finish all the personal care tasks I need to without ever rushing my clients care.” Another added, “I have ample time to get to my home care visits and never have to rush my work.” Staff also said they regularly provided personal care to the same core group of people. A member of staff told us, “I provide personal care to the same people, so I have got to know them really well and what they need.” Another added, “I work regularly with the same clients, so I have become familiar with all their likes and dislikes.” The training staff received was a mixture of online learning and in-person practical training courses. Staff told us the training was always relevant to their role and demonstrated good awareness of their working roles and responsibilities. A member of staff remarked, “My induction was very comprehensive and taught me a lot about how to be a good carer. Im also attending a National Vocational Quality [NVQ] level 3 course in social care at a local college with the rest of the team.” Staff also said they felt supported by the registered manager who regularly observed their working practises and held supervision and team meetings with them. A member of staff told us, “I do have regular meetings with the manager [registered] and the rest of the team. The manager [registered] often observes me working during my home care visits and gives us all feedback about what we do well and what we might do better.”

The provider’s staff recruitment processes were thorough, and records demonstrated that they were followed. The provider conducted thorough pre-employment checks to ensure the suitability of staff for their role. These included checks on prospective new staff’s identify, previous employment, their character, their right to work in the UK and Disclosure and Barring Service (DBS) checks. DBS checks provide information including details about convictions and cautions held on the Police National Computer. This information helps employers make safer recruitment decisions. The provider used an electronic call monitoring (ECM) system to help them coordinate and monitor staffs home care visits. The ECM system logged the exact times staff arrive and leave the home of people they support, and automatically notified the registered manager if staff are late for a scheduled home care visit, left early or missed a visit altogether. In addition, people received continuity of care from the same core group of staff who were familiar with their specific individual needs, preferences and daily routines. Training records showed staff had received all the relevant training they required to safely meet the needs of people they supported. New staff had to complete shadowing home care visits with more experienced staff and a comprehensive induction, which was mapped to the Care Certificate. The Care Certificate is an agreed set of standards that define the knowledge, skills and behaviours expected of specific job roles in health and social care sectors. It is made up of 15 minimum standards that should form part of a robust induction programme. Staff had ongoing opportunities to reflect on their working practices and to identify any further training or learning they might need. This included weekly spot check observation of their working practices during home care visits, fortnightly team meetings and annual work performance appraisals.

People told us staff wore appropriate personal protective equipment [PPE] when they supported them with any personal care. One person said, “They [staff] wear gloves and a facemask when they’re helping me with any of my personal care tasks.” A relative added, “The agency regularly drops shoe covers, masks, aprons and gloves off whenever they visit us at home.”

Managers and staff told us they had received up to date infection control and food hygiene training. A member of staff told us, “We have enough rubber gloves, shoe covers, aprons and facemasks and I have attended an infection control course.”

The provider followed current best practice guidelines regarding the prevention and control of infection and had an up to date infection prevention and control policies and procedures in place.

At the time of our assessment there were no service users that needed support with their prescribed medication.

Although the provider did not support anyone to manage their medicines, at the time of this assessment staff had received safe management of medicines training as part of their induction. The registered manager assured us staff competency to manage medicines safely would be routinely assessed at least annually or more frequently if required.

People’s care plan included detailed information about medicines they were prescribed and how they preferred them to be administered. People currently receiving a service from this provider chose to manager their own medicines or be supported by their family. Staff had received safe management of medicines training.