Rossall

Updated 22 January 2020

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

This inspection was carried out by two inspectors, a specialist advisor, with a social work background supporting people who live with dementia, 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.

Service and service type

Rossall is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We spoke about Rossall with four people, four relatives, twelve staff and the registered manager. We further discussed the home with two visiting healthcare professionals. 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 walked around the building to carry out a visual check and ensure Rossall was clean, hygienic and a safe place to live.

We looked at records related to the management of the service. We did this to ensure the provider had oversight of the home, responded to any concerns and led Rossall in ongoing improvements. We checked care records of three people and looked at staffing levels, recruitment procedures and training provision.

Updated 22 January 2020

About the service

Rossall is a nursing home providing personal care to 46 people with complex needs at the time of our inspection. The service can support up to 46 people within three units spread over one floor. There are multiple lounges, rest spaces, dining areas and themed rooms for people’s comfort and relaxation.

People’s experience of using this service and what we found

The provider continued to have exceptionally high staffing levels and skill mixes to maximise people’s safety and welfare. A relative commented, “The home is a well organised team, each member fully supporting each other. I cannot speak highly enough of the team.” People and relatives told us this meant they were empowered to lead significantly more purposeful lives. The provider excelled in protecting people from harm, including extensive training provision. They were also highly innovative and effective in using evidence-based tools and procedures to retain people’s safety. A relative stated, “Absolutely, [my relative] is not at all unsafe. I can’t praise this place enough.” The registered manager continued to maintain very good standards in the safe management of people’s medicines. The focus was centred on administering medication only where it maximised a purposeful life.

The provider was highly effective at ensuring people were vigorously assessed and monitored through extensive, multi-disciplinary and proactive treatment programmes. A visiting professional said, “Having worked for quite some time with this home, I find it is without doubt excellent. It is the most enthusiastic and compliant of all the services we work with.” The provider continued to maintain an outstanding model to meet people’s nutritional care. A relative told us, “[My family member] absolutely does not go hungry, she has everything she needs.” The provider had an extensive training programme that led to extremely effective and skilled staff. A relative confirmed, “Yes, absolutely the staff are well trained.”

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. The policies and systems in the service supported this practice. A visiting professional stated, “The care records show an exemplary standard in the application of the Mental Capacity Act (2005).” Staff demonstrated outstanding skills in deploying different methods to help people fully participate in their care. The provider excelled at maintaining and enriching a highly adapted environment to support distressed individuals, including sensory areas to stimulate them and provide activities.

The management team and staff embraced people’s diversity and excelled in sensitive care delivery centred on optimising people’s human rights. A visiting professional described staff as exceedingly calm, professional and kind when assisting each person. People and relatives unanimously described staff as exceptionally caring. A relative commented, “What really sets them apart is their kindness and compassion. Often going the extra mile to make not just my [relative], but myself and my family feel very safe and secure.”

The registered manager provided an outstanding range of activities to improve people’s social skills and mental welfare. A staff member told us, “The activities are amazing and we keep this as our main focus.” The management team created a highly proactive care model to ensure staff were responsive to people’s needs. They delivered outstanding end of life care by optimising people’s comfort, wishes and symptom management and instilled this in their workforce.

The provider worked with other organisations to enhance its excellent service delivery. The management team analysed survey results with a strong desire to continuously improve. Extensive service auditing was clearly directed at reviewing any lessons learnt to maximise people’s safety and quality of life. Rossall had very strong leadership with an excellent caring approach to its workforce. A relative said, “[The registered manager] is very hands on. You can see her any time.” A staff member added, “I really like it here. I feel well supported and the opportunity for promotion contributes to a very positive culture within the home.”

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was outstanding (published 07 June 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.