R C Care Rosehill Ltd

Updated 30 July 2021

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.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was completed by two inspectors.

Service and service type

Rosehill 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. The current registered manager was in fact the Nominated individual who took on this role in the interim of finding a new manager. 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. The new manager is in the process of registering with CQC.

Notice of inspection

This inspection was unannounced.

What we did before 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. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

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 six staff including the manager, cook and care staff. We spoke with five people about their experience of living at Rosehill, although only two in any detail.

We reviewed a range of records. This included four people’s care records and multiple medication records. We looked at three staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at some policies, service improvement plan and quality assurance records. We spoke with three care professionals who regularly visit the service.

Updated 30 July 2021

About the service

R C Care Rosehill Limited (Rosehill) is a residential care home and is registered to provide personal care to up to 17 people, including those living with dementia. At the time of inspection there were 13 people living at the service.

Rosehill is an adapted detached house on the outskirts of Bideford. It has bedrooms on three floors with a stair lift to access those on the first and second floor. There are communal areas on the ground floor including a lounge and dining area. There is a secure courtyard for people to enjoy some outside space safely.

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

Most people said they were happy with the care and support provided by staff at Rosehill. Not everyone could give an informed view, but our observations showed people looked relaxed and at ease with the staff team and their surroundings.

Since the last inspection in September 2020 the service had employed a new manager who had worked with the registered provider and staff team to make some significant improvements to the way the home was being run, how care was being recorded and to the general environment. This has impacted positively towards people having a better experience of life with the service.

The service had a new electronic care plan recording system. This had enabled the manager to fully update people’s care plans in a systematic way and ensure all relevant details were included. This in turn had helped ensure staff understood people’s individual needs and how best to care for them. Monitoring of these plans and daily records had helped to improve the accurateness and timeliness of changing plans as people’s needs changed.

Staff recruitment was robust, and staff had the right training and support to do their job effectively. Improvements had been made to the number and skills of staff available on each shift. This had impacted positively for outcomes for people. One staff member said, “We are able to spend more quality time with people.”

Care and support was being delivered in a person-centred way. People’s choices and rights were fully considered. People said they felt happy and safe living at Rosehill. One person commented “This has been my home for a long time, and I am very settled and happy here.”

The manager had worked with the local authority quality assurance team to develop and embed systems for quality audits checks and reviews. This covered all aspects of care delivery, records and the environment and equipment. People, families and staff were being consulted about the running of the service. Staff morale was good, and staff felt valued and listened to.

Medicines were being safely managed and people received their medicines in a timely way.

Infection control processes had improved since the last inspection and we were assured that people, staff and visitors were protected because the registered manager and provider were up to date with all the latest guidance.

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 inadequate (Published 30 November 2020)

The provider completed an action plan after the last inspection to show what they would do and by when to improve. They have also been sending us monthly reports on their quality assurance systems.

This service has been in Special Measures since November 2020. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

Why we inspected

We carried out an unannounced comprehensive inspection of this service on 29 September 2020. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve safe care and treatment, protecting people from abuse, safe recruitment, staffing, making notifications and good governance.

In addition, we imposed a condition on the provider’s registration as they had failed to comply with Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities Regulations 2014) -Good governance. This meant the service were required to provide monthly reports to show their progress on meeting these requirements. We also issued a warning notice in respect of Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities Regulations 2014)- Safe care and treatment

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions of Safe, Responsive and Well-led which contain those requirements.

The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has changed from inadequate to good. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for R C Care Rosehill Ltd on our website at www.cqc.org.uk.

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.