Rose Court Nursing and Residential Home

Rose Court Nursing and Residential Home is situated in a residential area of Radcliffe near Bury Greater Manchester. The home is purpose built and provides accommodation with nursing and personal care for up to 109 people, some of whom live with dementia. At the time of our inspection there were 87 people living at the home.

People’s experience of the service and what we found:

The registered manager was highly motivated, having a clear vision and was enthusiastic in promoting and supporting teamwork as well as valuing contributions from people, their relatives, and staff. The registered manager worked collaboratively with other agencies to enhance people's experiences as well as promote their rights. Feedback received evidenced a high level of confidence in the registered manager to continually drive improvements, enhancing the experiences of those living and working at Rose Court.

The provider had demonstrated their commitment in supporting the registered manager to develop the service taking into consideration the needs of those currently living at Rose Court. Effective management systems were in place to monitor and review the service helping to identify areas of continuous improvement. Actions identified were added to a home improvement plan and were seen to be addressed in a proactive and timely manner.

People and their relatives said staff were both knowledgeable and respectful, delivering a good standard of care and support which met their individual needs and wishes. An extensive range of activities and opportunities were provided, both in and away from the home, enabling people to maintain their independence as well as promoting their social and emotional well-being.

Care plans reflected the current and changing needs of people. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Plans to help mitigate the risks to people’s health and well-being were in place. People had good access to relevant health care support to help maintain their health and well-being. People received their medicines as prescribed. People were offered balanced and nutritious meals. Kitchen staff knew people’s dietary needs.

Robust recruitment processes were followed ensuring the suitability of staff. Sufficient numbers of staff were available. A comprehensive programme of staff training and development was provided. Staff said they were supported in their role, encouraged to develop new skills as well as being provided with opportunities for career progression.

A good standard of accommodation was provided. Suitable aids and adaptations were available to aid people's mobility and promote their safety. Servicing and maintenance checks were carried out to ensure the premises and equipment were kept safe. Good hygiene standards were maintained throughout the home.

Systems were in place for the recording and reporting of any safeguarding concerns and complaints. People, their relatives and staff were confident their views were listened and responded to.

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

Rating at last inspection

The last rating for this service was Good (published 14 November 2017).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

Follow Up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

We found the following examples of good practice.

The home had made safe arrangements for visits from relatives. The home had a stand-alone visiting pod in its grounds. In addition, it had two visiting rooms indoors as well as several open-air visiting spaces. Visits had to be booked in advance. Staff deep cleaned visiting rooms after each use.

The home had created ‘cohorted spaces’ that comprised of units of four or five bedrooms and a communal area. The home used a 'red, amber, green' rating system to show the Covid-19 status of each cohorted space. A cohorted space rated ‘red’ meant there were Covid-19 cases or people self-isolating on the unit. The home allocated designated staff to cohorted spaces that were rated ‘red’ to prevent transmission. In addition, the home allocated one-to-one support to people who were confused or prone to wandering. Staff undertook ‘shadow cleaning’ while they followed them.

Staff promoted handwashing among the residents by using innovative practices. For example, they provided people with lemon-scented warm towels and warm antibacterial wipes before and after meals.

Staff monitored people for symptoms daily by checking their temperatures and oxygen saturation levels. Staff also used simple techniques such as offering a person a taste of brown sauce if they had concerns about their appetite. This helped to identify any issues with the person’s smell and taste senses as these are potential indicators for Covid-19.

Staff used various supportive techniques to limit people’s distress during Covid-19 tests. For example, ‘mirroring’ where staff took a test and asked the person to copy them; or helping someone to administer the test themselves; and taking a nasal swab only.

The provider gave staff laundry bags, additional uniform, and access to the home’s laundry facilities. Staff used a separate changing room away from the residential units where they changed into their uniforms for their shift and donned personal protective equipment (PPE). Staff changed out of their uniforms when they finished their shifts.

The home had a very high standard of visible cleanliness and hygiene. The home had a highly motivated team of housekeepers available from 8am to 6pm, Monday to Sunday. Care staff undertook cleaning duties at other times. The home had designated infection prevention and control (IPC) champions in the housekeeping, clinical and care staff groups who had received additional training. They advised on IPC practice and monitored PPE compliance throughout the home.

Further information is in the detailed findings below.

Rose Court Nursing and Residential Home is situated in a residential area of Radcliffe near Bury Greater Manchester. The home is purpose built and provides care and accommodation for up to 109 people. People are cared for with a wide range of needs, from residential care to nursing. The home is set on three levels. There are lounges, dining areas and bedrooms on all three floors. All bedrooms are single accommodation. There were 86 people living at the home at the time of our inspection.

At the last inspection in June 2015 the service was rated Good. At this inspection we found the service remained Good, with an outstanding rating in the Well-Led section of the report.

Staff had received safeguarding training and understood their responsibilities to report unsafe care or abusive practices.

We found staff had been recruited safely and the service had sufficient staffing levels in place to provide the support people required. We saw staff could undertake tasks supporting people without feeling rushed.

Risk assessments had been developed to minimise the potential risk of harm to people during the delivery of their care. These had been kept under review and were relevant to the care provided.

We looked around the building and found it had been maintained to a good standard, was clean and hygienic and a safe place for people to live. We found equipment had been serviced and maintained as required. We saw care workers assisting people with mobility problems. They were kind and patient and assisted people safely.

Staff wore protective clothing such as gloves and aprons when needed. This reduced the risk of cross infection.

We found medication procedures at the home were safe. Staff responsible for the administration of medicines had received training to ensure they had the competency and skills required to administer medicines to people safely. Medicines were safely kept with appropriate arrangements for storing in place.

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 support this practice.

Staff we spoke with and records seen confirmed training had been provided to enable them to safely support people who lived at the home. We found staff were knowledgeable about the support needs of people in their care.

People told us they were happy with the variety and choice of meals available to them. We saw regular snacks and drinks were provided between meals to ensure people received adequate nutrition and hydration.

People had access to healthcare professionals and their healthcare needs were being met.

People who lived at the home told us they were happy with their care being provided and liked the staff who looked after them. We observed staff providing support to people throughout our inspection visit. We saw they were kind and patient and showed affection towards the people in their care.

We saw people who lived at the home were clean and well dressed. They looked relaxed and comfortable in the care of staff supporting them.

Systems were in place to help ensure people received the care they wanted when they were nearing the end of their life.

Staff knew people they supported and provided a personalised service. Care plans were organised and had identified the care and support people required. We found they were informative about care people had received.

People who lived at the home and their visitors told us they enjoyed a wide variety of activities which were organised for their entertainment and to promote their wellbeing.

The service had a complaints procedure which was displayed in the entrance hall. Records of all complaints, concerns and compliments made were kept at the service.

There was a strong commitment to continually strive to improve the service. The registered manager was proactively involved in looking at new initiatives, such as the Teaching Care Home Project and a new system to help the management of liquid medicines.

The registered provider and registered manager used a variety of methods to assess and monitor the health and safety and quality of the service provided to people living in the home.

All the staff we spoke with regardless of their role told us that they had received safeguarding training and that they would have no hesitation speaking to the manager if they had any concerns about the treatment of people living at the home. They also said they could challenge each other's practice regardless of role.

We saw copies of four recent relatives feedback questionnaires from Clarence and Windsor units. Relatives thought the home was clean and tidy and the laundry service was good.

At the time of our visit the home's overall appearance was "tired". However we were told that a major refurbishment of all the floors of the building was due to start at the end of September 2013.

People we spoke with said that the staff team were 'very nice,' 'I get on well with all the staff. I help them where I can as they work very hard' 'I am happy with all they are doing for me' and 'staff are very kind'.

People's care records contained detailed information to show how they were to be supported and cared for. People told us they were well looked after. They told us; 'The staff are wonderful and they look after us very well'. 'They are all great and know what they are doing'.

The medication system was safe and people told us they received their medicines when they needed them.

Regular monitoring of the services and facilities provided was in place to help protect people against the risks of inappropriate or unsafe care.