CQC report explained · a residential care home
What the CQC found at Roscarrack House
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- Inspectors found risks were not always identified or reviewed. They found incorrectly set pressure-relieving mattresses, unsafe medicine records, two unnoticed incidents of a person leaving, and gaps in recruitment records.
- Effective?
- Requires improvement
- People's needs and food support were generally well understood, but consent and mental capacity records were incomplete. Some staff training updates were also overdue.
- Caring?
- Good
- No rating was given for Caring in this report. Inspectors observed caring and skilled interactions, and said staff understood people's individual needs.
- Responsive?
- Good
- No rating was given for Responsive in this report. Care plans reflected people's needs and choices, but one relative said there was not enough to keep a busy-minded person occupied.
- Well-led?
- Requires improvement
- Management oversight was not effective enough. Audits had missed important problems, roles had only recently been discussed, records were not always accurate and required notifications had not always been sent to CQC.
What inspectors found, February 2023
Roscarrack House is Rated Requires Improvement; inspectors found risks, medicines records and management checks were not always reliable.
Inspectors made an unannounced visit on 19 January 2023. One inspector reviewed care records, recruitment files and other records, and spoke with people, relatives, staff and a healthcare professional.
They found several safety problems. These included pressure-relieving mattresses set incorrectly, medicines that were not recorded properly, unsafe recruitment records and a person leaving the home twice without staff noticing. A fire had also recently happened, although remedial work was being carried out.
Care was often kind and personalised. People enjoyed the food, staff knew their needs and there were activities. However, consent records, formal feedback, staff access to care plans and management audits were not consistently good enough.
The overall rating changed from Good at the previous inspection, published on 10 September 2020, to Requires Improvement. This means the service was not consistently safe, effective or well-led, and there was an increased risk that people could be harmed.
Kind and personal care
Inspectors saw caring interactions and found that staff understood people's individual care and communication needs.
“We observed caring and skilled interactions between staff and people living at the service.” from the report
Food and mealtimes
Staff understood people's support needs at mealtimes. Meals were adapted where needed, and people told inspectors they enjoyed the food.
“Many people ate in the dining room and it was a sociable event with staff chatting whilst they provided support.” from the report
Staffing levels
There were enough staff to meet people's needs during the inspection. New staff shadowed experienced staff and had their competence assessed.
“The service had sufficient staff to meet people's needs at the time of this inspection.” from the report
People could leave unnoticed
seriousA person living with dementia left the home twice without staff noticing and reached the main road. The person's risk had already been identified, but effective action had not prevented a second incident.
“One person, who was living with dementia, had managed to leave the service on 2 occasions unnoticed by staff.” from the report
Pressure mattress checks
seriousTwo pressure-relieving mattresses were not set correctly, and there was no system for recording regular checks. This could increase the risk of skin damage.
“This meant people could be at risk of developing skin damage.” from the report
Medicine records
seriousA controlled medicine was stored without the required record, and prescribed creams were not dated when opened. Audits had not found these problems.
“There was no record anywhere in the service of these medicines arriving, being administered by the community nurses or stored since the person no longer needed them.” from the report
Recruitment checks
seriousNew staff files did not consistently contain full employment histories or references. One person had started work without references on file.
“This meant the registered manager could not assure themselves the staff were safe to work with vulnerable adults.” from the report
Consent and privacy
seriousImages of people were displayed on a public social media page without consent being sought. Capacity assessments were also not recorded, so there was no evidence that best-interest decisions had been made.
“The registered manager had not sought the consent of people prior to displaying their images on a public platform.” from the report
Weak management checks
needs fixingAudits did not identify important problems, records were not always accurate and incidents were not recorded together with accidents. This limited management oversight and learning.
“The audit cycle was not always robust or effective in improving aspects of the service.” from the report
- 01What checks are now recorded to make sure pressure-relieving mattresses are set correctly for each person?
- 02How are medicines requiring stricter controls recorded, stored and checked now?
- 03What safeguards are in place to prevent a person at risk of leaving from doing so unnoticed?
- 04How do you now check that employment histories, references and induction records are complete before staff work unsupervised?
- 05How are mental capacity, best-interest decisions and consent for photographs recorded and reviewed?
This inspection rated Safe, Effective and Well-led and also examined infection prevention and control; Caring and Responsive were not rated in the report. This explanation was written from the published report of 18 February 2023 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, September 2020
Roscarrack House was inspected but not rated; inspectors found good infection control and no concerns about coronavirus safety.
Inspectors visited on 11 August 2020. This was a targeted inspection during the coronavirus pandemic. They looked at infection prevention and control in the home.
Inspectors were assured that the home was using protective equipment safely, managing visitors, testing people and staff, and following shielding and social distancing guidance. They also found that the home was clean and had suitable infection control audits and policies.
The home had previously experienced coronavirus infections among some people and staff, but everyone had recovered. Inspectors also found that staff supported contact with families and that people were enjoying social activities.
The service was inspected but not rated. This means the inspection did not provide an overall quality rating or ratings for the other four areas.
Infection control training
Staff had received training and guidance about infection control and responding to the coronavirus pandemic.
“Staff had received suitable training and guidance regarding infection control, and how to respond to the coronavirus pandemic.” from the report
Infection control systems
The home had updated policies and audit systems to check infection control standards and keep people safe.
“Suitable audit systems were in place to check infection control standards, and ensure people stayed safe.” from the report
Contact with families
Staff helped people keep in touch with family and friends through phone calls and garden visits while maintaining physical distance.
“Staff helped people to stay in touch with family and friends through phone calls and visits in the garden.” from the report
Social activities
The home was providing social activities, and inspectors saw that people were enjoying the entertainment taking place.
“The service was now providing a range of social activities for people.” from the report
Inspectors raised no specific concerns in this report.
- 01How are visitors currently managed to prevent infections spreading?
- 02How often are staff and residents tested, and what happens if someone tests positive?
- 03How do you keep the infection prevention and control policy up to date?
- 04What activities and arrangements are currently available to help residents stay in touch with family and friends?
- 05What ratings did the home receive for caring, effectiveness, responsiveness and leadership at its previous full inspection?
This was a targeted inspection of infection prevention and control during the coronavirus pandemic; the service was inspected but not rated and the other areas were not assessed. This explanation was written from the published report of 10 September 2020 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Roscarrack House
4 rated inspections over 7 years: the service has slipped, from Good to Requires improvement.
- February 2023Requires improvementcurrent ratingSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- September 2020Inspected but not ratedSafe: Inspected but not rated
- July 2018Goodstayed GoodSafe: GoodEffective: GoodWell-led: Good
- March 2017Goodstayed GoodSafe: Good
- April 2016GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- July 2013
Report published without a new overall rating.
- July 2012
Registered with the Care Quality Commission on 5 July 2012.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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10 live-in carers within about two hours of Cornwall
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £980 to £1,200 a week. 8 can care for a couple. 12 years' experience on average.
“He had been a little anxious before she arrived, but has since stated that he would be very happy for her to care for him again”
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.