CQC report explained · a residential care home
What the CQC found at Roseacres
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- Some health and safety risks were not fully assessed, and staff did not always have clear instructions to manage them. Inspectors also saw a staff shortage affecting mealtimes and activities.
- Effective?
- Good
- People received appropriate assessments, training, food and drink support, healthcare and support with decision-making. This rating remained Good from the previous inspection.
- Caring?
- Good
- Caring was not covered by this focused inspection. The rating was carried forward from the previous inspection.
- Responsive?
- Good
- Responsive was not covered by this focused inspection. The rating was carried forward from the previous inspection.
- Well-led?
- Requires improvement
- Quality checks did not identify or fix the problems found with risk management. The home had also not improved the crowded lounge areas identified at the last inspection.
What inspectors found, September 2022
Rated Requires Improvement; inspectors found gaps in risk management, staffing cover and quality checks, although care was often kind and effective.
This was an unannounced focused inspection on 21 June 2022. Inspectors spoke with people, relatives and staff, observed care and mealtimes, and checked care records, medicines records, staff files and management records.
The home was rated Requires Improvement overall. Safe and Well-led were rated Requires Improvement. Effective was rated Good. Inspectors found that some risks were not properly assessed or explained to staff, and staffing shortages affected mealtimes and activities on the inspection day.
People received medicines safely and as prescribed. Staff were trained, supported people to eat and drink, helped them access healthcare and worked within the Mental Capacity Act. People, relatives and staff also described an open and positive culture.
The inspection found two legal breaches. These concerned safe care and treatment, and good governance. The provider was asked to send an action report, and CQC said it would check whether the action was taken.
Medicines
Inspectors found that medicines were given safely and as prescribed. Records were complete, and staff received training and checks of their competence.
“Medicines administration records were clear and contained no gaps.” from the report
Staff training
Staff received induction, regular training, supervision and appraisal. Training included areas such as dementia, diabetes and moving and handling.
“The service provided staff with the skills and support they needed to do their work.” from the report
Food and healthcare
People were offered choices of meals and drinks, and staff supported them to stay hydrated. The home worked with healthcare professionals when people needed support.
“Staff supported people to eat balanced meals and stay hydrated.” from the report
Positive culture
People, relatives and staff generally spoke positively about the care and management. People and relatives could give feedback through meetings, conversations and surveys.
“There was an open and fair culture within the service which focused on people and ensured they received good care.” from the report
Incomplete risk guidance
seriousSome people did not have important risk assessments. Other assessments did not clearly explain what staff should do, including when someone was at risk of choking or malnutrition.
“The absence of risk assessments meant appropriate guidance was not available for staff which could lead to people being at risk of harm.” from the report
Staffing shortages
needs fixingInspectors saw too few staff on the inspection day. This affected mealtimes and activities, and staff appeared rushed when meeting people's needs.
“On the day of inspection, we witnessed a shortage of staff which impacted on people's mealtimes and activities.” from the report
Weak quality checks
seriousThe home's audits did not reliably identify or correct problems with risk management and care records. Some issues found in an earlier audit were still not corrected promptly.
“Systems were either not in place or robust enough to assess, monitor and improve the quality and safety of the services provided.” from the report
Crowded communal areas
minorThe main dining area and lounge areas remained busy and noisy. Inspectors said this made the dining experience less pleasant, and the issue had also been found at the previous inspection.
“At this inspection, we found no improvements had been made to address this issue.” from the report
- 01How have you updated risk assessments and staff guidance for choking, diabetes, recurrent infections and malnutrition?
- 02What contingency arrangements are now in place when staff are absent, and how do you check that mealtimes and activities are not affected?
- 03What action has been taken to reduce noise and crowding in the dining and lounge areas?
- 04How do your quality checks now make sure care records and risk guidance are complete and corrected promptly?
- 05What progress has been made in response to the two regulatory breaches identified by CQC?
This was a focused inspection covering Safe, Effective and Well-led; Caring and Responsive were not inspected and their previous ratings were carried forward. This explanation was written from the published report of 28 September 2022 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, November 2017
Rated Good; inspectors found safe, kind and personalised care, with some records and activities needing improvement.
Inspectors visited the home without warning on 5 and 9 October 2017. They spoke with people living there, relatives, staff and community health and social care professionals. They observed care and checked care plans, medicines records, staff files and management records.
They found enough staff to keep people safe, suitable recruitment checks, clean premises and safe medicines support. Staff knew people's routines and preferences. People were treated respectfully, supported to make choices and helped to stay independent. Health, nutrition and hydration were monitored well.
There were some shortfalls. A few care records, including skin care plans and capacity assessments, were not fully up to date. Daily activities had been affected because an activity worker had left, although a replacement was about to start. The home was rated Good overall and Good in all five areas.
Kind and respectful staff
Staff were observed speaking warmly to people, using their names and giving them time. People and relatives described staff as friendly, helpful and caring.
“Staff demonstrated positive, respectful and friendly attitudes towards people using the service.” from the report
Personalised care
Care plans included people's routines, preferences, life histories and support needs. Staff knew people well and supported individual choices.
“People received individualised care because staff knew their routines and preferences and supported them well.” from the report
Health and nutrition support
The home monitored people's health, food and fluid intake and worked with community healthcare professionals when support was needed.
“There were strong systems for monitoring people's health, nutrition and hydration.” from the report
Safe medicines support
A new computerised system helped staff give medicines at the right time and record whether they were taken. The records checked by inspectors were clear and complete.
“People received medicines safely. A new computerised system was helping to eliminate risks relating to medicines management.” from the report
Quality monitoring
The home used audits, an improvement plan and management checks to identify risks and track improvements.
“The provider had established an effective governance structure to support ongoing learning and improvement at the service.” from the report
Some care plans were incomplete
needs fixingTwo people's skin care plans did not fully explain the equipment or updated guidance staff should follow. The manager said these plans were updated after the inspection.
“One person's skin care plan did not guide staff on what equipment such as pressure cushions were to be used to support them.” from the report
Capacity records were not always reviewed
needs fixingInspectors found that some capacity assessments and decisions were out of date or missing. The manager said the systems would be reviewed more closely.
“However, our checks of five people's capacity assessments and decisions found two had not been reviewed since 2015.” from the report
Activities had been reduced
minorThe departure of one activity worker affected daily activities. A replacement worker was about to start, with the aim of restoring activities seven days a week.
“However, one of the two activity workers had recently left, which was having an impact on the provision of daily activities.” from the report
Some communal areas felt crowded
minorA relative found the home cramped and said there were not enough places to sit. Inspectors also noticed busy and crowded lounge areas at some times.
“It's a homely environment, but it feels a big cramped which makes visiting difficult. There's not enough places to sit.” from the report
- 01How are capacity assessments and best-interest decisions now reviewed, and how often are they checked?
- 02Have all skin care plans been updated with the correct equipment and current healthcare guidance?
- 03How many activities are now provided each week, and has the seven-days-a-week activities programme been restored?
- 04How many care staff are on duty at the busiest times, and has recruitment changed the staffing arrangements?
- 05Are medicines stock checks now being completed regularly with the computerised medicines system?
This was an unannounced comprehensive inspection covering all five key questions, with all five ratings checked at the same time. This explanation was written from the published report of 4 November 2017 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 Roseacres
6 rated inspections over 7 years: the service has held its Requires improvement rating throughout.
- September 2022Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- November 2017Goodstayed GoodSafe: GoodEffective: GoodWell-led: Good
- March 2016Goodup from Requires improvementSafe: Good
- November 2015Requires improvementstayed Requires improvementSafe: Requires improvementResponsive: Good
- September 2015Requires improvementstayed Requires improvementSafe: Requires improvementEffective: GoodResponsive: Inadequate
- May 2015Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- October 2014Inspected but not rated
- September 2014Inspected but not rated
- January 2014
Report published without a new overall rating.
- November 2013
Report published without a new overall rating.
- October 2013
Report published without a new overall rating.
- November 2012
Report published without a new overall rating.
- February 2012
Registered with the Care Quality Commission on 20 February 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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