CQC report explained · a residential care home
What the CQC found at Rosehill House Residential Home
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 environmental, fire safety, infection control and medicines problems. There were also not always enough staff to keep people safe.
- Effective?
- Requires improvement
- People were supported with food, drinks, healthcare and their assessed needs. However, mental capacity and consent records were not consistent, and some training needed refreshing.
- Caring?
- Good
- This area was not inspected during this focused inspection. Inspectors observed kind and respectful interactions, with staff spending time getting to know people's needs and wishes.
- Responsive?
- Good
- This area was not inspected during this focused inspection. Inspectors said people and relatives had contact with the manager, but people had limited opportunities to express their views about the service.
- Well-led?
- Requires improvement
- The provider's checks did not identify several safety, medicines, infection control, records and environmental problems. Incident information was recorded but not properly analysed to prevent repeat events.
What inspectors found, April 2023
Rosehill House Residential Home was rated Requires Improvement; inspectors found kind care but important safety, medicines, infection control and management problems.
Inspectors visited without notice on 9 and 14 March 2023. They spoke with people living there, relatives, staff and health professionals. They reviewed care records, recruitment files, medicines records and other documents.
The home was not always safe. Inspectors found risks in the building, fire safety concerns, unlocked hazardous areas, poor infection control, unsafe medicines arrangements and times when there were not enough staff. They also found that some required training had not been refreshed.
People were generally treated kindly and supported with food, drinks and healthcare. Staff understood people's routines and preferences. However, records about consent and mental capacity needed improvement, and quality checks had failed to identify several problems.
The overall rating changed from Good to Requires Improvement. Safe, Effective and Well-led were rated Requires Improvement. This was a focused inspection of those areas, so the other key question ratings were carried forward from the previous comprehensive inspection.
Kind staff
Inspectors saw positive, respectful relationships between staff and people. Staff knew people's routines, preferences and individual needs.
“Staff interactions were positive and centred on people's individual needs. The atmosphere was happy and relaxed.” from the report
Support with food and health
People were offered balanced meals, drinks and snacks. Staff worked with healthcare professionals and followed their advice.
“People were supported to eat a balanced diet.” from the report
Safeguarding awareness
People and relatives said they felt safe. Staff had safeguarding training and understood how to recognise and respond to concerns.
“People were protected from the risk of abuse.” from the report
Family visits
Family and friends were able to visit without restrictions, helping people maintain their relationships.
“People were supported to maintain relationships with family and friends, who were welcome to visit the home without restrictions.” from the report
Building and environmental risks
seriousFire exits were not easy to identify. Trailing wires, disconnected door guards and unlocked areas containing tools and hazardous substances created risks of injury.
“This meant environmental risks were not always managed to ensure people could not access areas that were unsafe.” from the report
Infection control and condition of the home
seriousInspectors found damaged surfaces, stains, strong smells and equipment needing cleaning or replacement. Infection control checks had not found these issues.
“There were cracks in the plaster on walls, stains and marks on furnishings and flooring, and equipment that needed cleaning or replacing.” from the report
Medicines management
seriousThere were no clear instructions for some medicines prescribed when needed. Fridge and room temperatures had not been checked for more than a week.
“Medicines were not managed safely, which placed people at risk of harm.” from the report
Weak quality checks
seriousThe provider's audits did not identify important problems. Incident information was recorded but not analysed to reduce the chance of things happening again.
“Systems in place for checking on the quality and safety of the service were not always effective.” from the report
Mental capacity records
needs fixingRecords did not consistently show how people's rights and decisions were considered. This included best-interest decisions about CCTV for people who might lack capacity to consent.
“The provider was not consistently working within the principles of the MCA, and people's rights under the MCA were not always recorded.” from the report
- 01What has been completed to make fire exits, electrical equipment, trailing wires and hazardous storage areas safe?
- 02How are medicines prescribed for use when needed now assessed, instructed and recorded, and how often are storage temperatures checked?
- 03What cleaning, repair and refurbishment work has been completed since the inspection, and how is infection control now checked?
- 04How many care, domestic, cooking and maintenance staff are currently in post, and how do you ensure there are enough staff on each shift?
- 05What action has been taken to improve mental capacity records and best-interest decisions, including decisions about CCTV?
This was a focused inspection of Safe, Effective and Well-led; Caring and Responsive were not inspected, and the other ratings were carried forward from the previous comprehensive inspection. This explanation was written from the published report of 20 April 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, December 2021
Rosehill House Residential Home was rated Good; inspectors found safe care and good management, but the activities role had been vacant for several weeks.
This was an unannounced, focused inspection on 10 November 2021. Two inspectors reviewed information, spoke with three people and four staff, and checked care, medicine, staffing and management records.
The home was rated Good overall. Inspectors found people were safe, risks were assessed and reviewed, medicines were administered safely, and infection control arrangements were in place. Staffing was considered enough to meet people's care needs.
Inspectors also found the home was well-led. The registered manager knew people well, kept in contact with relatives and staff, and used checks and reviews to improve care.
Only Safe and Well-led were inspected. The ratings for Effective, Caring and Responsive came from the previous comprehensive inspection, so this report does not give fresh findings on those areas.
Risk management
Risks were assessed before people moved in, reviewed regularly and shared with staff. Inspectors found clear controls to help keep people safe.
“Risks to people's safety were assessed and action taken to mitigate these risks.” from the report
Safe medicines
Medicines were organised and given as prescribed. Staff had training and regular checks of their competence.
“Medicines systems were well-organised and people were receiving medicines when they should.” from the report
Infection control
Inspectors were assured that the home had arrangements for visitors, protective equipment, testing, cleaning and managing outbreaks.
“We were assured the provider's infection prevention and control policy was up to date.” from the report
Accessible management
People and staff knew the registered manager, who spoke with people regularly and encouraged staff to raise concerns.
“The registered manager had an open-door policy and staff were encouraged to discuss and share any concerns.” from the report
Quality checks
The provider and registered manager used audits and daily checks to oversee the home and improve care.
“Good governance arrangements were in place. The provider undertook regular audits which covered all aspects of the service and ensured a focus on improving quality at the home.” from the report
Activities vacancy
minorThe activities role had not been covered for several weeks because of two vacancies. Inspectors said there were enough care staff to support activities in the afternoon, and recruitment was under way.
“There were two vacancies at the home which meant the activities role had not been covered for a period of weeks” from the report
No residents' meetings
minorThere had not been any residents' meetings. The manager spoke with people regularly instead, but families may want to check how residents can share views collectively.
“There had not been any residents' meetings, however the registered manager spoke with people regularly to engage them in the home.” from the report
- 01Has the activities role now been filled, and what activities are currently available each afternoon?
- 02How are residents' views gathered now that there have not been residents' meetings?
- 03How are changes in each person's risks recorded and passed to staff at handovers?
- 04How often are medicines staff checked as competent, and what happens if a medicines error is found?
- 05What improvements have been made as a result of the recent incident reviewed by the home?
This was a focused inspection of Safe and Well-led only; the ratings for Effective, Caring and Responsive came from the previous comprehensive inspection. This explanation was written from the published report of 9 December 2021 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 Rosehill House Residential Home
7 rated inspections over 6 years: the service has held its Requires improvement rating throughout.
- April 2023Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
Read what inspectors found at Rosehill House Residential Home →
- December 2021GoodSafe: GoodWell-led: Good
Read what inspectors found at Rosehill House Residential Home →
- December 2020Inspected but not ratedSafe: Inspected but not rated
- October 2020Goodup from Requires improvementSafe: GoodWell-led: Good
- September 2019Requires improvementup from InadequateSafe: Requires improvementEffective: Requires improvementWell-led: Requires improvement
- February 2019Inadequatedown from Requires improvementSafe: InadequateEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Inadequate
- April 2018Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- November 2016Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- August 2014
Report published without a new overall rating.
- May 2014
Report published without a new overall rating.
- September 2013
Report published without a new overall rating.
- June 2013
Report published without a new overall rating.
- October 2012
Report published without a new overall rating.
- August 2012
Report published without a new overall rating.
- July 2011
Report published without a new overall rating.
- April 2011
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 24 December 2010.
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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