CQC report explained · a residential care home
What the CQC found at Roselands Residential Home
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, June 2021
Rated Requires Improvement; inspectors found safe, kind and responsive care, but records and management systems were not yet reliable enough.
This was an unannounced inspection by one inspector on 27 and 28 April 2021. Inspectors spoke with five people, ten staff, two visiting professionals and six relatives. They observed care and checked care, medicine, staff and management records.
The home was rated Good for Safe, Caring and Responsive. Inspectors found enough staff, safe medicines, good infection control, kind care and a range of activities. People were supported with food, drinks and access to healthcare.
Effective and Well-led were rated Requires Improvement. Mental capacity assessments and best-interest decisions were not recorded in enough detail. Some care plans lacked important information, and quality checks had not yet ensured that improvements were fully embedded.
The overall rating stayed at Requires Improvement, although the home was no longer breaching regulations found at the previous inspection. The report says more time was needed for improvements to become part of everyday practice.
Safer risk management
Inspectors found that risks linked to weight loss, pressure damage, falls and the environment were better managed than at the previous inspection.
“At this inspection we found improvements had been made and risks to people were well managed.” from the report
Good infection control
The home was clean and tidy. Visitors were tested, protective equipment was used and arrangements were in place to reduce infection risks.
“We found the home was clean and tidy throughout. Frequently touched surfaces were cleaned regularly throughout the day.” from the report
Kind and respectful care
Staff knew people well and supported their choices, privacy, dignity and personal care preferences.
“People were supported and treated with dignity and respect; and involved as partners in their care.” from the report
Personalised activities
People could take part in group and individual activities, including activities for people who stayed in their rooms.
“There was a wide range of group and individual activities taking place each day.” from the report
Improved meals
Meals were freshly cooked at the home. People were offered choices, alternatives, snacks and drinks, with support for individual dietary needs.
“All meals were now fresh home cooked meals which were prepared and cooked at the home.” from the report
Mental capacity records
needs fixingRecords did not clearly show how decisions were made, whose views were considered or why restrictions were in a person's best interests. Some consent forms had been signed by relatives when the person had capacity or when legal authority was not clearly recorded.
“Mental capacity assessments and best interest decisions were not decision specific. They did not detail how decisions were made” from the report
Incomplete care plans
needs fixingSome care plans did not contain enough practical information for staff. The report gave catheter care and diabetes support as examples.
“The care plan did not include details of when staff should change the catheter bag, or how they should do this.” from the report
Management checks had not fully worked
needs fixingAudits found some problems, but the required improvements had not yet been completed and embedded in daily practice.
“However, further improvements are needed to ensure these improvements continue and are fully implemented and embedded into everyday practice.” from the report
Limited activity records
minorAlthough activities were taking place, records did not consistently show what people had done or link activities to their care plans.
“Although people engaged in a wide range of activities, there was no detailed information about what they done and whether they had engaged in the activity.” from the report
- 01How do you now record mental capacity assessments and best-interest decisions for each specific decision?
- 02How do you show that the person and their relatives were involved in decisions about care?
- 03Have all care plans been updated with clear instructions for catheter care, diabetes support and other individual health needs?
- 04How do your audits check that care plans and activity records are complete and kept up to date?
- 05How are staff competencies for insulin support checked and reassessed?
This was an unannounced inspection covering all five key questions and infection prevention and control measures; it also reviewed progress since the previous inspection. This explanation was written from the published report of 16 June 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.
What inspectors found, November 2019
Roselands Residential Home was rated Requires Improvement; inspectors found kind staff but important problems with safety, choice, personalised care and management.
This was an unannounced inspection on 23 September 2019. Two inspectors spoke with people, relatives, staff and visiting health professionals. They checked care records, medicines, recruitment files, accidents, complaints and quality checks.
The home was not always safe or clean. Inspectors found poor recording of weight loss, insufficient repositioning to reduce pressure sore risks, unsafe upstairs windows, stained beds and problems with laundry. Medicines were managed safely, and people said they felt safe.
People were generally positive about staff, but they were not always given choices about personal care or involved in care planning. Food received mixed feedback, people in their rooms did not always get activities or stimulation, and care plans lacked important personal information.
All five areas were rated Requires Improvement. The previous rating was Good, published in May 2017. The report found four legal breaches and said the provider needed to make improvements.
Kind and respectful staff
People and relatives gave positive feedback about staff. Inspectors also observed reassuring and caring interactions.
“People gave positive feedback about staff and how they were treated.” from the report
Medicines managed safely
People received medicines as prescribed. Records and procedures covered storage, administration, disposal and medicines taken when needed.
“There were clear procedures for the receipt, storage, administration and disposal of medicines.” from the report
Staff training
Staff had completed training relevant to people's needs, including safeguarding, pressure sore prevention and mental capacity.
“We saw from records that all staff were up to date with training.” from the report
Learning from incidents
The manager reviewed accidents and incidents for patterns. Inspectors gave an example where changes after a fall resulted in no further falls for one person.
“The registered manager understood how to use accidents and incidents as learning opportunities.” from the report
Family involvement
The home allowed family and friends to visit openly. Relatives said they were kept informed about changes and appointments.
“Roselands had an open-door policy to family and friends.” from the report
Risks were not managed consistently
seriousRecords did not show accurate food and fluid targets or totals, and the home did not know how much weight some people were losing. People at risk of pressure sores were not always repositioned often enough.
“Risks to people were not always identified.” from the report
Unsafe and unclean areas
needs fixingSeveral upstairs windows did not have restrictors. Inspectors also found stained beds, a rusty food freezer and an overflowing pot of cigarette ends.
“The care home was not always clean.” from the report
Poorly personalised care
seriousCare plans lacked life history and guidance about some conditions, including dementia and depression. One person was meant to receive daily one-to-one support in their room, but there was no evidence this was happening.
“People's care plans lacked detail around their life history and things that were important to them.” from the report
Not enough meaningful activity
needs fixingPeople who stayed in their rooms were not always included in activities or given stimulation. Some people said they were bored.
“People told us they felt bored and did not take part in any meaningful activities within home.” from the report
Weak quality checks
seriousThe home's audits had not identified several problems found by inspectors, including issues with weights, laundry, cleanliness and care plans.
“The audit processes had also failed to identify the gaps in people's care plans around making them person centred.” from the report
- 01What has changed to make sure weight loss, food and fluid intake, and pressure sore risks are recorded and acted on?
- 02Have all upstairs windows now been fitted with restrictors, and how are cleanliness and laundry standards checked?
- 03How can residents now choose when to have a bath or shower, and how are their care plans reviewed with them?
- 04What activities are available for people who spend time in their rooms, and how is social isolation prevented?
- 05How are consent and best-interest decisions now recorded for sensor mats and CCTV?
This was an unannounced planned inspection covering the home, the care provided and all five CQC questions; the previous ratings had been Good in the report published in May 2017. This explanation was written from the published report of 20 November 2019 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 Roselands Residential Home
4 rated inspections over 6 years: the service has slipped, from Good to Requires improvement.
- June 2021Requires improvementcurrent ratingstayed Requires improvementSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- November 2019Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- May 2017Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- June 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- September 2013
Report published without a new overall rating.
- October 2012
Report published without a new overall rating.
- September 2012
Report published without a new overall rating.
- August 2011
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 10 January 2011.
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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