CQC report explained · a residential care home
What the CQC found at Rosemary Cottage
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- People felt safe and staff understood their needs, medicines and safeguarding duties. However, old care records were not always easy to use, and damaged kitchen cupboards created an infection control risk.
- Effective?
- Good
- This question was not inspected in this report. Its previous rating was used when calculating the overall rating.
- Caring?
- Outstanding
- This question was not inspected in this report. Its previous rating was used when calculating the overall rating.
- Responsive?
- Good
- This question was not inspected in this report. Its previous rating was used when calculating the overall rating.
- Well-led?
- Requires improvement
- Staff and relatives described approachable management and good communication. However, care plans were not regularly reviewed and one authorised deprivation of liberty notification had not been sent to the CQC until the inspection.
What inspectors found, December 2022
Requires Improvement; inspectors found kind and safe support but out-of-date care records and a kitchen infection risk needed attention.
This was an unannounced inspection on 9 November 2022. One inspector spoke with people, relatives, managers and staff, and reviewed care plans, medicines records, staff files and management records.
People and relatives said they were happy with the support. People felt safe, staff knew them well, medicines were given as prescribed, and there were enough staff. The home supported people to make choices and worked with health professionals.
Inspectors found that some care files contained old versions of documents and care plan audits had not been regular. Parts of the kitchen had peeling and damaged cupboards, which created an infection control risk. The kitchen was due to be replaced in January 2023.
The overall rating was Requires Improvement. Safe and Well-led were both rated Requires Improvement. The rating fell from Good at the previous inspection in 2018. The report says the home needed to make improvements, but it does not say that the service was placed in special measures.
People felt safe
People and relatives said they felt safe and were happy with the support. Staff knew people well and understood how to protect them from abuse.
“People told us they felt safe living at Rosemary Cottage.” from the report
Kind, individual support
Staff supported people to make everyday choices, work towards goals and take part in activities. Care plans reflected individual needs, including support with choking risks.
“People were supported to make day to day choices and set goals and aspirations.” from the report
Safe medicines support
Medicines were given, recorded and stored safely. Staff acted quickly when errors were found and understood the risks of over-medication.
“People were supported by staff who followed systems and processes to administer, record and store medicines safely.” from the report
Enough staff
Inspectors found enough staff, including one-to-one support for activities and visits. Regular agency staff were used when staffing levels were low.
“The service had enough staff, including one to one support for people to take part in activities and visits when they wanted to.” from the report
Out-of-date care records
needs fixingSome care folders held several versions of documents, and reviews and audits had not been regular. This could make it harder for new or agency staff to find the latest information.
“People's care records were bulky and contained a large amount of out of date information.” from the report
Kitchen infection risk
needs fixingPeeling and damaged kitchen cupboards were identified as an infection control risk. The report said the kitchen was due to be refurbished in January 2023.
“The kitchen had peeling and damaged cupboards which were an infection control risk.” from the report
Missed notification
needs fixingOne authorised deprivation of liberty notification had not been submitted to the CQC. It was submitted during the inspection and a new double-checking process was introduced afterwards.
“One person's authorised deprivation of liberty notification had not been submitted to CQC.” from the report
Scattered recruitment records
minorStaff information was held in different places, making it difficult to audit recruitment records effectively.
“Staff information was located in different places, such as locked in the office and some details held by the HR department.” from the report
- 01Have all care folders been audited, reviewed and cleared of old versions of care plans?
- 02Was the kitchen refurbishment completed, and how is the kitchen now checked for infection risks?
- 03Has the planned electronic care record system been introduced, and how do you make sure agency staff see the latest information?
- 04What checks are now in place to make sure all CQC notifications are submitted on time?
- 05How are recruitment records held and audited across the home and the provider's central HR department?
This was a focused inspection of Safe and Well-led; the other key question ratings were not inspected and the previous ratings were used to calculate the overall rating. This explanation was written from the published report of 20 December 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, January 2018
Rosemary Cottage was rated Good overall, with Outstanding caring and only a minor fire-drill recording issue identified.
The inspection was unannounced and took place over two days. One inspector spoke with people living there, staff, the manager, relatives and health and social care professionals. Records, medicines, staffing, training, equipment and quality checks were also reviewed.
Inspectors found people were safe, received their medicines properly and had enough staff support. Care plans were detailed and reflected people's wishes, health needs and abilities. Staff supported people to make choices, stay independent, eat safely and take part in activities.
The strongest finding was caring. Staff were described as kind, patient, respectful and creative in meeting complex needs. The home remained Good overall and kept its previous Outstanding rating for caring. Inspectors identified one area for improvement because records did not show that all staff took part in fire drills periodically.
Kind and individual care
Staff listened carefully and understood people's communication, including gestures and facial expressions. They treated people with dignity and adapted their approach to each person's personality and wishes.
“People were relaxed in staff's company and staff listened and acted on what they said or gestures and body language.” from the report
Creative support with eating
Staff worked hard to make sure people with textured or pureed diets could still enjoy meals and outings. They sought advice and changed routines and equipment where needed.
“Staff showed continued innovation in this area and had researched local eateries.” from the report
Good understanding of health needs
Staff recognised changes in people's health and worked with health professionals. Care plans included clear guidance about communication, mobility, eating and drinking.
“Health and social care professionals felt staff had a very good knowledge and understanding of the people they supported.” from the report
Choice and independence
People were supported to choose where they spent time, what they ate and how they followed their daily routines. Staff encouraged people to do what they could for themselves.
“People were able to make choices about their care and support.” from the report
Activities and community life
People had a varied programme of activities and outings, including work on the farm, shopping, music, art and trips to local places.
“People had a programme of activities in place, which they talked about and obviously enjoyed.” from the report
Fire-drill records
minorThe home did not have a record showing that all staff periodically took part in fire drills. Inspectors identified this as an area for improvement.
“Records showed that there was no check to ensure all staff periodically were involved in the fire drills and this is an area we have identified for improvement.” from the report
- 01How do you now check and record that every staff member takes part in fire drills?
- 02What medicine errors have occurred since the inspection, and how do you check that the extra safety measures are working?
- 03How will you support my relative's particular eating, drinking or swallowing needs?
- 04How will my relative be involved in care-plan reviews and decisions about daily routines and activities?
- 05How do staff recognise changes in a person's health when they communicate through gestures or behaviour?
This was an unannounced inspection covering all five CQC questions, with ratings remaining Good overall and Outstanding for caring. This explanation was written from the published report of 19 January 2018 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 Rosemary Cottage
3 rated inspections over 7 years: the service has slipped, from Good to Requires improvement.
- December 2022Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: GoodCaring: OutstandingResponsive: GoodWell-led: Requires improvement
- January 2018Goodstayed GoodSafe: GoodWell-led: Good
- September 2015GoodSafe: GoodEffective: GoodCaring: OutstandingResponsive: GoodWell-led: Good
- February 2014
Report published without a new overall rating.
- April 2013
Report published without a new overall rating.
- December 2011
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 30 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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