CQC report explained · a residential care home
What the CQC found at Roseneath Avenue
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 had clear risk assessments and medicines were managed safely. However, safeguarding concerns were not always identified, documented or raised, and there was mixed feedback about staff continuity.
- Effective?
- Requires improvement
- Care plans and health support were generally comprehensive and personalised. Regular agency staff had not always received the training, supervision or competence checks needed to support people with complex needs.
- Caring?
- Good
- People received kind and compassionate care. Staff respected privacy, dignity and choices, and supported people to communicate and become more independent.
- Responsive?
- Good
- Support was generally personalised and communication needs were understood. Inspectors found one care plan did not fully assess cognitive and sensory needs, and one person's recorded activity was not meaningful.
- Well-led?
- Requires improvement
- Staff and managers showed commitment to people and to improvement. However, safeguarding, agency staff support, audits and openness with relatives were not managed consistently enough.
What inspectors found, September 2023
Overall rated Requires Improvement; inspectors found kind, person-centred care but safeguarding, agency staff support and management oversight needed improvement.
This was an unannounced inspection on 17 May and 12 June 2023. Inspectors spoke with people, relatives and staff, observed care, and checked medicines, care plans, risk assessments, staff files, incident records and audits.
People were treated with kindness and respect. Staff supported communication, independence, activities, healthcare and medicines well. Each person had their own flat, and people were involved in planning their care.
Inspectors found important safety and management weaknesses. Safeguarding concerns were not always recognised or managed properly. Regular agency staff had not always received suitable training or supervision. Audits had not identified some problems, including an unpleasant mattress and a failure to be open with relatives after an incident.
The overall rating was Requires Improvement. Safe, Effective and Well-led were rated Requires Improvement, while Caring and Responsive were rated Good. The previous overall rating was Good, published on 21 December 2018.
Kind and respectful care
Inspectors found that staff treated people warmly and compassionately. Staff used language people understood and respected their dignity and choices.
“People received kind and compassionate care from staff who used positive, respectful language which people understood and responded well to.” from the report
Communication support
Staff understood people's different ways of communicating, including body language, sounds, pictures and symbols. This helped people express themselves and take part in decisions.
“Staff had good awareness, skills and understanding of individual communication needs, they knew how to facilitate communication and when people were trying to tell them something.” from the report
Personal space and independence
Each person had a self-contained flat designed around their needs. Staff encouraged people to take part in everyday tasks such as cooking and laundry.
“Each person had their own self-contained flat which they were able to decorate in a way that reflected their personalities.” from the report
Safe medicines support
Inspectors found that medicines were given on time and handled through appropriate systems. Staff had training and competency checks for medicines administration.
“People received their medicines safely and on time.” from the report
Safeguarding was not always managed
seriousSome potential safeguarding concerns were not recognised, recorded or investigated appropriately. Inspectors said this placed people at risk of harm.
“The lack of recognising and raising safeguarding concerns placed people at risk of harm.” from the report
Agency staff training
seriousRegular agency staff who had worked at the home for several months had not always received training, supervision or competence checks for complex learning disability and autism support.
“Regular agency staff were not provided with any training, supervision or assessment of competence in working with people with complex needs.” from the report
Weak management checks
seriousAudits did not identify some problems, including a mattress that smelled strongly of urine. Inspectors also found one incident where the home was not open and honest with relatives.
“Systems were either not in place or robust enough to demonstrate that there was adequate oversight of the home.” from the report
Activities were not always meaningful
needs fixingOne person had mainly been recorded as walking daily in the garden, although they already had access to it. The provider said activities were being reviewed.
“This is not a meaningful activity as people generally had access to the garden.” from the report
- 01What actions have you completed in response to the three breaches, and what evidence can you show of improvement?
- 02How do you now check that regular agency staff have training, supervision and competence in each person's specific needs?
- 03How are safeguarding allegations and concerns identified, recorded, investigated and reported to the local authority and CQC?
- 04How do your audits now identify environmental problems, such as unsuitable mattresses, before they affect people's comfort?
- 05How are meaningful activities and the daily activity conditions linked to people's DoLS authorisations being recorded and checked?
This unannounced inspection covered all five key questions and included infection prevention and control; it was prompted partly by safeguarding and staffing concerns. This explanation was written from the published report of 7 September 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, February 2022
Roseneath Avenue was inspected but not rated; inspectors found good COVID-19 infection control and visiting arrangements.
This was an announced, targeted inspection on 31 January 2022. Inspectors looked mainly at infection prevention and control, visiting arrangements and whether COVID-19 staffing pressures affected the home.
Inspectors were assured that the home had suitable arrangements for testing, vaccinations, personal protective equipment, cleaning, ventilation, visits and new admissions. They also found that staff knew what to do if there was a COVID-19 outbreak.
The home was inspected but not rated. This means the report does not give an overall quality rating or a rated judgement for the other key areas of care.
Infection control
Inspectors found the home was meeting good infection prevention and control guidelines. The premises were clean and hygienic, with cleaning stations and adequate ventilation.
“We were assured that this service met good infection prevention and control guidelines as a designated care setting.” from the report
Safe admissions
The home used risk assessments, testing and isolation when admitting a new resident during the pandemic. Staff also carried out welfare and mental health checks during isolation.
“Risk assessments were in place to ensure a safe transition would be achieved.” from the report
Visits continued
Visitors were not restricted in number, although they had to book and provide evidence of a recent lateral flow test or test at the entrance.
“The provider did not place any restrictions on the number of visitors that service users had but they needed to book in before coming.” from the report
Protective equipment and vaccination
The home had PPE stations, trained staff and systems to check vaccination and testing requirements.
“The home had sufficient supplies of Personal Protective Equipment (PPE).” from the report
Inspectors raised no specific concerns in this report.
- 01What infection prevention and control arrangements are in place now?
- 02How are visitors currently asked to book, test or show evidence of testing?
- 03How do you manage admissions, including testing and isolation, when someone new moves in?
- 04How do you manage staffing pressures, and have they affected people's support?
- 05How do you check that staff and visiting professionals meet current vaccination and testing requirements?
This was a targeted inspection of infection prevention and control, visiting arrangements and COVID-19-related staffing pressures; the service was inspected but not rated in the areas covered. This explanation was written from the published report of 25 February 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.
Every inspection of Roseneath Avenue
5 rated inspections over 8 years: the service has held its Requires improvement rating throughout.
- September 2023Requires improvementcurrent ratingSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- February 2022Inspected but not ratedSafe: Inspected but not rated
- December 2018Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- August 2017Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- July 2016Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- October 2015Requires improvementSafe: GoodEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Good
- January 2014
Report published without a new overall rating.
- April 2013
Report published without a new overall rating.
- April 2011
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 6 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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