CQC report explained · a residential care home
What the CQC found at Rosetrees
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were protected from abuse and avoidable harm. Inspectors found that risks and medicines were managed safely, recruitment checks were completed, and staffing levels were sufficient.
- Effective?
- Good
- Staff had relevant training, supervision and appraisals. People received suitable food and healthcare support, although feedback about the meals was mixed.
- Caring?
- Good
- People and relatives described staff as kind and caring. Inspectors observed respectful interactions and support for people's privacy, dignity, choices and independence.
- Responsive?
- Good
- Care plans were personalised and regularly updated. People had activities and opportunities to take part in community life, and complaints were handled according to the home's procedure.
- Well-led?
- Good
- Inspectors found an open culture and approachable management. Audits, meetings and feedback systems were used to monitor quality and make improvements.
What inspectors found, May 2019
Rated Good; inspectors found safe, kind and well-organised care, but people gave mixed views about the food.
This was an unannounced inspection on 10 April 2019. Inspectors reviewed records, spoke with people living in the home, relatives, staff, volunteers and a healthcare professional, and observed care.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found that people were protected from abuse, risks and medicines errors, and that there were enough staff.
People were treated with kindness and respect. Their care plans were personalised, staff supported their choices, and people had access to activities, healthcare and religious and community activities.
The report says the overall rating was unchanged from the previous inspection in October 2016. Improvements had been made to staff supervision and appraisals, and to the environment for people living with dementia.
Kind and respectful staff
People and relatives spoke positively about staff. Inspectors observed patient, compassionate care and support for privacy and dignity.
“People and their relatives praised staff for their caring attitude and kind approach.” from the report
Safe care
The home had systems for safeguarding, managing risks and medicines, and investigating accidents and incidents.
“Recruitment of staff continued to be safe and robust.” from the report
Personalised support
Care plans included people's needs, preferences and life histories. Staff were kept informed when people's needs changed.
“Care plans were personalised and contained information about people's care needs and preferences.” from the report
Improved staff support
The previous inspection found gaps in supervision and appraisals. Inspectors found regular supervision and appraisals during this inspection.
“During this inspection, we saw records of regular supervision and appraisals.” from the report
Quality monitoring
Management used audits, meetings and feedback to check the quality of care and identify action needed.
“We saw that the service took action where this was required.” from the report
Mixed feedback about meals
minorSome people said the food was cold or not good, while others were positive. Management said they were working with people and relatives to improve mealtimes.
“Most of the time the food is cold.” from the report
- 01What changes have been made to address people's comments that food was sometimes cold or not good?
- 02How do you check that meals meet each person's dietary requirements and preferences?
- 03How are staff supervision, appraisals and refresher training kept up to date?
- 04How are care plans updated when a person's needs change?
- 05What activities and religious or community links would be available for my relative?
This was a scheduled, unannounced inspection covering all five CQC questions and the overall quality and safety of the home. This explanation was written from the published report of 30 May 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.
What inspectors found, October 2016
Rated Good overall; inspectors found safe, kind and responsive care, but effective care Requires Improvement.
Inspectors visited the home without notice on 30 August 2016. They spoke with people living there, relatives, staff and a community nurse. They observed care, medicines, meals and activities, and reviewed care records, staff files, rosters, complaints, audits and other documents.
People told inspectors they felt safe and that staff were kind, respectful and available. The home had enough staff, safe recruitment processes, good medicines records overall, personalised care plans, activities and systems for handling complaints and checking quality.
The effective rating was Requires Improvement. Inspectors found gaps in staff supervision and appraisals, some incomplete information about nutrition, hydration and diabetes, and a need to make the environment more suitable for people with dementia. The home was given a recommendation to seek specialist advice about this.
Staffing and safety
Inspectors found enough staff to meet people's needs. People and relatives said staff were available and easy to contact.
“The service had sufficient staffing numbers to meet people's needs.” from the report
Kind and respectful care
People described staff as caring and friendly. Inspectors saw patient and considerate interactions and found that privacy, dignity and choice were respected.
“People told us staff listened to them and understood their needs.” from the report
Personalised support
Care plans included people's histories, preferences, health needs and religious requirements. They were reviewed regularly and updated when needs changed.
“The care plans were detailed and included people's personal information, life history, eating and drinking, medication, religious needs and health related information and correspondence.” from the report
Activities and inclusion
The home offered a range of activities and supported people to take part according to their abilities and interests. It also supported religious activities.
“We saw people enjoying the activities and the activities were facilitated to include those who were less able to participate.” from the report
Quality checks
The home had audits, meetings, surveys and other checks to monitor care and identify improvements. People, relatives and staff were asked for their views.
“The service had systems for assessing and monitoring the quality and safety of the service.” from the report
Staff supervision
needs fixingRecords showed gaps in staff supervision and appraisals. The manager said training and scheduled supervision were being put in place after the inspection.
“We looked at the staff supervision and appraisal records, and saw gaps in them.” from the report
Care records
needs fixingSome daily records did not fully show people's nutrition and fluid intake. Risk assessments also needed to be more detailed and individualised.
“We found a few gaps in the records and they did not always detail people's nutrition and hydration intake.” from the report
Diabetes information
needs fixingCare plans did not set out enough information about diabetes risks, including signs of low or high blood sugar.
“The care plan lacked information on risks associated with diabetes such as hypoglycaemia and hyperglycaemia and signs to look out for low and high blood sugar levels.” from the report
Dementia-friendly environment
needs fixingThe building needed clearer signs, colour zoning and more personal memory displays to help people with dementia find their way and recognise spaces.
“There was a lack of signage and colour zoned walls to support people with dementia in accessing various rooms and facilities in the service.” from the report
As-needed medicines guidance
needs fixingSome charts for as-needed medicines did not explain how often doses could be given or provide clear administration guidance.
“some PRN medication administration charts did not contain information on frequency of doses and clear guidance on administration.” from the report
Handover structure
minorInspectors observed that staff shared information at handover, but the meeting was not structured and staff were unclear about what information to pass on.
“We observed a staff handover meeting and although, staff gave information on people's care, there was lack of structure and staff were not sure of what information they were expected to share.” from the report
- 01What action has been completed to ensure every staff member receives regular supervision and an appraisal?
- 02How do you record people's food and fluid intake, and how do you check that these records are complete?
- 03What information is now included in diabetes care plans about low and high blood sugar risks?
- 04What changes have been made to signs, colour zoning and memory displays for people with dementia?
- 05How do you make sure as-needed medicines charts contain clear dose frequency and administration instructions?
This was an unannounced comprehensive inspection covering all five key questions, based on observations, discussions and records reviewed at the home. This explanation was written from the published report of 11 October 2016 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 Rosetrees
2 rated inspections over 3 years: the service has held its Good rating throughout.
- May 2019Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- October 2016GoodSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- March 2014
Report published without a new overall rating.
- December 2012
Report published without a new overall rating.
- July 2011
Report published without a new overall rating.
- November 2010
Registered with the Care Quality Commission on 12 November 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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