CQC report explained · a residential care home
What the CQC found at Rosewood Care Home
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, November 2023
Rosewood Care Home was rated Requires Improvement; inspectors found caring staff and enough staff, but ongoing safety and management failures around water systems and recruitment.
This was an unannounced follow-up inspection on 29 June 2023. Two inspectors spoke with people, relatives, staff and healthcare professionals. They reviewed care records, medicine records, staff files and records about how the home was managed.
The home had enough experienced staff. Medicines, infection control, safeguarding and fire safety were managed well. People and relatives spoke positively about the care, privacy, activities and staff. Inspectors also found that people were supported to make choices and that the home worked well with outside professionals.
However, inspectors were still not assured that legionella and safe water risks were being properly monitored. Some water checks were missed, and action had not been taken when recorded water temperatures created a possible scalding risk. Recruitment checks were also inconsistent, and management systems did not always identify or deal with problems promptly.
The overall rating remained Requires Improvement. Safe and Well-led were both rated Requires Improvement. This visit only inspected those two areas, so the other ratings were carried forward from the previous inspection.
Kind and respectful care
People and relatives described the care positively. Staff asked permission before providing care and protected people's privacy.
“Staff asked for permission to give care and support and always closed the door for privacy when providing personal care.” from the report
Enough staff
Inspectors found enough experienced staff to meet people's needs. People, relatives and a healthcare professional raised no concerns about staffing levels.
“There were sufficient numbers of experienced staff to meet people's needs.” from the report
Medicines managed safely
Medicines were stored, administered and recorded safely. Staff understood how to give medicines when needed.
“People received their medicines in a safe and effective way from staff who had received appropriate training.” from the report
Positive relationships
People, relatives, staff and outside professionals gave positive feedback about the staff team and manager. Activities and feedback from people were taken seriously.
“People and their relatives, staff and external professionals, gave positive feedback about the registered manager and staff team.” from the report
Good partnership working
The home worked with healthcare professionals, including when people were at risk of falls. Professionals said staff listened to and acted on their advice.
“The service worked well in partnership with external professionals, including GP's, occupational therapists, and community health teams.” from the report
Water and legionella risks
seriousThe home still did not have robust monitoring of legionella and safe water systems. Some flushing checks were missed, and water temperatures that could cause scalding were recorded without prompt action.
“This meant outlets were not flushed every week as identified and required in the risk assessment to minimise the risks of legionella bacteria accumulating in the water system.” from the report
Weak management oversight
seriousManagement systems did not always identify risks or ensure that information was acted on quickly. Inspectors said this placed people at risk of harm.
“Systems to assess, monitor and improve the quality and safety of the service were not always effective, so that appropriate responses to information were delayed or not taken.” from the report
Inconsistent recruitment checks
needs fixingSome staff files did not include full employment histories, explanations for gaps or complete references. The manager took action after inspectors raised this.
“However, processes were not consistently applied and did not always meet legal requirements.” from the report
- 01What evidence can you show that the new legionella risk assessment actions have been completed and are being checked regularly?
- 02How are little-used water outlets identified and flushed every week, including when the usual staff member is absent?
- 03What happens when water temperature checks show a possible scalding risk, and how quickly is the problem corrected?
- 04How do you now check that every new staff member has a full employment history, explanations for gaps and complete references?
- 05What progress has been made on the action plan requested by CQC for the two breaches?
This was an unannounced focused follow-up inspection of Safe and Well-led; Effective, Caring and Responsive were not inspected and their previous ratings carried over. This explanation was written from the published report of 1 November 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, August 2022
Rosewood Care Home is rated Requires Improvement; inspectors found a serious gap in legionella safety checks alongside otherwise safe and caring support.
This was an unannounced inspection carried out over visits on 11, 24 and 27 May 2022. One inspector and one Expert by Experience spoke with people, relatives, staff and the manager, and checked care, medicine, staffing and management records.
The home was clean and well maintained. People and relatives said they felt safe and well cared for. Staff knew people well, staffing levels were considered sufficient, medicines were generally managed safely, and risks such as falls and skin damage were assessed.
Inspectors found that the risk of legionella had not been properly assessed or controlled. They also found weaker cleaning records, some lapsed staff training and gaps in management checks. The home was rated Requires Improvement for Safe and Well-led.
Only Safe and Well-led were inspected during this visit. The ratings for the other three questions carried over from the previous inspection, but the overall rating fell from Good to Requires Improvement.
People felt safe
People and relatives said they felt safe, included and well cared for. Staff understood safeguarding procedures and people were confident concerns would be dealt with.
“All the relatives we spoke with were very confident that people were safe and well cared for by staff.” from the report
Enough capable staff
Inspectors found enough staff to meet people's needs. Staff knew people well and showed they could use moving equipment safely.
“People were supported by sufficient numbers of staff to meet their needs and keep them safe.” from the report
Medicines generally managed safely
Medicine records were complete and staff were trained. Medicines were stored and given in line with prescriptions, and staff knew people's medicine needs.
“People received their medicines safely and in line with their prescription.” from the report
Positive leadership relationships
People, relatives and staff described the manager as approachable and supportive. The manager also worked well with health professionals to improve care.
“The registered manager worked well with people, their relatives and staff to create a friendly and open atmosphere in the service.” from the report
Legionella risk was not controlled
seriousThere was no legionella risk assessment, and regular water temperature checks and flushing of little-used outlets were not in place. This created an increased safety risk and led to a breach of regulation.
“We identified there was no risk assessment in place and no regular pre tap temperature checks or flushing of little used outlets.” from the report
Cleaning records were not clear
needs fixingStaff used a cleaning checklist but did not clearly record what had been cleaned. Inspectors also saw poor hygiene during a medicine round, although this was corrected on a later visit.
“There was a detailed check list of what needed to be cleaned and when, which staff used, however they did not keep clear records of what they had done.” from the report
Management checks were incomplete
needs fixingRegular audits did not include robust legionella checks, and staff files had not been audited recently. Some staff training had lapsed and supervision was not always regular.
“However, robust legionella checks were not included in the regular audit which had resulted in the risk not being managed in line with guidance.” from the report
Policies and supervision needed tightening
minorIt was not always clear when policies had last been reviewed, and staff supervision had not happened regularly for everyone.
“Records showed that staff supervisions were not always happening regularly for all staff.” from the report
- 01Has the legionella risk assessment now been completed, and how often are water temperatures checked?
- 02How are little-used water outlets flushed and how can families see that these checks are recorded?
- 03What has been changed to make cleaning records clear and complete?
- 04Have all overdue staff training courses and staff supervisions now been completed?
- 05How is the manager checking that the action plan from this inspection is being followed?
This was a focused inspection of Safe and Well-led, including infection prevention and control; the ratings for Effective, Caring and Responsive carried over from the previous inspection. This explanation was written from the published report of 12 August 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 Rosewood Care Home
5 rated inspections over 8 years: the service has slipped, from Good to Requires improvement.
- November 2023Requires improvementcurrent ratingstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: OutstandingWell-led: Requires improvement
- August 2022Requires improvementdown from GoodSafe: Requires improvementWell-led: Requires improvement
- February 2020Goodstayed GoodSafe: GoodWell-led: Good
- July 2017Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: OutstandingWell-led: Good
- July 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- May 2013
Report published without a new overall rating.
- November 2012
Report published without a new overall rating.
- April 2011
Registered with the Care Quality Commission on 12 April 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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