Roseside

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

We found breaches in respect of safe care and treatment in respect of the delivery of person centred nursing care. We found that the day to day care of people was not always clearly co-ordinated or joined up. There was also little evidence of managerial oversight to ensure people experienced joined up, continuity of care.

People’s communication needs were not always appropriately supported. Information was provided mainly in written format for example the complaints policy, menus and service user/relative meeting minutes. The service did not comply in full with, the Accessible Information Standard.

There were processes in place to enable people to share their views on the service however due to a lack of suitable communication aids and alternative communication formats, the ability of some people to do this was hindered. Some of the processes in place to do this therefore were not suitable for people living with communication difficulties, yet records showed they had participated in this process.

Referrals to other health and social care professional in support of people’s needs were made appropriately and equitably.

There were activities co-ordinators employed by the service to provide a range of social and recreational activities for people to enjoy.

This service scored 61 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Care plans did contain some information relating to the person, their likes, dislikes and preferences, which helped staff to shape the support provided in line with their preferences and wishes. However, staff lacked sufficient information in some areas of people’s needs such as physical and mental health to enable them to support people in a person-centred way. Daily care records also showed the support provided was inconsistent and not always in accordance with the support outlined in their care plan.

Not all support was provided in a person centred way. Some people’s 1:1 support was not provided in accordance with their care plan or agreed parameters. Some people did not have the tools or equipment in place to express their needs or to soothe their distress.

People’s clinical needs were not always monitored and responded to in a person centred way as the medicines prescribed to treat those conditions had not been given appropriately.

Staff had access to care plans to learn about people’s wishes and preferences, where this information was available.

We observed staff were patient and attentive when providing support.

People received appropriate health care support from external professional, including medical professionals, GPs, physiotherapy, speech and language therapy, district nurses, dieticians and mental health.

When changes to the advice and guidance given by other health ands social care professionals were made, care plans were not always updated properly with this advice. This meant that the advice documented was sometimes contradictory. This increased the risk of inappropriate care and treatment being provided.

We found that the day to day care of people was not always clearly co-ordinated or joined up. There was also little evidence of managerial oversight to ensure people experienced joined up, continuity of care. Suitable explanations for why shortfalls in the co-ordination of people's care were found, could not be given. Feedback from the manager and other staff when questions were asked about people's care were not sufficient or transparent.

Partners provided no feedback in this area.

There were systems in place to ensure referrals to other health and social care professionals were made. Staff had access to Telemeds and the home’s own GP for medical advice.

The processes in place to ensure all aspects of people’s care was integrated and co-ordinated were not fully robust. Shortfalls in the management of some health conditions and the administration of medicines to treat those conditions was not robust. Record keeping with regards to people’s day to day care also required improvement.

We observed people’s communication needs, identified in their care plans were not always appropriately supported. Only one person in the home who lived with communication difficulties had communication aids and systems in place to help them communicate with staff. Information was provided mainly in written format, for example, the complaint policy, menus and service user/relative meeting minutes. The service did not comply in full with the Accessible Information Standard.

Staff told us they had access to policies and procedures in respect of their role. Staff had access to care planning information and updates on people’s progress was given verbally at handover meetings.

People’s personal information was collected and stored in line with data protection legislation. We found however that care records did not routinely contain details of who people’s information could be shared with. This required improvement.

People we spoke with told us they felt able to make suggestions and raise any care related concerns. Due to a lack of suitable communication aids and alternative communication formats, the experience of some people to participate in decisions about their care was difficult.

Regular staff meetings took place to enable staff to be involved in discussions about the delivery of people’s care.

There were processes in place to enable some people to provide feedback on their care. For example, there was a monthly care plan review process and service user of the day scheme which focused on assessing a person’s satisfaction with various aspects of service delivery, such as meals, laundry etc via a series of questions.

We found however that the service user of the day scheme was a long and complex set of questions asked of the person living in the home, all undertaken on the same day. The format of the service user of the day did not appear to be appropriate or user friendly for some of the people living in the home to fully engage with. For example, we saw that some people with communication difficulties and people whose ability to withstand long conversations had completed these questions and provided responses, yet their care plans indicated they were not always able to communicate reliably or concentrate for long periods of time. This called into question the validity of some of their responses.

There were opportunities for people living in the home to express their views in service user meetings, where they were able.

People told us they had access to regular support and care.

Staff told us their rotas were arranged in advance to ensure everyone had access to the support they needed as required. Records showed other health and social care professionals were involved in aspects of people’s care. For example, district nurse, dieticians, GPs.

No concerns were raised by partners.

There were processes in place to ensure people had equal access to the service and the support of other health and social care professionals.

Records showed people had equal access to support from staff, their GP and other health and social care professionals.

Staff had completed training in topics important to ensuring equity in experiences and outcomes. For example, equality and diversity, person centred care and privacy and dignity.

There were activities co-ordinators employed by the service to provide a range of social and recreational activities for people to enjoy. Staff told us events took place across the units such as bingo, singers, musical panto, and a memory bus. People were also supported to attend external events accompanied by staff.

People’s access to a range of social and recreational activities promoted their emotional wellbeing and inclusivity. People’s care plans included information on their personal characteristics, including equality and diversity to ensure it was respected.

There was an equality and diversity policy in place for both people living in the home and staff.

No-one at the time of inspection was on end of life care. Care plans did not indicate that discussions around people’s end of life wishes and preferences had been discussed. It is important these discussions take place whilst people are well enough and have the capacity to make decisions about their future care. The end of life care plans that were in place were generic and not person centred.

Staff did not provide any feedback in this area, however they had access to and were aware of where to find people’s hospital passport information should the person be admitted to hospital.

There was process in place to assess people’s end of life needs. However, this was not always used to the best of its ability to plan for people’s end of life care. There was a process in place to ensure that ‘Do not resuscitate orders’ (DNARs) were agreed appropriately. Where people did not have the capacity to consent to a DNAR, the Mental Capacity Act had been followed in their best interests.