Rosemount Care Home

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

The service was now rated requires improvement. We found a breach in relation to assessment of risk and governance. People were not at the centre of their care. Some people were involved in any aspect of the care planning and review process. Care was not sufficiently joined up with partner agencies and safety issues were not always appropriately escalated and addressed. The providers oversight mechanisms had failed to ensure records were accurate and up to date and included information to help staff provide good quality care.

This service scored 50 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People and their families told us that staff knew them well and there preferences. They told us there were activities available in the home which they enjoyed. Some families members told us that there families members did not have care plans and they had not been involved in compiling one.

Staff told us person-centred care meant and that they treat everyone as an individual. Care plans did not always support staff to deliver person-centred care.

Staff knew people individually, and we observed care, which was generally positive,with staff showing a patient and understanding approach. However, care plans lacked detail and some contained no information at all. There was insufficient detail in relation to the support people needed and how they wanted to be supported. There was limited evidence people and their relatives had been involved in planning and making shared decisions about their care, and records did not fully reflect people’s physical, mental, emotional, and social needs.

People’s care was not always delivered in a way that met their assessed needs. The provider failed to ensure they supported flexibility and a joined up approach during transitions in care, including when people were admitted to and from hospital.

The new manager acknowledged that full assessment of people's needs had not been completed in the past. This meant they would not fully understand the needs and preferences of people before they took the decision to admit people. Since coming into post, the new manager had commenced work on updating the care plans to ensure they were robust and contained sufficient information.

Partners told us full assessments of people’s needs was not always undertaken by the provider before they moved from hospital to the home. There were also concerns about the information provided to emergency services when they attended the home.

There was limited evidence in care records that care delivery had been considered in a wider context. Records relating to other professional involvement were not always clear. Important information such capacity, Best Interest Decision Making and DNACPR information had not been completed. Medical care plans contained limited information about medical conditions and no information as to when additional support should be sought.

We received mixed feedback from people and their families regarding the provision of information. Some people told us they were kept up to date with their care and treatment whilst others told us they did not receive information about appointments and information relating to their care and treatment. One family member told us, “I rang up and spoke to administrative person. I asked for feedback, but I am not getting it. I tried to find out when the social worker went in, but they did not phone back. Staff talk to me and tell me things, but they are not consistent."

Staff and leaders told us they knew how to communicate with people who were unable to do so verbally.

Care plans did not always reflect how staff needed to communicate with people that had specific needs. We did not see other information available in alternative formats for people.

People told us they did not always feel listened to or that any concerns would be dealt with. One person told us, “I've complained about the time it takes for them to see to me.” One relative told us, “I rang up and spoke to administrative person. I asked for feedback, but I am not getting it.” There was a lack of evidence to demonstrate that all people and their relatives had been involved in decision making about their care and whether any changes had been made as a result of any feedback or involvement.

Staff told us they would raise concerns to management if they had them. Historically, they felt they had not been listened to and acted on by management, however, noted this had improved since the new manager had come into post.

A complaints folder was in place, and formal complaints had been dealt with appropriately and responses given. Meetings for people and relatives hadn’t always been well attended. We discussed whether the times of these meetings could be altered to allow people to attend different ones. The new manager explained they were going to organise quarterly meetings at different times/days such as at the weekend and evening. Processes did not always support people with communication needs to engage in providing feedback. We reviewed an individual satisfaction survey for one person however, by each question they have stated that they were unable to answer it.

People’s experience was comprised as their care and support needs had not been fully assessed, care planned and reviewed. We could not be confident people could access care, treatment, and support when they needed it.

Staff told us that activities were available within the home however, they were limited on the weekend. Activities outside the home were organised but these were not always available to everyone in the home.

Partners shared concerns people were not receiving appropriate care as and when it was needed, in particular, in relation to the provision of specialist dietary needs, diabetes care and medicine management.

Staff had a good understanding of people as individuals, although without direct reference to care plans. Care plans were not fully completed and did not always identify and support the meeting of people’s needs. Records in relation to the Mental Capacity Act and Best Interest Decision Making were not in place. Access around the home was generally good with all facilities accessible for wheelchairs although there was an issue with the ramp leading to the courtyard. Since the inspection, the new manager has taken action to fix this.

The provider had sought information from people about their care and support by way of a ‘residents’ survey’ and a ‘residents and relatives’ meeting. There was also a ‘You said, we did’ board in the home. However, it was not always clear what action had been taken in response to some of the issues raised. There was a lack of evidence that all people had been involved in tailoring their care, support, and treatment to ensure equality in experience and outcomes. Leaders recognised this and were taking action to make improvements.

Some staff told us they did not always feel they had the skills they needed to tailor care, support and treatment in response to people’s wishes and expectations. Leaders supported this view and were taking action to make positive changes.

The new manager understood the importance of making it easier for people to share their views via their preferred communication method and was ensuring this was a priority.

Care plans did not include enough detail in relation to life changes and end of life care to be able to understand what was important to them.

We received very little feedback from staff in relation to how they supported people to plan for their future. No one at the service was receiving end of life care at the time of the assessment, care plans did not include detail on life changes and what was important to them.

Care records did not include detail on supporting people with life changes which were important to them, including making informed choices about their future care and preferences for how they would like to be supported at the end of their lives.