Roseworth Lodge - PAMMS Assessment Report

Care plans were seen to be person centred and included information such as life history and what is important to the person. Information was seen to be consistent from assessments through to the care planning stage. Both residents and relatives confirmed that the home communicate well with relatives to ensure they are kept up to date with their loved one's presentation. Visitors are welcomed into the home at any time and residents access the community with the activity coordinators and family. Visitors were seen to be offered food and drink to join their loved one when visiting during mealtimes. Observation and discussion confirmed that residents are treated with dignity and respect, and privacy is respected. A relative described the home as 'one big family' and commended the staff for their kindness. 

Resident and relative involvement in care planning was clearly recorded in care plans. Care plans documented individuals' preferences, strengths and weaknesses. Dietary likes and dislikes, allergies or other nutritional needs were recorded in assessment and care plan documentation. Family and friend links were regularly referenced in care plans, including where certain people were preferred to be consulted about decisions (both when formal and informal processes in place) or simply in reference to a person's importance in the resident's life.

Capacity assessments were seen to be in place and recorded those involved in the decision making with care plans referencing how to support individuals in decision making and respecting choice. Deprivation of Liberty Safeguards were scanned on to the system and corresponding care plans and records were in place. Staff were observed to seek appropriate levels of consent when interacting with residents. Residents were given choices and treated with respect when making decisions. Staff were familiar with residents' preferences for things such as drinks but were noted to confirm this with residents before serving. 

Several needs assessments were on file and with associated care plans where required. Daily records were seen to be written respectfully however were variable in detail, while most were seen to contain the specifics of meals eaten and support delivered, some used only the generic pre-set options on the electronic care planning system. Overall records were of good quality however there were areas such as fluid charts, repositioning logs and oral care which were seen to be lacking.

Observation of staff interaction demonstrated that residents were safe and their needs were being met in a timely manner. Residents appeared settled and well cared for. Those spoken with confirmed they felt safe and well looked after and relatives confirmed the same of their loved ones. They confirmed they are informed if there are any concerns and kept up to date where necessary.

Medication rounds were seen to be carried out in a safe and person-centred manner with good hand hygiene observed. Medication trolleys and rooms were clean, tidy and secure and appropriate record keeping seen.

The home was seen to be clean, tidy and free from malodour. The kitchen was clean and tidy. Food had date of opening and use by recorded. Staff were seen to follow appropriate practices in relation to infection prevention and control and food hygiene.

The premises was seen to be safe with fire escapes and corridors free from hazard blockage. The home has been awarded their dementia friendly accreditation. This work identified some areas in which they can improve upon their dementia friendly environment, which are being actioned. Equipment was seen to be stored appropriately, and appropriate service certification was in place including Lifting Operations and Lifting Equipment Regulations (LOLER) testing, fire safety, fixed wiring, gas servicing and so on, with the required regular checks seen to be conducted.

The appropriate recruitment documents were noted within staff files including evidence of right to work checks (including visa documentation), and references which had been verified. A Disclosure and Barring Service (DBS) matrix was in place. All were seen to be in place and up to date, with the contractual 3 yearly updates scheduled, this included visiting professionals. A matrix was also in place for monitoring of nursing pins and all were seen to be in date with the pins recorded appropriately. 

A dependency tool was in place and the staffing levels were noted to exceed that which is required per this calculation. Rotas evidenced appropriate staff knowledge and skill mix per shift, across all roles (nurses, seniors and care staff, domestic, maintenance and kitchen). Staff advised that plenty of training is available, including refresher training, and this allows them to carry out their role safely, alongside 'hands on' experience in the role. A training matrix was reviewed which identified training compliance to be at 96 per cent.

There was evidence that the provider continually gathers and evaluates information about the quality of services delivered which included satisfaction surveys, meetings for staff, residents, relatives and visitors, monitoring of complaints and compliments, analysis of accidents and incidents and several audits. A range of audits are conducted by both departmental staff (kitchen, maintenance, domestic) and the managerial staff. The managerial audits include a specific review of the departmental staff audits. The audits were noted to identify where gaps had occurred and recorded follow up actions taken, giving assurance of managerial oversight and a responsive approach.