Healthwatch Kingston Enter & View Report: Rosclare Residential Home
Healthwatch have a legal power to visit health and social care services and see them in action. This power to Enter and View services offers a way for local Healthwatch to meet some of our statutory functions and allows us to identify what is working well with services and where they could be improved.
Overall, we found Rosclare to be a comfortable and friendly environment where residents seemed generally happy and well cared for. On the day of our visit Rosclare ran smoothly, and the residents were provided with a number of different activities within the care home, which many seemed to enjoy. Our recommendations included more opportunities for activities outdoors.
The food provided was generally a good standard and appreciated by most however, we did recommend that the food variety and menu options needed reviewing.
Rosclare is not a purpose built care home. Healthwatch Kingston felt that the building had a comfortable feel and had been largely well-adapted for its new purpose however some of the rooms were busy at times.
The management team and staff at Rosclare were welcoming of the Enter and View, and since our visit in March 2024, Rosclare have already addressed may of the Healthwatch Kingston recommendations.
“It must be difficult to cater to so many people and please everyone, especially as some people in here may be ‘very old’ and struggle to eat some foods.”
Key Finding
Healthwatch Kingston Recommendations and Provider Response:
Recommendations (1-3) - Building exterior:
1. Review ramp access up to and into the building through the front door and ensure disabled access is clearly visible.
Rosclare Residential Home (RRH) Response: ‘Reviewed – identified need for small additional ramps on internal side of door sills.’
Action: ‘New ramps and signage fitted on internal side of front and back doors 7/5/24.’
2. Consider requesting additional bins from the council (if recycling bin capacity is an ongoing issue).
RRH Response: 'RBK Waste Collection did not collect the recycling for 12 consecutive weeks despite RRH chasing. Routine collections have started again as of 5 Apr 24 and bin capacity is once again ample.’
3. Explore a front garden area development project to improve residents’ view through the lounge window. Consider how to include residents in the project to promote a sense of ownership and safe use of the space. This could include introducing more flowering plants for seasonal awareness, and perhaps a bird table to provide visual stimulation and connection to nature.
RRH Response: ‘The front garden has been planted with flowers several times, however this is south facing sun-trap in which flowering plants quickly wither and die due to the heat despite maintenance. Therefore, hardy green bushes are planted around the perimeter of the garden, some of which flower seasonally.’
Action: ‘A colourful bird bath has been purchased (1/5/24) and will be placed in view of the living room window. – Delivered broken, waiting for return and replacement 14/5/24. Residents involved in planting herbs for back garden (see point 12 below).’
Recommendations (4 and 5) - Rosclare reception area:
4. Introduce a second notice board in the reception area, where the fire and evacuation procedures can be grouped together with clear signage.
Action: ‘A dedicated board has been purchased for all fire and evacuation procedures. Ordered 1/5/24. Installed with all fire notices 6/5/24.’
5. Add a notice asking visitors to wait in the reception area until a member of staff is available to help them.
Action: ‘Signage ordered 7/5/2024 delivered 14/5/24, awaiting handyman to fit.’
Recommendation (6-9) - Communal spaces:
6. Consider making a memory space for residents with dementia in the lounge.
RRH Response: ‘There is actually already a dedicated memory space for residents on the easel in the Living Room. The other side of the easel is used for word games; the word games side is the side that was facing outward during the HWK visit, hence it may have been overlooked.’
7. Introduce signage to where the fire evacuation sledge is located on the first floor, with clear instructions on how to use it.
RRH Response: ‘We will add evacuation slide signage with directions to instructions. Evacuation slide has clear printed instructions on front cover and staff have been trained to use it.’
Action: ‘Custom signage designed and ordered 14/5/24. Fitted 16/5/24.’
8. Consider implementing a handrail on the corner to the first-floor bedrooms, to allow for additional support with the overlapping step.
RRH Response: ‘There are banisters on both staircases. On advice of fire safety inspector, we cannot add a further handrail to the corner as this will limit the width of the fire escape route. The chair lift handles do provide additional stable support even for residents who do not use the lift itself.’
9. Install a banister or handrail leading up to the landing on the second floor, to provide support for those that may need it.
RRH Response: ‘Where the banister stops there are balustrades to grip on to so our residents and visitors have not had an issue with this. It is important that we do not create a hazard by adding a section or banister which sticks out.’
Action: ‘Carpenter will attend to design a bespoke extension to handrail without creating a safety hazard if possible – instructed 10/5/24, awaiting site inspection.’
Recommendations (10) – Dining:
10. Explore introducing staggered mealtimes to help alleviate cramped dining.
RRH Response: ‘We will stagger according to resident preferences and practicalities. NB. Most residents choose to eat together.
Action: ‘Some residents who don’t eat well around others are brought in early for meals and this is in their care plans. Others prefer to eat in their rooms. Some prefer to eat a little later so come in later on.’
Recommendations (11-14) – Back garden area
11. Introduce fire safe bin for smokers to safely dispose of cigarettes.
Action: ‘Fire safe bin ordered 1/5/24, delivered 9/5/24, awaiting installation.’
12. Explore including herbs and other textural plants in the garden borders to provide a sensory garden space for residents.
RRH Response: ‘At the time of the visit none of the flowers had bloomed. There are now a number of bright plants (red, pink, blue and yellow/white) in bloom. Rosemary and bay leaf are now producing scent.’
Action: ‘Sage, Fennel and Oregano purchased and placed in garden 15/5/24. To be planted in planter during resident gardening activities on Monday afternoon 20/5/24.’
13. Ensure the door to the garden shed is always locked.
RRH Response: ‘Handyman had just opened the shed to do a job.’
Action: ‘Staff have been instructed to shut and lock sliding door even during jobs.’
14. Consider a better way to safely navigate the access ramp to the garden.
RRH Response: ‘The access ramp through the conservatory is for wheelchair access rather than self-mobilisers (who are familiar with the dining room route). Conservatory door is unlocked by staff for wheelchair users as necessary.’
Recommendations (15-16) – Environment:
15. Create accessible infection control signage for use at each entrance of the building so that if there is an infection outbreak in the home, visitors are informed of the risk before entering the building. It would be helpful if this signage was made available in languages spoken by the resident and their visitors.
Action: ‘White boards for infection notices to be mounted at both entrances. Boards ordered 14/5/24. Delivered 15/05/2024. Handyman to fit.’
16. Create a general repair and maintenance log to track required actions such as changing light bulbs and fixing the front gate.
Action: ‘Maintenance log and Improvement log created 15/3/24 and kept updated on an ongoing basis.’
Recommendations (17-19) – Mealtimes:
17. Improve vegetarian menu and include hot and cold vegetarian options for all three mealtimes.
RRH Response: ‘Menu is being revised as suggested. NB. Vegetarian options have proved unpopular with the majority of residents - this may be a generational issue.’
Action: ‘Menu with hot and cold vegetarian options revised and implemented 14/05/24.’
18. Conduct frequent surveys with residents to refresh mealtime menus and introduce variety.
RRH Response: ‘Residents are surveyed every 3 months with regard to meals. In addition, meals are tweaked on an on-going basis according to feedback at mealtimes from residents.’
19. Consider how to include different fruit and vegetable options and promote to resident like the suggested ‘Fruity Fridays’.
RRH Response: ‘NB. Bananas and canned fruit are available daily. Vegetables routinely served as part of balanced meals.’
Action: ‘Seasonal fresh fruit is now purchased for residents once or twice a week. The fruit must be ripe and soft enough for the residents to chew. The exact day of the week depends on the availability of suitably ripe fruit but is usually on Weds/Thurs/Fri.’
Recommendation (20-24) - Activities:
20. Consider alternatives for those that are not engaging in the group activities, such as more outdoor activities, and walks (weather permitting).
RRH Response: ‘As noted, some residents do not like to participate in group activities. We do offer individual activities such as walks, colouring, crosswords, puzzles, and beauty care. However, we cannot make residents participate and we have to respect their preferences.’
Action: ‘Continuing to offer individual activities on an ongoing basis.’
21. Contact Kingston Voluntary Action to find out if they could direct volunteers to visit the home for coffee mornings where residents can have regular informal chats.
RRH Response: ‘We already have volunteer (i) local Duke of Edinburgh school children and (ii) Kingston Advocacy Group volunteer coming in for regular chats with residents on an on-going basis.’
Action: ‘Contacted KVA by phone on 8/5/24, awaiting email with potential additional volunteers. Existing volunteers will continue as usual.’
22. Consider using puzzle mats, so that residents can do puzzles and roll them up at the end of a session, as surface space is limited within the communal areas.
RRH Response: ‘We do have large jigsaw puzzles which residents and staff do together and then staff tidy up.’
Action: ‘We have purchased a bingo set which is played in communal areas then tidied up.’
23. Introduce dementia friendly training, from an external provider, along with how to better support young older residents with dementia.
Action: ‘Shortlist of accredited trainers including Alzheimer’s Society and University College London (UCL) identified 14/5/2024. Discussions starting with a view to providing training by 30/06/24.’
24. Set times for activities to help residents and their family and friends to plan appropriate time for their visits.
Action: ‘Activity times added to activity chart 16/5/24.’
Healthwatch Kingston Enter & View Report: Rosclare Residential Home
To read the the full report, including feedback from the residents and staff at Rosclare and the Healthwatch Kingston observations on the day of the Enter and View Visit, you can download the full report:
