Rosedale/Rosewood

The service has two bungalows each with accommodation over one floor. The service has an adjoining space in the centre between the two bungalows where there is an office/staff bedroom and laundry. Each bungalow consists of a living room, dining room, kitchen, bathroom, additional toilet and three bedrooms.

We found the following examples of good practice.

The home had comprehensive policies and procedures to manage any risks associated with the COVID-19 pandemic. This included the management of people with a COVID-19 positive diagnosis.

People living in the home and their relatives were supported to maintain contact. When visitors were unable to access the home, for example if they tested positive for COVID-19, window visits were facilitated.

A programme of regular COVID-19 testing for both people in the home, staff, and visitors to the home had been implemented. All visitors, including professionals were subject to a range of screening procedures, including showing evidence of vaccination, temperature check and a negative lateral flow test before entry into the home was allowed.

There was an ample supply of PPE for staff and any visitors to use. Hand sanitiser was readily available throughout the service. Staff had received updated training on the use of PPE, and we observed staff wearing it correctly during out inspection. Clear signage and information were in place throughout the home to remind staff of their responsibilities.

Daily cleaning schedules and touch point cleaning were implemented by staff.

Rosedale/Rosewood is a residential care home providing personal care to five people with a learning disability and/or autism at the time of the inspection. The service can support up to six people.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service received planned and co-ordinated person-centred support that was appropriate and inclusive for them.

People’s experience of using this service and what we found

People told us they felt safe and happy. Staff were caring, kind and respectful. There was a happy family atmosphere at the home. People and staff cared about each other and enjoyed spending time together.

There were systems and processes in place to help protect people from the risk of abuse. People received their medicines safely. There were enough staff on duty to meet people's needs. Safe recruitment procedures were followed. There was a positive approach to safety and risk which was not restrictive for people.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People had enough to eat and drink and their choices were respected. Staff supported people to buy, prepare and cook food. People were supported to have access to a range of healthcare professionals to ensure they remained healthy. Staff were well trained and supported.

Staff had a good understanding of people’s needs, preferences and goals. Care plans reflected people’s individual needs and people were supported accordingly. Staff supported people to maintain contact with those important to them and promoted inclusion within the local community.

A range of audits and checks were carried out to monitor the quality and safety of the service. Action was taken if any issues or concerns were identified. The registered manager promoted people leading fulfilled lives and led by example. The service was well run.

The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

The Secretary of State has asked the Care Quality Commission (CQC) to conduct a thematic review and to make recommendations about the use of restrictive interventions in settings that provide care for people with or who might have mental health problems, learning disabilities and/or autism. Thematic reviews look in-depth at specific issues concerning quality of care across the health and social care sectors. They expand our understanding of both good and poor practice and of the potential drivers of improvement.

As part of this thematic review, we carried out a survey with the registered manager at this inspection. This considered whether the service used any restrictive intervention practices (restraint, seclusion and segregation) when supporting people.

The service used positive behaviour support principles to support people in the least restrictive way. No restrictive intervention practices were used.

Rating at last inspection

The last rating for this service was good (published 7 April 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

The last inspection of this service was carried out on 5 August 2015. At that time we found the provider had breached two regulations. This was because there were gaps in necessary training for staff and staff had had not received supervision at regular intervals so they were not supported in their role. Also some people’s care records were out of date and incomplete, so it was not possible to determine whether these still reflected people’s needs or whether staff were providing support in the right way.

During this inspection we found the provider had made improvements to address both these matters. Staff now received the necessary training and support to make sure they were confident in their roles. Also people’s care records had been reviewed and updated to make sure they reflected people’s needs. This meant staff had current guidance to support people in the right way.

There was a registered manager at the service who had been in post for just over one year. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

The five people who lived at this home had learning disabilities and some people had limited communication. This meant they could not tell us their views about the service. Relatives told us people felt “safe” with the staff and were “happy” at the home.

Staff had up to date training in safeguarding adults. They were aware of their responsibilities to report any concerns and were confident these would be dealt with by the provider.

There were enough staff on duty to help keep people safe and to go out into the community. Most staff had worked at the home for several years or had transferred from other homes operated by the provider. There had been only a small number of new staff members start work here since the last inspection. The provider carried out the right checks to make sure new staff members were suitable to work with vulnerable people.

Staff supported people with their medicines. There had been mistakes with medicines management over the past year. The staff had worked closely with healthcare professionals to manage medicines in a safer way. Some staff had been retrained and there were more robust checks of medicines.

Staff understood the Mental Capacity Act 2005 for people who lacked capacity to make a decision and Deprivation of Liberty Safeguards to make sure they were not restricted unnecessarily. For example five people needed staff support and supervision when out in the community because they had little understanding of road safety. Two people had support from an independent advocate to make sure their rights were protected without compromising their safety.

Relatives said people enjoyed the meals at their home. They were supported with their nutritional health and staff prepared meals which met their individual dietary needs. People were supported to be involved in shopping, choosing and preparing meals where possible.

There were good relationships between people and staff. People were encouraged to make their own choices and decisions about their day to day lives, wherever their capabilities allowed. Staff were respectful of people’s individual and diverse needs. Relatives and care professionals said people were treated with dignity and respect.

Relatives told us they felt people were well cared for in the home. Staff were very knowledgeable about people’s individual preferences and communication methods. People received personalised care that put them at the centre of the service.

There had been a good improvement to the range and opportunities for people to take part in activities, especially in the local community. These included swimming, cinema, line dancing, shopping trips, craft shops, horse riding and a hydrotherapy pool.

Relatives and care professionals were very positive in their comments about the open, approachable management style of the registered manager. The registered manager and provider had made improvements to the service people received. The provider had effective quality assurance processes that included checks of the quality and safety of the service.

One staff member we spoke with told us, 'I love my job' and 'The people who live here come first.' Another staff member told us, 'Our priority is the people who live here.' We spoke with two people with limited verbal skills who were able to confirm that they were happy living at the home.

We spoke with staff and found that they were very knowledgeable about people's likes and dislikes and how they wished to be supported. We were able to see how people's skills and independence were promoted. We saw that staff were very caring and supportive of people.

We saw that people who used the service had a choice of food and drink and were involved in menu planning and shopping for food.

We saw that there was enough staff on duty to care and support people who used the service.

At the last inspection we found that staff appraisals were not up to date. At this inspection we checked the action the manager had taken to ensure that these were now up to date. We looked at five staff records which showed that appraisals had been carried out in May 2013.

The bedrooms in the service were large and decorated for each individual. The communal areas were tidy and large enough for people to use comfortably.

The service was located on its own grounds with a large garden to the rear of the building.