This inspection took place on 26 May and 3 June 2015. It was unannounced.
Rookhurst provides care for up to six people who are living with a learning difficulty, this may include people with Autistic Spectrum Disorder, behaviours that challenge and people living with mental health conditions. At the time of the inspection there were five adults living at Rookhurst. The home is owned by Trust Care Management Limited who also provided supported living services.
Rookhurst was a domestic-style, two-story house, which was situated in a quiet residential road. People’s bedrooms were provided on both floors. There was a living room and a dining room on the ground floor, as well as a large garden to the rear of the building.
Rookhurst was last inspected on 27 May 2014 and no breaches of regulation were found. We performed this inspection because we had received information of concern relating to people’s care and welfare from more than one source.
The service had a registered manager who had been appointed since the last inspection. 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 provider had not ensured there were enough staff on duty to follow people’s agreed care plans and enable people to choose what they wanted to do.
Staff had not been trained in areas which were specified in people’s care plans. Staff had been provided with training in other relevant areas such as first aid and infection control.
People did not have some of their care needs documented in their care plans. This meant there was not a consistent approach when supporting people. Where people’s care needs were documented, care plans were not always followed by staff.
The provider’s audit had not identified where improvements needed to be made in the service, this included people’s care plans and staff deployment.
Activities were provided to people but they were not always provided using a planned approach and were subject to staff availability.
Improvements were needed in the management of medicines in relation to certain areas, such as prescribed skin creams. Other areas were safe, such as when people were given their medicines to take when they went out of the home.
There were both environmental and individual risk assessments. Issues relating to fire safety were in the process of being addressed.
The service sought feedback from people, which was mainly positive. However one person had reported on the difficulty of using a wheelchair on the drive. The drive continued to be uneven, and there was no action plan to address this.
There had been an increased turnover in staff. Although newer staff were less familiar with the service, there were also benefits, managers reported new staff had brought in different ways of working. All staff had been recruited using safe systems.
Staff were positive about the improvements made by the new registered manager, particularly in relation to the benefits for people living in the home. The new manager had also addressed a range of other areas, including making sure people had been referred to the Local Authority under Deprivation of Liberties Safeguards. All staff spoken with reported they received regular supervision and they found the manager supportive when they raised issues.
Staff had a good understanding of their responsibilities for keeping people safe and knew how to alert relevant authorities if they identified a person might be at risk of harm. The provider had ensured staff were trained in The Mental Capacity Act 2005 and understood their responsibilities under this Act.
People’s privacy was respected. Staff supported people’s diversity and individual choice. People were supported in maintaining links with their families.
Menus had been revised with both people and staff, to include principals of health eating. The mealtime had a comfortable, family atmosphere.
Staff knew how to support people’s medical needs and referred people for specialist advice when needed.
We found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report. Please note that the summary section will be used to populate the CQC website. Providers will be asked to share this section with the people who use their service and the staff that work at there.