Background to this inspection
Updated
19 October 2021
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
Inspection team
The inspection was carried out by three inspectors and a medicines inspector. An inspector and a medicines inspector visited on 01 September 2021, one inspector on 03 September 2021 and one inspector on 06 September 2021.
Service and service type
Rose House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
This inspection was unannounced.
What we did before the inspection
The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.
We reviewed information we had received about the service since registration and sought feedback from the local authority. We used all of this information to plan our inspection.
During the inspection
We spoke with seven members of staff including the registered manager, facilities director, care workers and the behaviour support trainer. We reviewed a range of records. This included all care and medicine records. We looked at two staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.
We are improving how we hear people’s experience and views on services, when they have limited verbal communication. We have trained some CQC team members to use a symbol-based communication tool. We checked that this was a suitable communication method and that people were happy to use it with us. We did this by reading their care and communication plans and speaking to staff or relatives and the person themselves. In this inspection, we used this communication tool with two people to tell us their experience.
After the inspection
We sought to speak to relatives about their experience of the care provided.
Updated
19 October 2021
Summary
We expect¿health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right¿support, right care, right culture is the guidance CQC¿follows to make assessments and judgements about services supporting¿people with a learning disability or autistic people.
About the service
Rose House is a residential care home providing support to three young adults at the time of our inspection. The service can support up to four people in one adapted building.
People’s experience of using this service and what we found
The service¿could¿show¿how they met¿the principles of Right support, right care, right culture.¿¿
People lead¿confident, inclusive¿and empowered¿lives because¿of the¿ethos, values,¿attitudes and behaviour¿of the management and staff.¿¿
The¿needs and¿quality of life¿of people formed the basis of the culture at the service. Staff understood their role¿in making sure that people were always put first. They provided¿care that was genuinely person centred.¿¿¿
The leadership of the service had worked hard to create a¿learning culture. Staff felt empowered to participate in their learning and suggest improvements.¿There was a¿transparent, open and honest culture¿between people, those important to them, staff and leaders. They all felt¿confident¿to raise concerns and complaints.
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’s care and support was provided in a safe, clean, well equipped, well-furnished and well-maintained environment which met people's sensory and physical needs.¿¿
• People¿were protected¿from abuse and poor care. The¿service had¿enough¿appropriately skilled¿staff to meet¿people’s¿needs and keep them safe.¿¿¿
• People¿were¿supported to be independent and had control over their own lives.¿Their human rights were upheld.¿¿
• People received¿kind and compassionate care from staff who protected¿and respected¿their privacy and dignity and understood each person’s individual needs.¿People had¿their communication needs met and information was shared in a way that could be understood.¿
• People’s¿risks¿were assessed¿regularly¿in a¿person-centred¿way, people had opportunities for positive risk¿taking.¿People were involved in managing their own risks whenever possible.¿¿¿
• People who¿showed signs of distress had proactive plans in place to reduce the need for restrictive practices. Systems were in place to report and learn from any incidents where restrictive practices were used.¿¿
• People made¿choices and¿took part in¿meaningful¿activities which were part of their¿planned care and support. Staff supported them to achieve their¿aspirations and¿goals.¿¿¿¿
• People’s care, treatment and support plans,¿reflected¿their sensory, cognitive and functioning needs.¿
• People received¿support that¿met their needs¿and aspirations.¿Support¿focused on¿people’s¿quality of life and¿followed¿best practice.¿Staff regularly evaluated¿the quality of¿support given, involving the person, their families and other professionals¿as appropriate.¿
• People received¿care, support and treatment from trained staff and specialists able to meet their needs and¿wishes.¿Managers ensured that staff¿had¿relevant¿training,¿regular¿supervision and appraisal.¿¿
• People and¿those important to them, including advocates,¿were actively involved in planning their care.¿Where needed a¿multidisciplinary team worked well together to¿provide¿the planned care.¿¿
• Staff understood their roles and responsibilities under the Human Rights Act 1998, Equality Act 2010, Mental Health Act 1983 and the Mental Capacity Act 2005.¿¿
• People were supported by staff who understood best practice in relation to learning disability and/or autism. Governance systems ensured people were kept safe and received a high quality of care and support in line with their personal needs.¿People and¿those important to them,¿worked with leaders¿to¿develop and improve¿the service.¿
Why we inspected
The inspection was prompted in part due to concerns received about behaviour management. A decision was made for us to inspect and examine those risks.
During this inspection we sought assurance that the service was applying the principles of Right support, right care, right culture.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
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.