Archived: The Rose

The care service has not been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities using the service were not supported to live as ordinary a life as any citizen.

The provider and the registered manager are the same person. A registered manager is a person who has registered with the CQC 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 and associated Regulations about how the service is run. The provider had not been present at the service since 03 September 2017 and they had not ensured the appropriate support was in place for people who lived at The Rose in their absence. At the time of our visit there was an acting manager in post who was not registered with CQC and who was covering the absence of the provider. The acting manager told us that they did not know when the provider would return.

People’s health needs were not managed appropriately to ensure people were safe. Staff had not reported safeguarding concerns to help keep people safe.

Safe and effective recruitment practices were not followed to ensure that all staff were suitably qualified and experienced. There were no arrangements in place by the provider to ensure there were sufficient numbers of suitable staff available at all times to meet people’s individual needs.

People who lived at The Rose had no best interest or mental capacity assessments (MCA) in place and staff did not promote daily choices for everyone.

Staff had not received inductions, training or competency assessments. People were not supported to express their views; they were not always involved with decisions about their care. Risk assessments did not address all areas of concern and lacked the guidance needed to inform staff how to keep people safe.

People were not supported to maintain their interests or develop personal goals.

There were no systems in place to monitor the quality and audit the service. Daily notes and other documentation such as reviews of care plans had not been completed since October 2016. Meetings for people and staff were not completed.

There was a manager in post who had registered with the Care Quality Commission (CQC). A registered manager is a person who has registered with the CQC 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 and associated Regulations about how the service is run. The registered manager is also the provider for this location.

Relatives and staff very were complimentary about the manager, deputy manager and how the home was run and operated. However we found regular audits had not been completed and there was no improvement plan for the home.

People communicated to us that they felt safe, happy and well looked after at the home. Staff had received training in how to safeguard people from abuse and knew how to report concerns, both internally and externally.

Safe and effective recruitment practices were followed to ensure that all staff were suitably qualified and experienced. Arrangements were in place to ensure there were sufficient numbers of suitable staff available at all times to meet people’s individual needs.

Plans and guidance had been drawn up to help staff deal with unforeseen events and emergencies. The environment and equipment used were regularly checked and well maintained to keep people safe.

Relatives were positive about the skills, experience and abilities of staff who worked at the home. They received training and refresher updates relevant to their roles and had regular supervision meetings to discuss and review their development and performance.

People were supported to maintain good health and had access to health and social care professionals when necessary. They were provided with a healthy balanced diet that met their individual needs.

Staff made considerable efforts to ascertain people’s wishes and obtain their consent before providing personal care and support, which they did in a kind and compassionate way.

Staff had developed positive and caring relationships with the people they cared for and clearly knew them very well. People were involved in the planning, delivery and reviews of the care and support provided. The confidentiality of information held about their medical and personal histories was securely maintained throughout the home.

Care was provided in a way that promoted people’s dignity and respected their privacy. People received personalised care and support that met their needs and took account of their preferences. Staff were knowledgeable about people’s background histories, preferences, routines and personal circumstances.

People were supported to pursue social interests and take part in meaningful activities relevant to their needs, both at the home and in the wider community. They felt that staff listened to them and responded to any concerns they had in a positive way. Complaints were recorded and investigated thoroughly with learning outcomes used to make improvements where necessary.

People were happy for us to see their rooms and we noted that these reflected the personalities and interests of the individuals concerned. We observed that people were living in a well maintained, comfortable, domestic style house that met their needs and provided good access to the local community.

People told us about the educational and leisure activities they took part in with support from staff. We were told that everyone living at The Rose had recently attended the wedding of one of the resident's relatives. During our visit people told us about their birthdays and the parties that had taken place.

We noted that there had been improvements in maintaining records related to the people living and working within the service and staff training.