Archived: Rotherham Crisis (Cedar House)

Rotherham Crisis (Cedar House) is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement.

CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The home provides short-term accommodation for people experiencing a mental health crisis. The service has four beds, which can be accessed for a maximum of seven nights, during which time staff will provide emotional and practical support, over a 24 hour period to assist people using the service to resolve their crisis. At the time of the inspection, one person had just left the service and there were no current service users.

The home is located in Rotherham, South Yorkshire, close to the town centre. It is in its own grounds in a quiet residential area close to various community and leisure facilities.

At the time of the inspection the service had a registered manager. 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 and associated Regulations about how the service is run.

We found that appropriate steps were taken to ensure that the service was safe. There were up to date risk assessments and these were followed by staff. Staff had received training in safeguarding, and there was appropriate guidance for staff to follow in the event of suspected abuse.

People received care and treatment that met their needs. People told us that staff understood them and were responsive to their changing and complex needs. When people required the attention of external healthcare professionals this was sought quickly, and care plans showed that the guidance of external healthcare professionals was followed by staff.

Staff had received appropriate training to assist them in carrying out their roles, and there were plentiful opportunities for staff development. Staff told us they enjoyed their work and felt well supported in their roles.

Further information is in the detailed findings below

We inspected Rotherham Crisis (Cedar House) on 18 May 2016. The inspection was unannounced. The service was last inspected in June 2014, and no concerns were identified at that inspection.

Rotherham Crisis (Cedar House) provides short-term accommodation for people experiencing a mental health crisis. The service has four beds, which can be accessed for a maximum of seven nights, during which time staff provide emotional and practical support over a 24 hour period to assist people using the service to resolve their crisis. At the time of the inspection, two people were staying at the service.

The home did not have a registered manager. The previous registered manager had left their position a few months prior to the inspection and had therefore, accordingly, cancelled their registration. A new manager had been appointed and they had submitted an application to register with CQC. 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 service was safe. Staff had received training in safeguarding and knew how to report any concerns regarding possible abuse. Our records showed that the provider had acted appropriately when people were at risk of abuse.The provider used robust systems to help ensure care staff were only employed if they were suitable and safe to work in a care environment.

The service was effective. People received the support they needed to reach goals and identify how to obtain the support they needed. The manager was knowledgeable about the Mental Capacity Act 2005, and its Code of Practice. People using the service had given informed consent to their care and support.

The service was caring. People were treated with kindness and received support in a considerate way which was tailored to their needs and preferences. People using the service were involved in planning their care, and their privacy, dignity and independence was protected.

The service was responsive. People agreed to the support they received and were involved in reviewing their care to ensure it continued to meet their needs.People knew how they could raise a concern about the service they received. Where issues were raised these were investigated and action was taken to resolve the concern.

The service was well-led. Although there was no registered managr in post, this was due to staff turnover and a new manager had already applied to register with CQC. The provider had systems in place to monitor the quality of the service provided. These were thorough and effective.

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, speaking with the staff supporting them and looking at records.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

People were treated with respect and dignity by the staff, and staff were given support and guidance to ensure that they cared for people safely. People were protected from the risk of abuse because staff had appropriate training and guidance had been followed. People were cared for by staff who had appropriate background checks undertaken by the provider prior to the offer of employment. Systems were in place for managers to monitor the quality of the service and make sure it was run safely.

Is the service effective?

People's needs were assessed and care and treatment was planned and delivered in line with their individual care plan. Care plans contained assessments of people's care and support needs. These assessments described the steps staff should take to ensure each person's needs were met. Staff received appropriate support to meet the needs of people living at the home. Audits and reviews took place to ensure that care was delivered in a way that met people's needs.

Is the service caring?

We observed that staff were caring and respectful towards people. Each care task we observed took place in a patient and kind manner. People spoke positively about their experience of receiving care at the home.

Is the service responsive?

Staff acted on people's needs and in accordance with their wishes. Where people needed specific support or care, we saw evidence that this was delivered in accordance with people's needs.

Is the service well-led?

There was a quality assurance system in place, where staff internal and external to the home carried out a quality monitoring programme. This was detailed, frequent and thorough. Staff we spoke with believed they were well led and had confidence in the

management team.

People's health, safety and welfare was protected when more than one provider was involved in their care and treatment, or when they moved between different services. This was because the provider worked in co-operation with others. One person who used the service told us: 'The staff help bring everything together.'

People who use the service, staff and visitors were protected against the risks of unsafe or unsuitable premises. The provider had up to date certificates for gas safety, electrical installation, fire fighting equipment and portable appliance testing.

People were cared for by staff who were supported to deliver care and treatment safely and to an appropriate standard. One member of staff told us: 'I've received a great deal of support from my manager and the company for my studies.'

People were protected from the risks of unsafe or inappropriate care and treatment because accurate and appropriate records were maintained.

People experienced care, treatment and support that met their needs and protected their rights. People were very positive about the service as a whole and said "it's a haven" and 'I always feel safe'. They said of a staff member 'I don't know what I'd do without them.'

People who use the service, staff and visitors were protected against the risks of unsafe or unsuitable premises. We spoke with one person who said: "I really like my room and it has a lovely view."

People were cared for, or supported by, suitably qualified, skilled and experienced staff. Appropriate checks had been undertaken before staff began work. Each file we checked contained evidence that the provider carried out background checks on staff before they commenced work.

There was an effective complaints system available. Comments and complaints people made were responded to appropriately. One person told us told us that they understood how to make complaints, and that when they had raised concerns things had been changed.