The Care Quality Commission
  • Care Home
  • Care home

Archived: Rosswood Gardens

Overall: Requires improvement read more about inspection ratings

4,6,8 & 10 Rosswood Gardens, Wallington, Surrey, SM6 8QZ (020) 8647 8193

Provided and run by:
Metropolitan Support Trust

Important: The provider of this service changed. See new profile

All Inspections

14 October 2014

During a routine inspection

This inspection took place on 14 October 2014 and was unannounced. At the last inspection on 19 September 2013 we found the service was meeting the regulations we looked at.

Rosswood Gardens is a care home and short stay respite unit that provides accommodation and personal care for up to 23 people. The service specialises in the care and support of younger adults who have learning disabilities, including people living with autistic spectrum disorders. The accommodation is split across four adjoining houses that are self-contained each with their own separate entrance, communal lounge, and kitchen, toilets, bathroom and laundry room. People are free to use the communal areas in all three of the houses. Each person has their own bedroom. The respite unit can accommodate a maximum of six people at any one time and is not accessible from the main care home.

There were 13 people living in the home and two people staying in the respite unit when we visited.

The service had a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (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 2008 and associated Regulations about how the service is run.

Although people told us Rosswood Gardens was a comfortable place to live; we found the environment was not always adequately maintained. For example, we found damaged and missing cupboard doors in all the laundry rooms, ripped curtains in most communal areas, an offensive smelling toilet and saw the rear garden was overgrown. We also found that systems used to assess the quality of the service had not identified the issues that we found during the inspection. This meant the quality monitoring processes were not effective as they had not ensured that people received appropriate care and support that met their needs.

You can see what action we told the provider to take at the back of the full version of the report.

People told us they felt safe living at Rosswood Gardens. Staff knew how to protect people if they suspected they were at risk of abuse or harm. Risks to people’s health, safety and wellbeing had been assessed and staff knew how to minimise and manage these to keep people safe from harm or injury.

There were enough properly trained and well supported staff working in the service to meet people’s needs. People told us, and we saw that staff had built up good working relationships with people using the service and were familiar with their individual needs and preferences.

People told us they were happy living at the home. They also said staff were kind and caring, and our observations and discussions with relatives supported this. We saw staff treated people with dignity, respect and compassion.

Staff supported people to keep healthy and well through regular monitoring of their general health and wellbeing. Where there were any issues or concerns about a person’s health or wellbeing staff ensured they received prompt care and attention from appropriate health and social care professionals.

People were also encouraged to drink enough and eat sufficient amounts of nutritionally well balanced food.

Care plans were in place which reflected people’s specific needs and their individual choices and beliefs for how they lived their lives. People were appropriately supported by staff to make decisions about their care and support needs. People were involved in developing and regularly reviewing their care plans, and we saw people were supported to make decisions about their care and support.

People had access to their local community and could choose to participate in a variety of interesting and fulfilling in-house and community based social, educational and vocational activities. We saw staff encouraged and supported people to be as independent as they wanted to be. People were also encouraged to maintain relationships that were important to them.

The service had a clear management structure and people who lived there, relatives and staff felt comfortable about sharing their views and talking to managers if they had any concerns or ideas to improve Rosswood Gardens. The manager and deputy manager demonstrated a good understanding of their role and responsibilities, and staff told us the managers were competent, supportive and fair.

There were effective systems in place to monitor the safety and quality of the service provided at Rosswood Gardens. The provider regularly sought people’s views about how the care and support they received could be improved.

The registered manager had received training in Deprivation of Liberty Safeguards (DoLS) to understand when an application should be made and in how to submit one. This helped to ensure people were not being deprived of their liberty unlawfully.

19 September 2013

During an inspection looking at part of the service

At our previous inspection of Rosswood Gardens we identified that action needed to be taken by the provider to ensure people who used the service were always involved in making decisions about the care and support they received.

During our follow up visit we found that appropriate action had been taken by the provider to address these concerns, . We spoke with ten out of the thirteen people who lived in the main residential part of the home and one person who received respite services. They told us staff who worked there were kind and that they felt involved in making important decisions about the care and support they received. One person said 'all the staff are nice. They always ask me what I want to eat and what I want to do'. Another person told us 'my key-worker sometimes talks to me about my care plan. We have lots of meetings so I can tell them what I need'.

Although the people receiving services in the home and the respite unit told us they were happy with the care they were provided; the provider may wish to note that some of the services medication arrangements for storing, recording, auditing and disposing of medicines prescribed people were inadequate.

8 May 2013

During a routine inspection

During our inspection we spoke with ten out of the thirteen people who lived at Rosswood Gardens. We also spoke with the services newly registered manager and four support workers. We did not meet any of the people who used the respite service because they were all involved in community based activities when we visited.

People who use the service told us they were happy with the care and support they received at the care home and that the people who worked there were kind and caring. Several people said they felt safe living at Rosswood Gardens and were able to talk to staff if they were unhappy or had any concerns. One person told us 'I like living here. The staff are nice and good at their jobs'. Another person said 'I have got a lot of friends who live with me at Rosswood Gardens'.

We saw staff treated people who used the service with respect and dignity. We found staff were suitably trained and were familiar with the individual needs, abilities, preferences and daily routines of the people they supported.

We also found the provider had effective systems in place to ascertain the views of people who used the service and those that acted on their behalf.

However, although people told us they were happy living at Rosswood Gardens and we saw that they were well supported by staff; we found people's needs may not always be fully met because they were not involved enough in making decisions about the care and support they received.

30 January 2013

During an inspection looking at part of the service

We spoke to six people who were using the service when we visited Rosswood Gardens. They told us that staff that worked at their home were kind and caring, and that they felt safe living there. One person said 'it's alright here'. Another person told us 'I get on well with everyone who lives here'. Throughout our visit we saw staff treated people using the service with respect and courtesy. We also saw staff actively encouraged and supported people to make informed choices about their lives.

However, although people told us they were happy and we saw that they were well supported and kept safe; we found that failures to promote independence meant people may not always have sufficient opportunities to maintain and develop their independent living skills. We also found people's social needs and wishes were not being fully met. This was because people were not given enough appropriate opportunities and support to participate in meaningful activities within their local community.

27 July 2012

During an inspection looking at part of the service

We used a number of different methods to help us understand the experiences of people who either lived permanently at Rosswood Gardens or used its respite services because of people's diverse needs and various methods of communication. These methods, included: Speaking to people who were able to verbally communicate with us in a meaningful way; the Short Observational Framework for Inspection (SOFI), which is a specific way of observing care to help us understand the experience of people who could not talk with us; reviewing records the provider is required to keep; and, talking to members of staff that were on duty at the time of our inspection.

The service has experienced unusually high levels of management turnover in the last eighteen months and currently does not have an appropriate person in day-to-day charge with the right mix of qualifications, skills and experience. Typical feedback we received from people who use the service, included: 'Managers are always coming and going, it's very sad' and 'It would be nice to have a manager who could run the place properly'.

People told us they chose the care and support they received. For example, what times they got up and went to bed, what and when they ate, and what activities they participated in. However, several people said they were not always given appropriate information regarding the care and support choices that were available to them.

Furthermore, most of the comments we received people about the opportunities they had to participate in meaningful activities, especially in the wider community, were also rather negative. Typical feedback, included: 'We get bored here sometimes', and 'There use to be more staff about so we could go out more'.

However, all these negative comments made above notwithstanding, all the people we met told us they felt safe living or staying at Rosswood Gardens and most people spoke very positively about their experiences of the care and support they received there. Typical feedback we received, included: 'I really like living here', 'I have stayed here a lot ' I like coming here', and 'I have lived here a long time and do not want to move'.

All the feedback we received from people was also very complimentary about the staff that worked at the service. People told us staff understood their needs and provided them with the care and support they needed in the way that they wanted.

People also said staff were nice and always treated them well. Typical comments, included: 'Staff always knock on my bedroom door before they come in' and "The best thing about living here is the staff'.

People we met told us members of staff always respected their privacy and dignity. During our inspection we observed members of staff engage with the people who use this service in a very kind and courteous manner. For example, we saw members of staff always knock on people's bedroom doors and wait patiently for a response from the occupant before entering the room.

People said their views and experiences were taken into account in the way the service was provided. Most people we spoke with told us staff always listened to them and they could express their views about how the service was run with their key-workers and at group meetings with their fellow peers.

25 November 2010

During a routine inspection

Overall, we found the service treated the people who lived there with respect and had systems in place that enabled to influence its day-to-day running, but to maintain this; we have made a number of suggestions. Firstly, information people who use the service may find useful should be made more readily available in easy to read formats that everyone can understand. Secondly, the 'institutional' practice of labelling storage furniture used in bedrooms to make it easier for staff to find items of clothes should cease.

People who use the service told us they were treated with respect, involved in discussions about the care they received, and were able to influence how their home was run. Typical comments, included ' 'staff help me make my own choices', 'I can get up when I want and always choose what I wear', 'staff always ask me what I want to eat and drink', and 'I like the information boards cos you can see what's happening'.

We found that improvements are needed regarding outcomes relating to consent to care. This is because the provider does not have any systems in place to enable people who use the service to give their informed consent regarding the care they receive. Furthermore, staff have a limited understanding of the Mental Capacity Act (2005) because they have not received any training in this area.

We did not receive any feedback from the people who use the service regarding consent to care.

Overall, we found that people who live at Rosswood Gardens receive safe and appropriate care that meets their needs and supports their rights but, to maintain this, we have suggested that some improvements are made: People who use the service are not always being actively encouraged and/or supported to take 'responsible' risks and to do as much for themselves as they are willing and capable of doing. The service must ensure risk assessments are carried out that balance safety with the rights of the people who use the service to make informed choices and take 'reasonable' risks, as part of a structured programme that promotes independent living skills. These assessments must also take into account peoples willingness and capacity to make such decisions.

We found that Rosswood Gardens was ensuring the food and drink they provide meets people's individual dietary needs. This is because the service was able to provide us with clear evidence to demonstrate that people's dietary needs and preferences are well catered for. People are provided with a daily choice of varied nutritionally well-balanced meals that looked well presented and appetising. The feedback we received from people about the meals they were provided was in the main very positive, and included comments such as - 'I like the food' its alright', 'the food is good here, and you can always choose what you want as well', and 'I can normally choose what I eat and its usually pretty good'.

We found that Rosswood Gardens was ensuring people who use the service get safe and coordinated care from other health and social care professionals and agencies involved in supporting them. This is because the service has built up good working relationships with community based health and social care professionals, which includes GP's and care managers.

We found that staff working at Rosswood Gardens always ensure people who live there are protected from abuse and have their human rights respected.

This is because the service was able to provide us with clear evidence to demonstrate their safeguarding arrangements are sufficiently robust and understood by staff to minimise the risk of people who use the service being abused, harmed and/or neglected. The feedback we received from people who use the service and some of their relatives was very positive about the way staff handle safeguarding issues. Typical comments, included ' I'll tell my keyworker if someone hurts me' and 'I trust the staff here...I feel confident my 'loved one' is safe and well care for'.

We found that the provider's arrangements are sufficiently robust to ensure the people who use the service live in a clean environment that complies with the Department of Health's codes of practice on the prevention and control of infection.

A person who uses the service told us 'staff are much better these days at keeping the place clean and tidy'.

Overall, we found that people who live at Rosswood Gardens receive the medicines they are prescribed when they need them, and in a safe way. However, people prescribed 'as required' (PRN) medication should have much clearer procedures in place that ensures staff know when and how to use this type of medication.

The layout of the premises ensures the people who use the service live in a non-institutional environment which feels and looks quite homely.

All the people who use the service we met expressed satisfaction with the layout of the home. Typical feedback, included ' 'I like living here' I've got all I need in my bedroom', 'I chose the colour my bedroom was painted', and 'I like sitting in the lounge watching television on my own sometimes'.

However, a number of improvements are also needed. Firstly, the providers own maintenance arrangements are woefully inadequate and need to be reviewed as a matter of urgency to ensure both routine and urgent repair work is carried out in a timelier manner. Secondly, the temperature of one bedroom we viewed remains uncomfortable hot and a solution to this on going problem needs to be found as soon as possible. Finally, the disused stair lift in the main building needs to be removed as it represents a tripping hazard and makes climbing and descending this stair case unnecessary difficult and dangerous.

We found the provider makes sure they have the right specialist equipment that encourages and promotes the independence of the people who use the service. We did not receive any feedback from the people who use the service regarding the equipment used at Rosswood Gardens.

We found that Rosswood Gardens was meeting the essential standard regarding requirements relating to workers. This is because the provider has sufficiently robust recruitment checks in place to ensure it employs the right calibre of staff to meet the health and welfare needs of the people who use the service, as well as keep them safe.

We found that Rosswood Gardens was meeting this essential standard because the service was able to provide us with clear evidence to demonstrate there are enough competent staff on duty at all times to meet the health and welfare needs and wishes of the people who use the service. The overwhelming majority of all the feedback we received from the people who use the service, as well as some of their relatives, was extremely positive about staff who work at Rosswood Gardens. Typical comments, included ' 'staff deserve more recognition' they do everything to make the people who use the service comfortable', 'the staff are great here'it's the best thing about the place', 'you cant fault the commitment of the staff', and 'I like the staff, they're good to me'.

We found the provider was ensuring staff who work at the service are properly trained, have opportunities to develop and improve their skills, and are now supervised at regular intervals. However, we are concerned staffs overall work performance and their training needs and goals are not being formerly appraised at least once a year. Annual appraisals need to be carried out to enable the provider to identify any gaps in staffs knowledge and skills, which they can then use to inform the planning of future training programmes. Read the full inspection report (PDF)