Rose Meadow

Updated 17 August 2019

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 team consisted of two inspectors.

Service and service type

Rose Meadow 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.

It is a legal requirement for a service to have a manager registered with the Care Quality Commission. At our previous inspection, the manager had just been employed. At this inspection, the manager was in the process of registering with the Care Quality Commission. The registered manager and 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. We offered the provider the opportunity to share information they felt was relevant. We also reviewed information we had received about the service since the last inspection. We sought feedback from the Local Authority who work with the service.

During the inspection

We spoke with three people who used the service and one relative about their experience of the care provided. We spoke with three members of staff and the manager.

We reviewed a range of records. This included five people’s care records and medication records. We also looked at a variety of records relating to the management of the service, including policies and procedures.

Updated 17 August 2019

About the service

Rose Meadow has been registered since October 2011. The service provides accommodation, personal care and support for up to ten people in Misterton, North Nottinghamshire. At the time of our inspection, seven people were using the service. The service is focused on supporting people with a diagnosis of a learning disability.

Since October 2015, government policy has aimed to develop care services in line with 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 and autism using the service can live as ordinary a life as any citizen. Rose Meadow was registered with the Care Quality Commission before the ‘registering the right support policy. Rose Meadow does not currently fit within best practice models for ’registering the right support’. This is due to the size of the property and amount of people currently supported. Despite the property being large, the outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

People’s experience of using this service and what we found

Improvements to records and staff knowledge, meant people now lived in a safe environment. Risks were safely managed, and people were kept safe from abuse. The provider and manager had clearly learnt from previous concerns and this had resulted in a safer service.

People’s needs were effectively assessed and there was evidence of multi-agency professional involvement. People received effective care. People reported positively about the food, and people were provided with a balanced diet. Staff had received increased training and they now had excellent knowledge of the people they supported.

People were supported to have maximum choice and control over their lives. 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 support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

Our previous inspection found that staff had not been guided on how to respond to incidents at the service. Unskilled staff had then responded in non-caring ways. Staff had reflected that they wished to improve their work but were unsure how to respond to people. This inspection found that staff had now received clear guidance and support. They responded appropriately and compassionately to people. There was a caring ethos at the service.

There was an improved approach to personalised care. People’s individual needs had been considered and care was designed to promote people’s goals. There was a focus on improving people’s independence. People now received a responsive service which was led by their preferences.

The previous inspection was rated inadequate. This was mostly due to poor oversight in the absence of a registered manager. This poor oversight had resulted in poor quality care. After our report, we received a clear action plan explaining how the service planned to improve. This inspection found the service had followed this plan and substantial improvements had been made. There was also improved auditing structures to try to prevent a reoccurrence of previous concerns. While we were reassured, we require ongoing evidence that the service has sustained these improvements. This will ensure that people continue to receive a good level of care.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection (and update):

The last rating for this service was Inadequate (published 9 March 2019).

At the last inspection, we were concerned about the safety of the service. This included breaches of regulations 11, 12, 17 and 18 of Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The provider completed an action plan after the last inspection to show what they would do to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

This service was in Special Measures since the last inspection. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any key questions. Therefore, this service is no longer in Special Measures.

Why we inspected

This was a planned inspection based on the previous rating. This inspection was carried out to follow up on action we told the provider to take at the last inspection.

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.