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La Rosa Residential Care Home Good


Inspection carried out on 1 May 2018

During a routine inspection

La Rosa Care Home is a residential care home for seven people with mental health issues. The service is a large residential home based over three floors in the London Borough of Lambeth. At the time of the inspection there were five people using the service.

At our last inspection on 15 December 2015 we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and on going monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

People continued to receive support from staff to maintain their safety. Staff were aware of the providers policy on reporting and escalating suspected abuse. Staff received on-going training in safeguarding and whistleblowing. The service had devised, monitored and developed risk management plans that identified risks and gave staff clear and current guidance on how to mitigate identified risks. Where incidents had taken place, these were regularly reviewed to learn from them.

People’s medicines were managed safely to ensure they received their medicines as prescribed. Records confirmed medicines were audited regularly to ensure any errors identified were addressed swiftly.

People continued to be supported by sufficient numbers of suitably qualified staff to keep them safe. Staffing levels were flexible to meet people’s changing needs. Staff continued to receive effective training to enhance their skills and knowledge. People received support from staff that reflected on their working practices through regular supervisions and annual appraisals.

Cleaning schedules were in place in line with the provider’s infection control policy, to minimise the risk of cross contamination. Maintenance issues were identified and action taken to rectify the issue was taken in a timely manner.

People were encouraged to maintain their independence, gaining daily living skills to enhance their lives. People’s health and wellbeing was regularly monitored and where concerns were identified, action was taken in conjunction with healthcare professionals to address this and changes implemented into the delivery of care.

People continued to be encouraged to make decisions about the care and support they received. Consent to care and treatment was sought prior to care being delivered. Staff received on going training in Mental Capacity Act 2005 and Deprivation of Liberty Safeguards.

People were supported to develop their care plans, wherever possible. People were encouraged to share their views around how they wanted to receive care. Care plans were person centred and reviewed regularly, changes were shared with staff.

People were aware of how to raise a complaint. Complaints were documented and action taken swiftly to minimise repeat incidents and seek a positive resolution.

People continued to be supported to develop end of life care plans, in a way that did not affect their mental health.

People, their relatives and staff spoke positively about the registered manager and management team as a whole. People were encouraged to share their views in an open and inclusive service that sought people’s views in a way to improve the service.

The registered manager carried out regular audits of the service to drive improvements. Audits were reviewed and action plans implemented where required.

Inspection carried out on 15 December 2015

During a routine inspection

This inspection took place on 15  December 2015 and was unannounced.

La Rosa is a residential home that provides accommodation and support to up to seven people with mental health needs. At the time of the inspection there were seven people living at the service.

There was a registered manager in post. 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.

We last inspected the service on 19 June 2014 and the service met all areas we inspected.

People received their medicines as prescribed and safely in accordance with good practice. There were robust systems in place to ensure the safe management of medicines. Staff had sufficient knowledge on medicine administration, storage and recording.

People were protected against the risk of abuse by staff that had sound knowledge on how to identify the different types of abuse and how to appropriately report any concerns of suspected abuse. People told us they felt safe living at La Rosa.

People were protected against identified risks. The service had comprehensive risk assessments in place to mitigate against known risks. Staff had clear guidelines on how best to support people when faced with known risks.

People had care plans that were person centred and tailored to their needs. People were actively encouraged to be involved in the development of their care plans. Care plans were reviewed regularly and updated to reflect peoples changing needs.

People were supported to access health care professionals to monitor and support their health and wellbeing. People were encouraged to maintain a healthy diet and were provided with sufficient food and drink to meet their nutritional needs.

The service demonstrated good practice and were aware of their responsibilities in line with the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). MCA and DoLS aim to make sure that people in care homes, hospitals, and supported living are looked after in a way that does not deprive them of their liberty and ensures that people are supported to make decisions relating to the care they receive. Services should only deprive someone of their liberty when it is in the best interests of the person and there is no other way to look after them, and it should be done in a safe and lawful manner. At the time of the inspection, one person was under a general DoLS application.

People were supported by skilled and knowledgeable staff. Staff received on-going training in all aspects of care to ensure people’s needs were met. Training included, safeguarding, health and safety, medicine management and mental health awareness.

People were supported by staff that had undergone the relevant checks to ensure their suitability to work. The service provided all new employees with a comprehensive induction programme to ensure they had the suitable skills and abilities to carry out their role effectively. The service had employed suitable numbers of staff to meet people’s needs.

People received care and support from kind, caring and compassionate staff, who respected their privacy and dignity at all times. Staff received regular supervisions and annual appraisals and were able to reflect on the care and support they delivered and identified further training requirements.

The service encouraged feedback of the service provision to improve the quality of care provided. Quality assurance questionnaires were carried out and where appropriate action taken to address identified areas of concern.

People were protected against an unsafe environment. The service carried out regular health and safety checks of the environment to ensure people were safe from harm.

Inspection carried out on 19 June 2014

During a routine inspection

At our last inspection on 30 December 2013, we found that people�s needs were not always assessed and care and treatment was not planned and delivered in line with their individual care plan or delivered in a way that was intended to ensure people�s safety and welfare. We found people's personal records including medical records were not up to date, accurate or fit for purpose. We found that at this inspection improvements had been made

A single inspector completed this inspection. During our visit we gathered evidence to answer our five questions; Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?

Is the service caring?

People told us that staff were kind and supportive. Staff were aware of the individual needs and preferences of the people living at the home. People were supported to be independent and were encouraged to participate in activities out of the home and were supported to develop their daily living skills, such as cooking.

Each person had a care plan they had contributed to by talking with the manager and their keyworker (a designated staff member from within the team).

Is the service responsive?

People told us that they were able to choose what they wanted to eat and cook for themselves and other residents. Staff supported people to make decisions and made arrangements with people so that they were able to have their needs and wishes listened to.

Staff made referrals to health and social care professionals when people�s health and social care needs changed. Staff responded to people�s changing needs, one person's physical health care needs had changed. The social worker told us that staff had kept them well informed of the persons increasing needs and worked extremely hard to ensure these increased needs were met whilst a nursing placement was found.

Is the service safe?

People told us that they felt safe and happy living at La Rosa Residential Care Home.

We spoke with eight health or social care professionals involved in the care of people living at La Rosa Residential Care Home. They told us they had no concerns about the quality of care provided.

Any risk areas were identified and ways to reduce these risks were in place. Staff we spoke with knew the type of support and approach needed for each person and we saw that the support described in the plans was being provided. For example, one person needed assistance to mobilise round the communal areas and we saw staff provided this assistance.

There were systems in place to deal with emergencies. Staff told us that they were aware of how to manage people�s safety. There were sufficient staff on duty to meet people�s needs throughout the day and night.

Is the service effective?

People had an assessment of need before coming to the home, from this information and individual care plans were developed. We saw that the care plans were made available to people and their relatives. Care plans identified people�s wishes, concerns, risk assessment and a management plan to minimise risks identified.

Each person had a named member of staff who met with them each month to discuss their care and support needs and develop written plans for how these needs were to be met. People also met as a group to make decisions about activities, menus and house rules.

Is the service well led?

People told us that they felt able to raise and discuss concerns with staff or the manager as appropriate. There were quality assurance systems in place to improve the lives for people. We saw that staff had regular meetings with staff and people living at La Rosa Residential Care Home.

People met as a group to make decisions about activities, menus and house rules. People's diversity, values and human rights were respected. The provider confirmed that people's names had been added to the electoral roles so that they could take part in elections if they wished.

Inspection carried out on 30 December 2013

During a routine inspection

We observed the interactions between staff and service users whilst they carried out care activities. We found that they were inclusive and respectful of people who use the service. People were able to make their own decisions about care and were "independent".

We spoke with two people who used the service, both of whom informed us that although they had had �very minor� concerns �a long time ago� and �in the past�, however, currently they had no concerns with regard to their care, the staff or the staffing. Staff were considered to be �pretty good�, skilled and �up to the job� as well as �really, really nice� and �very, very helpful�.

We spoke with the two members of staff who were onsite who informed us that the �work load is good� and that there was a �lot of teamwork going on. We share the workload�. We also discussed recruitment, training, assessments and the working environment with both members of staff. We found there were sufficient staff on duty to meet the needs of people.

We looked at policy records with regard to staff recruitment, training and development as well as policies regarding on-call and lone work and found good arrangements in place for the recruitment and support of staff. We found that records were not kept up to date or accurately.

Inspection carried out on 8 March 2013

During a routine inspection

We found that people were being supported to maintain their physical and mental health and were fully involved in developing care plans for how the support was to be provided.

We spoke with five of the people using the service. Their comments to us included

"I visited the service many times before moving in and I was pleased that they changed the colour of the carpets and walls as I had asked. I haven't been here long but so far so good".

"I am happy with the service. The food has got better

"I am happy here and I feel safe"

"I feel safe. Basically it's alright here. Most of the staff are OK. My key worker has helped me a lot with things like buying winter clothes but sometimes I feel staff pressure me to take part in social activities when I don't want to."

"I feel very safe here. The manager has helped me a lot. Staff respect me and knock on my bedroom door before they come into my room. The house is clean, tidy and warm. I help staff to cook and go to college and the manager helped me to plan a holiday with my family last year".

"If I don't like a meal because it's too spicy the staff cook me an alternative meal that I like instead"

"If I have a complaint I talk to my keyworker or the manager and they sort it out".

We found that there were a sufficient number of suitably trained and qualified staff available to meet people's needs. The staff understood how to help people to maintain their personal safety.

Inspection carried out on 24 November 2010

During a routine inspection

People we spoke to when we visited knew who their key workers were and were aware of and had contributed to their written care plans.

One person told us that he liked having a key worker to talk to if he had any problems or felt depressed.

People who use this service are encouraged to get involved and contribute to regular meetings about how the service is being run and we saw evidence of this when we visited the service.

When we visited we asked the people who use the service what they would do if they had a complaint. The people who commented said that they would talk to the manager or their key worker.

When we visited some of the people who use the service said that they knew the registered provider and that she visited the service often, accompanying them on daytrips to places of interest in the summer.

Two people who use this service said that the food is Okay and we saw that people could make their own meals and hot drinks if they wished. We saw that personal preferences and cultural needs are catered for.

We saw that people can raise complaints about their treatment and there are regular opportunities for them to raise any concerns they may have.

Reports under our old system of regulation (including those from before CQC was created)