This inspection took place on 12 March 2018 and was announced. We gave the provider short notice of our inspection due to the nature of the service. This was so the registered manager could be available to assist us with our inspection. We contacted family members and healthcare professionals by telephone on 20 and 22 March 2018.Rosehill is a 'care home'. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
Rosehill accommodates up to six people with a learning disability and/or autistic spectrum disorder. The care service has 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 and autism using the service can live as ordinary a life as any citizen. At the time of our inspection there were six people living at the service.
A registered manager was in place at the time of our inspection. 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.
We last inspected this service on 3 September 2015 when it was rated 'Good' overall. Without exception previous CQC inspections have found the service to be compliant with our regulations. During this inspection we found the service remained good and met all the fundamental standards we inspected against.
People were cared for by staff who knew them well and understood how to support them and maximise their potential. The service's visions and values promoted people's rights to make choices and live a dignified and fulfilled life. This was reflected in the care and support that people received. Staff understood people's different ways of communicating and how to make people feel valued. They supported people to make decisions for themselves and spoke with people about their wishes and preferences. People were listened to and their voice was heard.
We found staff were committed to delivering a service which improved the lives of the people who use the service in fulfilling and creative ways. We found that the manager had encouraged staff to constantly think about improvements. We found that the management style had led to people who use the service and staff feeling that they were an integral and essential partner in the operation and enhancement of the service.
Staff were devoted to ensuring each individual found their lives were enriched. We found staff empowered people to voice their wants and aspirations for their lives and then supported them to achieve these goals.
Relatives described the care at Rosehill as ‘a brilliant home.’ Relatives told us how the service had made a huge impact on their family members by enabling them to lead full and rewarding lives. Staff did not view the complex needs of the people who used the service as a barrier to them participating in similar activities to those of their peers. People had been supported to explore and engage in an extensive range of activities.
People had made use of the SMART (specific, measurable, achievable, realistic and timely) target system. These targets were a way of setting goals for people to work towards in areas that really mattered to them and which improved their quality of life. Staff also used a wide range of communications techniques such as pictures or the PECs system, Makaton and signs to enable people to discuss their ideas and as indicators that people were not enjoying themselves. The strong focus on person-centred care had an extremely positive impact on people. Staff were innovative at responding to changes in people's needs and identifying new support strategies for people.
Care records showed that people’s needs were assessed before they started using the service and comprehensive support plans were written, which ensured the support provided met people’s needs. Risk assessments about people's individual care needs were in place, for example in relation to epilepsy and emotional distress. Measures were identified that would minimise the risks identified and these were set out in people's care plans.
Staff had adopted a positive approach to risk management and did not unduly restrict people in the activities they engaged in. This had clearly led to people being able to tolerate transitions and change to the point whereby they enjoyed a fulfilling and fun-filled life.
Staff received regular supervision and they had annual appraisals. Staff were respected within the organisation and were provided with comprehensive training including specialist training. Staff were attended specialist accredited training around working with people who live with a learning disability or Autism Spectrum disorders. There were enough staff on duty to meet people's needs.
People were supported to have enough to eat and drink and attend appointments with healthcare professionals.
We found staff had an understanding of safeguarding and how to whistle blow. The manager was aware of risks within the service and was undertaking an analysis of risks.
The provider had an effective recruitment and selection procedure in place and carried out relevant vetting checks when they employed staff. People who used the service were able to share their opinion on potential recruits and this had led to effective selection of appropriate employees.
The home was clean, spacious and suitable for the people who used the service and appropriate health and safety checks had been carried out.
There were appropriate systems in place to record and respond to complaints. Relatives we spoke with said they had not needed to complain and felt any concerns would be dealt with correctly.
Relatives felt the service was well managed. Staff described the registered manager as approachable and the service as well-led. The provider had an effective quality assurance process in place. People who used the service, family members and staff were regularly consulted about the quality of the service via meetings and surveys.