15 November 2017
During a routine inspection
The care service has not 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 using the service were not supported to live as ordinary a life as any citizen.
The provider and the registered manager are the same person. A registered manager is a person who has registered with the 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 and associated Regulations about how the service is run. The provider had not been present at the service since 03 September 2017 and they had not ensured the appropriate support was in place for people who lived at The Rose in their absence. At the time of our visit there was an acting manager in post who was not registered with CQC and who was covering the absence of the provider. The acting manager told us that they did not know when the provider would return.
People’s health needs were not managed appropriately to ensure people were safe. Staff had not reported safeguarding concerns to help keep people safe.
Safe and effective recruitment practices were not followed to ensure that all staff were suitably qualified and experienced. There were no arrangements in place by the provider to ensure there were sufficient numbers of suitable staff available at all times to meet people’s individual needs.
People who lived at The Rose had no best interest or mental capacity assessments (MCA) in place and staff did not promote daily choices for everyone.
Staff had not received inductions, training or competency assessments. People were not supported to express their views; they were not always involved with decisions about their care. Risk assessments did not address all areas of concern and lacked the guidance needed to inform staff how to keep people safe.
People were not supported to maintain their interests or develop personal goals.
There were no systems in place to monitor the quality and audit the service. Daily notes and other documentation such as reviews of care plans had not been completed since October 2016. Meetings for people and staff were not completed.