Archived: Rosefern Residential Home

At the last full inspection on 14 October 2014, we asked the provider to take action to make improvements (for example to person-centred care and good governance), and this action had been completed when we undertook a follow up inspection in August 2015.

At this comprehensive inspection, we saw that improvements had been maintained and there were no further breaches. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Rosefern Residential Home on our website at www.cqc.org.

There was a registered manager at this service. 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.

Staff were trained to keep people who used the service safe and they knew how to raise a concern if they saw poor practice. Care plans were detailed and included associated risk assessments that were recorded and reviewed regularly.

There were sufficient staff employed to meet people’s needs and they had received an effective induction. They were supported through supervision by senior staff. People and professionals had confidence in the skills and knowledge of staff.

Medication was administered and recorded safely by staff. Medication reviews were carried out regularly and people's care plans showed that people received their medication appropriately, with any changes logged as they occurred.

Safety and maintenance checks were carried out and recorded regularly in the home. Evacuation plans were specific to each person and the emergency on-call system gave staff clear guidance on the procedure.

People were protected because staff were aware of and followed the principles of the Mental Capacity Act (MCA) 2005.

Consent was sought from people before care and support was given. If people required support with decision making then staff made referrals to the right professionals to ensure that decisions were made in people's best interests.

There were a variety of meal choices available and people were involved in choosing the menu. Snacks and drinks were available when people wanted them.

People who used the service were positive in their comments about the staff approach and we saw that staff showed respect to people and maintained their dignity and privacy. Professionals made positive comments about people being supported in a kind and caring manner.

Staff gave a person-centred approach to support and we observed that people’s preferences, views and choices were respected. This was reflected appropriately in their care plans. People were supported to choose and engage in activities both inside and outside of the home.

In order to maintain the quality of the service a variety of audits were completed and reviewed regularly. Service policies and procedures were in place and these were also available for people in an appropriate format.

The service was led well by a registered manager and a deputy manager who both had experience of working with people who had a learning disability. People's care plans and files contained records that were clear and detailed. Professionals were positive in their comments about the open and positive attitude of the managers.

When we visited the service we spoke to the manager and four care staff. We looked at three care files and associated risk assessments. We spoke to four people who were using the service. We looked in every room at the service.

We saw that people were consulted about their care and if that was not possible there was involvement with peoples representatives. We saw that the service had written plans of care to ensure that peoples support needs were met and that there were appropriate risk assessments in place where necessary. People told us that they liked living at the service and were happy. One person said, "I'm very happy here. I like it very much". Another gave a thumbs up sign indicating that they were happy with the service. We saw people being taken out for a walk and people told us that they went to the local shops. Staff told us that people were taken to the local public house on occasions.

We saw that people had their own room which was personalised with their own possessions. People were supported by staff who had been recruited safely and had received satisfactory training. Staff told us that they were well supported by the manager and that they would be confident in raising concerns.

We saw that people using the service were relaxed and happy when interacting with the staff. People using the service were able to express themselves in their own way and the staff had a good understanding of each person using the service.

People's consent to care was gained and we saw evidence that people received the care they needed. For example we saw up to date plans of care which considered individual physical, emotional and mental health care needs. We saw risk assessments and that all documentation was kept up to date to ensure people had their changing needs met. We saw that the home consulted with specialists to make sure people had the benefit of expert advice.

People were protected from harm and the risk of harm through staff training and risk assessments. The service also referred safeguarding incidents to the local authority and to CQC as required. Staff had training in the Mental Capacity Act (2005) and Deprivation of Liberty safeguards (DoLS) to ensure people's rights were protected.

There were sufficient staff on duty to offer safe and personalised care.

The home had a complaints procedure, we saw that the home dealt with complaints appropriately and people told us that they knew how to complain.