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Inspection carried out on 16 October 2017

During a routine inspection

Care service description

Roselands is a residential care home for 15 people with learning disabilities.

Rating at last inspection

At the last inspection on 21 October 2015, the service was rated Good. The service was rated Outstanding in the Responsive domain.

Rating at this inspection

At this inspection we found the service remained Good and was Good in the Responsive domain.

Why the service is rated Good

People told us they were happy living at the service and that it was well managed. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. There were always enough staff to keep people safe. Risks relating to people’s care and support were assessed and mitigated and people were supported to be as independent as possible.

People told us that staff were kind and caring. Staff treated people with respect and dignity. People led active lives and participated in a range of activities both inside and outside of the service. People told us they were looking forward to performing a show for their friends and relatives and that they were proud of their recent fundraising efforts.

The kitchen was open and people were supported to prepare drinks and food when they were able. People took it in turns to shop for meals and choose what they wanted to eat. Staff had made prompt referrals to healthcare professionals when they needed additional support and advice. People and their relatives told us they saw a doctor when they were unwell and received their medicines when they needed them.

Staff knew how to recognise and respond to abuse and the registered manager had reported any safeguarding concerns to the local authority. Action had been taken to minimise the risk of them happening again. There had been no complaints since our last inspection. People and their relatives told us they were happy with the support provided. Regular feedback was sought from people and their relatives. All the feedback we saw was positive, and included comments such as, ‘Due to the high standard of care and management overall it is impossibly difficult to offer any suggestions in this delightfully peaceful and happy environment.’

Staff received appropriate training and were supported by the registered manager to carry out their roles effectively. The registered manager completed a range of checks on the service, including care plan reviews, environmental checks and weekly audits of medicines to ensure people were safe. Regular fire drills were held so people knew how to evacuate the service in an emergency. Staff were recruited safely. The Care Quality Commission had been notified of important events within the service, as required by law.

Further information is in the detailed findings below.

Inspection carried out on 21 October 2015

During a routine inspection

This inspection was carried out on 21 October 2015 and was unannounced.

Roselands provides accommodation for up to 15 people who have a learning disability and who need support with their personal care. Accommodation is arranged over two floors and most bedrooms have en suite facilities. There were 15 people living at the service at the time of our inspection.

The registered manager was present throughout our inspection. 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.

The registered manager, a deputy manager, assistant manager and senior staff, provided leadership to the staff and led by example. Staff were motivated and felt supported by the registered manager and management team. The staff team had a clear vision of the aims of the service which was based on equality and mutual respect. Staff treated people as individuals and gave each person centred support. Staff told us the registered manager was approachable and they were confident and positive about her management style.

There were enough staff, who knew people well, to meet peoples’ needs. Peoples’ needs, appointments and activities had been considered when deciding how many staff were required on each shift. Staff were checked before they started to work at the service to make sure they were safe and suitable to work with people. Staff were trained and supported to provide safe care. Staff met regularly with the registered manager to discuss their role and practice and any concerns they had.

Staff knew the signs of abuse and were confident about how to raise a concern. Emergency plans were in place and staff knew how to keep people safe in an emergency. Possible risks to people had been identified and were managed to keep people as safe as possible without restricting them in any way.

People’s needs had been assessed to identify the care they required. Care and support was planned with people and reviewed to make sure people continued to have the support they needed. People were encouraged to be as independent as possible. Detailed guidance was provided to staff about how to provide all areas of the care and support people needed.

Medicines were stored and administered safely. People had the support they needed to remain healthy and well. Staff responded to any changes in people’s health needs, people told us that staff always called their doctor if they felt unwell. Staff had worked very closely with health professionals, especially from the local community team, which had led to good outcomes for people.

The Care Quality Commission is required by law to monitor the operation of the Deprivation of Liberty Safeguards which applies to care homes. Arrangements were in place to check if people were at risk of being deprived of their liberty. Systems were in operation to obtain consent from people and to comply with the Mental Capacity Act 2005. People were supported to make decisions and choices about all aspects of their lives.

People were supported to participate in hobbies and activities that they enjoyed. There was a lovely atmosphere, with lots of laughter, people told us about their holidays and about fundraising events that had helped to plan and organise. People were involved in planning the menu and cooking meals and were supported to have a balanced diet; everyone said the food was very good.

A variety of equipment was provided to support people to remain as independent as possible. Staff listened to what people told them and responded appropriately. People were treated with respect and their privacy and dignity was maintained. People told us that they had no complaints and if they did they would speak to the staff who would listen to them and take action.

The caring and enabling attitude of the registered manager and staff team was very clear. All staff had an unconditional positive regard for everyone they supported, staff spoke about supporting people to achieve their goals and ambitions and about the importance of supporting people to lead fulfilling, meaningful lives.

The environment was safe, clean and homely. Maintenance and refurbishment plans were in place. Safety checks were completed regularly. Everyone had their own bedroom which was very personalised, most with en suite facilities and people told us that their bedrooms were comfortable.

The registered manager completed regular checks of the quality of the service provided. When shortfalls were found action was taken quickly to address these and prevent them from occurring again. People, their relatives and staff were asked about their experiences of the care. These were used to improve and develop the service.

Accurate records were kept about the care and support people received and about the day to day running of the service. This provided staff with the information they needed to provide safe and consistent care and support to people. Information was provided to people in a way that was suitable for them.

Inspection carried out on 10 October 2013

During a routine inspection

Some of the people who used the service were not able to communicate with us. We spoke with the people who could, and they told us that they were happy at the service. One person said �It�s nice here�. We spoke to relatives of the people who used the service. They told us that they were very pleased with the way the service looked after their relatives. One relative told us �it�s a weight off my mind, my relative always looks neat and tidy and even though they do not always recognise me they are pleased to see me and like telling me how kind the staff are�.

We looked at the care records of four people who used the service. We saw that each person had a set of care records that were individual to their needs and contained detailed information about their mental and physical health needs. We saw that they were person centred as they included people�s likes and dislikes along with photos of family members and friends. We observed members of staff encouraging interactions with people by talking about their photos and experiences.

We looked at staffing and recruitment records and spoke with staff. We saw that the manager had carried out relevant checks for new staff when they joined the service to ensure that they were suitable for the role.

We looked at how the service monitored quality. We saw that there were systems in place at a local and corporate level. The service also took on board the comments from people who used the service to make improvements.

Inspection carried out on 31 January 2013

During a routine inspection

People who could, told us that they enjoyed living at Roselands. One person who uses the service told us "I lived in another home for a long time, but its better here, I feel safe and happy, people are nice here." A relative we spoke to told us " I couldn't be more grateful for the excellent care my relative receives. I was apprehensive about them moving into residential care but the manager put me at ease straight away. The staff are very caring and want to do their best for the people who live here and they always make families feel very much part of the home. Another relative said, "Roselands has given my relative a quality of life they didn't have before. Its wonderful to see them as they are now. I can visit any time I like and there is always a happy atmosphere. I know my relatives condition will deteriorate but to see someone with a learning disability and dementia showing signs of improvement is incredible, the manager and staff are truly dedicated in what they do".

Most people who use the service had difficulty with verbal communication and we found that staff knew the people who use the service very well. They were able to "tune in" to peoples needs and adjust their communication to enable individuals to easily understand what was being communicated. We found that staff worked together to create a relaxed yet vibrant atmosphere and focused on working therapeutically to meet peoples individual needs and wishes holistically and in a person focused manner.

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