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Rosedene (Active Prospects) Good

Reports


Inspection carried out on 13 December 2017

During a routine inspection

This inspection took place on 13 December 2017. At the last inspection in November 2015 the service was rated Good. At this inspection we found the service remained Good.

Rosedene (Active Prospects) is a ‘care home’. People in care homes receive accommodation and 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.

Rosedene (Active Prospects) accommodates eight people with a learning disability in one adapted building. 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.

The service had 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.

People were protected from improper treatment and avoidable harm by a team trained in safeguarding and skilled in risk assessing. People received their medicines safely and lived in a clean and hygienic environment. The provider implemented robust recruitment procedures to assure itself that staff were suitable to work in care.

People’s needs were assessed and supervised staff were trained to meet the needs identified in people’s assessments. People ate nutritious meals and accessed healthcare services whenever they needed to. Staff respected people’s choices and treated people in line with the Mental Capacity Act 2005.

Staff were caring and respectful and supported people to maintain relationships with relatives and friends. They respected people’s privacy and provided care and support that promoted people’s dignity and independence. Staff recognised people’s cultural preferences and provided people with information in ways that were accessible.

The service was personalised and people received care that was responsive to their needs and preferences. There was a high tempo and wide range of activities for people to participate in. How people communicated was assessed and staff had guidelines on supporting each person’s expression and understanding. The provider had a clear complaints policy which people could be supported to use.

People and staff expressed confidence in the registered manager and her deputy who the staff described as role models. Staff felt supported, encouraged and listened to. The provider actively promoted the voice of people and encouraged people to participate in self-advocacy and to help shape the delivery of support across the whole organisation. The quality of care people received was audited by the registered manager, other care home managers and senior managers from the provider organisation. Regular and productive partnership working was in evidence to support the delivery of high quality care to people.

Inspection carried out on 24 June 2016

During an inspection looking at part of the service

The last inspection of this home was carried out on 05 November 2015 when we found the provider was in breach of the regulations. This was because the provider had failed to notify the Care Quality Commission (CQC) in a timely manner about all the incidents and events involving people who lived at Rosedene. This related specifically to several incidents that had resulted in people being injured and the service not notifying us about the outcome of applications they had made to the local authority to deprive people of their liberty. People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the MCA. The application procedures for this in care homes is called the Deprivation of Liberty Safeguards (DoLS). After the home’s last inspection, the provider wrote to us to say what they would do to meet their legal requirements in relation to these breaches. We undertook an unannounced focused inspection on 24 June 2016 to check the provider had followed their action plan and now met legal requirements.

This report only covers our findings in relation to this topic. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for ‘Rosedene’ on our website at www.cqc.org.uk’

Rosedene is a care home that provides accommodation and personal care for up to eight people. The home specialises in supporting older adults who have learning disabilities. The home also caters for people living with physical disabilities. There were eight people living at the home when we inspected.

At the time of our inspection the service had not had a registered manager in post since November 2015. A new manager was appointed in March 2016 and they were in the process of becoming the registered manager. 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.

During our focused inspection, we found that the provider had followed their action plan. We saw legal requirements had been met because the provider now notified the CQC in a timely way about the occurrence of any incidents and events that affected the health, safety and welfare of people living at the home.

Inspection carried out on 5 November 2015

During a routine inspection

This inspection took place on 5 November 2015 and was unannounced. The last Care Quality Commission (CQC) inspection of the home was carried out in November 2013, where we found the service was meeting all the regulations we looked at.

Rosedene is a care home that can provide accommodation and personal care for up to eight older adults living with a learning disability. Half the people using the service also had a physical disability. There were eight people living at Rosedene at the time of our inspection.

The registered manager of the home left the previous week and an acting manager has been in day-to-day charge of Rosedene ever since. The new acting manager is also registered with the Care Quality Commission (CQC) to manage another care home also owned by Prospect Housing and Support Services. The acting manager told us they were in the process of applying to register with the CQC as the manager of both the care home they currently run and Rosedene. Like registered providers, registered managers 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 had failed to notify the CQC about all the incidents that had affected the health, safety and welfare of people living at the home, which included injuries to people and the outcome of any applications made to the local authority to deprive people of their liberty. This meant the CQC could not take appropriate follow up action where needed because we were not made aware of any of the events outlined above.

People we spoke with told us they were happy living at Rosedene and felt safe there. We saw staff looked after people in a way which was kind and caring. Our discussions with people using the service and their relatives supported this. People’s rights to privacy and dignity were also respected.

Staff knew what action to take to ensure people were protected if they suspected they were at risk of abuse or harm. Risks to people’s health and wellbeing had been assessed and staff knew how to minimise and manage these risks in order to keep people safe. The service also managed accidents and incidents appropriately and suitable arrangements were in place to deal with emergencies. The provider ensured regular maintenance and service checks were carried out at the home to ensure the building was safe.

There were enough suitably competent staff to care for and support people. The home continuously reviewed and planned staffing levels to ensure there were enough staff to meet the needs of people using the service.

Staff were suitably trained, well supported and knowledgeable about the individual needs and preferences of people they cared for.

People were supported to maintain social relationships with people who were important to them, such as their relatives. There were no restrictions on visiting times.

People participated in meaningful social, leisure and recreational activities that interested them both at home and in the wider community. We saw staff actively encouraged and supported people to be as independent as they could and wanted to be. We saw people could move freely around the home.

People were supported to keep healthy and well. Staff ensured people were able to access community based health care services quickly when they needed them. Staff also worked closely with other health and social care professionals to ensure people received the care and support they needed.

People received their medicines as prescribed and staff knew how to manage medicines safely.

There was a choice of meals, snacks and drinks and staff supported people to stay hydrated and to eat well.

Staff supported people to make choices about day to day decisions. The manager and other staff were knowledgeable about the Mental Capacity Act (2005) and best interests meetings were held in line with the Act to make decisions on behalf of people who did not have the capacity to make decisions themselves.

Deprivation of Liberty Safeguards (DoLS) were in place to protect people’s safety, and the staff were aware of what this meant and how to support people appropriately. DoLS provides a process to make sure that people are only deprived of their liberty in a safe and correct way, when it is in their best interests and there is no other way to look after them.

The service had a clear management structure in place. The acting manager led by example and was able to demonstrate a good understanding of their role and responsibilities.

The views and ideas of people using the service, their relatives, professional representatives and staff were routinely sought by the provider and used to improve the service they provided.

People and their relatives felt comfortable raising any issues they might have about the service with staff. The provider had arrangements in place to deal with people’s concerns and complaints appropriately.

There were effective systems in place to monitor the safety and quality of the service provided at the home. The registered manager, when in post had taken action if any shortfalls or issues were identified through routine checks and audits. Where improvements were needed, action was taken.

We identified one breach of the Care Quality Commission (Registration) Regulations 2009 during our inspection. You can see what action we told the provider to take at the back of the full version of the report.

During a check to make sure that the improvements required had been made

At our previous inspection of Rosedene we identified that action needed to be taken by the provider to ensure people who used the service had access too easy to read and understand information about the homes complaints procedures. As a result we required the provider to send us a written report of the action they were going to take to achieve compliance with this outstanding issue.

As we had requested, the provider supplied us with documentary evidence that showed us they had taken appropriate steps to bring the homes complaints procedures to the attention of people who used the service and their representatives.

The acting manager told us in their action plan that they had designed a new easy read complaints and suggestions document, which was written in plain language and used photographs to clearly explain to people who used the service how they could make a complaint and/or suggestion. We were told that everyone who lived at Rosedene had been given a copy of the new complaints document, which staff who worked there had explained to people who used the service, and that copies were conspicuously displayed on the notice board in the entrance hall.

In this report the name of the registered manager appears who was no longer in post and therefore not managing the regulatory activities at Rosedene at the time of our desktop review. Their name appears because they were still the services registered manager on our register at the time.

Inspection carried out on 2 October 2013

During a routine inspection

During our inspection we used a number of different methods to help us understand the experiences of people who lived at Rosedene, which included a specific way of observing the care and support people who could not talk with us received. We met six out of the seven people who used the service and spoke at length with one of them. They told us they were happy living at Rosedene and felt the staff that worked there were kind and caring.

We also talked to the services newly appointed acting manager, the deputy manager and three experienced support workers.

We saw people received safe and appropriate care and support. This was because there were enough suitably skilled and experienced staff on duty to meet people�s health and social care needs. We also saw people were treated with respect and dignity by the staff.

However, although we saw people who used the service were well supported; we found the provider had failed to ensure service users and their representatives had access to easy to understand information about the homes complaints procedures. This meant stakeholders might not know how to make a complaint if they were unhappy with the care and support provided at Rosedene.

In this report the name of the registered manager appears who was no longer in post and therefore not managing the regulatory activities at Rosedene at the time of our inspection. Their name appears because they were still the services registered manager on our register at the time.

Inspection carried out on 21 December 2012

During a routine inspection

We found that everyone had a person centred plan which contained personal objectives, guidelines and risk assessments. People who use the service were involved in determining their care and support and that they were supported to make decisions about their lives. People we spoke with said that they liked living in the home. We observed positive interaction between people who use the service and staff where staff were assisting residents in making choices. There were detailed health action plans and records and evidence of the involvement of external health professionals. We also met an advocate who was visiting one person at the service. We saw the safeguarding policy and evidence that staff had attended safeguarding training. We observed the staff rota and training records talked to staff about their experience of working with people with learning disabilities. We were told by one member of staff that they had worked with some of the residents for more than 25 years and that they knew them well. We were also told by an advocate that "this is a really nice home" and that they were impressed by the attitude and behaviour of the staff.

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