Rosemary Cottage

Rosemary Cottage is a residential care home providing personal care to up to six people. The service provides support to people with a learning disability and autistic people. At the time of our inspection there were six people using the service. The service is a purpose-built property and accommodation is provided on one level, located in a rural area on the outskirts of Woodchurch village.

People’s experience of using this service and what we found

People and their relatives told us they were happy with the support they received. People told us, or indicated with a thumbs-up, that they felt safe living at Rosemary Cottage. Relatives told us they were happy with the care and support provided.

Some care files contained out of date information which made it difficult to find the most relevant information. For example, some files contained different versions of care plans. Care plan audits had not been completed regularly. Parts of the kitchen were an infection control risk due to peeling cupboards. The kitchen is due to be replaced in January 2023.

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

Right Support:

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People were supported to make day to day choices and set goals and aspirations. When people needed support to make decisions with them, or on their behalf, staff followed appropriate processes to make sure decisions were made, with relevant people, in the person’s best interest.

Right Care:

Staff had good knowledge about keeping people safe and how to report any concerns. Staff completed training about how to recognise and report abuse. People’s care plans reflected their individual needs. There were enough skilled staff who knew people well. People had their medicines on time and as prescribed. Rosemary Cottage was clean, and people were generally protected from the risks of infection.

Right Culture:

Staff told us they felt valued and were supported well by the management team. There was a positive culture within the staff team and people were at the heart of the service. People and their relatives were closely involved in the planning of their care and support.

The management team completed checks and audits, such as environmental, medicines and infection control.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 19 January 2018).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

You can see what action we have asked the provider to take at the end of this full report.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has changed from Good to Requires Improvement based on the findings at this inspection.

We have found evidence that the provider needs to make improvements. Please see the Safe and Well-Led sections of this report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Rosemary Cottage on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Rating at last inspection

At the last inspection, the service was rated Good overall and Outstanding in the ‘Caring’ domain.

Rating at this inspection

At this inspection, we found the service remained Good and outstanding in the ‘Caring’ domain. .

Why the service is rated Good

People’s care was exceptional: People knew their needs and wishes were understood by staff because they were always met. Staff looked for creative ways to ensure people’s needs were met, and ensured obstacles were overcome when possible. People were relaxed in staff’s company and staff listened and acted on what they said or gestures and body language. People were consistently treated with dignity and respect and their privacy was respected. Staff were very kind and patient in their approach, but also used good humour. People received care and support from a dedicated team of staff that put people first and were able to spend time with people in a meaningful way. Staff had built up relationships with people and were familiar with their life stories and preferences.

People were protected from abuse, as staff understood how to recognise and report any suspicions of harm or abuse. People received their medicines safely and when they should. Risks were assessed and staff took steps to keep people safe whilst encouraging their independence wherever possible.

People were involved in the planning of their care and support. Care plans contained clear and detailed information about people’s wishes and preferences. They showed people’s skills in relation to tasks and what support they required from staff, in order that their independence was maintained. People had reviews of their care and support where they and/or their representatives were able to discuss any concerns or aspirations.

People were encouraged and supported to make their own decisions and choices and staff respected these. Staff had received training in the Mental Capacity Act (MCA) 2005. The MCA provides the legal framework to assess people’s capacity to make certain decisions, at a certain time. When people are assessed as not having the capacity to make a decision, a best interest decision is made involving people who know the person well and other professionals, where relevant. The registered manager understood this process.

People were protected by safe recruitment procedures. New staff underwent an induction programme, which included shadowing experienced staff, until staff were competent to work on their own. Staff received training relevant to their role and people’s needs. Staff had opportunities for one to one meetings and team meetings, to enable them to carry out their duties effectively. The majority of staff had gained qualifications in health and social care. People had their needs met by sufficient numbers of staff and staff rotas were based on people’s needs, activities and health appointments.

People had a varied diet and were involved in planning the menus. Staff supported people’s special dietary needs. People had a programme of leisure activities and went out and about, as they wished.

People had complex health needs and were supported to maintain good health and attend appointments and check-ups. Appropriate referrals were made to health professionals as required.

People did not have any concerns, but felt comfortable in raising issues. Their feedback was gained both informally and formally. The registered manager had an open door policy and took action to address any concerns or issues straightaway to help ensure the service ran smoothly.

Further information is in the detailed findings below.

People were satisfied with their care and support and 'liked' living at Rosemary Cottage. People knew about their care plans and the information they contained as staff had read and explained their content to them.

People received safe and coordinated services where more than one provider of services was involved in their care and treatment.

People told us they received their medicines at the times they needed them, and in a safe way.

People received care and support from staff who were supported and trained. People told us all the staff were 'nice' and helped them when they needed help.

People had opportunities to raise concerns and give feedback about the service provided.

People had consented to their care and support. They were satisfied with their care and support and liked living at Rosemary Cottage. People told us they knew about their care plans and the information they contained as staff had read and explained their content to them.

People liked their own rooms and had chosen the colour scheme. They said the home and equipment were well maintained. People said they 'liked' the new extension as it gave them 'more room'. People talked about how they helped with some of the household chores and that the home was always clean and tidy. One person said, 'I do dusting'.

People felt there were sufficient staff on duty to meet their needs. They said staff were always on hand to help them when they needed help.

People had no concerns. However they knew who to speak to if they had. One person told us they did speak to a staff member about a concern and they 'sorted it out'.