Archived: Rosamar

Updated 6 December 2022

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was conducted by one inspector and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Rosamar is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Rosamar is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced and took place on 7 and 15 September 2022.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make.

We used information gathered as part of monitoring activity that took place on 04 July 2022 to help plan the inspection and inform our judgements. We used all this information to plan our inspection.

During the inspection

We spoke with one person who used the service and three members of staff, including the registered manager and two care support staff. We reviewed a range of records. This included four people's care records, staff recruitment records and records relating to the maintenance of the premises and equipment. We also spoke on the telephone with five relatives of people who lived at Rosamar.

Updated 6 December 2022

About the service

Rosamar is a residential care home providing accommodation and personal care for up to ten people with a learning disability. At the time of this inspection there were seven people in residence.

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

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. The service was not always able to demonstrate how they were meeting some of the underpinning principles of Right support, Right care, Right culture.

People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service

did not support this practice. The service was not always able to demonstrate how they were meeting some of the underpinning principles of Right support, Right care, Right culture.

Right Support

There was no evidence people were given choice and had an opportunity to pursue goals and aspirations. Staff training was not up to date and staff competency in administering medication had not been checked. People’s needs were assessed and monitored. Staff enabled people to access health and social care support in the community although this was not based around people’s individual preferences. Staff communicated with people in ways that met their needs. The provider ensured the home's environment was well equipped and well-furnished. People had a choice about their living environment and were able to personalise their rooms.

Right Care

People had not always been supported to take part in activities and pursue interests based on their individual preferences. People and relatives said they were happy with the care and support received. Staff protected and respected people's privacy and dignity. Staff understood and responded to people’s individual needs. Staff understood how to protect people from poor abuse.

Right Culture

People were not always supported in a way which ensured they had choice and control in their daily lives. There was a lack of oversight from the registered manager regarding quality assurance within the service. Risks relating to the home environment had not been mitigated to keep people safe. There was no formal process to ensure staff had supervision and appraisals. There was no evidence to demonstrate staffing levels on a day to day basis.

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 26 October 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.

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 of this inspection.

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

Enforcement and Recommendations

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified breaches in relation to the premises and equipment, staff training and supervision and a lack of robust governance and quality assurance processes.

Follow up

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

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.