The Rose Road Association

We found the following examples of good practice.

The provider worked within government guidance during the COVID-19 pandemic. The provider’s response was managed through regular meetings of senior leaders dedicated to COVID-19 issues. Additional checks supplemented regular audits and walk rounds.

The provider had experienced staff retention and recruitment difficulties due to sector workforce challenges including competition with other employers, vaccine hesitancy, and stress. They had maintained a safe, compliant environment by limiting at times the number of respite places they could accept. They continued to recruit new staff.

The provider had made use of individual risk assessments to support people safely if they were at particular risk of infection and taking special precautions such as shielding.

The provider maintained high standards of hygiene, cleanliness, and maintenance, taking into account frequent changes to room occupancy typical of a respite service. The registered manager took and followed advice from both the provider’s organisation and local health and social care partners.

The Rose Road Association (Outreach Service) provides support and activities for children and young people up to 25 years who may be living with a physical disability, learning disability or autism. It supports people in their own home, in the community and in a six bed residential respite unit. At this inspection, there were nine people who received the regulated activity of personal care in their home, and one person at the residential respite unit.

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

People’s experience of using this service:

• People received individual, tailored care and support which led to exceptional outcomes. Care and support met their needs, and reflected their diversity, preferences and choices. Feedback from people and their family carers always reflected very responsive care and support. There were individual and personalised measures in place to make sure people’s communication needs were met.

• The provider had effective processes in place to make sure people received care and support safely. Safeguarding procedures took into account the complex needs of children and young people who were vulnerable as a result of their circumstances. There were systems in place to identify, assess and respond to individual risks to people’s health and welfare.

• The provider’s recruitment processes made sure staff were suitable to work in the care sector. The provider had made improvements to people's medicines care plans, how medicines were stored, and in making sure lessons learned when things went wrong were communicated to staff.

• People’s care and support was based on assessments and care plans which took into account relevant standards and professional guidance. Staff were supported to deliver high quality care and support. Legal requirements were met with respect to consent, mental capacity and deprivation of liberty.

• People received care and support in a caring environment which promoted their privacy, dignity and independence. The provider took steps to make sure people could be involved in decisions about their care and support.

• 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.

• The provider worked with other organisations to develop and share good practice. There were effective management systems and processes to deliver high quality care and to drive and sustain improvements.

Rating at last inspection:

At the last inspection (12 July 2016) we rated the service good overall.

Why we inspected:

This was a planned inspection to check the service remained good.

Follow-up:

We did not identify any concerns at this inspection. We will therefore re-inspect this service within the published timeframe for services rated good. We will continue to monitor the service through the information we receive.

There was a registered manager in place for the Community Outreach 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. However a registered manager was not in post at the time of our inspection for The Oaks respite service because the previous manager had recently left.

We found people’s safety was compromised in some areas. Medicine care plans were not stored with people’s medicines, so were not readily available in an emergency. A fridge was available to store medicines; however, no guidelines were available for staff to monitor it was working correctly. Accidents and incidents were not always followed up and monitored appropriately to keep people safe.

Relevant recruitment checks were conducted before staff started working at the service to make sure they were of good character and had the necessary skills. There were enough staff to meet people’s needs. Staff had received training in safeguarding adults and knew how to identify, prevent and report abuse. People were supported to receive their medicines safely from suitably trained staff.

Staff received regular one to one sessions of supervision to discuss areas of development. They completed a wide range of training and felt it supported them in their job role. New staff completed an appropriate induction programme before being permitted to work unsupervised.

Staff sought consent from people before providing care and support. The ability of people to make decisions was assessed in line with legal requirements to ensure their rights were protected and their liberty was not restricted unlawfully.

People received varied meals including a choice of fresh food and drinks. Staff were aware of people’s likes and dislikes and offered alternatives if people did not want the menu choice of the day. People were able to access healthcare services.

People were cared for with kindness, compassion and sensitivity. Care plans provided comprehensive information about how people wished to receive care and support. This helped ensure people received personalised care in a way that met their individual needs.

People were supported and encouraged to make choices and had access to a wide range of activities. The provider sought feedback through the use of quality assurance questionnaires and used the results to improve the service. The provider and manager used a series of audits to monitor the quality of the service.

A complaints procedure was in place. There were appropriate management arrangements in place and staff felt supported.

The person using the respite service told us they enjoyed staying there and were happy with the support they received from staff. The family members all spoke very positively about the care their relative received. One person told us, 'I can only sing its [the service's] praises,' and that 'at times it has been a lifeline.' Another person told us, 'It's the only place I will let [the person] stay without me. I trust them.' A relative of a person using the outreach service told us, 'They really are the best agency, full stop.'

Staff supported people's right to make choices and give consent to care and treatment whenever possible. Where people lacked capacity to make decisions, appropriate next of kin were required to give consent and this helped to ensure care and treatment were in people's 'best interests.'

We reviewed care plans for eight people using the service, and found they were up-to-date and contained essential information to enable staff to meet people's care and welfare needs. People experienced appropriate care and support that met their needs and was centred on them as individuals.

The building and grounds were well laid out and maintained. People were living in an environment that supported their needs and was conducive to their health and well-being.

There were enough qualified, skilled and experienced staff working to make sure people's care and welfare needs were met at all times.

The provider had an effective system in place to deal with complaints, and the provider took account of people's complaints and comments to improve the service.

They told us that they liked the fact that the carers were consistent and that they kept them informed of any issues and concerns. One parent said that they had peace of mind when their child was with one of the carers and had confidence in their abilities.

We found that young people's privacy, dignity and independence were respected. They experienced care, treatment and support that met their needs and protected their rights. The provider had a clear policy and procedure in place for staff to follow which protected people who used the service from the risk of abuse. Young people were protected against the risks associated with medicines. They were cared for, or supported by, suitably qualified, skilled and experienced staff. People were cared for by staff who were supported to deliver care and treatment safely and to an appropriate standard.