Archived: Rosewarne Care

Rosewarne Care accommodates up to six people who have learning disabilities. Four people were using the service at the time of our inspection. The service is situated in a semidetached property with an enclosed outdoor space in a rural location on the outskirts of Camborne.

The service had a 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. The service is a family run business and support is provided in a domestic style. The registered manager is also one of the registered providers and is responsible for meeting people’s day to day support needs. The registered manager was supported by a team of three part time care staff and an office administrator.

People were relaxed and comfortable at Rosewarne care and told us, “It’s very nice here” and “I am happy living here.” Staff had received safeguarding training and understood their responsibilities in relation to protecting people from abuse and harm. The registered manager had responded appropriately to an incident that had occurred and acted to ensure people were protected from discrimination.

The registered manager and staff knew people well and understood their individual care and support needs. People enjoyed the company of their support staff and there was a relaxed, comfortable and homely feel to the service. People approached staff for support without hesitation and staff responded immediately to address people’s needs. One person told us, “[The staff] are all kind.” Staff told us they enjoyed their role and took pleasure in describing people’s achievements.

Staff were well motivated and told us the registered manager, who they worked alongside every day, provided effective leadership. Staff told us, “Most of the time the registered manager is here and she is always on the end of the phone if you need her, It’s a great place to work” and “You have nothing to be worried about”.

Information was stored securely and there were systems in place to monitor the service’s performance, gather people’s feedback and identify where improvements could be made. All Firefighting equipment had been regularly serviced and utilities had been regularly tested by appropriately skilled contractors.

People’s medicines were managed safely. Medicine administration records had been accurately completed and staff had been provided with appropriate guidance on the use of as required medicines.

Registered manager and staff team were sufficiently skilled to meet people’s care and support needs. Rotas showed there were enough staff available to meet people’s needs and staff told us, “There is always somebody here.” Although the service had not recently recruited new members of staff appropriate induction procedures were available. Staff records showed all necessary pre-employment checks had been completed for existing staff before they were permitted to provide care.

Detailed assessments of people’s needs were completed before they moved into the service. This was done to ensure the service could meet the person’s needs without impacting on people already using the service. The assessments process included visits to the person’s home and the person visiting the service to meet staff and other residents. People’s initial care plans were based on information gathered during the assessment process combined with background information from commissioners and relatives.

People’s care plans were sufficiently detailed and staff had a detailed understanding of each person individual needs. People’s care plans had been reviewed and updated regularly and people were involved in these processes. Care plans included information about how people preferred to be supported as well as guidance on how to provide support when the person was feeling upset or anxious.

People were able to choose how to spend their time and to access the community when they wished. During our inspection one person was attending a work placement and another person was supported to go shopping and out for lunch by a member of staff. Two people chose to spend their time in the service and were supported by the registered manager to engage with a variety of activities including, dancing, craft activities and exercise routines. Staff told us, “I take [person’s name] out every Wednesday for lunch” while one person said, “I don’t stop in, it’s no good stopping in.” Health and social care professionals told us, “This service had tapped into my client's motivation, sourcing some good ideas for her to trial local activities and groups” and “I feel the people that live there have a good quality of life.”

The Registered manager and staff had a good understanding of the Mental Capacity Act 2005 and records showed that where people lacked capacity staff had consistently acted in their best interest. However, a necessary Deprivation of Liberty Safeguards application to the local authority had not been made in relation to recent changes in one person’s care plan. We discussed this situation with the registered manager who subsequently made the necessary application. We have recommended that the registered manager review current guidance to ensure people’s rights were protected at all times.

People told us they were happy living at Rosewarne Care home. We saw people moved about the home without restriction and were at liberty to choose how they spent their time. One person told us they were looking forward to walking into the local town. Another person shared with us that they had been unable to attend their work placement that day due to a back injury but would hopefully return the following day.

We saw there was appropriate referral and care planning documentation used in respect of people who lived at the home. We looked at a range of care documentation which supported the view that people's needs were well understood and staff acted with respect and care in supporting people appropriately. We saw people were involved in making decisions about their lives at Rosewarne Care home including how they spent their time.

We saw the premises was of a suitable design and layout and there were appropriate maintenance arrangements and risk assessments in place to protect the people who lived at the home.

We followed up on the system of recruitment and training of staff at Rosewarne Care which had been identified as non-compliant at the last inspection. We saw the registered providers and home manager had undertaken work to ensure all records were now up to date. A new system for identifying and following up on references for potential employees was now in place. We checked training records for staff and saw areas identified at the last inspection as in need of updating had been completed.

We saw there was appropriate referral and care planning documentation used in respect of people who lived at the home. We looked at a range of care documentation which supported the view that people's needs were well understood and staff acted with respect and care in supporting people appropriately. We saw people were involved in making decisions about their lives at Rosewarne Care including how they spent their time. People told us they felt 'in charge' of their own lives and they were happy to be so. We were shown how people had personalised their rooms and people told us they were happy with their rooms.

We saw the home was clean and welcoming. The management operated effective systems which ensured appropriate standards of cleanliness and hygiene were adhered to.

We reviewed the system used by the registered managers to recruit staff members. We saw that there was inconsistency in the methods used to take up references and in one instance reference documents were not available for inspection. In a second instance, where a telephone reference had been conducted, there was a lack of records available to substantiate this.

We talked with staff and reviewed rota arrangements for staffing the service and were satisfied there were sufficient numbers of staff employed at the home.

We found people were involved in making decisions about their care and treatment however information was not always made available to them in an appropriate form such as the complaints procedure and service user guide.

Staffing arrangements were not in place to ensure suitable care and support was provided over twenty four hours to ensure the safety and well being of people who lived in the home.

Staff received professional development and training however there was not a formal system of supervision and appraisal to help ensure high standards of care.