Archived: Roseleigh

When we last visited the home on 9 September 2015 the service was meeting the regulations we looked at and was rated Good overall. However, we rated the service Requires Improvement in the key question ‘Is the service well-led?’ because there was no registered manager in post.

At this inspection we found the service was Good overall and for each key question.

There was a registered manager in post at the time of our inspection. 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 abuse and improper treatment as staff understood their responsibilities in relation to safeguarding well and received annual training in this. The provider had processes in place to share learning across the organisation and improve when things went wrong, such as when there were incidents and accidents and safeguarding allegations.

The provider managed risks relating to people’s care and also the premises through well. People received care in premises which were safe, clean and well maintained. The premises met people’s support needs and people had access to all communal areas.

The provider checked staff were suitable to support people and there were enough staff deployed to support people safely. The provider managed people’s medicines safely.

People received care in line with the Mental Capacity Act 2005 and staff understood their responsibilities in relation to this Act as they received annual training. The provider applied for and followed authorisations to deprive people of their liberty (DoLS) as part of keeping them safe.

People’s needs and choices were assessed by the provider and people and their relatives were involved in the process.

Staff understood people’s needs, including their health needs, and supported people to maintain their health. People received their choice of food and drink.

People were supported by staff who felt well supported by the provider. Staff received suitable induction, training, supervision and annual appraisal to help them understand the best ways to support people. The provider worked well with other services in the organisation as well as with external organisations in providing joined-up care to people.

Staff were caring and supported people respectfully, maintaining their privacy and dignity. People were supported to be as independent as they wanted to be. People were supported to maintain relationships with those who were important to them.

People were involved in reviewing their care and the provider reviewed people’s care regularly so information was reliable for staff to follow in caring for people. People were supported to participate in activities they enjoyed.

The provider encouraged people to feedback on the service and communicated openly with people, relatives and staff. The provider had a complaints procedure to investigate and respond to any complaints.

The registered manager and staff had a good understanding of their role and responsibilities and leadership was visible and capable at all levels.

The provider monitored and assessed the service well and promptly made improvements where any shortfalls were identified.

At the last inspection on 22 November 2013 we asked the provider to take action to make improvements to act in accordance with legal requirements where people did not have capacity to consent, to have specific written procedures in place to plan for all reasonable foreseeable emergencies, to protect people who used the service against risks associated with unsafe or unsuitable premises and implement an effective system to regularly assess and monitor the quality of service that people received.

After the inspection in November 2013, the provider wrote to us to say what they would do to meet legal requirements and all actions of their action plan would be completed by 18 March 2014. At this inspection in March 2015, we found action had been taken and as a result people's care and safety had improved.

We spoke with two people who used the service and three members of staff including the manager. We spent time observing the interactions between staff and people because not everyone who used the service was able to directly answer our questions.

Before people received any care or treatment they were asked for their consent but where people did not have capacity to consent the provider was acting in accordance with legal requirements. We found the provider ensured their staff received training about the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards. We found staff assessed a person's mental capacity and where a person's liberty and freedom was restricted, made applications for authorisation to the local authority in accordance with legal requirements.

There were written arrangements in place to deal with foreseeable emergencies. We found the provider had developed a business contingency plan which was localised for the service and meant care for people who used the service would continue in the event of a foreseeable emergency.

The provider had taken steps to provide care in an environment that was suitably designed and adequately maintained. We found the provider had completed repairs to doors, windows and locks. The provider had also undertaken action to ensure people who used the service were kept safe from risks of hazards for example, removal of a butane gas cylinder. Also the provider ensured staff personal belongings were stored in a locked room.

There was a system for assessing and monitoring the quality of the service. Peoples’ views were listened to and acted on.

Some of the people who used the service showed us their rooms and how they had individualised it to match their preferences. One person told us they liked their room.

We spoke to two relatives of people who used the service. They told us they were involved in care planning and reviews, they were kept informed about any change, contact was good from the service and it was also easy to contact the service, they communicate well and frequently, the staff were nice, they felt their relative was safe. Peoples’ relatives also said they had no complaints but felt the staff were very approachable and would feel comfortable to raise any concerns.

One persons’ relative told us they had questioners in the past and another had not. One persons’ relative told us there relative told told them they are happy at Roseleigh and that they love it there.

Our visit was unannounced and early in the morning and we found that the home was clean and fresh and people were treated with dignity and respect.

We found that before people received any care or treatment they were asked for their consent, but where people did not have capacity to consent the provider did not act in accordance with legal requirements.

We found that people experienced care, treatment and support that met their needs, but there were no service specific written procedures in place to plan for all reasonable foreseeable emergencies. This meant that if an emergency situation did occur there would be no contingency procedures recorded to enable the agency to continue to provide safe appropriate care.

People were not always protected against the risks associated with unsafe or unsuitable premises.

We saw that the health and safety of people was promoted, reviewed and audited and the views of people were sought and recorded. However, although the provider did have an effective quality assurance system which they had used in the past, this had not been completed since 2011.

Some of the people who used the service had more complex needs which meant that they were not able to tell us about their experiences of using the service; therefore we spoke with relatives of people and used observation to help inform our judgment.

Our observations showed that some people used different methods of communication, for example the use of body language or signs. We observed that staff recognised these communication methods and responded appropriately. We saw that people were relaxed and at ease with staff and there was a lively and happy atmosphere in the home.

Relatives of people told us that they are happy with the care provided at Roseleigh. They also spoke highly of the staff and described them as "Very good" and "Stunning at what they do".

Staff told us that they "Loved" working at the home and felt supported by their manager.

We found that appropriate checks were in place to confirm the suitability of staff to work with vulnerable people.