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Inspection carried out on 9 March 2021

During an inspection looking at part of the service

Rhodelands is a residential care home for seven people with learning disabilities, and/or autism and complex needs. There were seven people living at the home at the time of our inspection.

We found the following examples of good practice.

¿ The registered manager and staff were knowledgeable about best practice guidelines in relation to infection prevention and control.

¿ There was personal protective equipment (PPE) around the home for staff to use.

¿ Staff had received infection control training and were confident they knew how to put on and take off PPE in the right way.

¿ People and staff are responsible for cleaning the home. We saw the home was cleaned throughout the day in touch points were wiped regularly.

¿ Testing, when needed, was completed weekly for staff and monthly for people using the service.

¿ People were able to consent to the testing programme and vaccination programme.

¿ People’s temperature was checked twice a day to ensure the early signs of illness could be identified.

¿ The provider had reviewed the latest guidance in relation to friends and relatives visiting the home, and systems were in place to accommodate visitors safely.

Inspection carried out on 11 November 2019

During a routine inspection

About the service

Rhodelands is a residential care home and is registered to provide care for up to seven younger adults with learning disabilities or autistic spectrum disorder. At the time of our inspection seven people used the service. The home stands in its own grounds with an enclosed garden and car parking.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

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

At this inspection we found continued evidence to support the overall rating of good and there was no evidence or information from our inspection and on-going monitoring that demonstrated serious risks or concerns.

The service was safe. There were systems and processes in place to protect people from harm. Medicines were safely managed and administered by suitably trained and competent staff. Recruitment processes were of good quality.

People and their relatives were positive about the service and the care provided. Staff were kind, caring and compassionate. The home was welcoming and friendly. It was clear people and staff had formed good relationships. Staff respected people’s privacy and dignity.

People were cared for by staff who knew how to keep them safe and protect them from avoidable harm. There were suitable and sufficient numbers of qualified staff to support people in line with their assessed needs.

Care planning was extremely person-centred and people were encouraged to retain their independence. People were supported by a regular staff team who knew them well. Social activities met people’s individual needs and enabled people to live as full a life as possible.

The registered manager was proactive and visual within the home. They operated an open-door policy. People, relatives and staff knew them well.

The provider had a complaints procedure in place and relatives were aware of how to make a complaint. Relatives and staff were regularly consulted and asked for feedback about the quality of the service.

The registered manager was clear in their desire to provide person-centred and high-quality care to everyone who used the service. Relatives and staff felt the service was well-managed.

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's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

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 7 March 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Inspection carried out on 24 January 2017

During a routine inspection

This inspection took place on 24 January 2017 and was unannounced.

There is a requirement for Rhodelands to have a registered manager and a registered manager was in place. 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 registered to provide residential care for up to seven younger adults with learning disabilities or autistic spectrum disorder. At the time of our inspection seven people used the service.

Some areas of the service could not always be effectively cleaned, and cleaning had not always been completed to the timescales set by the provider.

Not all shortfalls identified by the provider were risk assessed and managed to set timescales.

We requested one notification that had not been sent in a timely manner. Notifications are changes, events or incidents that providers must tell us about.

Other systems and processes to ensure good practice were in place, for example checks on fire safety.

Staff had been trained in and had an understanding of safeguarding and how to keep people safe from potential abuse. Staff were recruited in line with the provider’s policy and procedures, and checks were completed to ensure staff employed were suitable to work at the service.

Staffing levels were based on meeting people’s needs and enough care hours were provided to do so.

Medicines were stored securely and were managed in line with the provider’s policies and procedures. However, not all records for the management of medicines were complete.

Risks to people’s health, for example from risks from medicines or other health conditions were identified and actions taken to reduce those risks.

Staff understood how to provide care to people in line with the Mental Capacity Act 2005 (MCA). Applications for Deprivation of Liberty Safeguard (DoLS) authorisations had been made when required by the registered manager.

People were given the opportunity to express their preferences for meals and drinks. We saw people had access to food and drink throughout the day.

Other healthcare professionals were involved in supporting people’s health care needs when needed to ensure people maintained good health.

Staff were supported by the registered manager and were confident in their role and responsibilities. Staff had skills and knowledge relevant to people’s needs.

Staff provided care that respected people’s privacy and dignity. Staff had built kind relationships with people.

Care plans were developed to include people and their relatives’ views. Care plans were reviewed and people and families felt involved in the process.

Staff helped to create a calm and inclusive atmosphere in the service.

Events and activities were open to family members, and people had regular contact with their local community.

People were supported to enjoy activities that were of interest to them. People had personalised their bedrooms to reflect their hobbies and interests.

Staff listened and responded to any views, suggestions and complaints. Any complaints were recorded, investigated and resolved to people’s satisfaction.

Inspection carried out on 27 February 2015

During a routine inspection

We completed an announced inspection of Rhodelands on 27 February 2015. We gave notice the day before the inspection so the manager could inform people using the service about our inspection.

At our previous inspection in June 2014, we had identified breaches in Regulations relating to consent to care and treatment, care and welfare, cleanliness and infection control, assessing and monitoring the quality of services and record keeping. Following this the provider sent an action plan telling us about the improvements they intended to make. During this inspection we looked at whether or not those improvements had been met and we found that they had.

Rhodelands is a care home registered to provide care for up to seven people who have learning disabilities and autism.

There was a registered manager in place at Rhodelands 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 using the service were happy and comfortable with the staff members supporting them. Families we spoke with told us they felt their relatives were cared for safely at Rhodelands. Sufficient staff were available to safely support people with their care and interests.

Risks at the location, including those associated with medicines and healthcare acquired infections were identified and well managed. The provider had taken steps to reduce the risk of abuse to people by following robust recruitment practices and checking to make sure staff understood safeguarding practices.

Where people did not have the capacity to make certain decisions the provider had acted in accordance with the requirements of the Mental Capacity Act (MCA) 2005. The MCA is a law providing a system of assessment and decision making to protect people who do not have capacity to give consent themselves.

Staff were supported and developed by the management team and received training to support them with their job role. Staff demonstrated a good understanding of people’s care needs and communication methods. People’s day to day needs were well managed and people had input from other professionals to support their care planning.

Staff cared about people at the service and staff supported people with kindness and respect. People using the service were supported to be involved in planning and evaluating their care. People’s preferences were incorporated in how people wanted to decorate their own rooms and where they wanted to go on holiday. People were supported to maintain relationships that were important to them.

Action had been taken in response to previous complaints over the maintenance of the garden. People were supported to give feedback on the service and this had been included in an action plan written by the manager to develop the service further.

Quality assurance systems were in place to identify where further improvements were required. The manager had a clear aim to be open and transparent and staff had confidence in her leadership.

Inspection carried out on 18 June 2014

During a routine inspection

As part of our inspection we spoke to a family member of one person using the service and three members of staff. We spoke briefly to one person directly supported by the service, however we were unable to obtain further views of people directly supported by the service. This was because some people would find it difficult to reliably give their opinion about the service they received due to their learning disability.

We considered all the evidence we gathered under the outcomes we inspected. We used the information to answer the five questions we always ask. Below is a summary of what we found. If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

We found that people using the service were not always protected from the risks associated with healthcare associated infections. This was because systems designed to prevent and control infections had not been followed.

We found that records for people�s care and treatment and other records for the safe running of the service had not always been accurately maintained.

Emergency plans were in place to keep people safe in the event of an emergency.

Is the service effective?

We found that people using the service required advocates so their views could be independently represented. However the service had not arranged any advocates for people.

We found that people�s assessed needs were not always supported in line with their care plan.

Is the service caring?

One family member we spoke with told us, �My relative is much calmer now. Staff take my relative out. I think it is the best home they�ve been in. The staff are nice and calm and there is a good atmosphere.�

We observed staff caring for people in a friendly manner and taking them out to places of interest.

Is the service responsive?

The manager had responded to a recent judgement by the Supreme Court regarding people being deprived of their liberty. We found that the manager had completed all the necessary actions in relation to this recent judgement.

We found that the service had not always responded to requests made by other professionals to follow up and monitor people�s health conditions.

Is the service well-led?

Systems in place to audit and identify improvements had not been used appropriately.

Comments made by staff and people using the service had been used to make some improvements to the service however these improvements were not always sustained.

Plans for future improvements were being supported by the new manager. One member of staff told us, "The new manager is absolutely great."

Inspection carried out on 30 September 2013

During an inspection looking at part of the service

This was a follow up inspection. Please see our previous report for full comments.

The provider had carried out safeguarding training for all staff to ensure that they were fully aware of the provider�s policy and how to report concerns.

There was evidence that regular audits were being carried out and that action had been taken as a result of these. There were clear systems for the recording of medication and for the disposal of medication. Staff who administered medication had all had their competency assessed.

Inspection carried out on 14 May 2013

During a routine inspection

As part of this inspection we spoke with four members of staff including the registered manager. The people who used the service were not able to fully communicate with us due to their complex needs; therefore we also spoke with three relatives and two social workers who had knowledge of the service.

One person stated that the home was �brilliant�, another told us that they felt the home �was one of the better places and they really do cater for their interests�.

Relatives and professionals we spoke with felt that provider was generally meeting the needs of people who used the service. Care plans were person specific and updated on a regular basis.

Staff had received relevant training and there were procedures in place to safeguard people who used the service. However, we found that not all staff understood their reponsbility in ensuring that they followed the provider�s procedures for reporting concerns.

We found that people were not always given medication in accordance with the prescribing directions. There was not always sufficient information for staff about when to give a person medication that was �as required�.

Staff received regular supervision and had annual appraisals which helped to ensure that they were supported. The majority of staff were up to date with mandatory training.

We found that the provider had an effective complaints procedure in place.

During a check to make sure that the improvements required had been made

We followed up one area of non-compliance identified in a previous inspection. We reviewed evidence that demonstrated the provider's compliance in this area.

Inspection carried out on 19 June 2012

During a routine inspection

At the time of our visit there were seven people living at the home. We spoke with one person, two relatives, four staff members and two professionals who have had contact with the service.

One of the people using the service who we spoke to told us they liked living in the home. A family member stated that �it�s pretty good�.

A visiting professional stated that �they are working really well� with people and meeting their needs.

The staff we spoke to at the home all enjoyed working there and described a very positive environment for staff and people using the service. One staff member told us �it�s like one big family, staff and service users�.

Inspection carried out on 27 January 2012

During a themed inspection looking at Learning Disability Services

People talked about the things they enjoyed doing. This included shopping, cooking, playing pitch and putt and crown green bowls in the summer and singing on the karaoke machine.

People told us they liked to go into the wooden lodge in the garden, where they could play snooker with the staff, use the exercise bike and the sensory room.

People appeared relaxed and at home and were able to move freely around the communal areas of the home. People were generally unsure what abuse was. One person told us: �I feel safe here.�

Reports under our old system of regulation (including those from before CQC was created)