Archived: Rosemerryn

The service provides care and accommodation for up to three people who have autistic spectrum disorders. At the time of the inspection two people were living at the service.

The service had a registered manager in post. 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 comfortable and happy at Rosemerryn House and relatives told us people were, “Absolutely safe.” Staff confirmed people were safe and well looked after and commented, “This house is very safe and people are very happy.”

Staff understood their role in protecting people from abuse and had received regular training on local safeguarding arrangements. Staff recruitment processes were robust and designed to ensure people’s safety.

Risks that had been identified both within the service and the local community had been assessed and appropriately managed. People were supported to engage with a wide variety of activities within the local community and risk management measures had been designed to enable people to take managed risks in doing activities they enjoyed.

At our previous inspection, we found there were regularly not enough staff on duty to safely support people in the local community. At this inspection we found that staffing levels had improved and the service was fully staffed. Staff rosters showed all planned care shifts had been allocated to staff for the next two weeks. Staff told us they had not recently experienced staffing shortages similar to those found during our previous inspection. One of the service’s managers said, “We haven’t had any issues like that since I have been in charge.” People’s relative told us, “The staff team are a bit more stable and I am hopeful things are improving in relation to consistency of staff.”

We did identify occasions in the week prior to our inspection were staffing levels had dropped below those the service was commissioned to provided. This occurred in the evening and did not directly impact on safety or people’s activities. Staff told us, “Occasionally we have been pulled by head of operations to support other services but this has only been in the evening. It does not happen during the day so both [people] are able to do their activities.” This meant the service was no longer in breach of the regulations.

People at Rosemeryyn lived active and varied lives. Records showed people routinely engaged in a wide range of activities they enjoyed within the local community. Staff told us, “[Person’s name] chooses what he wants to do each day” and “There is enough for people to do, we are going for a nice walk in a minute and have been to Dairyland and horse riding recently. They do loads of different activities.” While a relative said, “I think [my relative] does get to do enough. It has settled down and he is back to doing what he enjoys.”

Staff received three weeks of induction training before they began working in the service. During this initial training period staff completed all of the courses the provider had identified as necessary to enable staff to meet people care needs. Records showed training was regularly updated and staff told us, “There is no lack of training.”

Manager and staff understood the requirements of the Mental Capacity Act 2005 and appropriate applications had been made to the local authority for the authorisation of potentially restrictive care plans.

Staff knew people well and took pride in describing people’s individual achievements. Care plans included details of people’s preferred methods of communication and guidance for staff on how to support people to make decision and choices. We saw staff used these techniques effectively and care records showed staff had consistently respected people’s decision and choices.

People’s care plans were accurate and staff told us, “Care plans are constantly reviewed and reflect current needs. Key workers are on it and have tailored the care plan to ensure people are happy and productive. I have been very impressed with the key workers here.” People’s relatives told us they had been involved in the process of reviewing the care plans. Care plans were accurate and up to date.

The service was well led. Staff were well motivated and focused on supporting people to live enjoyable and varied lives. Staff comments included, “It is actually a good place to work” and “Morale is pretty good here in this house as we get out to do so much.” People’s relatives told us they were happy with the overall quality of the service and one relative said, “I am convinced [My relative] is in the right setting.”

Although the registered manager was not based in the service full time, staff told us he visited regularly and they felt well supported. Staff comments included, “They are quite good managers here, always there if you need them” and “We see the [registered manager] every week.”

The service had appropriate quality assurance systems in place and people’s relatives told us when they reported concerns these were addressed and resolved.

We spoke with the registered manager, Spectrums' Head of Operations, three members of staff and two relatives. Relatives we spoke with were positive about the care and support at Rosemerryn, comments included; 'If I wasn't entirely happy they wouldn't be there' and, 'The staff genuinely care, I've never had any concerns about the care'.

We examined peoples care files and found the information was up to date and reviewed regularly.

We saw where people lacked capacity best interest meetings were held with people who knew and understood the person.

People had a choice of suitable and nutritious food.

People were protected from abuse although further systems were required to ensure people were more fully protected from financial abuse.

Premises were well maintained and met the needs of the people living at Rosemerryn.

There were sufficient numbers of suitably qualified, skilled and experienced staff.

Rosemerryn operated robust quality assurance procedures.

We observed staff interact with people who used the service in a kind and calm manner. We saw that staff showed, through their actions, conversations and during discussions with us empathy and understanding towards the people they cared for. We saw that people's privacy and dignity was respected by the way that staff assisted people with their personal care.

We examined people's care file and found the records were up to date and reviewed as the person's needs/wishes changed.

We found that people who used the service were involved in making day to day decisions and participated in tasks at home, such as cooking, cleaning and doing their laundry.

We found that staffing levels were in the main satisfactory and met the needs of the people who used the service. Staff said they had received sufficient training and support to enable them to carry out their roles competently.

Systems for safeguarding people from abuse were appropriate. We were reassured that a review of the management of challenging behaviours would be undertaken. Legal safeguards were understood by staff and used to protect people's rights.