We carried out a review of the data available to us about Rockfield House on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Rockfield House, you can give feedback on this service.
Rockfield House is registered to provide care and accommodation for up to 14 adults with a learning disability, autism or mental health needs. The House is a spacious and has a separate annex building which is more semi-independent and used to help people transition into the community.
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 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.
The service was a large home, bigger than most domestic style properties. It was registered for the support of up to 14 people. Ten people were using the service. This is larger than current best practice guidance. However, the size of the service having a negative impact on people was mitigated by the building design fitting into the residential area and the other large domestic homes of a similar size. There were deliberately no identifying signs, intercom, cameras, industrial bins or anything else outside to indicate it was a care home. Staff were also discouraged from wearing anything that suggested they were care staff when coming and going with people. People set their own meal times around their individual plans for the day.
People’s experience of using this service and what we found
Everyone we spoke with said they felt safe living at the home. There was enough staff on duty to be able to support people safely. Staff recruitment and selection remained safe. Medication was well managed and stored correctly. Staff knew the correct process to follow if the felt someone was being harmed or abused.
Staff were trained and had the appropriate skills to support people safely. Staff engaged in regular supervision. There were no set meal times, people planned their own meal times in accordance with their own daily planner. Where needed, people were supported with their eating and drinking needs.
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.
Staff treated people with kindness and respect. We observed staff supporting people in communal areas, and speaking to them with respect, offering choices and empowering people. People were involved in their care plans and review processes.
Information within support plans was person centred. These support plans contained information about people’s backgrounds, likes dislikes and routines Support plans were person centred and contained information about people’s backgrounds, likes, dislikes and routines. There was an emphasis on people achieving their own individual outcomes. People were supported to engage in employment opportunities where appropriate and complaints were well managed.
There was strong leadership and oversight within the service. Different audits had identified the need for positive changes to be implemented, most of which had already been actioned. The registered provider and the staff team had taken on board feedback from the last inspection and implemented some new processes, which were shared with us.
The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.
The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. 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
The last rating for this service was good (published 24 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.
Rockfield House is registered to provide care and support for up to 14 adults with a learning disability. Bedrooms are spacious with en-suite facilities and the home also has two separate bathrooms which are equipped to help people with their mobility.
The home is close to local shops and other amenities and there are direct bus routes into Liverpool city centre. Parking facilities are available at the front of the home.
At the last inspection in October 2014, the service was rated Good. At this inspection we found the service remained Good.
The deputy manager had systems in place to ensure that staff were recruited safely and checks were carried out before they started working with vulnerable people. There was also a process to analyse incidents and accidents. Staff we spoke with knew what action to take in relation to reporting safeguarding and whistleblowing concerns. Rotas showed that there were enough staff on shift to support people with their needs. Risk assessments were robust and reviewed every month or when required. Medication processes were well managed.
Staff training was well managed and staff underwent regular supervision and yearly appraisal. Staff were trained in a range of subjects, however, we saw that not all staff were trained in MAPA, which we saw was essential to be able to support people who can display challenging behaviours. The manager has since contacted us to update us that most of the staff we identified have now been trained.
The service was adhering to the principles of the Mental Capacity Act 2005 (MCA) and associated legislation, and any DoLS were kept under review and applied for in people’s best interests.
Everyone we spoke with, family members and people who lived at the home told us they liked the staff and they felt the staff cared about them. Staff we spoke with all told us they enjoyed their roles, and felt proud to be working at Rockfield House. Care plans were completed with the involvement of people and their families.
There was information stored in each person’s care file which was person centred and which took the needs, preferences and backgrounds of each person into account. Each person had a one page profile in place. Complaints were well managed. There was a complaint’s procedure on display in the main hallway, and everyone said they knew how to raise a complaint.
Quality assurance systems were effective and measured service provision. Regular audits were taking place for different aspects of service delivery by ‘heads of’ department. Regular action plans were drawn up when areas of improvement were identified. Staff and resident meetings regularly took place to seek the views of people who lived in the home.
Further information is in the detailed findings below
Rockfield House provides accommodation and personal care for up to 10 people who have a learning disability including autism. The accommodation is over one level. There is a spacious lounge and a dining room, kitchens and an activity room. There are two well-maintained garden areas.
A registered manager was 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 living at the home were kept safe from abuse because the staff understood what abuse was and the action they should take to ensure actual or potential abuse was reported. Staff had been appropriately recruited to ensure they were suitable to work with vulnerable adults. People and their families told us there was sufficient numbers of staff on duty at all times.
We saw that staff and visitors were made aware of the need to ensure safety at all times. Visitors to the home we spoke with at the time of our inspection commented that they always felt safe in the home environment as there was always staff available.
People living in the home could be unpredictable in their behaviour. We observed staff supporting people in a way that ensured their safety whilst maintaining their dignity. The care records we looked at showed that a range of risk assessments had been completed depending on people’s individual needs. These assessments were detailed and specific to challenging behaviours and were aimed at trying to get the person to be as independent as possible, including accessing the local community safely.
Relatives we spoke with told us the manager and staff communicated well and kept them informed of any changes to their relative’s health care needs. People said their individual needs and preferences were respected by staff. People were supported to maintain optimum health and could access a range of external health care professionals when they needed to, as well as regular review by the companies own health care professionals. People told us they received an adequate amount of food and drink. We saw that individuals requiring specific diets were catered for and monitored.
We looked at how medicines where managed in the home. We found safe medicine practices which was monitored and reviewed. People’s medication was regularly reviewed at clinical team reviews lead by a consultant psychiatrist. We discussed and recommend that the provider considers the National Institute for Clinical Excellence (NICE) guidance relating to the management of medicines in care homes when undertaking frequency of competency assessments for staff administering medicines.
People and their relatives described management and staff as caring, considerate and respectful. Staff had a good understanding of people’s needs and their preferred routines and had developed care so that it was planned individually. We observed positive and warm interactions between people living at the home and staff throughout the inspection.
Staff told us they were well supported through the induction process, supervision and appraisal. We saw the training programme in place and staff told us they were supported and encouraged to develop their skills. There was a high percentage of staff with formal qualifications in care which evidenced a good knowledge base for their role.
The principles of the Mental Capacity Act (2005) [MCA] were adhered to for people who lacked mental capacity to make their own decisions. We saw examples where care and treatment had been carried out in people’s best interest and this had included assessment of the person’s mental capacity and good practice with reference to the MCA Code of Practice. Seven of the people living at the home were subject to Deprivation of Liberty Safeguarding (DoLS) authorisation. DoLS is part of the Mental Capacity Act (2005) and aims to ensure people in care homes and hospitals are looked after in a way that does not inappropriately restrict their freedom unless it is in their best interests. We found the manager and senior staff knowledgeable regarding the process involved.
Arrangements were in place for checking the environment to ensure it was safe. We spent time with the staff lead for health and safety who outlined the audits or checks that took place at the home. In addition, health and safety audits were conducted by senior managers for the provider [owner]. We observed that the building was clean and tidy. We saw an example of a Personal Emergency Evacuation Plan (PEEP) that had been developed for one person living at the home. This meant that the person was highlighted as at risk and needed support in case of the need for evacuation from the building in the event of a fire.
The culture within the service was person-centred and open. There were systems in place to learn from the outcome of incidents, complaints and other investigations. A process was in place for managing complaints and we found that complaints had been managed in accordance with this process. People who lived at the home were able to get involved with aspects of the running of the home and provided feedback regarding how care programmes were organised.
A statement of purpose was in place for Rockfield House. We highlighted to the manager that some of the information was not up-to-date and some necessary information was not included. The manager said they work to update this.
We asked about notifications that are required to be sent to the Commission to inform us of key events in the home. We were aware that there were people in the home who were subject to Deprivation of Liberty Authorisations from the local authority. These are notifiable to CQC. The registered manager and the deputy manager were aware that notifications needed to be made following assessment by the local authority.
We spoke with four members of staff who held different roles within the service. Staff had a good understanding of the individual complex needs of the people who used the service and they were person centred in their approach. People were appropriately supported to make choices and decisions about their care. One person told us, 'I choose what I get up to.' People that used the service and relatives described Rockfield House as a safe place to live. We saw good evidence of the service involving relatives and health and social care professionals in review meetings.
People told us their needs were met and they were happy with the care and support provided. Comments included: 'The staff understand me and the support I need' and 'I tell the staff if I am unhappy about something and they will help me.' Care records demonstrated that people's needs had been assessed and appropriate plans were in place to meet identified support needs. We found evidence of care plans being reviewed regularly.
There was a staff training programme in place and staff said they felt well supported by the manager. Staff told us they enjoyed working at Rockfield House and that morale was good. We saw evidence of regular staff supervision and appraisal. Before staff began working in the service they undertook an appropriate induction programme.
Rockfield House cares for people with a learning disability and challenging behaviour, therefore conversation with some residents was limited. We spent some time in the communal areas making observations of how people were being cared for. This helped us to observe the daily routines and gain an insight into how peoples care and support was being managed.
We observed staff assisting people who required care and support. Staff treated people with respect and provided support or attention on a one to one basis. One staff member said, 'The one to one staff support is needed for some residents who present challenging behaviour.' One resident spoken with said, 'I like the staff who help me there is always plenty around.'
Residents and staff we spoke with told us the home was kept clean and they were happy with the level of cleanliness maintained. We saw bedrooms of residents and were told residents and relatives were able to furnish them with their own belongings and possessions. One resident said, 'I like my music pictures on the wall in my room.'
We spoke with Liverpool contracts monitoring team. They told us they had no concerns with the service.
People using the service told us that staff are good and that they treat them well and with respect. They told us about some of the activities which they are involved in at home and in the local community such as helping with domestic tasks around the home, shopping for food and personal items and going to college. People told us that staff help them to be independent and encourage them to do things for themselves.
People using the service told us that they like living at the home and that they feel safe there. They also told us that the staff are good and treat them well.
People using the service told us that they have been given information about what to do if they are worried about their care and treatment at the home.
People said they would tell the manager or other staff members if they were treated badly by anyone. They also said they would tell somebody if they saw any other person who uses the service being badly treated.
People told us that all the staff who work at the home are very good and they know what they are doing. We were also told that staff are respectful, good at listening, hard working and always helpful.
People using the service told us that they are involved in recruiting staff, one person told us about their experience of interviewing for new staff.
People using the service told us that they think there are always enough staff on duty to help them and other people who live there. People told us there is always a member of staff around when you need them.
People using the service told us that they feel safe in the hands of the staff that work at the home.
They also told us that staff know what they are doing and they think all the staff are properly trained.
People told us that they are confident that staff will deal with any incidents which occur at the home.