Rose House

Rose House is a residential care home providing personal care for up to two people with learning disabilities or autistic people. At the time of our inspection one person was using the service.

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

Right Support:

The model of care and setting did not consistently maximise people’s choice, control and independence. People were not always supported to have maximum choice and control of their lives and staff did not always support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice. Assessments of people’s ability to make decisions had not all been completed.

The manager and staff team were aware of people’s strengths and had considered possible goals for the person but due to a lack of consistent staff, they were unable to ensure people had a fulfilling and meaningful everyday life.

People were supported to take part in activities and interests in their local area; however this had been limited due to low staffing levels.

Systems were in place to report and learn from any incidents but these had not always been used effectively.

The environment needed upgrading. Furniture and fittings were planned to be replaced but there was no plan to redecorate the service in the near future. The environment was not arranged in a way that was stimulating to people.

Staff supported people with their medicines in a way that helped them achieve good health outcomes. However, staff competency to administer medicines safely had not always been assessed in line with the provider’s policy.

People who experienced periods of distress had proactive plans in place which ensured restrictive practices were only used by staff if there was no alternative. The service was in the process of reviewing all restrictions and planning to reduce them where possible.

People were able to enjoy privacy when they wanted to.

People could access specialist health and social care support in the community or at home when necessary.

Right Care:

People were able to communicate with experienced staff as they understood people’s individual communication needs; however people had not always been able to communicate with agency staff and this had, at times, caused frustration to people.

The manager and permanent staff team were focused on delivering care that reflected people’s range of needs, however they had not always been able to do this. This had at times impacted on people’s wellbeing and enjoyment of life.

People received kind and compassionate care from staff who protected and respected their privacy and dignity.

Staff were in the process of reviewing risk assessments relating to people’s needs. Where appropriate positive risk taking was encouraged and enabled.

Right Culture:

Identified actions such as upgrading fire doors and redecorating the premises had not been undertaken promptly.

Health and safety checks had not been carried out consistently in line with the provider’s schedule.

Audits and checks of the service had not all been completed as required by the provider’s schedule.

Opportunities and plans to improve people’s support had not always been taken because of a lack of staff who knew people well.

Managers and senior staff modelled good practice and led by example. Staff were supported by the manager and were offered the opportunity to debrief after any incident.

The manager had a clear vision for the direction of the service which demonstrated ambition and a desire for people to achieve the best outcomes.

People received support from trained specialists when necessary, who helped staff understand people’s needs and provided consistent support.

Staff training in safeguarding, fire safety and positive behaviour support was not all up to date.

The manager regularly evaluated the quality of support given, involving the person, their families and other professionals as appropriate. Relatives were involved in planning the person’s care and in any important decisions.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The provider was asked by the Local Authority in September 2022 to take over the care and support at this location from another provider, the care transferred to the new provider in November 2022.

This service was registered with us on 21 November 2022 and this is the first inspection.

The last rating for the service under the previous provider was inadequate, published on 24 March 2022.

Why we inspected

This inspection was prompted by a review of the information we held about this service. We needed to check to see if the provider had made improvements since taking over the service.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

Enforcement and Recommendations

We found breaches relating to consent, person centred care and the governance of the service. Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.