Roselea

Roselea is a care home that provides accommodation and personal care for up to 11 adults with a learning disability and/or autism in one adapted building. At the time of the inspection 11 people were living at the service.

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

Systems were in place to protect people against identified risks from choking. Care plans and risk assessments provided clear guidelines.

Where safety incidents occurred, these were analysed for any lessons to be learned. People's risks were reviewed with health professionals and action taken to keep people safe. Staff knew how to act in the event of a choking incident and were confident to manage each person's risk

We were assured the service was following safe infection prevention and control procedures to keep people safe.

We found several examples of good infection control practices. These included; ensuring people went to venues for activities which were COVID-19 secure.

Why we inspected

We undertook this targeted inspection to check on a specific concern we had following a choking incident. The overall rating for the service has not changed following this targeted inspection and remains Good.

CQC have introduced targeted inspections to follow up on Warning Notices or to check specific concerns. They do not look at an entire key question, only the part of the key question we are specifically concerned about. Targeted inspections do not change the rating from the previous inspection. This is because they do not assess all areas of a key question.

We found no evidence during this inspection that people were at risk of harm from these concerns.

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 coronavirus and other infection outbreaks effectively.

Please see the safe section of this full report. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Roselea on our website at www.cqc.org.uk.

Follow up

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

Roselea is a residential care home providing accommodation and personal care for up to 11 people with a learning disability and/or autism. At the time of our inspection there were 11 people living at the service. The property is an adapted cottage with bedrooms available on the ground and first floor. First floor rooms were accessed by stairs. On the first floor there were three self-contained flats for people who wanted and could live more independently. There was garden space for people to access at the rear of the premises.

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.

The service was a large home, bigger than most domestic style properties. It was registered for the support of up to 11 people. 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’s experience of using this service and what we found

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.

There were enough staff available to safely meet people’s needs. Staff were recruited safely, as the provider carried out the required checks prior to employing applicants. People had support from staff who had been trained and were supported by management. Staff told us they felt they had the skills to carry out their roles effectively.

People had their medicines as prescribed and staff made sure medicines were reviewed regularly. People’s risks were safely managed with risk management plans in place to give staff guidance.

The service was clean and well maintained. Safety checks regarding the environment were carried out regularly such as testing fire systems. People had their own rooms or self-contained flats which they could personalise if they wanted.

People had support to plan and prepare their own meals if they wanted. People’s health needs were recorded in a health action plan. Staff made timely referrals to healthcare professionals when needed. Staff worked as a team to make sure people’s needs were met. They used handovers to share information with each other.

People’s relatives told us staff were caring. People had a key worker who took time to get to know them and their needs well. People were involved in their care. They had care reviews to discuss their support and talk about how well it was working for them. People had their own personalised care plan which was reviewed when needed.

There was an open and positive culture at the service. Staff told us management were supportive and approachable. Team meetings were held regularly, and staff could share their ideas for improvements. Quality monitoring was carried out by the manager and the provider to assess and monitor quality and safety. Any improvements were added to an action plan for the service, which was monitored until actions were completed.

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 23 June 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.

This inspection was unannounced. This meant the provider did not know we would be visiting.

There was a registered manager in post at the service. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider. 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.

At our last comprehensive inspection in January 2015 we found, a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This was because staff had not always received the necessary training to meet people's health needs. We rated the service overall as ‘Requires Improvement’ at that time. The provider sent us an action plan telling us the action they would take to make the required improvements. We carried out a focussed inspection in July 2015 and saw those improvements had been made. We were able to change the overall rating of the service to ‘Good’ as a result of that inspection.

At the last inspection, the service was rated good.

At this inspection we found the service remained good.

Why the service is rated good.

People received a service that was safe. The registered manager and staff understood their role and responsibilities to keep people safe from harm. People were supported to take risks, promote their independence and follow their interests. Risks were assessed and plans put in place to keep people safe. There was enough staff to safely provide care and support to people. Checks were carried out on staff before they started work to assess their suitability to support vulnerable people. Medicines were well managed and people received their medicines as prescribed.

The service was effective in meeting people’s needs. Staff received regular supervision and the training needed to meet people’s needs. Arrangements were made for people to see a GP and other healthcare professionals when they needed to do so. The registered manager and staff understood the principles of the Mental Capacity Act (MCA) 2005 and, worked to ensure people's rights were respected.

People received a service that was caring. They were cared for and supported by staff who knew them well. Staff treated people with dignity and respect. People’s views were sought and they were involved in making decisions about their care and support. People were supported to maintain relationships with family and friends. People’s independence was promoted.

The service was responsive to people’s needs. People received person centred care and support. Staff monitored and responded to changes in people’s needs. They were offered a range of activities both at the service and in the local community. People were encouraged to make their views known and the service responded by making changes.

People benefitted from a service that was well led. The registered manager and senior staff maintained a clear focus on continually seeking to improve the service people received. A comprehensive quality assurance system was in place. This system was based upon regular, scheduled audits which identified any action required to make improvements. This meant the quality of service people received was monitored on a regular basis and, where shortfalls were identified they were acted upon.