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Rosekeys Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

Updated 31 October 2019

Rosekeys is a residential care home providing accommodation and personal care to people with learning disabilities and autism.

The Secretary of State has asked the Care Quality Commission (CQC) to conduct a thematic review and to make recommendations about the use of restrictive interventions in settings that provide care for people with or who might have mental health problems, learning disabilities and/or autism. Thematic reviews look in-depth at specific issues concerning quality of care across the health and social care sectors. They expand our understanding of both good and poor practice and of the potential drivers of improvement.

As part of thematic review, we carried out a survey with the manager at this inspection. This considered whether the service used any restrictive intervention practices (restraint, seclusion and segregation) when supporting people.

The service used some restrictive intervention practices as a last resort, in a person-centred way, in line with positive behaviour support principles. However, shortfalls were identified as training had not been refreshed for all staff in in this area.

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 13 people. Seven people were using the service. This is larger than current best practice guidance. Staff did not wear anything that suggested they were care staff when coming and going with people.

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

Some areas of the home were clean, however we found some areas were poorly maintained. We also identified poor infection control practices which hadn’t been identified by the providers audits.

The property was large and spacious but needed redecoration and the gardens needed attention.

Staff were trained and knowledgeable in safeguarding people. We identified a shortfall in the safeguarding of one person’s finances.

There were shortfalls in the audits which the provider needed to strengthen and embed into practice.

Risks to individuals and the environment were assessed and monitored. Fire equipment was serviced and regularly tested however, not all staff had taken part in a fire evacuation.

Refresher training had expired for a number of staff meaning they may not have been able to effectively carry out their role in supporting people with behaviours which challenge others. Staff told us they received regular supervision and support.

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.

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.

There were enough staff on duty to meet people's needs and we saw staff were effectively deployed. There was a recruitment system in place that helped the employer make safe recruitment decisions when employing new staff.

Safe systems were in place for medicines and we saw people were receiving them on time and as they were prescribed. Staff received appropriate training and competency assessments in administration of medicin

Inspection areas

Safe

Requires improvement

Updated 31 October 2019

The service was not always safe.

Details are in our safe findings below.

Effective

Requires improvement

Updated 31 October 2019

The service was not always effective.

Details are in our effective findings below.

Caring

Good

Updated 31 October 2019

The service was caring.

Details are in our caring findings below.

Responsive

Good

Updated 31 October 2019

The service was responsive.

Details are in our responsive findings below.

Well-led

Requires improvement

Updated 31 October 2019

The service was not always well-led.

Details are in our well-Led findings below.