Rose House

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 71 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

People’s needs were regularly assessed and updated in line with changes. Care plans were detailed and person-centred, with clear guidance for staff on how to support individuals safely and respectfully. For example, 1 person’s care plan included specific instructions for managing distress and promoting independence, such as not rushing them when dressing and encouraging choice in clothing.

Staff demonstrated awareness of people’s preferences and communication styles.

The service supported people to live in a way that reflected their individual needs and preferences, in line with Right Support, Right Care, Right Culture.

The provider did not always ensure that care and treatment was based on best practice and evidence-based guidance. While staff supported people with kindness and compassion, there were gaps in understanding and applying evidence-based approaches. For example, staff lacked knowledge of methods to support anxiety in autistic people and did not consistently use bespoke communication systems. The absence of these highlighted a missed opportunity to embed effective communication strategies.

Staff lacked some understanding of evidence- based practice. Examples were seen where air mattress settings were not considered. Also, a lack of understanding around systems to stop the over medication of disabled people. This created a risk-averse culture that avoided pushing people beyond their comfort zones, potentially limiting opportunities for growth.

The service had begun implementing Positive Behaviour Support (PBS) training and specialist learning disability training although this was still in progress. Staff had expressed a desire for more autism-specific training.

The provider ensured staff, teams and services worked together effectively to deliver joined-up care and support. Staff collaborated well with health and social care professionals, responding to people’s changing needs. For example, the service worked with district nurses and hospices to support people with palliative care needs. Staff were passionate about supporting people well with the end-of-life care.

Care plans reflected input from families and professionals, and staff were aware of people’s health fluctuations, and took appropriate action. Observations showed staff supported people with dignity and respect, and relatives described the service as “like an extended family”.

However, some inconsistencies were noted. For instance, not all staff were aware of protocols for specialist equipment, and communication plans were not always accessible or inclusive of specific methods. Despite this, the overall culture promoted teamwork and shared responsibility.

The provider supported people to live healthier lives by encouraging them to take ownership of their health and wellbeing. People were supported to access health professionals and attend regular appointments. Care plans included health questionnaires, mental health assessments, and clear guidance on managing conditions such as diabetes, asthma, and epilepsy.

Staff encouraged independence, such as helping people make drinks or choose meals. People were supported to go swimming, attend religious services, and participate in activities like Zumba and museum visits.

However, some opportunities to promote independence were missed. For example, 1 person expressed a desire to cook but could not access the kitchen due to a step. Systems were being considered on how to overcome this. Staff were aware of dietary needs and used specialist tools to monitor this and had access to thickener guidance.

The provider monitored and improved outcomes for people by reviewing care and adapting support based on feedback and observations. Care plans were regularly updated and included detailed information on health conditions, risks, and preferences. Staff monitored outcomes such as blood sugar levels, skin integrity, and emotional wellbeing. For example, 1 person’s care plan included repositioning charts and mattress settings based on her weight.

Staff discussed patterns and made changes to improve care. Observations showed staff responded promptly to distress and supported people with kindness.

The provider made sure people consented to their care and treatment, and when they lacked capacity, decisions were made in line with legislation. Consent was considered carefully, with Mental Capacity Assessments (MCAs) and Deprivation of Liberty Safeguards (DoLS) applications in place. Care plans reflected people’s preferences, and staff supported decision-making. For example, 1 person with capacity agreed to hourly cigarettes and had signed a consent agreement.

Staff understood the importance of least restrictive practices and adapted care to meet individual needs. One person had a MCA for a chair alarm, and another had a sensitive end-of-life plan that respected their wishes not to discuss it further.