Rosebank Care Home

Rosebank is a residential service which provides accommodation and personal care for a maximum of 17 people with learning and physical disabilities and autism.

Since the last inspection in October 2016 best practice guidance for care services supporting people with learning disabilities has been developed and designed. ‘Registering the Right Support’ and other best practice guidance help ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes. On this inspection we looked at whether the service was meeting this best practice guidance; we found there were some shortfalls in the service provision.

People’s experience of using this service:

We found that people received care in a safe way. Individual risks to people and the environment had been identified and assessed and measures put in place to manage them and minimise the risk of avoidable harm occurring.

There were systems in place to monitor medication so that people received their medicines safely.

Staff had positive regard for the people being supported. People were clearly happy living at Rosebank. We found examples where people had improved their quality of life since they had been living at Rosebank and had been able to experience and develop communication skills where as previously they had not been given the opportunity. This had improved their wellbeing.

People's individuality and diversity was nurtured; individual achievements were acknowledged and celebrated, and people were treated with equal respect and warmth.

Staff treated people with kindness, compassion and respect and staff ensured that people’s dignity was maintained.

Although people did access the local community there were some barriers to this relating to the number of staff available in the care home setting. This was particularly in evidence at weekends when only two staff were available.

Care plans identified intended outcomes for people and how they were to be met in a way they preferred. There were some instances were better forward planning might assist with people accessing the local community. Specific support for some people was not always included in care plans.

People and family members knew how to raise concerns. There were easy read formats available for people understand information and staff took time to ensure people could raise any worries or concerns.

The leadership of the service promoted a person-centred care and a positive culture within the staff team. The registered manager showed a continued desire to improve on the service and displayed a good knowledge and understanding around the importance of working closely with other agencies and healthcare professionals where needed.

Rating at last inspection:

Rosebank was last inspected in October 2016. The report was published on 29 December 2016. At that time, it was rated as Outstanding under two of the domains we inspect by; Caring and Well led. At this inspection, we again heard some very positive examples to support this. However, some of our findings showed that this was not consistent in fully meeting the values of Registering the Right Support across the service and we therefore rated Caring and Well led as Good.

Further detail is in the full report.

Why we inspected:

This was a planned inspection that was scheduled based on the previous rating. We inspected to check whether the service had sustained its Outstanding rating. We found that the service continued to meet the characteristics of Good and the overall rating was reduced to Good.

Follow up: We will continue to monitor the service and follow up inspections will be planned in line with statutory requirements.

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

Rosebank is a residential service which provides accommodation and personal care for a maximum of 17 people with learning and physical disabilities. At the time of the inspection 15 people were living at the service. The majority of the people living at the service at the time of the inspection were semi-independent and did not require intensive care and support. The service is based in a large Edwardian property near to the town centre of Southport.

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.

Throughout the inspection we observed staff interacting with the people living at the service in a manner which was exceptionally knowledgeable, compassionate and caring. People living at the service and their relatives spoke very positively about the attitude and approach of the staff. The atmosphere created within the service was very relaxed, informal and homely.

The service’s approach to the provision of information and general communications was particularly innovative. Rosebank made extensive use of information technology (IT) and social media to maximise its level of engagement with people using the service, their relatives, staff and other stakeholders. People spoke extremely positively about the impact that this approach had on them, their level of engagement and their relationships.

Rosebank was extremely good at sharing best-practice approaches with other providers in the area. The management team had established strong links with provider groups, both locally and nationally and had openly shared some of its progressive systems and practices at no cost for the benefit of other people using services. The service also maintained links to national organisations which developed and promoted best-practice approaches. We spoke with representatives of the local authority and other local providers. Each spoke very highly of the senior management team at Rosebank and the impact that the sharing of best-practice had on their organisations.

People had also been assisted to move to more independent living by the service. We were provided with evidence of incidents where people had been cared for in a supportive and flexible manner which allowed them to move-on to more independent living.

Information was provided in a way that made it easier for people to understand. Staff took time to re-word things when people didn’t initially understand. We saw that some important information, for example care documents, were produced in plain English and made use of images to support people’s understanding.

We saw that people had choice and control over their lives and that staff responded to them expressing choice in a positive and supportive manner.

Friends and relatives were free to visit at any time. They told us that they felt welcome and often attended parties and events at the service.

The service was exceptionally well-led by the registered manager and the proprietors. They recognised and valued the importance of effective communication, robust management systems and sharing best-practice approaches.

It was clear that the service had been and continued to be developed with direct input from people living at Rosebank, their relatives and staff.

The registered manager and the proprietors were clearly aware of the day to day culture at Rosebank and monitored staff daily to ensure that the values of the service were upheld. Each of the staff that we spoke with was able to explain the function and culture of Rosebank in clear, simple terms.

Staff had a good understanding of their roles within the service and knew what was expected of them. They spoke extremely positively about their roles and responsibilities.

Staff were recruited safely subject to the completion of appropriate checks. This included a requirement for two references and a Disclosure and Barring Service (DBS) check.

Risks to the people living at the service were appropriately assessed and recorded in care records. We saw risk assessments relating to; eating, going-out and road safety amongst others. Each risk assessment focused on maximising the person’s independence while safely managing any risks and had been recently reviewed.

The service had sufficient staff to meet the needs of the people living there. There were a minimum of two members of staff per shift with extra provision depending on activities.

Medicines were stored and administered safely in accordance with best practice.

Staff had the skills and knowledge to meet the needs of the people living at the service. Staff were given regular formal supervision and appraisal which was recorded on their file.

None of the people living at the service was subject to a DoLS authorisation. People’s consent to various aspects of their care had been sought and recorded on their care files.

People living at the service were supported to maintain good health by accessing a range of community services. The service also made use of an electronic consultation system to give people quick access to a healthcare professional.

We saw from our observations that the people living at the service were involved in discussions about care on a day to day basis. We also saw evidence that people were actively involved in regular reviews of their care.

We observed that care was delivered only when it was needed. The people living at the service were encouraged to be as independent as possible and received staff interventions on request or when staff assessed that support was required. Staff knew their needs and preferences and responded with confidence when care or communication was required.

Rosebank had a complaints procedure available to people living at the service and visitors. Complaints could be submitted in person, in writing or through electronic media. Information on how to complain was provided as part of the service user guide and contained contact details for external organisations.