Rosedale

Healycare Limited - Rosedale is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Rosedale is registered to provide accommodation and personal care for up to six people with a mental health diagnosis. There were five people living in the service on the days of our inspection.

At the last inspection on 29 March 2016, the service was rated ‘Good’. At this inspection the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

The service was managed by a registered manager who was registered on 28 September 2011. 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.

The service's arrangements around fire safety required expert input to ensure that people were completely safe and they were appropriate for the home. We have made a recommendation around this issue that you can see in the 'Safe' section of this report.

People received their medicine as prescribed by healthcare professionals. Medicines were stored securely to ensure they were safe. There were risk assessments which identified risks to people and management plans had been put in place to ensure people’s health and well-being were maintained.

People consented to the care and support they received. The service complied with the requirements of the Mental Capacity Act (MCA) 2005 and the Deprivation of Liberty Safeguards (DoLS). Staff had been trained and understood their responsibilities in relation to MCA and DoLS.

People were safeguarded from the risks of abuse and improper treatment. Staff had received training on safeguarding and they were knowledgeable on the procedure to follow if they had any concerns. There were sufficient staff available to safely meet people’s needs.

People told us staff were kind and caring. We observed that staff treated people with respect and promoted their dignity. People were supported to communicate their views about how they wanted to be cared for.

People’s nutritional needs were met. People told us they enjoyed the choice of food that was available to them. People had access to food and drinks throughout the day. People were kept occupied and encouraged to participate in activities.

The premises was clean and hygienic.

Staff were trained on various areas to ensure they had the relevant skills, knowledge and experience to provide good care to the people they looked after. Staff received regular support and supervision to carry out their duties effectively.

The service liaised with various healthcare professionals to meet the needs of people.

People had their individual needs assessed and their care planned in a way that met their needs. People received care that reflected their preferences and choices. Reviews were held with people and their relatives to ensure people’s support reflected their current needs.

People had opportunities to share their views and give feedback about the service and these were acted upon. The service was subjected to regular quality checks to ensure it was of good quality and met people’s needs.

Further information is in the detailed findings below.

Rosedale is registered to provide residential accommodation for six adults who have mental ill health. The home is a large terraced house situated in the centre of Haslingden town centre. Accommodation is provided in six single rooms, most of which have en-suite facilities. There is a communal lounge, dining room, and laundry room and kitchen area. A small enclosed courtyard is accessible at the rear of the property. At the time of the inspection the service was providing support to 4 people.

The service was managed by a registered manager. 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.

People living in the home told us they felt safe and well cared for. They did not express any concern over the care and treatment they received and they described staff as being “very good” “kind” and “caring”.

People were cared for by staff that had been recruited safely. Appropriate checks had been carried out to make sure staff employed were of good character. People using the service were involved in recruiting staff.

There were sufficient numbers of suitably qualified and experienced staff to support people. Staff were both trained and receiving training to support them in their duties. This helped to ensure the staff team had a good balance of skills and knowledge to meet the needs of people using the service and to provide a reliable and consistent service.

People’s medicines were managed safely and were administered by staff who were trained and competent.

There were good systems and processes in place to keep people safe. Staff had a good understanding of risk management. Risks to people had been identified, assessed and managed safely. People were encouraged to live their lives the way they chose and supported to recognise this should be done in a safe way.

We found the premises to be clean and hygienic and maintained. Regular health and safety checks were carried out.

The service liaised with other service sector professionals such as GP’s, care co-ordinators and psychiatrists. This helped to make sure people received co-ordinated and effective care and support.

The registered manager and staff understood their responsibilities in promoting people's choice and decision-making under the Mental Capacity Act (MCA) 2005. Staff followed the principles of the Mental Capacity Act 2005 to ensure that people’s rights were protected.

People’s nutritional needs were met and they were involved in menu planning and basic food preparation. Healthy options were promoted.

People told us they had their privacy respected by all staff. Each person had an individual care plan that was sufficiently detailed to ensure people were at the centre of their care. Care files contained a profile of people’s needs that set out what was important to each person.

People’s individual needs were assessed and care plans were developed to identify what level of care and support they required. People’s care and support was kept under review and people were consulted about their care to ensure their wishes and preferences were met and their independence was promoted.

People were given additional support when they required this. Referrals had been made to the relevant health and social care professionals for advice and support when people’s needs had changed.

Staff were knowledgeable about people’s individual needs, backgrounds and personalities and supported people to maintain their relationships with their friends and relatives.

People were supported to participate in a range of appropriate activities and to pursue their personal hobbies and interests.

People told us they were confident to raise any issue of concern with the registered manager and staff and that issues they raised would be taken seriously. They had weekly house meetings to discuss any matter that affected them. They also had contact details for other agencies they could approach to help them raise complaints.

People had also been encouraged to express their views and opinions of the service through regular house meetings, care reviews, and during day to day discussions with staff and management.

People said the management of the service was very good. There were opportunities for people to give formal feedback about the service, the staff and their environment in quality assurance surveys. Recent surveys showed overall good satisfaction with the service provided.

There were systems in place to monitor the quality of the service and evidence the findings supported business planning and development.

We found the required improvements had been made to the environment. Two bedrooms had been completely refurbished with en-suite facilities, furniture and floor coverings. People we spoke with were delighted with their new rooms and were waiting for their shower to be wired up by an electrician. One person told us the registered provider had ordered them pictures for their room and we noticed other new pictures had been placed around the home.

General maintenance was on-going. Improvements to the structure of the home had been made and a new laundry room created. We were satisfied the provider had made the required improvements that were to a good standard and were confident outstanding work would be completed.

We found the standard of hygiene had considerably improved. Staff were now more accountable for cleaning by having cleaning assigned to them. In addition to this recruitment for domestic support was underway and arrangements had been made for difficult to reach areas and more complex cleaning to be dealt with by using employing the services of a specialist cleaning agency. Rubbish in the backyard had been removed and there was better facilities for the storage of household waste. The open drain was to have a new cover fitted.

Testing for Legionella was completed recently and certified as being safe.

We saw improvements had been made to the environment. New carpets had been fitted in the hall, stairs and landing. General maintenance was on-going. Further work was required to bring the environment up to an acceptable standard as identified in the last inspection. We were satisfied improvements had been made and we saw evidence of plans in place for the on-going works. We were given a timescale of three months for completion.

The number of staff on duty had increased. People using the service told us they got out and about with staff support and they said they liked having the same staff team.

The provider told us they had increased their presence in the home and used this time to oversee improvements required. We were satisfied the provider understood their obligation to take responsibility to ensure adequate provision was made for improvements and essential day to day maintenance.

We considered the evidence we had gathered under the outcomes we inspected. We spoke with four people using the service, looked at two people's care records in detail and a selection of other records, policies and procedures. We also looked at staff recruitment records and spoke with two staff on duty, the manager and the provider.

This is a summary of what we found:

Is the service safe?

People's care plans were sufficiently detailed to make sure peoples' care and support was provided according to their wishes and safety. Risk assessments were completed to a good standard. They were thorough in determining level of risk. Action required for minimising or removing the risk whilst recognising people's right to take informed risks was recorded. Staff had been made aware of who may be at risk of for example, self-harm, self-neglect, and exploitation and had a plan of care to deal with these.

Staff had been trained and understood their obligation to apply the principles of the Mental capacity Act and Deprivation of Liberty Safeguards (DOLS). This is a legal framework designed to protect the best interests of people who are unable to make their own decisions. No person living at the home had been assessed as needing this safeguard in place on the day of our inspection.

People's care and treatment was planned and delivered in a way to protect them from any unlawful discrimination within the home and wider community. They had opportunities to continue to live as valued citizens and access community health and social facilities.

Staff were trained in emergency procedures such as fire and first aid.

Care had been taken to make sure people were kept safe by only employing people who had proven good character records.

Systems were in place to make sure the provider and management continually checked the service was safe. However we found improvements were required to make sure an acceptable standard of hygiene, and staffing was maintained.

We also found the maintenance of the premises was not satisfactory in providing a safe environment for people.

Is the service caring?

People told us they were happy with the care they received from the staff team. They commented, 'It's brilliant here. I get all the help I need. I don't need any help with personal care. I like cooking a meal. Nothing is too much trouble for the staff, they're fantastic.' "The staff will do everything they can to help you. We go out and we discuss things like meals we prefer at our house meetings, days out and holiday plans.' 'They're brilliant.' 'Nothing is too much trouble for them. They are very helpful and understanding', and 'Caring.'

Staff worked to care plans that were person centred, well written and sufficiently detailed on how best to meet individual needs. Daily records maintained showed staff responded to people's needs as required. Staff had received training to meet the needs of people living in the home.

Is the service responsive?

People were given opportunities to say what they wanted. This meant plans could be made to support people to achieve their aims. We saw evidence there was consultation with health and social care professionals to review the quality of people's care. Staff reviewed people's needs on an on-going basis to make sure people's changing needs were managed appropriately.

Residents meetings were held and people could say what they wanted and they felt listened to. A system was in place for receiving comments, compliments and complaints. People told us that they would know how to make a complaint, should they need to do so. We found where issues were raised with the provider, this was not always followed through with prompt action.

Is the service effective?

People told us they discussed their care. They had their own preferred lifestyles, routines, likes and dislikes that staff knew about. Care planning placed people at the centre of their care and offered needed support and encouragement for people to achieve their aims.

People's health and well-being was monitored and appropriate advice and support had been sought in response to changes in their condition. The service had good links with other health care professionals to make sure people received prompt, co-ordinated and effective care.

People told us they were consulted with and listened to at their house meetings. They had a programme of daily living and social activities. One person told us, 'I like my computer. I've just learned to send e-mails, it's great. I get a response more or less straight away.' And, 'Staff will get involved with whatever we are doing.' People we spoke with told us they went shopping, cooked meals and generally kept their rooms clean.

We were told staff were very good and supported people as they wanted. However we found where two staff were required for planned activities, consideration had not been given to the needs of people who potentially could become unwell. This meant pre-planned group activities were not always followed through.

Is the service well led?

People told us the management of the service was very good. They said they had regular meetings and considered this 'good' as they could have their say. People also told us they were treated well. If they had any concerns they knew who they could talk to.

The service had a registered manager responsible for the day to day management of the home. Staff were clear about their responsibilities and duty of care and were able to raise their views and concerns with the manager. They were supervised well and had appraisals. Meetings were held for staff and residents and these showed people were kept up to date and allowed people to be involved with all aspects of the running of the home including best practice issues and quality monitoring.

We saw evidence the service knew when to consult with health and social care professionals when required. This meant any decision about people's care and support was made by the appropriate staff at the appropriate level.

We reviewed the care files of two people who used the service and found evidence that there were procedures in place to ensure their consent was gained in relation to the care provided for them.

We reviewed the care files of two people who lived in Rosedale. We saw that care plans identified the needs of the person and included information on how they wished their care to be delivered and was reviewed on a monthly basis.

We found evidence that there were effective systems in place for the safe administration and management of medicines.

People spoken with said there was a sufficient number of staff on duty. Staff were provided with appropriate training and were supported by the manager at the home.

We found there was an adequate complaints process in place to ensure that any comments and complaints were listened to and acted upon.