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Notts Hill House Requires improvement

The provider of this service changed - see old profile

Inspection Summary

Overall summary & rating

Requires improvement

Updated 28 August 2019

About the service

Rosehill Rehabilitation Unit is a residential care home providing personal care and rehabilitation care for people who have acquired a head injury and neurodisability. The service is registered to accommodate up to 16 people. At the time of the inspection there were eight people living at the service.

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

People were not always supported to have maximum choice and control of their lives. Staff supported them in the least restrictive way possible; however, the systems in the service did not always support this practice. Mental capacity assessments had not always been completed. Where decisions had been made for people, there were no records that best interests' meetings had taken place with relevant people to discuss if the decision was in the person's best interests. This was immediately addressed and records were in place before the end of the inspection.

People had individualised care plans, which detailed the care and support they needed. This ensured staff had the information they needed to provide person-centred support for people. However, due to vacancies within the multidisciplinary team, some people were not receiving the ongoing rehabilitation people needed to move forward and the service was not delivered its purpose, of enabling and empowering people in their recovery. Staff expressed concern about this.

There were systems in place to check the quality of the service. However, internal audits and processes failed to identify or address the issues we found at this inspection.

Staff told us they were well supported by the manager and deputy manager of the service. Some staff told us they did not feel supported or valued by the provider. We spoke with the regional director who said they would meet with staff to discuss their concerns.

Staff were kind and caring. They had a good understanding of people as individuals, their needs and interests. Most people needed some support with communication and were not able to tell us their experiences; those who could told us they were happy, and we observed that people were happy and relaxed with staff.

There were enough staff who had been appropriately recruited, to meet people's needs. Staff understood what they needed to do to protect people from the risk of abuse.

Risks associated with people's individual health and care needs were now assessed and guidance was available to staff on how to minimise known risks to keep people safe. Incidents and accidents were well managed. People's medicines were managed safely.

Staff attended regular training to update their knowledge and skills and had opportunity to reflect on their practice through regular supervision meetings.

People were supported to attend health appointments, such as the GP or dentist and attended appointments for specialist advice and support when needed. People had enough to eat and drink and menus were varied and well balanced.

For more details, please see the full report which is on the CQC website at

Rating at last inspection and update

The last rating for this service was requires improvement. (published 31 July 2018). The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection although some improvements had been made, the provider was still in breach of regulations. The service remains rated requires improvement. This service has been rated requires improvement for two consecutive inspections.

Why we inspected

This was a planned inspection based on the previous rating.


We found three breaches of Regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what actions we asked the provider to take at the back of the report.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they im

Inspection areas



Updated 28 August 2019

The service was safe.

Details are in our safe findings below.


Requires improvement

Updated 28 August 2019

The service was not always effective.

Details are in our effective findings below.



Updated 28 August 2019

The service was caring.

Details are in our caring findings below.


Requires improvement

Updated 28 August 2019

The service was not always responsive.

Details are in our responsive findings below.


Requires improvement

Updated 28 August 2019

The service was not always well-led.

Details are in our well-led findings below.