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Inspection carried out on 17 November 2020

During an inspection looking at part of the service

Rose Court provides care and accommodation to adults with a learning disability. At the time of our inspection there were eight people living at the home.

We found the following examples of good practice.

Staff adapted visiting routines to support people to see and speak with their relatives when they were not able to come to the home, by taking the person to visit their relative.

One self-contained area of the home identified for isolation and zoning purposes, which would allow people to isolate in a range of rooms and with dedicated staff.

Staff complied with the requirement to use PPE and had worked with people so that they also understood the need for this.

The provider supported staff through risk assessments to make decisions about whether they wished to continue working and what they needed to do this.

Cleaning of the home, including frequently touched surfaces, had increased to reduce the risk of transmission of infection.

People were cared for exclusively by the home's own staff and systems were in place to ensure that as much as possible, including staff staying onsite if there was an outbreak.

Further information is in the detailed findings below.

Inspection carried out on 5 September 2018

During a routine inspection

“Rose Court is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one CQC contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Rose Court provides accommodation, care and support for up to 11 people who are living with a learning disability. At the time of our inspection there were ten people living at the service.

At the last inspection in January 2016, the service was rated Good.

At this inspection we found 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 has 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.

The registered manager was not available on the day of the inspection and we were supported by the deputy manager.

The environment was not well cared for and was not clean in all areas. We were informed following the inspection that a plan to improve the environment had been put in place.

People felt safe being supported at the service. Staff were knowledgeable about how to protect people from harm. They had received effective safeguarding training.

There were sufficient numbers of staff deployed to meet people's needs when required. Safe recruitment processes were in place to help ensure that staff were suitable to work in this type of service. Staff had received training and an ongoing support to help with their development.

People continued to be consulted about their care. Detailed care plans clearly documented their individual needs, preferences and choices. Risks to people’s health, safety and wellbeing had been assessed and there were effective risk management plans in place which mitigated risk. All care plans and risk assessments had been regularly reviewed to ensure that they were reflective of people's current needs.

People are supported to have maximum choice and control of their lives and staff (do not) support them in the least restrictive way possible; the policies and systems in the service support this practice.

People continued to be supported to access a range of health care professionals to help maintain their health and wellbeing. There were effective systems in place for the safe storage and management of medicine and regular audits were completed. People received their medicines as prescribed.

Staff were supportive and respectful. People's privacy and dignity continued to be maintained and respected. Staff knew people's needs and preferences and provided personalised support. People were supported to participate in meaningful activities and hobbies that were of interest to them.

People and staff found the registered manager and deputy to be supportive and approachable and were very positive about how they managed the service. People felt listened to and said that staff were responsive to any concerns they raised. Quality monitoring systems and processes were used to make improvements when required.

Inspection carried out on 8 January 2016

During a routine inspection

The inspection took place on the 8 January 2016 and it was unannounced. We last inspected the service in July 2014 and had found them to be meeting each of the standards we assessed.

The service provides accommodation and personal care for up to eleven people with learning disabilities and autism. At the time of our inspection, there were ten people using the service.

The home has a Registered Manager 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 & Social Care Act and associated regulations about how the service is run.

The service had safeguards in place to protect people from risk of harm. People’s care plans and risk assessments were detailed, person-centred and reflective of their changing needs. People were supported to access external healthcare services and staff had a good understanding of how to support people with a variety of conditions. People’s medication was managed, stored and administered safely.

People were given opportunities to contribute to their care and support and were included in reviews and meetings. People had a variety of interests and hobbies which they were supported to maintain both in and out of the home. People’s daily living skills and independence were encouraged and they were treated with dignity and respect by staff.

Staff received training which was relevant to their role and received regular supervision and performance management reviews. Interactions between people and staff were positive and friendly and staff were knowledgeable about the people being supported. Staff were able to tell us about ways in which they gained consent to give care, and had a good understanding of the Mental Capacity Act 2008 (MCA) and associated safeguards. Staff were given regular opportunities to contribute to the running of the service and develop their skills and knowledge. We found that there were enough staff on duty to keep people safe.

The service had robust quality assurance systems in place and held regular audits to identify any areas that required improvement. There was a complaints policy which detailed how people could make a complaint if required. The visions and values of the service were clearly visible through our inspection and were routinely discussed in staff meetings and supervisions.

Inspection carried out on 12 June 2014

During a routine inspection

When we visited Rose Court on 12 June 2014, we gathered evidence to help us answer our five questions: Is the service safe? Is the service effective? Is the service caring? Is the service responsive? Is the service well-led?

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, the staff supporting them and from looking at records.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

The home ensured that staffing numbers were adequate to safeguard the health safety and welfare of people who lived there.

We found that appropriate standards of cleanliness and hygiene were maintained to minimise the risk of people acquiring an infection.

There were suitable arrangements in place to protect people who may be at risk from the use of unsafe equipment.

Is the service effective?

We found that people�s care plans were detailed and included information on people�s likes and dislikes and how they wished to be supported.

People received care that was effective from staff who were suitably qualified and skilled to promote people�s safety and welfare.

Is the service caring?

We observed staff talking to people in a kind and respectful manner. Staff demonstrated genuine affection, care and concern for people. Staff were knowledgeable about people�s care needs including their preferences and personal histories. It was evident that people were listened to and staff responded to them in a caring way.

Is the service responsive?

We found that people�s assessed needs were kept under regular view. This ensured that care provided was current and met people�s diverse needs.

Staff enabled people to engage in activities that were important to them and met their individual needs. This meant that staff protected people from the risk of becoming socially isolated.

Is the service well led?

Staff spoken with said that they felt supported by the registered manager and regular staff meetings were held. At these meetings they were able to express their views and make suggestions on how care should be delivered.

Staff had delegated responsibilities. This meant that they knew and understood what was expected of them to ensure care was provided to a high standard.

We found that the home had quality assurance systems in place. This was to ensure care was provided to a high standard. Infection control, health and safety and medication audits were undertaken monthly.This demonstrated there was a system in place to monitor the quality of the care provided to ensure that it was safe and effective.

The home had arrangements in place to monitor accidents and incidents. These were analysed for the level of severity and measures put in place to minimise the risk of recurrence. It was evident that lessons were learnt from accidents and incidents.

Inspection carried out on 7 October 2013

During an inspection looking at part of the service

We visited Rose Court on 7 October 2013 to check that the compliance action we took against the provider in relation to safety and suitability of premises in July 2013 had been met.

We did not speak to people who lived at Rose Court. This was because some people who lived there were on holiday. Others were out shopping with staff or at the day centre.

We carried out a tour of the premises and found that the provider had taken action to ensure that people and staff were protected against the risks associated with unsafe or unsuitable premises.

Inspection carried out on 9 July 2013

During a routine inspection

When we visited Rose Court on 9 July 2013 we spoke with two people who use the service, three staff members and the registered manager. We also used a number of methods including observation to help us understand the experiences of people who used the service. This was because most of the people had complex needs and were not able to communicate verbally.

We found that people looked relaxed and comfortable in the company of staff who were supporting them. Staff enacted social stories to make people aware of their care and support and to obtain their consent to care.

Staff we spoke with were aware of the Mental Capacity Act 2005. A staff member said, �We always assume that people have capacity until it is proven otherwise.� This meant that people had their rights upheld.

We found that people received their medicines at the appropriate time. The medication administration record (MAR) sheets were fully completed in line with best practice. A person who used the service said, �I take a tablet at night which helps me to sleep.�

We found that areas of the premises were not appropriately maintained. Therefore, people were not protected against the risks associated with unsafe or unsuitable premises.

People were supported by staff who were appropriately trained, supervised and appraised.

The home had systems in place to ensure people�s comments or complaints were carefully considered and responded to appropriately.

Inspection carried out on 26 October 2012

During a routine inspection

When we visited Rose Court on 26 October 2012 we used a number of different methods, including observation to help us understand the experiences of people using the service, because most of the people using the service had complex needs which meant they were not able to communicate verbally.

We observed that people were offered support at a level which encouraged independence and ensured that their individual needs were met. There was a relaxed and calm atmosphere in the home and people were at ease in the company of the staff supporting them. The staff were polite and respectful in their approach and interacted appropriately with people.

We noted that people were involved in planning their care and making decisions about their support and how they spent their time. Some people were at the cinema at the time of our visit, and others were involved in carrying out tasks to support their personal development. One person confirmed the different activities and entertainment that they participated in.

Within the care files we saw that care documentation had been signed by the individual or their representative to confirm their involvement and agreement with their provision of care.