Archived: Rowan House Also known as Family Mosaic

Rowan House provides a supported living service and provides personal care for people who are unable to provide it for themselves, because of old age, illness or disability. Where people live in their own home and receive care and support in order to promote their independence. As there is a separation between the care and accommodation, the care they receive is regulated by the CQC but the accommodation is not. On the day of our inspection, 175 people were using the service. Some of the people using the service had complex needs and the frequency of the care and support depended on people’s individual requirements.

There was 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 and Social Care Act 2008 and associated regulations about how the service is run.

There were sufficient staff to meet people’s needs and to manage risk safely. Systems were in place so people could take their prescribed medicines safely. The provider had a robust recruitment process, which helped protect people from the risk of avoidable harm. Staff were supported to develop their skills and knowledge.

People's consent was obtained before any care was provided and the requirements of the Mental Capacity Act 2005 were met. Staff asked people's permission before carrying out any care tasks. People were supported to consume food and drink of their choice and if the person was able, staff supported and encouraged them to assist with meal preparation. Staff worked well with health care professionals, to ensure people maximised their health and wellbeing.

Staff had spent time developing positive relationships with people and knew them well. Support was given to people in a personalised way that responded to the changes in people’s lives. Guidance was in place to enable staff to provide a consistent and safe level of support. People and their relatives told us they were aware of how to make a complaint and felt they were listened to by the registered manager.

Staff were enthusiastic about working for the service and worked well as a team. The service had a robust approach to monitoring and improving the quality of the service and put continuous improvement at the heart of this approach.

We spoke with one relative, eight staff and two professionals. We observed care and support given to people in two supported living settings. We looked at three people's care records, including assessments from professionals and risk assessments developed by the service based upon that information. Other records viewed included policies and procedures, medication management records, incident and accident records, staff training records and quality monitoring systems used by the manager. We considered our inspection findings to answer questions we always ask; Is the service safe? Is the service effective? Is the service caring? Is the service responsive? Is the service well-led?

Is the service safe?

In relation to people at risk of choking we found that an initial screening risk assessment had been completed on all people who used this service. Those people identified potentially at risk had professional assessments to enable the service to develop plans to keep people safe.

Staff had received training to deal with health emergencies such as choking and this formed part of training in first aid.

We assessed the application and use of legislation of the Mental Capacity Act (MCA) 2005 and in relation to Deprivation of Liberty Safeguards (DoLS).We saw that there was a policy and procedure in place and that staff had received training. This demonstrated that staff at the service were aware of the legislation, but given the close timing of this inspection to the recent supreme court judgement, the service had yet to implement those changes. We found that not all 'best interest' decisions had followed good practice as set out in the principles of the MCA.

Is the service effective?

Systems were in place to monitor and audit the delivery of service, such as, management oversight, audits of medication and finance; we found this made for effective organisation in the delivery of care.

Staff were effectively supported to do their job. They were provided with training, supervision and leadership.

Is the service caring?

One relative told us, 'I believe the care is excellent. Staff are very compassionate. Keyworkers are very good. The staff do not moan, they have a positive attitude, they care and put the client welfare first. The managers are positive and move things forward.'

We found that staff when observed offered choice and respected people's decisions and enabled people to be as independent as they could be in their daily lives.

Is the service responsive?

People who used the service were provided with the opportunity to participate in activities within the service and in their local community that interested them. People's choices were taken in to account and listened to.

We found that the service was responsive to matters that had been brought to their attention. They had communicated well with us and kept us up to date with developments.

Is the service well-led?

We found that the managers in the service were keen to get matters right for people who used the service. They had responded well to incidents that arose in the last 12 months and had learnt from these. We could see that learning had been transferred to others settings within the service.

Managers were visible to staff and people who used the service as they frequently visited the supported living settings. Staff told us that managers were approachable and supportive.

Our overall findings were that this service was safe, effective, caring, responsive and well led. We found that all seven supported living establishments visited were customer focussed, led by managers and staff who were well trained and supported in their roles. Staff were very knowledgeable about the people they supported and responsive to their individual needs. People told us that they felt safe and happy living in their homes. One person using the service said, 'I love it here, love it, love it, I want to stay here for ever'.

People using this service were enabled to lead a fulfilling life. This included going on holiday abroad, day trips to Buckingham Palace followed by afternoon tea at the Ritz or seeing Cliff Richards in concert. We also saw people doing ordinary meaningful tasks such as tidying, weeding the garden, hanging out the washing and making cakes.