La Rosa 2

Updated 22 December 2021

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

As part of this inspection we also looked at the provider’s infection control arrangements, so we could understand the preparedness of the service in preventing or managing an infection outbreak.

Inspection team

The inspection was carried out by one inspector.

Service and service type

La Rosa 2 is a 'care home'. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.

The service did not have a manager registered with the CQC. The registered provider is legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was carried out over two-days on 16 and 23 November 2021. The first day was unannounced.

What we did before the inspection

The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.

We reviewed all the key information providers are required to send us about their service. This information helps support and plan our inspections.

During the inspection

We spoke in-person with four people who lived at the care home, the owner and three support workers, including a senior team leader.

We also looked at a range of records that included four people’s care plans, four staff files in relation to their recruitment, training and supervision, and multiple medication administration record (MAR) sheets. A variety of other records relating to the overall management of the service, including policies and procedures were also read.

Following the inspection

We received email feedback about the care home from a local authority social worker.

We continued to seek clarification from the provider to validate evidence found. We requested the provider send us additional evidence after our inspection, which they did, in relation to staff medicines and infection prevention and control (IPC) training, their IPC and COVID-19 policies and procedures, and various health and safety certificates.

Updated 22 December 2021

About the service

La Rosa 2 is a residential care home providing accommodation and personal care for up to six younger and older males with mental health care needs. At the time of our inspection the service was supporting six people in one adapted building. Half the people currently residing at the care home were also living with dementia.

People’s experience of using this service

People living at the care home were not always kept safe and had been placed at risk of avoidable harm. This was because the way the provider assessed, monitored and managed risks associated with the care home’s environment, fire safety, medicines and infection prevention and control (IPC) systems was not effective. The provider needs to take action to improve the service and repair all the faulty fire resistant doors, risk assess and cover radiators, check the buildings electrical wiring/installations, store medicines safely and ensure staff follow best IPC and COVID-19 practices.

The service was not consistently well-led, which also placed people at risk of harm. This was because a suitably competent person had not been registered with the CQC, the provider was not clear about their regulatory requirements to report incidents to us and their oversight and scrutiny systems were not operated effectively. The provider needs to take action to ensure a suitably competent person is appointed and registered by us to manage the service. They must notify us without delay about any safeguarding incidents involving people living at the care home and use their established governance audits more effectively to help them identify and take appropriate action to improve La Rosa 2.

People lived in a suitably adapted care home however, the care home’s environment was not appropriately maintained. Improvements are required and the provider agreed at the time of our inspection to resolve all the environmental maintenance issues described above by the end of 2021.

People told us they were happy with the standard of care and support provided at this care home.

People were protected against abuse and neglect. People were cared for and supported by staff who knew how to manage risks they might face. The service was adequately staffed by people whose suitability and fitness to work in an adult social care setting had been properly assessed.

People received good care from staff who had the right levels of training and support to deliver it. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests. People were supported to access food and drink that met their dietary needs and wishes. People were supported to stay healthy and access community mental health and social care professionals as and when required.

People were treated equally and had their human rights and diversity respected. Staff treated people with respect and dignity and upheld their right to privacy. People were supported to maintain and develop their independent living skills. People were encouraged to make decisions about the care and support they received and had their choices respected.

Up to date, person centred, electronic care plans were in place for everyone who lived at the care home, which helped staff meet their personal, emotional, health and social care needs. Staff ensured they communicated and shared information with people in a way people could easily understand. People were supported to participate in meaningful recreational and leisure activities that reflected their social interests. People were supported to maintain relationships with family and friends. People’s concerns and complaints were listened to and investigated by the provider. Plans were in place to help people nearing the end of their life receive compassionate palliative care in accordance with their needs and wishes.

The provider promoted an open and inclusive culture which sought the views of people living in the care home, their relatives, community health and social care professionals and staff working there. The provider worked in close partnership with various community mental health and social care professionals and agencies to plan and deliver people’s packages of care and support.

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

Rating at the last inspection

This service has a new legal entity and was reregistered with us on 30th June 2020. This is their first inspection since reregistering with us. The last rating for the service under the previous provider was good (published 14 July 2017).

At this inspection we found multiple breaches of regulations and the need for this provider to make improvements. Based on the findings at this inspection the overall rating for the service is requires improvement.

Why we inspected

This was a planned comprehensive inspection based on the service having a new legal entity and reregistering with us.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified two breaches at this inspection because the provider had failed to ensure risks associated with fire safety, medicines and IPC arrangements were always safely managed, and their oversight and scrutiny systems were effectively operated.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.