Rosebank Lodge

Rosebank Lodge is a residential ‘care home’ providing personal care and support to up to 13 people. The service provides support to people with learning disabilities and autistic people. At the time of our inspection there were 9 people living at the care home. The care home accommodates people in 1 adapted building.

A person who lived at the care home in their own self-contained accommodation did not receive any personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

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

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. 'Right support, right care, right culture' is the guidance Care Quality Commission (CQC) follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

The service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture.

Right Support

People received a service that was safe for them to live in and for staff to work. The service quality was reviewed regularly, and appropriate changes made to improve people’s care and support if required. This was in a way that suited people best. The care home had well-established working partnerships that promoted people’s participation and reduced the danger of social isolation.

Right Care

Staff were appropriately recruited and trained and there were enough of them to support people to live in a safe way, whilst enjoying their lives. Risks to people and staff were assessed, monitored, and reviewed. Complaints, concerns, accidents, incidents and safeguarding issues were appropriately reported, investigated, and recorded. Staff were trained staff to safely administer people’s medicines.

Right culture

The care home’s culture was positive, open, and honest, with leadership and management that was clearly identifiable and transparent. Staff were aware of and followed the provider’s vision and values which were clearly defined. Staff knew their responsibilities, accountability and were happy to take responsibility and report any concerns they may have.

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; the policies and systems in the service supported this practice.

The feedback we received from various community health and social care professionals was positive about the standard of care provided at Rosebank Lodge. For example, a community care professional told us, “My clients are very well cared for at Rosebank Lodge and enjoy living there.”

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

Rating at last inspection and update

This service has been in Special Measures since 15 November 2022 when we rated them Inadequate overall. During this inspection, the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

Why we inspected

We conducted an unannounced inspection of this service on 15 November 2022. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to comply with the Warning Notices and outstanding requirements we previously served in relation to Regulations 11 (Need to consent), 13 (Safeguarding service users from abuse) and 17 (Good governance) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014; and, Regulation 18 (Registration) Regulations 2009 - Notifications of other incidents.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the key questions safe and well-led which contain those requirements.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from inadequate to requires improvement. This is based on the findings at this inspection.

We could not improve the rating from inadequate to good though because to do so requires consistent good practice over time. We will check this during our next planned inspection of the service.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID19 and other infection outbreaks effectively.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Rosebank Lodge on our website at www.cqc.org.uk.

Follow up

We will collaborate with the provider to monitor how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

About the service

Rosebank Lodge is a residential care home. It was registered to accommodate and provide personal care and support to 13 people with learning disabilities or autistic spectrum disorder. At the time of our inspection 10 adults aged between 30 and 65 with mild to severe learning disabilities or autistic spectrum disorder lived at the care home.

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

Right Support

Staff did not support people to have the maximum control over their own lives. Staff did not do everything they could to avoid restraining people. The service failed to record when staff restrained people, and staff did not learn from those incidents and how they might be avoided or reduced. Governance processes were not always effective in providing good quality care and support.

Right Care

Staff did not always understand how to protect people from poor care and abuse. Staff had training on how to recognise and report abuse, however, did not always apply it. Staff spoke positively about the people they supported.

Right culture

People experienced harm because of a lack of protection, they experienced or were at risk of abuse, including unnecessary restraint, segregation and seclusion. The service had a closed culture whereby people were not supported to live safely and free from unwarranted restrictions because the service failed to adequately assess, monitor and manage safety well. Staff did not respect people’s rights. There is a lack of visible leadership, staff were reluctant to report incidents, and management failed to act on known issues.

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

Why we inspected

The inspection was prompted in part due to concerns received about people being unlawfully deprived of their liberty. A decision was made for us to inspect and examine those risks

We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

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 monitor the service.

We have identified breaches in relation to people’s need to consent, safeguarding service users from abuse and improper treatment, good governance and notification of other Incidents at this inspection.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe. And there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it. And it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.

Rosebank Lodge is a residential care home. It was registered to accommodate and provide personal care and support to 13 people with learning disabilities or autistic spectrum disorder. At the time of our inspection 10 adults aged between 30 and 65 with mild to severe learning disabilities or autistic spectrum disorder lived at the care home.

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

We have made a recommendation in relation to the provider’s responsibilities under the duty of candour.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence, and good access to local communities that most people take for granted. Right Support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people. The service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture.

People were encouraged and supported to make decisions about the care they received. The service placed importance on ensuring people-maintained relationships that were important to them and to harness skills to enhance their independence. People told us they liked living at the service and staff treated them well.

People were protected against identified risks as they received support from staff who knew how to keep them safe. Staff were aware of the provider’s safeguarding procedures and were confident to whistleblow should this be required. There were sufficient numbers of staff deployed to keep people safe. Medicines were managed safely and people received these as intended by the prescribing G.P. The provider had effective infection control procedures in place, including those in relation to COVID-19.

People received support from staff who underwent training to meet their needs. People’s specific dietary requirements were catered for. People’s health and well-being was continually monitored through joint working with external healthcare professionals. 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; the policies and systems in the service supported this practice.

People were supported by staff that treated them with compassion, kindness and respect. We observed staff laughing and joking with people and there was a warm and friendly atmosphere.

People were encouraged to participate in activities that met their social needs and preferences. People’s needs were regularly assessed, and records detailed their wishes. A complaints system in place ensured complaints were managed swiftly and in line with the provider’s complaints policy.

The management of the service was focused on enhancing people’s lives through meaningful interactions and opportunities. People received support from a service that was inclusive and worked in partnership with stakeholders. Staff confirmed the management team were supportive and open to ideas. People were encouraged to share their views wherever possible.

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

Rating at last inspection

The last rating for the service under the previous provider was good, published on 30 December 2017.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.