Archived: Rosedene

Rosedene is a residential care home providing accommodation and personal care and support for up to three people who have a learning disability. People using the service are supported to maintain their independence and live a lifestyle of their choice.

The service had a registered manager in post at the time of our inspection. 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.

Medicines were managed appropriately. However, we recommended that medicine receipt records should be signed by two members of staff to confirm the accuracy of the medication received into the home. We recommended, in relation to the handwritten MAR, that two members of staff sign the MAR to confirm the information has been transcribed correctly. This should also include allergy details. In addition where a person uses a patch to administer medicines, staff should sign the MAR twice to confirm removal and application.

There was an appropriate recruitment process was in place, which was overseen by the provider’s Human Resource department. There were enough staff to meet people’s needs. The Learning and Development Manager had responsibility for ensuring staff training and supervisions were kept up to date. When staff training and supervisions were due this was planned for on the staff rota.

Care records and risk assessments were in place for areas such as; travelling in vehicles and accessing the community. These were regularly reviewed and provided guidance to staff on how a person’s needs should be met. The care records evidenced people had accessed to other healthcare professionals when needed.

We saw evidence to show that equipment and appliances were maintained. The provider was fitting window restrictors to all first floor windows and temperature valves on the taps to prevent injury to people who lived at Rosedene. The provider had a redecoration schedule in place to ensure the home was updated over the next year. We found the home was clean and odour free.

People were supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice. Staff were knowledgeable about the MCA. They clearly explained how they supported people to make decisions about their care. Throughout the inspection we observed staff respecting people’s choices including, when to get up and have their breakfast.

Staff respected people’s privacy and dignity. We observed people's independence was promoted, and staff encouraged people to do as much for themselves as they were able. The provider had introduced a ‘bite sized bulletin’ to communicate with people. This was an easy read newsletter which would be published four times a year. It provided information regarding the registered manager, the CQC, how to make a complaint and explained the values of the company. Information regarding how to access advocacy services was displayed in the home.

The provider had a complaints policy and procedure in place. There had been no complaints raised since the last inspection.

Staff felt supported and asked to provide feedback on the service. The provider sought feedback on the quality of the service through questionnaires.

The registered manager had a monthly audit system in place and continued to make improvements to the auditing used within the service. The provider’s business excellence manager carried out quarterly compliance checks in areas such as complaints. A bi-monthly health and safety check was also completed to add further assurance that the service was effectively assessing, monitoring and improving the quality and safety of the service.

Rosedene is a residential care home providing accommodation and personal care and support for up to three people who have a learning disability. People using the service are supported to maintain their independence and life a lifestyle of their choice.

The service had a registered manager in post at the time of our inspection. 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.

During this inspection we looked to see if improvements had been embedded in to practice from our last inspection. We found insufficient progress had been made in some areas. We identified three breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

We looked at the procedures in place for managing medicines within the home and found some concerns. The medication policy in place did not give sufficient information to direct staff in how to store and administer medicines safely.

People were supported by sufficient numbers of staff to meet their needs. The provider had a safe recruitment system in place which involved pre-employment checks being made prior to the person commencing employment.

The staff we spoke with were very knowledgeable on safeguarding and knew how to recognise and report abuse if they needed to.

We looked at support plans belonging to three people and found there were no mental capacity assessments. Staff we spoke with told us that people they supported had capacity to make decisions about day to day life but would require further support with more complex decisions. This was not documents in support plans.

People were supported to have a healthy and nutritious diet which supported their needs. People were encouraged to take part in shopping for food items and meal preparation.

People had access to healthcare professionals when required and routine check-ups with doctors, dentists and opticians were also arranged.

Staff completed training relevant to their role and found the training valuable. Staff we spoke with felt supported by their managers and told us they had regular reflective meetings. These were one to one meetings with their line manager to discuss their work and training requirements.

We spoke with people who used the service and they told us they liked the staff team and felt they supported them well. Throughout the inspection we observed staff supporting people who used the service with consideration and respect. Staff knew people well and respected their likes and dislikes. We spoke with staff about maintaining privacy and dignity.

Prior to people receiving support from the service, an assessment was carried out to ensure the service could meet people’s needs. This information was then used to write support plans. We looked at support plans and found they gave enough detail about people to be able to support them well.

People were supported to maintain an active life and people were involved in a range of social activities of their choice.

The service had a complaints procedure and people who used the service told us they would speak with staff if they had any concerns. They were confident that their worries would be acted on and resolved.

We found some systems were in place to monitor the quality of service provision. However, these were not effective and did not always identify concerns.

We looked at policies and procedures and found that some of them required updating to guide staff in their working practice.

Staff had a good understanding of the needs of people living in the home. They were able to describe different people and what care they required.

People's needs were assessed and care and treatment was planned in line with their individual care plan. We looked at three care records and saw that records recorded information on people's daily routine. They described how people liked to spend their days. One person liked to go out and see the Christmas lights and on the day of the visit was being taken out to see the lights and to have lunch.

All of the staff we spoke to during our visit were familiar with safeguarding procedures. When asked what constituted abuse one member of staff said 'It can be anything, physical or mental'. The staff member said that she had never experienced any abusive behaviour towards people whilst she had been working in the home.

We saw that training records had information on staff attending training in areas such as safeguarding, fire safety, first aid, food safety, infection control, medication and challenging behaviour.

We asked how the provider monitored the quality of the care they delivered. We were told that the provider carried out an annual review with service users. We were shown information on the results of the questionnaire.

The manager said that one of the team leaders carried out unannounced visits to the home to audit staffs interaction with people and to monitor the environment.

We spoke to people who use the service and they told us that they had been included in decisions about what care and support they received and when this would be available. They told us that 'I like living here, it's really good' and 'the staff are lovely, we all decide what meals we have'.

We spoke with two members of staff who were able to demonstrate a good understanding of the needs of the people who lived at Rosedene. They told us that they were well supported by managers of the home and there were good opportunities for training.