Rosehill

Rosehill is a residential service providing personal care for up to 6 people with a learning disability. At the time of the inspection there were 6 people living at the service.

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 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.

Right Support

People were supported to have maximum possible choice, control and independence. Staff supported people to make decisions following best practice in decision-making. The management team clearly had an in-depth knowledge around capacity assessments and 'best interests' decisions. Staff communicated with people in ways that met their needs. Staff focused on people’s strengths and promoted what they could do, so people had a fulfilling and meaningful everyday life. Staff supported people to achieve their aspirations and goals. People were supported safely with medicines. Infection prevention and control practices reflected current guidance.

Right Care

People received kind and compassionate care. Staff protected and respected people’s privacy and dignity. They understood and responded to people’s individual needs. Staff understood how to protect people from poor care and abuse. Staff had training on how to recognise and report abuse and they knew how to apply it. The service had enough appropriately skilled staff to meet people’s needs and keep them safe. The service worked well with other agencies to do so. People’s care, treatment and support plans reflected their range of needs, and this promoted their wellbeing and enjoyment of life.

Right culture

People were supported by staff who understood best practice in relation to the wide range of strengths, impairments or sensitivities people with a learning disability and/or autistic people may have. This meant people received compassionate and empowering care that was tailored to their needs. Staff placed people’s wishes, needs and rights at the heart of everything they did. Staff were aware of and were working to best practice guidance for supporting people with a learning disability and/or autistic people.

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

Rating at last inspection

The last rating for this service was good (published 20 April 2018).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

This report only covers our findings in relation to the key questions safe and well-led. 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 remains good based on the findings of this inspection.

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

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Rosehill is a 'care home'. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Rosehill accommodates up to six people with a learning disability and/or autistic spectrum disorder. The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen. At the time of our inspection there were six people living at the service.

A registered manager was in place at the time of our inspection. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

We last inspected this service on 3 September 2015 when it was rated 'Good' overall. Without exception previous CQC inspections have found the service to be compliant with our regulations. During this inspection we found the service remained good and met all the fundamental standards we inspected against.

People were cared for by staff who knew them well and understood how to support them and maximise their potential. The service's visions and values promoted people's rights to make choices and live a dignified and fulfilled life. This was reflected in the care and support that people received. Staff understood people's different ways of communicating and how to make people feel valued. They supported people to make decisions for themselves and spoke with people about their wishes and preferences. People were listened to and their voice was heard.

We found staff were committed to delivering a service which improved the lives of the people who use the service in fulfilling and creative ways. We found that the manager had encouraged staff to constantly think about improvements. We found that the management style had led to people who use the service and staff feeling that they were an integral and essential partner in the operation and enhancement of the service.

Staff were devoted to ensuring each individual found their lives were enriched. We found staff empowered people to voice their wants and aspirations for their lives and then supported them to achieve these goals.

Relatives described the care at Rosehill as ‘a brilliant home.’ Relatives told us how the service had made a huge impact on their family members by enabling them to lead full and rewarding lives. Staff did not view the complex needs of the people who used the service as a barrier to them participating in similar activities to those of their peers. People had been supported to explore and engage in an extensive range of activities.

People had made use of the SMART (specific, measurable, achievable, realistic and timely) target system. These targets were a way of setting goals for people to work towards in areas that really mattered to them and which improved their quality of life. Staff also used a wide range of communications techniques such as pictures or the PECs system, Makaton and signs to enable people to discuss their ideas and as indicators that people were not enjoying themselves. The strong focus on person-centred care had an extremely positive impact on people. Staff were innovative at responding to changes in people's needs and identifying new support strategies for people.

Care records showed that people’s needs were assessed before they started using the service and comprehensive support plans were written, which ensured the support provided met people’s needs. Risk assessments about people's individual care needs were in place, for example in relation to epilepsy and emotional distress. Measures were identified that would minimise the risks identified and these were set out in people's care plans.

Staff had adopted a positive approach to risk management and did not unduly restrict people in the activities they engaged in. This had clearly led to people being able to tolerate transitions and change to the point whereby they enjoyed a fulfilling and fun-filled life.

Staff received regular supervision and they had annual appraisals. Staff were respected within the organisation and were provided with comprehensive training including specialist training. Staff were attended specialist accredited training around working with people who live with a learning disability or Autism Spectrum disorders. There were enough staff on duty to meet people's needs.

People were supported to have enough to eat and drink and attend appointments with healthcare professionals.

We found staff had an understanding of safeguarding and how to whistle blow. The manager was aware of risks within the service and was undertaking an analysis of risks.

The provider had an effective recruitment and selection procedure in place and carried out relevant vetting checks when they employed staff. People who used the service were able to share their opinion on potential recruits and this had led to effective selection of appropriate employees.

The home was clean, spacious and suitable for the people who used the service and appropriate health and safety checks had been carried out.

There were appropriate systems in place to record and respond to complaints. Relatives we spoke with said they had not needed to complain and felt any concerns would be dealt with correctly.

Relatives felt the service was well managed. Staff described the registered manager as approachable and the service as well-led. The provider had an effective quality assurance process in place. People who used the service, family members and staff were regularly consulted about the quality of the service via meetings and surveys.

We spoke to two members of staff who spoke positively and without prompt regarding local management, training and working conditions. We observed four members of staff interacting with people and found that they had formed positive and supportive relationships with people. We also spoke to two people who lived there and found that they received individualised care that enhanced their quality of life and enabled them to take part in activities important to them.

We reviewed the comments and complaints file and noted that there were no ongoing complaints.

People were out during the day at college or activities. A relative we spoke with told us 'he's out all of the time at discos, rock climbing of the pub'.

A member of staff we spoke with told us 'I love working here, the lads are great we go out and do things all of the time'.