Roseneath Avenue

Updated 7 September 2023

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 Health and Social Care Act 2008.

As part of this inspection, we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

This inspection was carried out by 1 inspector, a CQC senior specialist in learning disabilities and autism, a CQC pharmacist and 1 Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service. The Expert by Experience supported the inspection by making telephone calls to relatives of people living at Roseneath Avenue to gain their feedback.

Service and service type

Roseneath Avenue is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Roseneath Avenue is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post. However, at the time of the inspection, the registered manager had been off for a period of time and the inspection was supported by a senior support worker, the operations director and associate director for quality and governance.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with a senior support worker, 4 care staff, the operations director, the associate director for quality and governance sites in the south-east and 3 relatives. We also spoke with 3 people and observed 1 person who was unable to verbally communicate with us. We also used observations to see how people interacted with staff to gain an understanding of their experience of care. We looked at 6 people’s medicines records, 2 people’s care plans and risk assessments, 4 staff files including recruitment, records of accidents and incidents, numerous auditing processes and other documentation related to the running of the home.

Updated 7 September 2023

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.

About the service

Roseneath Avenue is a residential care home providing personal care for up to 6 people living with a learning disability and/or autistic spectrum disorder. At the time of the inspection, there were 6 people living at the home. Each person had a large flat within the home consisting of a bedroom, living and kitchen area and a bathroom and contained everything the person needed to live independently.

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

Right Support:

People were supported by staff to pursue their interests. The service worked with people to plan for when they experienced periods of distress so that their freedoms were restricted only if there was no alternative. Staff did everything they could to avoid restraining people. The service recorded when staff restrained people, and staff learned from those incidents and how they might be avoided or reduced. The service gave people care and support in a safe, clean, well equipped, well-furnished and well-maintained environment that met their needs. Staff supported people to make decisions following best practice in decision-making. Staff communicated with people in ways that met their needs. Staff supported people with their medicines in a way that promoted their independence and achieved the best possible health outcomes. 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. At the time of the inspection, there was a high usage of agency staff. We found concerns around the lack of training and supervision regular agency staff.

Right Care:

Staff had training on how to recognise and report abuse. However, we found some concerns around how safeguarding issues were identified and managed. Whist staff had training around safeguarding, we found safeguarding concerns were not always identified and managed appropriately. People received kind and compassionate care. Staff protected and respected people’s privacy and dignity. They understood and responded to their individual needs. People could communicate with staff and understand information given to them because staff supported them consistently and understood their individual communication needs. People who had individual ways of communicating, using body language, sounds, pictures and symbols could interact comfortably with staff and others involved in their treatment/care and support because staff had the necessary skills to understand them. People’s care, treatment and support plans reflected their range of care and support needs.

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. Staff placed people’s wishes, needs and rights at the heart of everything they did. People and those important to them, including advocates, were involved in planning their care. The service enabled people and those important to them to work with staff to develop the service. Staff valued and acted upon people’s views. People’s quality of life was enhanced by the service’s culture of improvement and inclusivity.

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 21 December 2018)

Why we inspected

The inspection was prompted in part due to concerns received about safeguarding and staffing. A decision was made for us to inspect and examine those risks.

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 COVID-19 and other infection outbreaks effectively.

The overall rating for the service has changed from good to requires improvement based on the findings of this inspection. We have found evidence that the provider needs to make improvements. Please see the safe, effective and well-led sections of this report.

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

Enforcement

We have identified 3 breaches of regulation in relation to managing safeguarding concerns, ensuring regular agency staff were appropriately trained and supported and the governance of the home.

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