Roselawn House

We found the following examples of good practice.

The provider had an infection prevention and control policy (IPC) in place and staff had received IPC training, including how to put on and take off personal protective equipment safely and hand washing.

The visiting arrangements for the service were in line with government guidance. People were also able to keep in touch with family and friends using video and telephone calls.

The home was clean, tidy and hygienic and cleaning and IPC procedures were carried out regularly and in line with best practice.

People and staff were tested for COVID-19 in line with government guidance and all staff had been vaccinated. Staff checked the vaccination status of professionals visiting the home.

The provider kept people and their families informed about COVID-19, government guidance and the arrangements for the home. Staff supported people in the home and in the community to reduce the risk of COVID-19 infection.

We found the following examples of good practice.

• The provider had appropriate arrangements for all visitors to help prevent the spread of Covid 19. They were required to have their temperatures taken, complete a Covid 19 risk assessment which included screening for symptoms of Covid 19 before being allowed to enter the home. Visitors were required to wear a face covering when visiting, and wash hands before and after mask use.

• The provider had appropriate arrangements to test people and staff for Covid 19 and was following government guidance on testing. This ensured that people and staff were tested for Covid 19 so that appropriate action could be taken if any cases were identified.

• The provider ensured that all their staff received appropriate training and support to understand and to manage Covid 19. This included best practice for infection control and the use of PPE.

• Staff also received appropriate guidance on how to support people with learning disabilities to understand the pandemic and Covid 19.

• The provider made appropriate support services available to staff in order to support their mental wellbeing through the pandemic and if they became unwell and when they returned to work.

• The provider made very good provision for people using the service to maintain links with family members, relatives and friends. People were supported to have visits from their relatives and friends in sheltered areas of the garden where two metre social distancing was observed. Visits were staggered and restricted to up to one hour and these areas were cleaned between visits.

• The provider recognised the disproportionate impact of the virus on health and social care workers from black and minority ethnic (BME) backgrounds. In response they have in place a risk assessment process in line with guidance from the Workforce Race Equality Standard. This has enabled BME colleagues to raise concerns and be heard.

At our last inspection in March 2016 we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

The care service had not been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. This was because the service was registered before the guidance was published. However, the service was working towards developing the provision in line with these principles. 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.

People continued to experience person-centred, flexible support. People's care needs were assessed, kept under review and they were fully involved in making decisions about their care and support. Assessments considered whether people had any needs in relation to their disability, sexuality, religion or culture. Staff understood and respected these needs.

Risks to people’s health and well-being were assessed and reviewed when needed. Staff took action to minimise these risks and keep people safe.

Staff knew how to recognise and report any concerns they had about people’s care and welfare and how to protect them from abuse. The provider followed an appropriate recruitment process to employ suitable staff. Staffing was managed flexibly so that people received their care and support when they needed it.

People received the support and care they needed to maintain their health and wellbeing. Referrals were made to other professionals as necessary to help keep them safe and well.

People received their medicines as prescribed although medicines were not always stored and managed in line with best practice guidance. We have made a recommendation concerning medicines management.

Roselawn House continued to be kept clean, well maintained and furnished to comfortable standards. The provider considered and recognised the needs of people with physical and sensory disabilities. People were provided with the necessary equipment to promote their independence and meet their assessed needs.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible.

The service remained responsive to people's individual needs. People were involved in their care planning, and staff respected their choices and promoted their independence. Care plans were updated to reflect any changes and ensure continuity of their care and support.

People's privacy and dignity was respected and upheld by the staff team and people were supported to maintain relationships with those who were important to them.

There were enough staff to support people’s needs and staff worked flexibly to support people with their preferred interests, activities and hobbies. People enjoyed varied social and leisure activities and had opportunities to try new ones.

The home had stable management and leadership. There was an established registered manager who worked alongside the staff team to ensure people received the care and support they needed. Feedback regarding the registered manager was positive from people, their relatives and staff.

People, their families and staff were encouraged to share their views and contribute to developing the service. Any concerns or complaints were acted on and the provider used feedback to improve the service.

The provider had systems in place that continued to be effective in assessing and monitoring the quality of the service provided. Action plans were used to highlight any areas where improvements were required and these were monitored to ensure that changes were made.

Further information is in the detailed findings below

Roselawn House is a care home that provides accommodation and personal care for up to eight people with learning disabilities. There were eight people using the service at the time of our inspection.

There was a registered manager 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.

People enjoyed positive and meaningful interactions with staff which demonstrated people felt comfortable in their presence. Staff treated people with kindness and respect and relatives were complimentary about their caring attitude. People took part in activities they liked or had an interest in. Staff knew what people enjoyed doing and staffing was organised flexibly to support their individual choices.

People were safe because the registered manager and staff understood their responsibilities to report any concerns about people's wellbeing. Staff knew how to recognise and respond to abuse and they followed appropriate procedures. Risks associated with people's care had been identified and staff knew how to manage them.

People’s rights were protected because the provider acted in accordance with the Mental Capacity Act (2005)(MCA). This is legislation that helps to protect people who are not able to consent to their care and support, and ensures people are not unlawfully restricted of their freedom or liberty. The manager and staff understood the requirements and their responsibilities under the MCA. Care plans were agreed with the person or someone close to them and took account of people's rights and independence.

People’s needs were assessed, monitored and reviewed. They experienced responsive care and support that was person centred and appropriate to their needs. Their individual preferences and diverse needs were known and staff supported their choices. Care plans and risk assessments were kept up to date and followed. When staff identified a change in needs, they involved relevant health professionals to ensure the person received appropriate care.

Roselawn House was clean, safely maintained and furnished to comfortable standards. Consideration had been given to the needs of people with physical and sensory disabilities and they were provided with specialist equipment to promote their independence and meet their assessed needs.

People were supported to keep healthy and their nutritional needs and preferences were met. Any changes to their health or wellbeing or accidents and incidents were responded to quickly. Referrals were made to other professionals to help keep them safe and well. Medicines were managed appropriately and people had their medicines at the times they needed them.

The registered manager and staff encouraged people and relatives to share their views and opinions about the service. Relatives were confident they could raise any concerns or issues, and these would be listened to and acted upon.

People received care and support from consistent staff who understood their individual needs. The staff were supported and trained to help them deliver effective care. They had access to key training, and were supported to attend other courses to meet people’s individual needs and enhance their personal development.

The registered manager had established good relationships with people's relatives who told us they felt informed and involved in their family member's care. Staff supported people to maintain relationships with those closest to them.

Staff experienced effective leadership and direction from the registered manager. Various ongoing audits, both internally and externally meant that the quality of care was regularly assessed and evaluated. Where improvements were needed, action was taken.

We observed that staff asked people for consent before any intervention and that staff had been given training when they had to make decisions on the person's behalf.

We found that care was planned in a thorough and individualised way and that staff supported people who used the service to make decisions about their lives.

People who used the service were supported to pursue interests and take part in activities all year round and that they were supported and encouraged to improve their ability to communicate.

We found that staff were appropriately recruited and supported. The provider had ensured that all the necessary checks were made prior to staff beginning their work and that staff were updated regularly on changes in care and areas of development.

We found that the provider had a robust complaints procedure in place and that people who used the service were supported to make complaints if required. We found that the provider kept accurate records of complaints and that staff were notified of the lessons learnt by any comments made by people who used the service or their relatives.