Archived: Rosebank Lodge

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 13 adults aged between 30 and 65 with mild to severe learning disabilities or autistic spectrum disorder lived at the care home.

The care home is larger than current best practice guidance suggests for residential services for people with learning disabilities or autistic spectrum disorder.

However, this has not had a negative impact on the people living there. This is because the service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence.

People’s experience of using this service

We found no evidence during this inspection that people were at risk of harm following two recent safeguarding incidents described below. This was because the provider had taken appropriate action to mitigate the risks associated with them.

People were protected against the risk of avoidable harm and abuse by staff who knew how to keep them safe. People told us they were happy with the care and support they received at Rosebank Lodge and felt safe living there. Staff managed potential risks people might face in a positive way that protected their dignity and rights. The provider deployed sufficient numbers of suitably vetted staff in the care home to keep people safe. People received their prescribed medicines when they should. People were protected against the risk of cross contamination as the provider had clear infection control measures in place.

The service was consistently well-led. The culture the providers had created promoted high-quality, person-centred care. People spoke positively about the managers. There were clear management structures in place and managers were visibly present in the care home. The provider had effective systems in place to assess and monitor the quality and safety of the service people received and learn lessons when things went wrong. Managers also sought the views of people living in the care home, their relatives and staff, and worked in close partnership with other external bodies and professionals. This all helped drive improvement.

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

Rating at the last inspection

The last rating for this service was Good (published 15 December 2018).

Why we inspected

This focused inspection was prompted in part by recent notifications we received about safeguarding incidents involving two people using the service. One incident is currently subject to a criminal investigation by the police, while the other is subject to a local authority safeguarding enquiry. As a result, this inspection did not examine the circumstances of either of these incidents, but did examine the risks associated with the Key Questions, Is the service Safe and Well-led?

No areas of concern were identified in respect of the other three Key Questions, ‘Is the service effective, caring and responsive?’. We therefore did not inspect them. Ratings from the previous comprehensive inspection for those Key Questions were used in calculating the overall rating at this inspection.

The overall rating for the service remains good. This is based on the findings at this inspection. Please see the Key Questions of Safe and Well-led sections of this full report.

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.

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.

A registered manager was in post who was present on both days of the 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.

This was a planned inspection based on the rating at the last inspection in July 2016 when we rated the service Good overall. At this inspection we found the evidence continued to support the rating of Good. There was no evidence or information from our inspection and ongoing monitoring that demonstrated any 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 was operated 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.

People were protected from avoidable harm, discrimination and abuse. Risks associated with people’s needs were assessed, planned for and monitored for any changes. There were sufficient staff to meet people’s needs and safe staff recruitment procedures were used.

People received their prescribed medicines safely and these were managed in line with good practice guidance.

Staff received the training and support they required including specialist training to meet people’s individual needs. People were supported with their nutritional needs. Staff identified when people required further support with eating and drinking and took appropriate action. The staff worked well with external health care professionals and helped people access health services as required.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. The principles of the Mental Capacity Act (MCA) were followed.

People received care from staff who treated them with dignity and respected their privacy. Staff had developed positive relationships with the people they supported. They understood how people communicated, their preferences, and what was important to them. Staff knew how to respond to people when they were distressed, working positively with external health and social care professionals when required.

People’s needs were assessed and planned for. Support plans were detailed, up to date and staff knew and understood people’s needs well. People were being offered improved opportunities to pursue their interests and hobbies with a renewed focus on quality of life. There was a complaints procedure and action was taken to learn and improve where this was possible.

The registered manager was committed to providing high quality person centred care and support. This ethos was central to how the service operated. There was an open and transparent and person-centred culture with good leadership evident. A newly appointed deputy manager had recently strengthened the management team

Further information is in the detailed findings below

Rosebank Lodge is a care home that provides accommodation and personal care for up to 13 people who have physical disabilities, some of whom also have learning disabilities. At the time of our visit there were 13 people living at Rosebank Lodge. The service provides a range of accommodation for people including studio type accommodation. Historically this has resulted in a range of people being admitted to the service, some people were independent in meeting their needs, whilst others require one to one support. The registered manager told us there was a longer term strategy to support those people who were more independent to move onto other services.

The service had a registered manager in post. 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 we spoke with were generally positive about the service, although we did receive some comments from people who felt it could have been better. We also completed an observation during lunchtime and noted staff could have been more caring when supporting people. We raised this with the registered manager who agreed there were shortfalls and agreed to review what had happened over lunchtime. Our observations of the evening meal showed a much calmer and congenial atmosphere.

Staff we spoke with were knowledgeable about what they needed to do if they suspected someone was at risk of harm. The provider had recruitment systems in place to make sure only suitable people were employed by the service.

Staff were well informed about people’s individual preferences. People were encouraged to make choices about how care was provided and to be as independent as possible. The provider trained staff so they could support people in line with their needs and best practice. Staff also received on-going support through team and one to one meetings so information was readily shared in the interests of people who used the service.

We saw the home provided care that met people’s diverse needs. People were able to choose a range of activities either in the community or within the home. Staffing levels were sufficient to meet people’s needs. People were encouraged to maintain links with their relatives.

Staff had a knowledge and understanding of the Mental Capacity Act 2005. The Act helps to ensure that people who were unable to make decisions for themselves are legally protected. The provider had trained staff so they had the knowledge to work within the remit of the Act. People were asked for their consent prior to care being provided.

People were supported to access appropriate healthcare services as and when they needed them. They were encouraged to eat and drink sufficient amounts to meet their needs. People received their medicines as they had been prescribed.

The provider had a clear process for recording and monitoring accidents and incidents. They ensured these were analysed and where patterns were identified action taken to minimise future incidents. Information in people’s care records was up to date and regularly reviewed.

People told us the registered manager was open and transparent. People were given a variety of ways to comment on the service which included anonymous questionnaires or making formal complaints. They told us they were confident that issues would be taken seriously and addressed.