Roseleigh

Updated 28 June 2022

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 Care Act 2014.

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

Two inspectors carried out the inspection. Following the first day of our inspection an Expert by Experience contacted relatives to gain their views of the service their loved ones received. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Roseleigh 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. Roseleigh is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

The inspection was unannounced.

Inspection activity started on 27 April and finished on 28 April 2022. We visited the service on both dates.

What we did before inspection

We reviewed information we had received about the service since the last inspection. This included safeguarding information and statutory notifications. Statutory notifications are information about important events which the provider is required to send us by law.

This information helps support our inspections. We used all of this information to plan our inspection.

The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.

During the inspection

We were unable to speak with people in real length throughout our inspection visits to gain their views as they had limited speech. Instead, we observed their body language, interactions with staff and viewed things they wanted to show us which were important to them. We spoke with three members of staff including the registered manager. We spoke with five relatives about their experience of the care provided to their loved ones.

We reviewed a range of records. This included three people’s care records and two people’s medication records. We looked at three staff files in relation to recruitment and training records. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at training data, support plan information and quality assurance records.

Updated 28 June 2022

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

Roseleigh provides accommodation and personal care to six people some who have a learning disability and physical needs. At the time of our inspection six people were receiving care and support.

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

Although risks to people had been identified, management had not always considered people’s individual needs and as a result there had been situations when one person was harmed due to two people being left alone together. In addition, one to one support was not always consistently provided meaning there was a potential for accidents and incidents to occur.

Staff were not deployed in an organised way and this resulted in people not always receiving the support they required. There was also a potential risk to people due to a lack of staff at night-time. Although the registered manager told us an additional staff member was being recruited, this had not yet happened.

People were not always supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support best practice. People’s communication needs were not always supported to enable people to be more involved in planning their care

The service was not always able to demonstrate how they were meeting some of the underpinning principles of right support, right care, right culture.

Right Support: The model of care did not always support people’s choice, control and independence. Although people were able to make their own decisions around their care and how they spent their time, some potentially restrictive practices were taking place without staff following the principles of the Mental Capacity Act 2005. Although people were encouraged to participate and learn daily living tasks in order to boost their independence, information was not always provided to people in a way they could understand.

Right Care: People’s care was person-centred and promoted people’s dignity and privacy. Staff showed regard for people’s comfort and they treated people with kindness. People had access to healthcare professionals and were supported by staff to attend appointments.

Right culture: There were positive values and attitudes of the management team and good relationships had been developed with the loved ones of those they cared for. This helped staff to provide personalised care.

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.

People lived in an environment that was personalised for them and they were provided with support from staff who had been trained appropriately.

Lessons were learnt from incidents and accidents which helped to keep people safe. Where concerns regarding medicines management were identified measures were taken and the issues addressed. Safeguarding concerns were taken seriously, reported and investigated in line with the guidance.

People, relatives and staff were given the opportunity to contribute towards the running of the service, through in-house meetings and surveys. The registered manager was open and honest with relatives and staff and demonstrated a good understanding of duty of candour; always apologising when things went wrong.

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

Rating at last inspection

This was the first inspection since the service registered with us on 9 May 2019. This is an established service which registered under a new provider on this date.

Why we inspected

We carried out this inspection as it was the first inspection of this service since the change of provider in 2019.

Enforcement and Recommendations

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified breaches in relation to people’s safe care and treatment, the mental capacity act, staffing and governance. Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

We will ask the registered provider for an action plan, telling us how they plan to make improvements to their service to demonstrated they can achieve a good rating. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.