Roslyn House

Updated 6 June 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.

Inspection team

The inspection was carried out by 1 adult social care inspector.

Service and service type

Roslyn House 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. Roslyn House 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.

There was a registered manager in post at the time of the inspection. However, the registered manager remained absent from the service. The deputy manager appointed immediately prior to our last inspection remained responsible for the day-to-day management of the service.

Notice of inspection

The service was given 1 hours’ notice of the inspection. This was because it is a small service and people are often out. We gave notice to ensure we would be able to meet both people the service supports during the site visit.

We visited the location on 9 May 2023.

What we did before the inspection

We reviewed the information we had received about the service as part of the planning process.

The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make.

During the inspection

We met and spoke with both people who the service supported, 2 care staff, the deputy managers and the provider. We also spoke by telephone with 1 person’s relative and gathered feedback from 3 health and social care professionals.

We looked at records relating to people’s care and the management of the service. This included 2 care plans and associated risk assessments, medicine administration records (MARs) and staff records.

We also asked the service to send us records relating to the management of the service, quality assurance audits and policy documents. This information was reviewed in detail after the site visit.

Updated 6 June 2023

About the service

Roslyn House is a residential care home providing accommodation and personal care for up to 9 people. At the time of this inspection 2 people were using this service.

The service was not registered as a specialist service for people with a learning disability or autistic people.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability or autistic people. We considered this guidance as there were people using the service who have a learning disability or who are autistic.

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

The deputy manager and provider now have an understanding of the principles of the Right support, right care, right culture guidance and were working towards supporting people to live as independently as possible.

People were now respected and consistently treated with dignity by their support staff. Disrespectful language had been removed from care planning documentation and the importance of use of respectful language had been discussed with all staff. People were now able to withdraw their consent to planned care and monitoring tasks and these decisions were respected by staff and managers.

People were comfortable approaching staff for support and during the inspection chose to spend time chatting with their staff.

Staff had been provided with guidance on how to protect people from identified risks and had provided people with appropriate reminders on road safety when leaving the service independently. We have made a recommendation in relation to how the service supported people to identify and understand risks associated with developing their independence.

The provider now recognised the need for additional staff training on how to support people when upset or anxious. However, this training had not yet been arranged. Where staff had not completed necessary training this had been raised as an issue during supervision meetings.

People received their medicines as prescribed and medicine storage areas were tidy and well organised.

The provider’s recruitment practices had been reviewed and updated to ensure all necessary pre-employment check were completed. No additional staff had been recruited since the last inspection.

People were now regularly supported to access the community and had been offered opportunities to attend religious services. On the day of the inspection both people went to the pub for lunch with staff support and people told us they had particularly enjoyed an event in a local community centre which they hoped to attend again in future.

Complaints and informal concerns had been appropriately investigated by the provider and action taken to resolve these issues. We have made a recommendation in relation to how information is fed back to people to help them understand the actions taken in response to concern raised.

The provider had taken action in response to the issued raised in our previous report and had worked closely with health and social care professionals to improve performance.

The provider’s quality assurance systems had been updated but required further development. Gaps in care monitoring records had not been prevented and action had not yet been taken to address issues in relation to staff skills.

The deputy manager provided effective leadership to the staff team who were complimentary of the support they had received since the last inspection.

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

Rating at last inspection and update

The last rating for this service was Inadequate, (published 6 May 2023).

At this inspection we have found significant improvements have been made and the service has now been rated requires improvement.

This service has been in Special Measures since February 2023. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

Why we inspected

We carried out an unannounced comprehensive inspection of this service on 23 February 2023. Breaches of legal requirements were found in relation to person centred care, risk and medicines management, safeguarding, dignity and respect, governance, and staffing. With support from the local authority the provider developed an action plan detailing what they would do and when to improve.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe, Caring, Responsive and Well-led which contain those requirements.

Enforcement and Recommendations

We have identified an ongoing breach in governance procedures and have made recommendations in relation to risk management and complaints handling.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request a further 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.