Background to this inspection
Updated
3 November 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 Health and Social Care Act 2008.
This was a targeted inspection to check whether the provider had met the requirements of the Warning Notice and requirement notice in relation to Regulation 12 (Safe Care and Treatment), Regulation 15 (Premises and Equipment) and Regulation 17 (Good Governance) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 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
This inspection was undertaken by one inspector.
Service and service type
Rosswood Gardens 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. Rosswood Gardens 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 not a registered manager in post.
Notice of inspection
This inspection was unannounced.
What we did before the inspection
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. Prior to the inspection we reviewed the information we held about the service, including information from the provider about key events that occurred. We used all of this information to plan our inspection.
During the inspection
We spoke with three people who use the service. We undertook general observations of the safety and suitability of the environment. We spoke with four staff members, including the operations manager, the manager, a senior care worker and a care worker. We reviewed records relating to the management of the service.
Updated
3 November 2022
About the service
Rosswood Gardens is a residential care home providing personal care to 10 people. The service can support up to 16 people. People using this service have a learning disability and/or autism. Rosswood Gardens is comprised of three adjoining properties.
People’s experience of using this service and what we found
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.
Right Support
The service did not provide people with care and support in a safe, clean, well equipped, well-furnished and well-maintained environment that met their sensory and physical needs. People did not benefit from an interactive and stimulating environment.
People were encouraged to be as independent as possible and had choice and control over how they were supported.
The service made reasonable adjustments for people so they could be fully involved in discussions about how they received support, including support in the community.
Staff enabled people to access specialist health and social care support in the community.
Staff supported people to make decisions following best practice in decision-making. Staff communicated with people in ways that met their needs.
Right Care
Staff did not appropriately assess risks people might face, including risks associated with the environment and access to items that may cause harm to people.
People’s care and support plans did not always reflect their range of needs and promote their wellbeing and enjoyment of life.
People received kind and compassionate care. Staff protected and respected people’s privacy and dignity. They understood and responded to people’s individual needs.
Staff understood how to protect people from poor care and abuse. The service worked well with other agencies to do so. Staff had training on how to recognise and report abuse and they knew how to apply it.
People who had individual ways of communicating, using body language, sounds, Makaton (a form of sign language), pictures and symbols could interact comfortably with staff and others involved in their care and support because staff had the necessary skills to understand them.
Right culture
Staff did not effectively evaluate the quality of support provided to people to ensure continuous improvement. The service did not have a culture of improvement and did not make timely improvements to enhance people’s quality of life.
People and those important to them were involved in planning their care. Staff asked people, their families and other professionals for their views about the service.
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 requires improvement (published 20 May 2021) and there were breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found that all of the improvements required had not been made and the provider continued to be in breach of regulations. The service remains rated requires improvement. This service has been rated requires improvement for the last two consecutive inspections.
Why we inspected
We undertook this focused inspection to check they had followed their action plan and to check whether they were now meeting legal requirements. We also assessed whether the service was applying the principles of Right support, right care, right culture. This report only covers our findings in relation to the Key Questions safe, effective and well-led which contain those requirements.
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. This included checking the provider was meeting COVID-19 vaccination requirements.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service remains requires improvement. This is based on the findings at this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Rosswood Gardens on our website at www.cqc.org.uk.
Enforcement
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 safe care and treatment, the premises and good governance at this inspection.
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 meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. 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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.