Rowandale

Rowandale is a care home providing personal care and accommodation for up to 11 people with a learning disability and/or physical disabilities. At the time of inspection there were 11 people living in the home.

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

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 using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them

The service was a large home, bigger than most domestic style properties. It was registered to support 11 people. 11 people were using the service. This is larger than current best practice guidance. There were two communal areas a sensory room situated just off the large lounge/dining room. This room was also a route through to other rooms. The service had tried to mitigate the impact of this on people. For one person who found it too busy, a separate lounge area had been created. People's bedrooms were spacious and reflected their taste and preferences. People had busy lives which reduced the amount of time they spent in the home.

People living at Rowandale continued to receive an exceptionally person-centred service. The provider went above and beyond to understand and respond to people's needs and preferences. Using total communication techniques, they had supported people's ability to express themselves and included their wishes in care planning and activities. People were engaged in a broad range of meaningful activities which improved their quality of life.

People continued to be safe and protected from the risk of abuse and avoidable harm. Comprehensive risk assessments followed best practice guidance and included positive risk taking to optimise people's opportunities to engage in activities.

The provider followed their robust recruitment procedure which ensured all staff had been safely employed. Induction training was thorough and the training for staff was up to date which meant they could provide effective care.

People's needs had been thoroughly assessed and their care plans included input from families and community-based professionals. People's health needs were identified, and they were supported to maintain regular appointments and screening.

People were supported to eat and drink, the service employed a speech and language therapist (swallowing) who provided specialist advice for people needing modified diets. Dieticians were involved when required for people who were nutritionally at risk.

The provider were compliant with the requirements of the Mental Capacity Act 2005 and associated Deprivation of Liberty Safeguards. People had been supported to make decisions in line with the best interest process in the Act.

Staff were observed to be kind and caring throughout the inspection. People were supported respectfully in ways that upheld their dignity. Excellent communication strategies ensured people had been supported to express their views.

The service was well led by a committed management team who continued to maintain high-quality, person-centred care, by leading by example and using effective checks and audits of care provided. Good communication at handovers, team meetings and one to one meetings ensured the team were well supported and informed.

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

Rating at last inspection:

At the last inspection the service was rated as outstanding in the Responsive domain and good in the other four domains. This meant the service was rated as Good overall.

Why we inspected:

This was a planned comprehensive inspection.

Follow up:

We will continue to review information we receive about the service until we return to visit as part of our re-inspection programme. If any concerning information is received, we may inspect sooner.

Rowandale is a residential care home registered to provide care for up to 11 young adults who have a learning disability. All facilities in the home were provided on one level. There was a large lounge and dining area and all of the bedrooms for people who used the service were of single occupancy. At the time of the inspection there were 11 people living in the home.

The service had a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

At the last inspection on 23 March 2014, we found the service was meeting the regulations that were applicable at the time.

During this inspection we found the service was meeting the requirements of the current legislation.

Staff and the registered manager were aware of the appropriate procedure to take if abuse was suspected. Staff demonstrated their understanding of the types and signs of abuse.

Relatives of people living in the home told us their family members were safe and they had no concerns. We saw positive meaningful relationships had been developed between people who used the service and the staff. People were seen reacting positively to staff, smiling and laughing in their presence.

Duty rotas demonstrated that there was enough staff on each shift to enable them to meet people’s individual needs. During our inspection we observed sufficient numbers of suitably qualified staff delivering people’s care in a timely and unrushed manner.

Medicines were safely administered, recorded and stored. We saw records had been completed in full and where gaps had been identified, notes confirmed the actions that the staff had taken as a result of these.

Staff files confirmed that staff were safely recruited to work in the home. We saw evidence of appropriate checks taking place. Staff had received regular up to date training that was relevant to their role. Staff confirmed they received all mandatory training along with a nationally recognised qualification. Supervision records had been completed. Staff confirmed regular supervision was taking place and felt supported by the registered manager.

The CQC is required by law to monitor the operation of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) and to report on what we find. The registered manager and staff were aware of their responsibilities in relation to MCA and DoLS. Referrals had been submitted to the relevant assessing authority. This would prevent people from being deprived of their liberty unlawfully.

Staff delivered care to people ensuring their privacy and dignity was maintained at all times. Where it was clear people required support, staff communicated with them using appropriate methods of communication for their individual needs. It was apparent that there were positive respectful relationships between people who used the service and the staff.

Relatives and professionals told us people’s experiences of care was exceptional. Staff demonstrated that they clearly understood people’s individual needs and the care they delivered was person centred. Staff were observed providing excellent personalised care. It was evident staff understood people’s needs thoroughly. People who used the service were seen laughing and smiling and reacting positively to all if the staff team.

There was an exceptional programme of activities in place for people. These were tailored around people’s likes, choices and abilities. Relatives told us they were delighted with the full programme of stimulating and fulfilling activities on offer. There was a dedicated activity team who ensured all activities were regularly reviewed and monitored to ensure people were enjoying them.

Complaints were dealt with effectively in the home. Records demonstrated the investigation that had been completed along with any actions that had been taken as a result of the investigation. All people we spoke with told us they had no complaints and felt confident any concern they raised would be dealt with swiftly and appropriately.

Care files contained up to date care plans and detailed people’s individual needs and the support they required. Relatives confirmed the home ensured they were involved in the development and reviews of care plans.

Leadership and oversight in the home was exceptional. All people we spoke with held the registered in high regard and demonstrated her passion for the work that she did. Evidence of innovation engaging people who used the service and staff in the running of the home were identified.

Regular audits were undertaken and included agreed actions as a result of these.

The provider had been awarded a gold award from Investors in People. This award recognises the quality of the service which is performing at a very high level.

We spoke with some close relatives of people who lived at the home and received some very positive feedback. People described staff in ways such as, 'kind', 'caring', and 'professional' and spoke highly of managers. People felt their loved ones received an excellent standard of care and expressed satisfaction with all aspects of the service.

During this inspection we looked at standards relating to care, welfare and medicines management. We also assessed arrangements for staff recruitment and training and assessed how the provider monitored standards.

We found that the service was compliant with the majority of areas we inspected. However, we identified some concerns in relation to the management of people's medication. We have asked the provider to make improvements and will be carrying out further checks to ensure the improvements are made.