We carried out a review of the data available to us about Rosewood on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Rosewood, you can give feedback on this service.
We found the following examples of good practice.
Prior to entering the service all visitors not subject to any other regular testing programme did a COVID-19 rapid test, a temperature check, health questionnaire and wearing personal protective equipment (PPE). Staff had enough supply of the correct PPE, they used this as detailed in guidance including putting it on and taking it off correctly.
Where people needed visits, these were pre-booked and facilitated for a limited period of time. People could also go for a walk in local parks and other outdoor areas when it was safe. Other means of staying in touch with relatives and friends included the use of social media, phone calls, e-mails and photographs.
People were supported with their wellbeing with news items, pictures, visits from relatives and additional hobbies or interests. The registered manager supported staff with regular briefings and wellbeing sessions.
Staff understood the principles of zoning and how people could be cared for away from others including for laundry and washing facilities. There was a cleaning programme in place with deep cleans and frequent disinfecting and sanitising of frequently touched items.
The provider had contingency plans in place to manage any potential future virus or infection outbreak and arrangements for people leaving or returning to the service. Staff could work in individual groups and support people until they were safe to return to communal areas within the home. Only these groups of staff would support a person if there were any infection outbreaks.
The care service has been developed and designed 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
Rosewood is registered to accommodate up to six people with physical disabilities and learning disabilities who may also have an autistic spectrum disorder. The accommodation is on one floor and has six single bedrooms with en suite facilities.
At our last inspection on 15 January 2016 we rated the service ‘Good’. However, we asked the provider to take action to make improvements in relation to the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS) and this action has been completed.
At this comprehensive inspection we found that improvements had been made. Mental capacity assessments had been completed and DoLS applications made where appropriate. Information was recorded in people’s support plans in relation to best interest decisions.
At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the home has not changed since our last inspection.
This inspection was completed on 12 June 2018 and there were six people living in the home at the time of the inspection.
A registered manager was 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.
The registered manager was not available as they were on leave on the day of the inspection. The provider had ensured that there was another manager supporting the people living in the home and the staff. The manager in Rosewood understood their responsibilities in relation to notifying CQC of certain events that happened at the service.
The service was safe because potential risks to people had been recognised and information on how to minimise risks had been recorded. Staff were aware of how to reduce risks to people. Staff understood their roles and responsibilities in relation to keeping people safe from harm and abuse. Medicines were managed safely. There were enough staff on duty to meet people’s support needs.
People received an effective service because their needs were met by staff who were well trained and supported to do their job. People were supported to have maximum choice and control of their lives. Staff supported people in the least restrictive way possible; the policies and systems in the service supported this practice. People's nutritional needs were met by staff who knew each person's needs well. People’s health and wellbeing was maintained and provided by a range of health and social care professionals.
People received good care because staff treated people with kindness, compassion, dignity and respect. People had choices in all aspects of their daily lives and were able to continue with interests and friendships outside the service. Staff ensured people remained as independent as possible.
People received a service that was responsive. People and their relatives (where appropriate) were involved in their personalised support plans and reviews. The information about them in relation to their care and support was up to date.
People were encouraged to take part in a range of activities that they enjoyed, some were planned and others were the choice of the person at that time. This helped prevent social isolation. Systems were in place to support people with end of life care should this ever be needed.
People had received a service that was well led. Quality assurance systems were used to check that the service provided quality care and made improvements where necessary. People were encouraged to share their views about the service being provided.
Further information is in the detailed findings below.
Rosewood is registered to provide accommodation and non-nursing care for up to six people. At the time of this inspection there were five people living in the home who had a learning disability.. Each person had their own bedroom in the bungalow. There was a communal kitchen/dining room, lounge and sun room for people and their visitors to use.
This unannounced inspection took place on 15 January 2016.
At the time of the inspection there was a registered manager in place. 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 could not be confident that they always received their medication as prescribed. There had been a high number of medication administration errors identified since October 2015. However the registered manager was taking action to reduce the number of errors and ensure staff were competent at administering medication.
The Care Quality Commission (CQC) is required by law to monitor the Mental Capacity Act (MCA) 2005, Deprivation of Liberty Safeguards (DoLS) and to report on what we find. The provider was not acting in accordance with the requirements of the MCA including the DoLS. The provider could not demonstrate how they supported people to make decisions about their care. Where
people were unable to do so, there were no records showing that decisions were being taken in their best interests. This also meant that people were potentially being deprived of their liberty without the protection of the law.
Staff knew what actions to take if they thought that anyone had been harmed in any way.
People confirmed and we saw that there were enough staff available to meet their needs. The recruitment process was followed to ensure that people were only employed after satisfactory checks had been carried out.
Staff were kind and compassionate when working with people. They knew people well and were aware of their history, preferences, likes and dislikes. People’s privacy and dignity were upheld.
Staff monitored people’s health and welfare needs and acted on issues identified. People had been referred to healthcare professionals when needed.
People were provided with a choice of food and drink that they enjoyed.
Care plans and risk assessments gave staff the information they required to meet people’s care and support needs.
There was a complaints procedure in place and people felt confident to raise any concerns either with the staff or the registered manager.
The registered manager obtained the views from people living in the home about the quality of the service and took action when improvements were identified..
We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.You can see what action we told the provider to take at the back of the full version of the report.
Below is a summary of what we found. The summary describes what people using the service, relatives and staff told us, what we observed and the records we looked at.
If you want to see the evidence supporting our summary, please read the full report.
This was an unannounced inspection. We spoke with four people who used the service. We also spoke with three members of staff and we had a telephone conversation with the manager who was not present at the time of the inspection. We looked at written records, which included copies of people's care records held in the office, medication storage and administration systems and quality assurance documentation.
Is the service safe?
We found the home to be warm and clean. The accommodation was adapted to meet the needs of the people living there, was suited to caring for people with limited mobility and was properly maintained.
We saw that care plans and risk assessments were informative and up to date. Staff we spoke with were familiar with their contents, which enabled them to deliver appropriate and safe care.
Is the service effective?
People we spoke with were satisfied with the care and support they received. This was consistent with positive feedback reported in the provider's own annual quality assurance survey. People were given information and support to help them understand the care and support available to them and were encouraged to increase their independence.
Is the service caring?
We spoke with four people who used the service. Due to their communication needs we were not able to have extended conversations with them. One person said to us, "The staff are really nice. I like the staff." Another person said to us, "I like my room; I like having my tea in my room."
There was a calm atmosphere throughout the home and a good rapport between staff and the people who lived there. We witnessed the care and attention people received from staff. All interactions we saw were respectful, kind and friendly and staff were attentive to people's needs. People were treated with dignity and respect.
Is the service responsive?
People were consulted about and involved in their own care planning and the provider acted in accordance with their wishes. Care plans and risk assessments were regularly reviewed.
Two staff members told us that the manager was approachable and they would have no difficulty speaking to them if they had any concerns about the service.
Is the service well led?
Staff said that they felt well supported by the manager and they were able do their jobs safely. The manager had a range of quality monitoring systems in place to ensure that care was being delivered appropriately by staff, that the service was continuously improving and that people were satisfied with the service they were receiving.
Care and support was regularly reviewed to ensure that people's needs were met. There was evidence of people's involvement in the planning of their care and support. However, improvements were needed to the completion of some care documentation to ensure that they were up to date.
The premises were kept clean and were generally well maintained to meet the needs of people. However the flooring in the lounge and hallways was stained and worn.
There were induction programmes and mandatory training in place to ensure that staff were competent to deliver care. Supervision was regularly provided for staff to monitor their work performance and development needs.
The home had an effective system to effectively deal with complaints. Complaints were responded to appropriately and people using the service told us that they knew who to talk to if they had any concerns or complaints.
People's needs were appropriately assessed, with well developed care plans providing clear guidance for staff about how to meet people's needs. People were involved in developing their care plans and their views and wishes were taken into account with regard to how they lived their lives.
The organisation had an effective system in place for monitoring the quality of the service that was provided. The views of the people who lived in the home were central to this process.
One family member told us she did have a concern about the lack of stimulus and activity for their family member but that things had improved greatly in the last year. She also told us, 'There seemed to be a never ending succession of different key workers for X (relative) but she now has someone who can work miracles with her'.
One chiropodist who knows the home well told us, 'Rosewood is by far the best of the Cambridgeshire Mencap homes I visit. They always know we are coming, patients are ready to be seen, care plans are good and sorting people's payments and receipts is always smooth. Staff always follow up any I we raise. I just know things will be done'.
One day services worker reported, 'Rosewood staff are very good at communicating with us about people and we have a good rapport with the assistant services manger. X (person using the service) is always very positive about her home environment and she would soon let us know if she wasn't'.