Rosehill House

Updated 28 April 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

The inspection was carried out by three inspectors.

Service and service type

Rosehill House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. 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

This inspection was unannounced.

What we did before the inspection

Before the inspection we reviewed previous inspection reports and other information we held about the home including statutory notifications. A statutory notification is information about important events which the service is required to send us by law. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We contacted health and social care professionals who worked with people and staff in the home. We received feedback from two social care professionals and a health professional.

During the inspection

Two inspectors visited Rosehill House on 21 February 2022. We looked around the home, including the annex, and observed staff supporting people. We spent time with the three people living in the home, and communicated with them and three members of staff. We looked at detailed care records for two people, and other records relating to the running of the service such as rotas, service development plans, staff training records and meeting minutes. The lead inspector and another inspector spoke with the registered manager and provider about the governance of the home on 3 March 2022.

After the inspection

On the day of our visit we asked the provider to send a poster to relatives and friends of people living in the home and to staff who were not present on the day. The poster asked for feedback and we requested this be provided by 1 March 2021. There was an administrative delay in sending this poster, so we agreed a longer period for feedback. We received feedback from two relatives. The last feedback was received on 8 March 2022.

Updated 28 April 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

Rosehill House provides care and accommodation for up to five people who have autistic spectrum disorders. The service is part of the Spectrum group who run several similar services throughout Cornwall. At the time of the inspection three people were living at the service. The service was based in a large detached house with an annex. The service is in a rural setting on the edge of a village.

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

The provider had was using one part of the location to provide accommodation for a member of staff from another service. We have made a recommendation relating to the risk management associated with this practice.

This service was able to demonstrate how they were meeting the underpinning principles of right support, right care, right culture.

Right support:

• Two people shared the annex and another person lived in the house. One person had moved to the annex enabling them to remain in their home as their needs changed.

• People were supported to have choice and control over their own lives. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service did support this practice.

• Staff focused on people’s strengths and interests. They promoted what people could do and supported them to pursue their interests.

• People were supported in ways that reduced periods of distress. People were clearly relaxed with staff and reassured by their presence.

• People lived in a home that reflected their personalities, needs and interests. Infection control procedures and measures were in place to protect people from infection control risks associated with COVID-19.

• Staff supported people to take part in home based activities and pursue interests in their local area if they enjoyed this. One person was keen to get out on a walk they had chosen when we visited.

• Staff enabled people to access health and social care support in their community. People were starting to return to activities that had been paused during the pandemic.

• Staff supported people to make choices and communicated with people in ways that met their needs.

• Staff supported people safely with their medicines and worked with health professionals to achieve good health outcomes.

Right care:

• People received kind and compassionate care. Staff protected and respected people’s privacy and dignity. They understood and responded to their individual needs.

• Staff understood how to protect people from poor care and abuse. Staff had training on how to recognise and report abuse and they knew how to apply it. People were relaxed with their staff.

• The service had enough appropriately skilled staff to meet people’s needs and keep them safe.

• People could communicate with staff. Staff understood their individual communication needs and were consistent in their approach. Where people needed staff to use specific language this was communicated clearly in their care plans.

• People who had individual ways of communicating, using body language, sounds, Makaton (a form of sign language), and pictures could interact comfortably with staff because staff had the skills to understand them.

• People received care that supported their needs and goals; staff were focused on their quality of life. One person had a delivery of new bedroom furniture, staff supported them to be engaged in the process, to enjoy their new acquisition. Their interaction about this was familiar and enthusiastic.

• People pursued individual interests and staff sought opportunities to try new activities that may enhance people’s lives.

• Staff promoted equality and diversity in their support for people. They sought to understand people’s histories and backgrounds and provided appropriate care.

Right culture:

• The staff at Rosehill House were committed to ensuring people were leading the lives they wanted. People were treated with dignity, respect and care.

• People led lives that reflected their personalities and preferences because of the ethos, values, attitudes and behaviours of the management and staff.

• People received good quality care, support and treatment because staff had the skills they needed and supported each other effectively.

• People were supported by staff who understood the wide range of strengths, impairments or sensitivities autistic people may have. This knowledge informed assessments and care plans and meant people received compassionate care that was tailored to their needs.

• Staff knew and understood people well and were responsive to them. They supported people to live a life of their choosing.

• Staff turnover was low, which supported people to receive consistent care from staff who knew them well.

• People and those important to them, including advocates, were involved in planning their care.

• Staff valued and acted upon people’s views and understood that these were expressed through how people presented themselves and their actions.

• People’s quality of life was enhanced by the staff team’s commitment to ensuring a respectful and inclusive culture. Systems were in place to monitor the quality of the care and support people received.

• The registered manager and staff team were open and transparent and acted on feedback given, and queries raised, throughout the inspection.

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

Rating at last inspection

The rating at the last inspection was Good. (Published March 2018)

Why we inspected

The inspection was prompted in part due to concerns in relation to staffing levels across the provider organisation and the impact on people’s support. A decision was made for us to inspect and examine those risks. We found no evidence during this inspection that people were at risk of harm from these concerns.

We undertook this inspection to assess that the service is applying the principles of Right support right care right culture.

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.

Enforcement and Recommendations

We made a recommendation in relation to good governance.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our reinspection programme. If we receive any concerning information we may inspect sooner.