Roswell Court

This comprehensive inspection took place on 25 April 2018 and was announced. The registered manager was given short notice because the location provides a domiciliary care service and we needed to be sure that someone would be in. Roswell Court was registered with the Care Quality Commission in February 2013 as a domiciliary care service.

CQC only inspects a service when people are provided with ‘personal care’; such as help with tasks related to personal hygiene and eating. Where people are receiving personal care, the CQC also take into account any wider social care provided, such as support with activities. At the time of the inspection the service was providing personal care for two people. There were three other people who had been supported with personal care by the service during the week of our visit. Two of these people had been taken into hospital and one was on holiday at the time of our visit. Other ‘homeowners’ (people living) in the complex received support visits which did not include personal care. We therefore did not inspect the services they were receiving.

The time of visits provided by the service ranged from 15 minutes to one hour, with the frequency of visits from twice a week to six times a day. There were nine care staff employed.

At the last inspection in February 2016 the service was rated Good. At this inspection we found the evidence continued to support the rating of Good. 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 service has not changed since our last inspection.

Why the service is rated Good:

The service had an experienced registered manager. A registered manager is a person who has registered with CQC to manage the service. Like registered persons, 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. They were supported by duty managers and care staff.

People said they felt safe and staff were able to demonstrate a good understanding of what constituted abuse and how to report if concerns were raised. People’s risks were managed well to ensure their safety. Where people required support with their medicines this was completed on time and in a safe way.

Care records were personalised to reflect people’s personal preferences. People’s needs were assessed before their care commenced and care plans were regularly reviewed and updated as their needs changed. The registered manager said they were going to pilot a new computerised care system. They said to keep people safe they would keep paper records running alongside the computerised records.

People were supported to maintain a balanced diet. People were able to use the restaurant facilities at the complex for main meals. Where needed, staff supported people with the preparation of other light meals such as breakfast and tea.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. The registered manager and staff demonstrated an understanding of their responsibilities in relation to the Mental Capacity Act (MCA) 2005.

Staff relationships with people were caring and supportive. Staff spoke confidently about people’s specific needs and how they liked to be supported. Care staff respected people’s privacy and dignity and maintained people’s independence as much as possible. They worked in partnership with other health and social care professionals to ensure people’s health needs were met in a timely way.

Staffing arrangements were flexible in order to meet people’s individual needs. Care staff were allocated people to support and a duty manager was available to step in where people required additional time. There were effective recruitment and selection processes in place. Staff received training and regular support to keep their skills up to date in order to support people appropriately. Staff spoke very positively about the registered manager and how the management team at the service worked well together. The culture at the service was open and honest and focused on each person as an individual and the service was tailored to people’s needs.

The provider had a quality monitoring system at the service. The provider actively sought the views of people, their relatives and staff. There was a complaints procedure in place. There had been no complaints made since our last inspection.

Further information is in the detailed findings below.

We previously inspected the service in December 2013 and did not identify any concerns or breaches of regulations. Roswell Court provides personal care to people living in their own apartments in an assisted living complex in Exmouth. At the time of the inspection they provided personal care to six people. Times of visits ranged from 30 minutes to an hour and the frequency of visits ranged from one visit a day to 28 visits a week.

When we visited there was 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. The previous registered manager left the service in 2013 and had not submitted an application to deregister with CQC. The provider had contacted this person and they have now submitted an application to remove themselves as registered manager at the service.

People were supported by sufficient numbers of care workers who had a clear knowledge and understanding of their personal needs, likes and dislikes. We observed the registered manager and care workers took the time to talk with people throughout the day as their office was situated in the assisted living complex.

There were safe and robust recruitment procedures to help ensure that people received their support from care workers of suitable character. Care workers had received a full induction and were knowledgeable about the signs of abuse and how to report concerns.

Care workers relationships with people were caring and supportive. They offered care that was kind and compassionate; they respected people’s privacy and dignity and maintained people’s independence as much as possible.

Care workers received a range of training and regular support to keep their skills up to date in order to support people appropriately. All of the care workers had or were working towards a higher qualification in health and social care. Care workers spoke positively about the registered manager, the teamwork and the open culture at the service. People were supported by a team that was well led with high staff morale.

Care files were personalised to reflect people’s personal preferences. Care plans identified people’s needs but had little detail to guide care workers to ensure they received consistent care. However we were confident people received consistent care because of the low staff turnover, small staff team and daily handover meetings. Health and social care professionals were regularly involved in people’s care to ensure they received the right care and treatment.

The registered manager and care workers demonstrated an understanding of their responsibilities in relation to the Mental Capacity Act (MCA) 2005.

The provider had a quality monitoring system at the service. The provider actively sought the views of people, their relatives and care workers. There was a complaints procedure in place, however there had been no complaints made regarding people receiving personal care at the service.

During our visit we spoke with the two people that had a care package with the agency, two carers, the area manager and the estates manager who was supporting the complex in the absence of a permanent manager. People who received a service from the agency told us they were happy with the care they received.

Comments from carers included 'it's the best job I've ever had', 'I love it here, and I do my best to make it work'.

People who used the agency were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening.

Appropriate checks were not always undertaken before carers began work for the agency. Two of the five files checked complied with all legal requirements.

We saw that regular audits were completed by the provider ensuring that people who used the domiciliary care agency benefitted from a service that monitors the quality of care that people received.

The previous manager's name appears on this report because at the time of the inspection they were still registered with the commission.