This was the first inspection of Roses Healthcare since registration in December 2017, conducted under the KLOE framework. The service could not be rated as it was supporting only one person and employed only two staff, providing insufficient evidence to assess the effectiveness of systems, recruitment, training or governance at scale.
Strengths
· Provider and registered manager were passionate, kind and caring, with relevant skills and knowledge to support the person in their care.
· Care plans were personalised and detailed, containing risk assessments, preferences and communication guidance tailored to the individual.
· Provider had appropriate medication training and administered medicines in accordance with policies and procedures.
· Infection control practices were followed with access to appropriate personal protective equipment.
· Provider had a good understanding of safeguarding responsibilities and knew how to report concerns to the local authority.
Roses Healthcare, a domiciliary care service supporting children and young people with learning disabilities and autism, received an overall Good rating across all five key questions at its first rated inspection in January 2023. The service demonstrated strong person-centred care, effective safeguarding systems and proactive staff training, with the notable gap of no registered manager in post at the time of inspection.
Concerns (3)
moderateGovernance: “At the time of the inspection there was no registered manager. The Nominated individual told us they would be submitting an application to the CQC to be registered as the manager.”
minorGovernance: “Audits of records had recently been put in place and needed to be embedded. The provider was aware for the need to fully embed the systems to help drive improvements.”
minorIncident learning: “following a complaint involving cancelled or missed care visit the provider had reviewed the procedure with staff as to what they needed to do if a family cancelled a care visit”
Strengths
· Personalised, holistic and strength-based care plans that were regularly reviewed with people and families.
· Staff were skilled in recognising signs of emotional distress and knew how to support people safely.
· Proactive approach to training, including specialist training for newly diagnosed health conditions.
· Strong person-centred culture with staff passionate about individualized care and achieving good outcomes.
· Effective safeguarding systems with staff trained to recognise and report concerns.
Quality-Statement breakdown (22)
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Assessing risk, safety monitoring and managementGood
safe: Staffing and recruitmentGood
safe: Using medicines safelyGood
safe: Preventing and controlling infectionGood
safe: Learning lessons when things go wrongGood
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawGood
effective: Staff support: induction, training, skills and experienceGood
effective: Supporting people to eat and drink enough to maintain a balanced dietGood
effective: Staff working with other agencies to provide consistent, effective, timely careGood
effective: Ensuring consent to care and treatment in line with law and guidanceGood
caring: Ensuring people are well treated and supported; respecting equality and diversity; respecting and promoting people's privacy, dignity and independenceGood
caring: Supporting people to express their views and be involved in making decisions about their careGood
responsive: Planning personalised care to ensure people have choice and control and to meet their needs and preferencesGood
responsive: Meeting people's communication needsGood
responsive: Improving care quality in response to complaints or concernsGood
responsive: End of life care and supportNot rated
well-led: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirementsGood
well-led: Promoting a positive culture that is person-centred, open, inclusive and empoweringGood
well-led: How the provider understands and acts on the duty of candourGood
well-led: Engaging and involving people using the service, the public and staff, fully considering their equality characteristicsGood
well-led: Continuous learning and improving care; working in partnership with othersGood