Rascasse

Rascasse is a 'care home' and is located in the village of Silver End in Essex. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.

Rascasse provides accommodation in a main house and adjoining annex. Rooms are all single use and the services registration has recently been increased to enable the service to support up to eight adults with learning disabilities. There were seven people living at the service on the day of our inspection. Individuals using this service have complex needs and require high levels of support to enable them to be safe and engage with others.

The service had an established registered manager. 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 service had a comprehensive inspection in February 2016 and was rated good overall and requires improvement in Safe. We subsequently received concerns about how an incident was managed at the service and we undertook a focused inspection in March 2017 to look at safety at the service. We found that the service was not meeting the requirements of the legislation and required them to take steps to address the shortfalls we found. At this inspection we found that improvements had been made.

The registered manager and registered provider were clearer as to their responsibilities under the duty of candour which is a duty on providers to be open and transparent when safety incidents have occurred. There were systems in place to identify risks and mitigate the risk of harm however we have made a recommendation that the fire safety systems in the Annex are reviewed and auditing strengthened.

Medicines were safety stored and clear systems in place for the administration of people's medicines. We have however recommended that staff recording is strengthened to enable more effective auditing.

The provider operated a safe recruitment system to ensure that staff were suitable and safe to work with people.

There were sufficient numbers of staff available to support people. New staff received induction training to prepare them for their role. Staff received ongoing training and supervision to reflect on their practice and ensure that they had the skills and knowledge to meet people's complex needs.

People had sufficient amounts to eat and their nutritional needs were met. There were clear systems in place to support people to access health support when they needed to.

Staff had a good understanding of consent and there were best interest assessments in place in line with the legal requirements. The registered manager was aware of their responsibilities with regard to the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DOLs).

People were supported by staff who knew them well and we observed that people had good relationships with staff. Staff were kind and respectful in their interactions.

Staff had access to comprehensive care plans and access to a range of professionals including a clinical psychologist to guide their practice. There were strategies in place to manage people's anxiety and behaviours which others may find challenging.

People were supported to have as full and meaningful live as possible.

There was a complaints procedure in place to address concerns and the management of the service had a number of ways of gathering people's views including the use of satisfaction surveys.

There was a clear management structure and relatives told us that they had good relationships with the service. There were systems in place to provide governance and drive improvement.

The five questions we ask about services and what we found