Church Rose Nursing Home

People's experience of the service and what we found: We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence, and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people. We considered this guidance as there were people using the service who have a learning disability and or who are autistic.

Right Support Risks to people were well managed which meant risk of harm to people had been considered .There was evidence to demonstrate people had been supported with things which were important to them such as maintaining contact with family and their hobbies, and staff knew people well. Medicines were well managed.

Repairs and general maintenance were dealt with promptly, which decreased risks to people.

People lived in a purpose built building with a safe outside space which we saw people enjoy. The home was situated in a residential area with facilities close by which people could access. There were adequate numbers of staff to support people.

Right care People's care plans and risk assessments reflected their current needs and what was important to them. Staff received appropriate training to meet people's needs. People were supported and encouraged, promoting their independence.

There was a stable team of staff who knew people's needs and were kind and caring.

Right Culture The registered manager and other staff members told us how the manager had worked hard to ensure the culture within the service was open and inclusive .

People were not consistently supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.

The provider had systems in place to monitor the quality and safety within the service. However, these needed some improvement as they had not highlighted some of the issues we found. For example, concerns about the implementation of authorised conditions for people with Deprivation of Liberty Safeguards (DoLS) and infection control practices. Where the provider's systems had highlighted concerns, at times there was a delay in completing the required actions.

The provider acted during the inspection to rectify the concerns in relation to authorised DoLS not being actioned.

We observed some infection control concerns such as, lack of evidence that equipment such as hoists had consistently been cleaned after use, staff wearing jewellery and long acrylic nails and clothing items which hung down, tables laid for meals where staff sat for handover, toilet rolls on top of toilet cisterns, un-used continence pads hanging on the dirty linen trollies, aprons hung over handrails. These issues were addressed by the management team at the time of the inspection.

People were supported to maintain links with loved ones. People had access to a variety of in-house activities to engage in, although some people told us these activities were not of interest to them. Although staff knew people well and how to meet their needs, this was not always supported by the daily records completed by staff members following the activity they had been involved in. The information around people's interests in care plans and risk assessments were detailed.

People and relatives knew how to raise concerns and most felt confident any issues would be addressed. However, two relatives told us they had raised concerns, which the registered manager said they would address but felt they had waited a long time before this has been actioned. The registered manager addressed these concerns when brought to their attention.

People were supported by staff who were trained and knowledgeable about how to identity and minimise risks regarding their safety and wellbeing.

Most staff felt supported in their role and described the management team as approachable, caring, and responsive. Some staff however, told us they felt they were not listened to.

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