The inspection took place on 21 March 2017 and was announced. At the last inspection on 21 October 2014, we identified areas of practice that needed improvement. This was because we identified issues in respect to training and supervision sessions for staff not being up to date. We saw that the required improvements had been made.

Rosewood is a community house supporting adults with learning disabilities and complex needs. It provides accommodation and personal care for a maximum of four adults. The service is located in a residential area in Burgess Hill. At the time of our inspection there were four people living in the service.

The service had a registered manager in post at the time of our inspection. 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.

Staff were skilled and felt fully supported by the provider to undertake their roles. They were given training updates, supervision and development opportunities. One member of staff told us “My induction was good and taught me about autism. It gave me a good insight into the people here and their condition”. Another member of staff added, “Training is fantastic and we can access the West Sussex County Council training. My training needs are met”.

The staff we spoke with were aware of their role in safeguarding people from abuse and neglect and had received appropriate training. We saw risk assessments had been devised to help minimise and monitor risk, while encouraging people to be as independent as possible. Staff were very aware of the particular risks associated with each person’s individual needs and behaviour.

People were happy and relaxed with staff. They said they felt safe and there were sufficient staff to support them. One person told us, “Staff know I’m alright. If I’m not well, they come and help me. It makes me safe”. When staff were recruited, their employment history was checked and references obtained. Checks were also undertaken to ensure new staff were safe to work within the care sector.

Medicines were managed safely and in accordance with current regulations and guidance. There were systems in place to ensure that medicines had been stored, administered, audited and reviewed appropriately.

People’s needs had been identified, and from our observations, people’s needs were met by staff. There was a lot of emphasis on observations, especially for signs of any discomfort, as people could not always communicate their needs easily.

We found the service to be meeting the requirements of the Mental Capacity Act and Deprivation of Liberty Safeguards (DoLS). The staff we spoke with had a good knowledge of this.

People were supported to eat and drink sufficient to maintain a balanced diet. They were supported to maintain good health and have access to healthcare services. We looked at people’s records and found they had received support from healthcare professionals when required.

There was very positive interaction between people and the staff supporting them. One person told us, “I get on well with all the staff”. Staff spoke to people with understanding, warmth and respect and gave people lots of opportunities to make choices. The staff we spoke with knew each person’s needs and preferences in great detail, and used this knowledge to provide tailored support to people.

People’s individual plans included information about who was important to them, such as their family and friends and we saw that people took part in lots of activities in the service and in the community.

The service had a complaints procedure, which was available in an ‘easy read’ version to help people to understand how to raise any concerns they might have. There was evidence that people were cons

The inspection took place on 21 October 2014 and was an unannounced inspection.

Rosewood is a a home that supports up to four adults with learning disabilities and complex needs. There were four people living at the service when we inspected.

The service has a 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.

People were safe and were supported by staff who understood how to keep them safe and what action they should take if they suspected abuse was taking place. Staff had been trained in safeguarding. Staffing levels were assessed and implemented to meet the complex needs of people and one relative said there were, “Always quite a few staff around”. Staff were recruited using safe recruitment practices and checks were undertaken, including criminal records checks. People had their risks assessed to ensure their freedom was supported with the minimum of restriction. Behaviour support plans were in place which gave detailed information to staff about how to support people who had behaviours that challenged. Accidents and incidents were recorded and patterns of accidents and incidents were identified so that lessons could be learned. Medicines were administered, stored, ordered and disposed of safely. Staff were trained in administering medicines and records were completed showing when medicines had been administered.

Staff received a range of comprehensive training, although not all training that needed to be updated annually had been completed by all staff. There were opportunities for staff to undertake additional qualifications if they wished. Staff supervisions should have been undertaken quarterly with staff, however, not all staff had received regular supervisions in line with the provider’s policy. Staff communicated effectively through a staff communication book and at handover between shifts. There was an induction programme for new staff where they could meet with other new staff from other services. People had sufficient to eat and drink. They went out food shopping twice a week and completed accessible shopping lists. These enabled people to choose what they wanted to eat and drink. People were supported to prepare their own meals. Access to healthcare services was available to people and they received ongoing health support. They visited healthcare professionals as needed. Mental capacity assessments were in place for people and they were assessed at admission to the service. Their capacity assessments were reviewed regularly. People had been assessed appropriately with regard to Deprivation of Liberty Safeguards (DoLS) and we found the home to be meeting the appropriate legal requirements.

People were cared for by staff who knew them well and were warm, friendly and respected their privacy. People had positive behaviour support plans in place. Care records gave detailed information about people and these ensured that care was personalised to meet their needs. Where they were able, people were involved in the planning of their care through monthly meetings. Communication tailored to the individual needs, for example, use of sign language or with photos.

People received care that was personalised to meet their needs. Activities were organised that enabled people to be activeaccording to their needs. People preferred activities to be organised in such a way that structured their days, so they knew what was happening on any particular day and when. People’s preferences and choices were recorded in their care plans and they were involved in making decisions about their care with their keyworkers. This involved setting of goals which people worked towards achieving to develop their independence. People were supported to stay in touch with their families and those that mattered to them and many visited their relatives on a regular basis. The service had not received any complaints within the year. When complaints were received, the provider had a policy in place which described what action would be taken and how complaints would be followed up.

Residents’ meetings were held and people were involved in the development of the service. People had been asked what they thought about the service through service user satisfaction questionnaires. Relatives had also been asked for their feedback and no concerns were received. Staff were aware of the whistleblowing policy and what to do if they had a complaint or concern. The service was led by a registered manager who was actively involved in the service. The provider visited on a monthly basis and was involved in the future planning for the service. Information was shared across the organisation between management and staff and people worked in a collaborative way. People who lived at the service were supported to achieve their goals. The service had a range of robust quality assurance processes in place that measured the quality of the service delivered and identified any improvements that might be needed to improve the quality of care. The service worked in partnership with other agencies, for example, local authorities and healthcare professionals.

There were four people living in the care home when we visited and we spoke with three of them and three members of staff. The people we spoke with told us they were happy in the home and enjoyed a varied nutritious diet. We observed their interactions with staff and could see that the people living in the care home felt comfortable, safe and secure with the staff. We saw evidence of their artwork hanging on the walls in the sitting room and we could see that their days were full, but they also had time set aside to relax on their own. The notes, audits and questionnaires held on file supported this. We saw daily activity schedules, risk assessments and care plans that demonstrated that the people living in the care home were safe and well treated and had active meaningful lives.

The staff we spoke with were attentive to the people living in the care home and promoted their welfare and independence. Staff were supported by their managers and other healthcare professionals and knew how to respond effectively in an emergency.

People had their own rooms where they could spend time on their own and staff respected their privacy and dignity. We saw that the staff were well trained to deliver appropriate care and that the provider had a process of continual assessment to monitor the quality of service provision.

During our inspection we noted that there were two registered managers for the service, we have been informed by the current manager (R Davies) that the other person has been promoted within the service and will now be applying to de register as manager.

There were four people living at the home at the time of the inspection. During our visit we spoke with two people who were using the service and three members of staff. People living at the home told us they liked the home and felt safe.

We made observations throughout the visit and saw people being offered choices as to what they wanted to eat and the activities they wished to participate in. People were supported to personalise their own rooms and to be as independent as possible.

We saw people being addressed in a respectful manner. We looked at people's individual support plans and observed that these were discussed with people who used the service and that these discussions were recorded. We saw that monthly audits of the service were completed by the provider ensuring that people who used the service benefit from a service that monitors the quality of care that people received.

Staff told us that they had received training in protecting adults from abuse and that they felt that they were supported and trained to carry out their roles and meet the needs of people who used the service.

People understand the care, treatment, and support choices available to them, and actively choose what they want to do. People are being supported and cared for in the way that they wish.

During our visit they indicated that they had a full lifestyle and that if there were any problems that staff would help them overcome these.