This inspection took place on 13 October 2016 and was unannounced. This meant the staff and registered provider did not know we would be visiting.

Rossendale Road was last inspected by CQC on 11 September 2014 and was compliant with the regulations in force at that time.

Rossendale Road provides care and accommodation for up to 13 people with an acquired brain injury. On the day of our inspection there were 12 people using the service.

The service had a registered manager in place. 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.

Accidents and incidents were appropriately recorded and investigated. Risk assessments were in place for people who used the service and described potential risks and the safeguards in place. Staff had been trained in safeguarding vulnerable adults. Medicines were stored safely and securely, and procedures were in place to ensure people received medicines as prescribed.

The home was clean, spacious and suitable for the people who used the service and appropriate health and safety checks had been carried out.

There were sufficient numbers of staff on duty in order to meet the needs of people who used the service. The registered provider had an effective recruitment and selection procedure in place and carried out relevant checks when they employed staff. Staff were suitably trained and received regular supervisions and appraisals.

The registered provider was working within the principles of the Mental Capacity Act 2005 (MCA) and was following the requirements in the Deprivation of Liberty Safeguards (DoLS).

People were protected from the risk of poor nutrition and staff were aware of people’s nutritional needs. Care records contained evidence of visits to and from external health care specialists.

People who used the service were complimentary about the standard of care at Rossendale Road. Staff treated people with dignity and respect and helped to maintain people’s independence by encouraging them to care for themselves where possible.

Care records showed that people’s needs were assessed before they moved into Rossendale Road and care plans were written in a person centred way.

Activities were arranged for people who used the service based on their likes and interests and to help meet their social needs.

The registered provider had an effective complaints policy and procedure in place.

Staff felt supported by the registered manager and were comfortable raising any concerns. People who used the service, family members, healthcare professionals and staff were regularly consulted about the quality of the service.

At the time of this inspection the service was not providing support and personal care to people living in their own homes in the community. We therefore did not inspect the regulated activity - ‘Personal Care’.

During the inspection we spent time in the company of people using the service. We spoke with three people who used the service, four members of staff, the manager and the operations manager. We considered all the evidence we had gathered under the outcomes we inspected. We have used the information to answer the five questions we always ask;

• Is the service safe?

• Is the service effective?

• Is the service caring?

• Is the service responsive?

• Is the service well-led?

This is a summary of what we found:

Is the service safe?

Processes and practices were in place to safeguard people from abuse and neglect. Arrangements were in place to appropriately review and respond to changes in circumstances in consultation with other professionals. However, we found there had been a lack of timely interventions to protect and safeguard people’s safety and wellbeing. The operations manager took action in response to this matter.

There were appropriate arrangements in place to manage people's medicines safely. However we found some improvements could be made with promoting people’s independence and involvement with their medicines.

There were sufficient staffing levels which aimed to provide people with safe effective care and support.

Is the service effective?

We found arrangements were in place to assess people's needs and abilities prior to using service. This meant individual needs and choices would be considered and planned for before they used the service.

Records and discussion showed people’s health and wellbeing was monitored and they were getting support as appropriate, for healthcare needs and with appointments.

Processes were in place for staff to attain nationally recognised qualifications. Staff spoken with, told us of the training they had received to develop their skills and knowledge.

Is the service caring?

During the inspection we observed staff considerately supporting people with their chosen activities and individual needs.

People indicated they were satisfied with various activities and community involvement. Arrangements were in place to offer a range of individual and group activities.

Care plan records were sensitively written in a person centred way; they identified people’s needs, abilities and choices. There were actions for staff to follow to respond to people’s support needs and preferred routines.

CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. Policies, procedures and a code of practice were available to support appropriate practice around DoLS and the Mental Capacity Act 2005. The manager and staff had received training on these topics. However, we found the care planning process was lacking in screening and highlighting people’s capacity to make their own choices and decisions.

Is the service responsive?

Arrangements were in place to regularly review and respond to people's changing needs, choices and abilities.

Risks to people’s wellbeing and safety were identified and managed, taking account of enabling their choices and their right to take risks.

Is the service well-led?

There was a registered manager who had day to day responsibility for the service. Support and expertise was also provided by external management within the organisation.

We found people using the service were involved as far as possible with decisions which affected them personally, on an informal daily basis, during reviews, meetings and through questionnaires.

People who used the service indicated they were satisfied with the care and support they experienced at Rossendale Road. One person said, “It’s alright”.

Staff spoken with considered team work at the service was good and said the manager was approachable and supportive.

Regular audit checks were being carried out on various processes and practices. This meant there were systems in place to assess and monitor how the home was operating and to evaluate the quality of the service.