Roseleigh is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. Roseleigh does not provide nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The service supports up to seven younger adults with learning disabilities and/ or autism. There were five people using the service at the time of our inspection.

When we last visited the home on 9 September 2015 the service was meeting the regulations we looked at and was rated Good overall. However, we rated the service Requires Improvement in the key question ‘Is the service well-led?’ because there was no registered manager in post.

At this inspection we found the service was Good overall and for each key question.

There was 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.

People were protected from abuse and improper treatment as staff understood their responsibilities in relation to safeguarding well and received annual training in this. The provider had processes in place to share learning across the organisation and improve when things went wrong, such as when there were incidents and accidents and safeguarding allegations.

The provider managed risks relating to people’s care and also the premises through well. People received care in premises which were safe, clean and well maintained. The premises met people’s support needs and people had access to all communal areas.

The provider checked staff were suitable to support people and there were enough staff deployed to support people safely. The provider managed people’s medicines safely.

People received care in line with the Mental Capacity Act 2005 and staff understood their responsibilities in relation to this Act as they received annual training. The provider applied for and followed authorisations to deprive people of their liberty (DoLS) as part of keeping them safe.

People’s needs and choices were assessed by the provider and people and their relatives were involved in the process.

Staff understood people’s needs, including their health needs, and supported people to maintain their health. People received their choice of food and drink.

People were supported by staff who felt well supported by the provider. Staff received suitable induction, training, supervision and annual appraisal to help them understand the best ways to support people. The provider worked well with other services in the organisation as well as with external organisations in providing joined-up care to people.

Staff were caring and supported people respectfully, maintaining their privacy and dignity. People were supported to be as independent as they wanted to be. People were supported to maintain relationships with those who were important to them.

People were involved in reviewing their care and the provider reviewed people’s care regularly so information was reliable for staff to follow in caring for people. People were supported to participate in activities they enjoyed.

The provider encouraged people to feedback on the service and communicated openly with people, relatives and staff. The provider had a complaints procedure to investigate and respond to any complaints.

The registered manager and staff had a good understanding of their role and responsibilities and leadership was visible and capable at all levels.

The provider monitored and assessed the service well and promptly made improvements where any shortfalls were identified.

Roseleigh is a residential home which provides care and accommodation for up to six adults with learning difficulties including autism. The home is a detached house located in Horley. On the day of our inspection six people were living in the home. People had varied communication needs and abilities. Some people were able to express themselves verbally; others used body language to communicate their needs. Some of the people’s behaviour presented challenges and was responded to with one to one support from staff.

This inspection took place on 9 September 2015 and was unannounced.

The home did not have 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 and associated Regulations about how the service is run. The manager of the home is in the process of registering to become manager of this location. They were not present on the day of inspection and we were supported during our inspection by another registered manager and the area manager.

Staff had written information about risks to people and how to manage these. We found the registered manager considered additional risks to people in relation to community activities and changes had been reflected in people’s support plans.

Staff had received training in safeguarding adults and were able to evidence to us they knew the procedures to follow should they have any concerns. One staff member said they would report any concerns to the registered manager. They knew of types of abuse and where to find contact numbers for the local safeguarding team if they needed to raise concerns.

Care was provided to people by a sufficient number of staff who were appropriately trained. Staff were seen to support people to keep them safe. People did not have to wait to be assisted.

People who displayed behaviour that challenged others had shown a reduction of incidents since being at the home and the number of staff on duty were adequate for their individual needs.

Processes were in place in relation to the correct storage of medicine. All of the medicines were administered and disposed of in a safe way. Staff were trained in the safe administration of medicines and kept relevant records that were accurate.

The Care Quality commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. The registered manager and staff explained their understanding of their responsibilities of the Mental Capacity Act (MCA) 2005 and DoLS and what they needed to do should someone lack capacity or need to be restricted.

People were provided with homemade, freshly cooked meals each day and facilities were available for staff to make or offer people snacks at any time during the day or night. We were told by the registered manager that people could go out for lunch if they wished.

People were treated with kindness, compassion and respect. Staff took time to speak with the people who they supported. We observed positive interactions and it was evident people enjoyed talking to staff. People were able to see their friends and families as they wanted and there were no restrictions on when people could visit the home.

People were at the heart of the service; and took part in a wide range of community activities on a daily basis; for example trips to the shops, and attending college. The choice of activities was specific and innovative to each person and had been identified through the assessment process and the regular house meetings held.

People had an individual support plans, detailing the support they needed and how they wanted this to be provided. We read in the support plans that staff ensured people had access to healthcare professionals when they needed. For example, the doctor, learning disablement team or the optician. People’s care had been planned and this was regularly reviewed with their or their relative’s involvement.

It was clear from our observations that the supporting manager and area manager knew the people very well and that people looked at them as a person to trust. Staff felt valued and inspired under the leadership of the management.

The manager had a robust system of auditing processes in place to regularly assess and monitor the quality of the service or manage risks to people in carrying out the regulated activity. The manager had assessed incidents and accidents, staff recruitment practices, care and support documentation, medicines and decided if any actions were required to make sure improvements to practice were being made.

The manager kept up to date with any changes in legislation that may affect the service, and participated in monthly forums with other managers from other services where good practice was discussed.

The service notified the Care Quality Commission of any significant events that affected people or the service and promoted a good relationship with stakeholders.

Complaint procedures were up to date and people and relatives told us they would know how to make a complaint. Confidential and procedural documents were stored safely and updated in a timely manner.

Staff were aware of the home’s contingency plan, if events occurred that stopped the service running. They explained actions that they would take in any event to keep people safe.

People’s views were obtained by holding residents meetings and sending out an annual satisfaction survey which staff supported people to complete using different methods of communication.

A single inspector carried out this inspection on 9 March 2015 to check whether action had been taken to improve the service since the last inspection.

At the last inspection on 22 November 2013 we asked the provider to take action to make improvements to act in accordance with legal requirements where people did not have capacity to consent, to have specific written procedures in place to plan for all reasonable foreseeable emergencies, to protect people who used the service against risks associated with unsafe or unsuitable premises and implement an effective system to regularly assess and monitor the quality of service that people received.

After the inspection in November 2013, the provider wrote to us to say what they would do to meet legal requirements and all actions of their action plan would be completed by 18 March 2014. At this inspection in March 2015, we found action had been taken and as a result people's care and safety had improved.

We spoke with two people who used the service and three members of staff including the manager. We spent time observing the interactions between staff and people because not everyone who used the service was able to directly answer our questions.

Before people received any care or treatment they were asked for their consent but where people did not have capacity to consent the provider was acting in accordance with legal requirements. We found the provider ensured their staff received training about the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards. We found staff assessed a person's mental capacity and where a person's liberty and freedom was restricted, made applications for authorisation to the local authority in accordance with legal requirements.

There were written arrangements in place to deal with foreseeable emergencies. We found the provider had developed a business contingency plan which was localised for the service and meant care for people who used the service would continue in the event of a foreseeable emergency.

The provider had taken steps to provide care in an environment that was suitably designed and adequately maintained. We found the provider had completed repairs to doors, windows and locks. The provider had also undertaken action to ensure people who used the service were kept safe from risks of hazards for example, removal of a butane gas cylinder. Also the provider ensured staff personal belongings were stored in a locked room.

There was a system for assessing and monitoring the quality of the service. Peoples’ views were listened to and acted on.

People who used the service told us of their planned activities for the day, such as going shopping or on a bus trip. They told us that they liked their meal and got enough food.

Some of the people who used the service showed us their rooms and how they had individualised it to match their preferences. One person told us they liked their room.

We spoke to two relatives of people who used the service. They told us they were involved in care planning and reviews, they were kept informed about any change, contact was good from the service and it was also easy to contact the service, they communicate well and frequently, the staff were nice, they felt their relative was safe. Peoples’ relatives also said they had no complaints but felt the staff were very approachable and would feel comfortable to raise any concerns.

One persons’ relative told us they had questioners in the past and another had not. One persons’ relative told us there relative told told them they are happy at Roseleigh and that they love it there.

Our visit was unannounced and early in the morning and we found that the home was clean and fresh and people were treated with dignity and respect.

We found that before people received any care or treatment they were asked for their consent, but where people did not have capacity to consent the provider did not act in accordance with legal requirements.

We found that people experienced care, treatment and support that met their needs, but there were no service specific written procedures in place to plan for all reasonable foreseeable emergencies. This meant that if an emergency situation did occur there would be no contingency procedures recorded to enable the agency to continue to provide safe appropriate care.

People were not always protected against the risks associated with unsafe or unsuitable premises.

We saw that the health and safety of people was promoted, reviewed and audited and the views of people were sought and recorded. However, although the provider did have an effective quality assurance system which they had used in the past, this had not been completed since 2011.

At the time of our visit there were six people living at Roseleigh but most of the people were out of the house doing a variety of activities to include fitness and trampolining clubs. On their return we spoke with two people who used the service. However, due to communication difficulties we were unable to discuss things at length. The people we spoke with were able to indicate that they were happy and enjoyed living in the home.

Some of the people who used the service had more complex needs which meant that they were not able to tell us about their experiences of using the service; therefore we spoke with relatives of people and used observation to help inform our judgment.

Our observations showed that some people used different methods of communication, for example the use of body language or signs. We observed that staff recognised these communication methods and responded appropriately. We saw that people were relaxed and at ease with staff and there was a lively and happy atmosphere in the home.

Relatives of people told us that they are happy with the care provided at Roseleigh. They also spoke highly of the staff and described them as "Very good" and "Stunning at what they do".

Staff told us that they "Loved" working at the home and felt supported by their manager.

We found that appropriate checks were in place to confirm the suitability of staff to work with vulnerable people.

People who use services at Roseleigh have multiple or complex needs. It was therefore difficult to ask them about their levels of satisfaction with the outcome areas inspected. We observed however that people using services, who are predominantly younger adults, appeared relaxed and at ease in their surroundings. Some of the people using services were out of the home on the day of the inspection. Records showed them to be busy taking part in a range of planned and meaningful activities.