Glen Rosa and Kitwood House provide accommodation and personal care to a maximum of 47 older people in single en-suite rooms. Glen Rosa provides accommodation and personal care for up to 33 older people. Kitwood House is a purpose built specialist unit attached to the main building, which provides care for up to 14 older people living with dementia. The service is located close to Ilkley town centre. We inspected the service on the 2 October 2017. On the day of the inspection 46 people were living in the home.

At the last inspection in July 2015 we rated the service ‘good’ overall and in each individual domain.

At this inspection overall we found the service had maintained the rating of ‘good.’ People and relatives were happy with the care provided and we saw some good examples of high quality care and support. However we rated the ‘Is the service safe?’ domain as ‘Requires Improvement.’ This was due to staffing levels not always being consistently maintained. However we did not identify any significant impact on people as a result of this. The management team had already identified this and we were felt assured this would be addressed through the management plans in place.

A registered manager was not in place, although steps were being taken to address this. The registered manager left in August 2017 and a new manager was now in post who had applying to be the registered manager for the service. This was being assessed by our registration department. 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 and relatives spoke positively about the care that was provided by the home. They said staff were appropriately trained, treated them well and told us the management team were effective in their role.

Medicines were safely managed. People received their medicines as prescribed and clear records were kept.

People said they felt safe. Risks to people’s health and safety were assessed and plans of care created for staff to follow. Learning had taken place following incidents to help improve the safety of the service.

The premises was safely managed and suitable for its purpose as a care home. Adaptions had been made to Kitwood House to ensure a suitable environment for people living with dementia.

People and relatives said there were usually enough staff in the home. However staffing levels were not always consistently maintained on both day and night shifts. We saw the service was in the process of over-recruiting to positions to reduce the likelihood this would continue.

Safe recruitment procedures were in place to ensure staff were of suitable character to work with vulnerable people.

Staff received a range of training which was relevant to their role. Staff said they felt well supported by management and received supervision and appraisal.

People praised the choice and variety of food available to them. Where people were at nutritional risk, measures were put in place to help protect them from harm.

The service was acting within the legal framework of the Mental Capacity Act (MCA) and Deprivation of Liberty Safeguards. Where people lacked capacity to make decisions, best interest processes had been followed in line with the Act.

The service worked closely with a range of health professionals to ensure healthcare needs were met. Health professionals spoke positively about the service.

Staff knew people well and treated people with kindness and compassion. Information on people’s lives and their current preferences had been sought to aid in the provision of personalised care.

People felt listened to and staff offered them choices on a daily basis.

People’s needs were assessed and used to produce appro

Our inspection took place on 27 July 2015 and was unannounced. This meant the provider and manager did not have advance notice that we would inspect the home on this day.

Glen Rosa and Kitwood House provide accommodation and personal care to a maximum of 47 older people in single en-suite rooms. Glen Rosa provides accommodation and personal care for up to 33 older people. Whilst Kitwood House is a purpose built specialist unit attached to the main building, which provides care for up to 14 older people living with dementia. The service is located close to Ilkley town centre.

The service had a registered manager, however they were on holiday on the day 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 told us they felt safe living at the home and felt comfortable when staff supported them. Staff had a good understanding of how to keep people safe and were supported by robust protocols in relation to safeguarding and emergency procedures. Potential risks were assessed and staff had a good understanding of what action they needed to take to help reduce risks to people’s health and wellbeing. We found medicines were managed in a safe way and people received their medicines when they needed them.

Our observations, discussions with people and staff and review of records led us to conclude that staffing levels were sufficient to help meet people’s needs and keep people safe.

People’s healthcare needs were evidenced as being met through effective care planning, being supported to access health professionals and staff promptly recognising and communicating changes to people’s needs so they could be reviewed and referred to other health services.

Mealtimes were a positive occasion where people were offered a variety of mostly home cooked foods. Care and kitchen staff worked well as a team to ensure mealtimes were relaxed but appropriately paced and that nutritional risks were effectively reduced.

Staff had a good understanding of the people they cared for and important issues such as safeguarding and the Deprivation of Liberty Safeguards. This knowledge was enhanced by a comprehensive training programme, regular supervisions and the maintenance of effective care records. Staff told us they felt supported and could approach the management team with any issues. The feedback people provided about the staff team was positive and demonstrated staff had built positive relationships with the people they cared for.

Staff sought people’s consent and appropriately used this to deliver care. Effective systems were in place to ensure the service met the legal requirements under the Deprivation of Liberty Safeguards and Mental Capacity Act 2005. Staff understood their role in protecting the rights of the people they cared for.

Feedback from people about the service, staff and standard of care provided was consistently positive. Staff treated people with kindness, respect and were consistently mindful to preserve people’s privacy and dignity. We observed staff regularly consulted people, offered choices and encouraged people to give their opinions to ensure the care and support provided was in line with people’s preferences. They adopted various methods of alternative communication to ensure people who lived with dementia were included, stimulated and understood the choices and options available to them. Staff helped people to retain their independence where ever this was possible.

People were encouraged to provide feedback and this was used to help improve the service and care provided. A complaints process was in place and advertised to people who used the service. Where people had made a complaint this was investigated and the provider listened to and responded to people’s views.

People spoke highly about how the home was run and said they were satisfied with the quality of the service provided. Effective governance processes and audit systems were in place and were used to improve the service and the quality of care provided.

We used a number of different methods to help us understand the experiences of people who used the service. This was because some of the people who used the service had complex needs which meant they were not able to tell us their experiences. For example, we observed care practices and talked to people's relatives and staff.

People who were able told us they enjoyed living at Glen Rosa and Kitwood House and were complementary about the care provided by staff. One person said "I have lived here a number of years, I am well looked after and have no concerns about the service or staff. Another said "Although I would obviously prefer to live in my own home I am happy living at Glen Rosa and appreciate the care and facilities provided."

We spoke with three visitors and they told us they were pleased with the standard of care and facilities provided by the service. One person told us although their relative had not lived at the home long they were very pleased with the care provided and were always made to feel welcome when they visited.

The staff we spoke with demonstrated a good knowledge of people's needs and were able to explain how individuals preferred their care and support to be delivered. We found the atmosphere within both Glen Rosa and Kitwood House was warm and friendly and we saw staff approached individual people in a way which showed they knew the person well and knew how best to assist them.

During our visit we spoke with five people who live at the home. They told us they could make decisions about what they did. One person said “I like it here because I can come and go as I please”.

People told us they were happy with the care and support they received from staff. One person said “I am very well looked after here, I get everything I need”.

People told us staff were kind, caring and worked really hard. However, people told us they sometimes had to wait to receive support from staff. One person said “Staff are not always there when you need them most”.

We spoke with two relatives while visiting the home. They told us they were involved in making decisions about their relatives care and treatment. They also said they were kept informed of any changes in their relatives needs. One relative said “It’s a pleasure to visit; staff always make me feel welcome”.