Roop Cottage provides accommodation, personal care and nursing for up to 35 people, some of whom may also have physical disabilities. The accommodation is over two floors and there is a passenger lift. There were 32 people living there at the time of the inspection.

The last inspection was in June 2016 and the service was rated ‘requires improvement’ at that time. This was because the premises were in need of refurbishment and better cleaning and medicines were not always managed well. Some risk assessments had not been reviewed and some equipment had not been sufficiently assessed for safety. The provider had addressed most aspects of the concerns, although progress was slow to refurbish the premises and there was still further work required to bring them to a better standard of repair and décor.

There was a registered manager in post. 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.

There was a welcoming, friendly atmosphere and people told us they were happy living at Roop Cottage. There had been some improvements to the premises and décor since the last inspection and the registered manager had prioritised main areas such as bathrooms and we were advised this work was ongoing, subject to the provider’s agreement. We have made a recommendation the provider improves the premises.

People said they felt safe and there were routine safety checks carried out. Individual risk assessments for people were in place and had improved in detail and accuracy since the last inspection.

Staff understood how to ensure people were protected against possible abuse and they knew how to report any safeguarding concerns.

People said they received their medicines on time, and systems for managing medicines were safely in place.

Staff felt supported in their role, there was clear direction for the team and there was regular staff training and supervision.

People enjoyed the meals and the food and drink provision was suitable for people’s needs.

Staff interaction with people was kind and caring and staff knew people well. People were encouraged to retain their independence and they told us they felt this was their home.

The activities staff knew people’s needs and individual interests. Activities provided meaningful engagement for people on an individual basis and in groups where appropriate.

Care records were maintained with sufficient information for staff to understand all aspects of people’s care needs and these were regularly reviewed. Care practice reflected what was written in people’s care records.

People knew how to make a complaint and there was a system for recording complaints and compliments.

The registered manager was experienced in providing care at Roop Cottage. People, relatives and staff felt supported and they were confident their views were valued. Systems were in place for monitoring the quality of the provision. The registered manager was aware of the strengths of the service and the areas to improve.

Roop Cottage provides accommodation, personal care and nursing for up to 35 people, some of whom may also have physical disabilities. The accommodation is over two floors and there is a passenger lift. There were 32 people living there at the time of the inspection.

The last inspection was in June 2016 and the service was rated ‘requires improvement’ at that time. This was because the premises were in need of refurbishment and better cleaning and medicines were not always managed well. Some risk assessments had not been reviewed and some equipment had not been sufficiently assessed for safety. The provider had addressed most aspects of the concerns, although progress was slow to refurbish the premises and there was still further work required to bring them to a better standard of repair and décor.

There was a registered manager in post. 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.

There was a welcoming, friendly atmosphere and people told us they were happy living at Roop Cottage. There had been some improvements to the premises and décor since the last inspection and the registered manager had prioritised main areas such as bathrooms and we were advised this work was ongoing, subject to the provider’s agreement. We have made a recommendation the provider improves the premises.

People said they felt safe and there were routine safety checks carried out. Individual risk assessments for people were in place and had improved in detail and accuracy since the last inspection.

Staff understood how to ensure people were protected against possible abuse and they knew how to report any safeguarding concerns.

People said they received their medicines on time, and systems for managing medicines were safely in place.

Staff felt supported in their role, there was clear direction for the team and there was regular staff training and supervision.

People enjoyed the meals and the food and drink provision was suitable for people’s needs.

Staff interaction with people was kind and caring and staff knew people well. People were encouraged to retain their independence and they told us they felt this was their home.

The activities staff knew people’s needs and individual interests. Activities provided meaningful engagement for people on an individual basis and in groups where appropriate.

Care records were maintained with sufficient information for staff to understand all aspects of people’s care needs and these were regularly reviewed. Care practice reflected what was written in people’s care records.

People knew how to make a complaint and there was a system for recording complaints and compliments.

The registered manager was experienced in providing care at Roop Cottage. People, relatives and staff felt supported and they were confident their views were valued. Systems were in place for monitoring the quality of the provision. The registered manager was aware of the strengths of the service and the areas to improve.

This was a scheduled inspection, which also followed up on our last visit in which outcomes 10 (safety and suitability of premises) and 14 (supporting workers) were non-compliant.

We carried out the inspection with our five questions in mind; Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?

Below is a summary of what we found.

Is the service safe?

We found the premises were safe, accessible, visibly clean and well maintained. We discussed people’s security with the manager and she explained unauthorised access was monitored to make sure people were safe. We saw furniture was appropriately maintained and in suitable condition, although there were two carpets still in need of replacing. We saw people easily accessed toilet and bathroom facilities and moved freely around the premises. The design and layout of each floor was similar and enabled people’s autonomy and safety.

Is the service caring?

Staff spoke with people in a patient, caring manner and there was evidence of good relationships between them. Where people were confined to bed, staff made regular checks to ensure their well-being and offered drinks or music to listen to. Staff we spoke with were enthusiastic about their work and all said they enjoyed caring for people.

Is the service effective?

We spoke with three visitors who came to see people living in the home. Two of the visitors we spoke with told us they were happy with the standard of care provided. They said the staff were approachable and kept them informed about their family members’ care. Another visitor said they thought the care could be better and they had expressed their concerns to management on occasion.

Staff had regular opportunities for training to be more knowledgeable in their role. However, some staff shifts were thirteen hours in length, which may reduce the effectiveness of staff’s abilities to care for people properly.

Is the service responsive?

We saw people’s wishes were respected with regard to when they wanted to get up and go to bed. For example, we noticed some people chose to stay in bed until mid-morning whilst others got up earlier and sat together in the lounge. One person told us they sometimes liked to stay in bed longer in the mornings and another said they preferred to stay up and watch television in the evenings.

Staff told us if they had concerns about a person’s health they would refer these to senior staff so that people received appropriate care and support.

Is the service well led?

We saw the manager was involved in people’s day to day care and she utilised her skills as a nurse to monitor their health. We saw the manager discussed people’s health needs with care staff during our inspection. The manager told us she liked to be present in the home as much as possible in order to keep in touch with people, relatives and staff. We found there were suitable quality assurance measures in place so people’s care and well-being was monitored effectively. The manager told us she carried out periodic reviews of care and practice to ensure people were supported and their needs met.

People we spoke with told us they liked living at the service, they felt safe and were well looked after. We also spoke with relatives and they told us that the service was very good and staff kept them informed of any issues or changes to their relative's health

We spoke with health care professionals who visited the home. They spoke positively about the service provided. They told us they were confident in the staff's abilities to meet people's needs.

People also told us that staff treated them with respect, listened to them, gave them choices, made them feel safe and supported them. One person told us. "I have settled very quickly because the staff have made me very welcome and are very good."

People were protected from the risk of infection and appropriate guidance had been followed. However the environment was in a poor state of repair. Carpets and furniture were stained and marked and not well maintained.

People were not always cared for by staff who were supported to deliver care and treatment safely and to an appropriate standard. This was because training was not up to date and staff had not been appraised.

There was an effective system to regularly assess and monitor the quality of service that people received.

People said they like living in the home and they think their care needs are met. One person said they like their room, the food and the people caring for them. One visiting relative said they visit the home regularly and the staff are always very good and people appear to be very happy. One visiting District Nurse says they don’t have any issues with the home and people continue to be well cared for.

People say they like living in the home. One person said ‘If they have any concerns they can tell someone and its sorted’ Another says the staff listen to what they have to say and things get changed’ One person said they ‘feel very safe and well cared for’. People we could not communicate with appeared to be happy, very relaxed and comfortable.

People say they like the people caring for them. One person said the carers are ‘very good’ and ‘very caring’. Another says ‘there is always someone there when you need them’. A visiting relative says the staff are ‘very good’ and they can speak to the manager at anytime.

People say they like the people caring for them. One person said the carers are ‘very good’ and ‘very caring’. Another says ‘there is always someone there when you need them’. A visiting relative says the staff are ‘very good’ and they can speak to the manager at anytime.

People say they like the people caring for them. Some people we could not communicate with appeared to be happy and positive relationships were observed being fostered between those living in the home and those caring for them.

People living in the home say they like the people caring for them. People we could not communicate with appeared to be relaxed and comfortable with those supporting them.