We carried out a comprehensive inspection of this service on the 25 April 2016, and a number of breaches to the legal requirements were found. After the inspection the provider told us what action they would take. We undertook a further inspection on the 4 May 2017 and found that the provider had made improvements and the legal requirements were now being met.

Rosebelle provides accommodation for up to six people who may have a learning disability or mental health support needs. At the time of our inspection there were five people using the service.

At the last inspection we asked the registered manager to improve the quality assurance and auditing system and the way they reviewed accidents and incidents. We asked them to look at how they could improve staff values, and levels of staff training. We recommended that the registered manager should implement infection control policies and procedures, and make sure that people had their nutritional requirements assessed. We asked the registered manager to involve people more and make improvements to the décor of the premises. At this inspection we found that these improvements had been made.

The registered manager looked at ways they could improve people’s safety by analysing themes and trends when accidents or incidents had occurred. They looked at different ways they could reduce risks to people.

The registered manager had implemented a quality assurance system and audits had been introduced and were being completed on a regular basis.

Medicine audits were carried out and staff with the responsibility for administering medicines had their practice observed to ensure that they could do this safely.

Since our last inspection, the registered manager had introduced a core set of values and staff told us these were dignity, self-determination, fulfilment, privacy and choice.

People’s information included guidance for staff so that they could follow a structured approach to recognising and managing certain health conditions. People were given nutritious meals and were involved with developing the menus.

The registered manager had improved their approach to managing the control and prevention of infection. Staff followed policies and procedures that met current and relevant national guidance.

Staff were given regular training in a wide range of topics and had a clear understanding of the requirements of the Mental Capacity Act 2005.

Some improvement's to modernise the décor of the communal areas had been completed since the last inspection. Other areas such as the bathroom and the garden area still needed some work which would be completed in the next six months.

The registered manager was present during 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.

We inspected this service on 25 April 2016. This was an unannounced inspection. The service is registered to provide personal care and accommodation for up to six people who may have a learning disability or mental health support needs. At the time of our inspection, five people were living at the service.

The registered manager was present during 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.

At this inspection we found the service to be in breach of regulations 18 and 14 of the Health and Social care Act 2008 (Regulated activities) Regulations 2014.You can see what action we told the provider to take at the back of the full version of the report.

The service did not always focus on how they could improve their safety records and did not analyse themes and trends when accident or incidents had occurred.

The provider did not have a core set of values that staff were required to work towards. Quality assurance systems were in place, but were inconsistently applied

Medicine audits were not carried out consistently and staff with the responsibility for administering medicines had not had their practice observed to ensure that they could do this safely.

The service did not manage the control and prevention of infection well and staff did not follow policies and procedures that meet current and relevant national guidance.

People could access food and drink as they wished, but care plans lacked nutritional assessments, which meant that staff could not follow a structured approach to recognising and managing certain conditions. People were given meal options that were nutritious, but were not involved with developing the menus.

Staff was given a thorough induction that gave them the skills and confidence to carry out their role. Staff training however was not kept up to date.

Staff did not have a good understanding of the requirements of the Mental Capacity Act 2005 and required training in this area. Records were effective in demonstrating people’s level of mental capacity and applications to apply for Deprivation of Liberty Safeguards (DoLS) to protect the rights of people had been submitted to the local supervisory body for authorisation. Improvements to modernise the décor of the communal areas and some of the bathrooms was required and plans had been put in place.

People and their relatives were involved in care planning and risks had been assessed. People’s privacy and dignity was maintained whilst encouraging them to remain as independent as possible, and activities were provided to meet the interests of individual people.

A complaints policy was in place along with an easy read version. All of the people we spoke with were happy to make a complaint should the need arise. People told us they felt safe and staff understood their responsibilities to protect people from harm and abuse.

We spent time with five of the people who used the service and spoke in more detail with two people to find out what it was like to live in Rose Belle. People told us that they felt safe, well cared for and happy living at the service.

We saw that people received care and support according to their assessed needs. Where people did not have capacity to consent to their care and support and where they required treatment the provider acted in accordance with the legal requirements and principles of Mental Capacity Act (MCA) 2005.

We found that there were enough qualified, skilled and experienced staff to meet people’s needs. We spoke with two staff who told us that they received training and support to do their jobs. They both spoke knowledgably about the people they provided care and support to. They told us that they felt there was enough staff on duty.

We found that people were protected from the risk of unsafe or inappropriate care and treatment because accurate and appropriate records were maintained.

We talked with three of the people who use the service. They told us that they liked living in the service. People also told us that they got on well with the staff, who supported them to go out to do their personal shopping, to follow their favourite activities, to be part of the local community and to go on holiday. They also told us that their rooms were comfortable and that they had their own belongings around them.

We observed that the staff were attentive to people’s needs. Staff interacted with people in a friendly, respectful and professional manner. We saw that staff sought people’s agreement before providing any support or assistance.

We saw that people were protected by the service’s safeguarding policy and that staff were supported in their work by being offered appropriate training and supervision.

People were encouraged and supported to make complaints. Staff on duty told us that they tried to ensure that complaints were dealt with informally and we saw that complaints that had been received were dealt with in line with the provider’s complaints procedure.