Rose Cottage is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Rose Cottage is a nursing home providing personal and nursing care for up to 29 older people. The accommodation is based over three floors, which are accessed by stairs or a lift. The home is situated in a residential area, close to local amenities and transport links.

In November 2017, the name of the registered provider and nominated individual changed.

At the time of this inspection, 28 people were living at Rose Cottage.

At our last inspection, we rated the service Good. At this inspection, we found the evidence continued to support the rating of Good and there was no evidence or information from our inspection and on going monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

At this inspection, we found the service remained Good.

Why the service is rated Good.

People receiving support and their relatives told us they were confident they or their family member was safe.

Staff were aware of their responsibilities in keeping people safe.

Policies and procedures for the safe handling of medicines were in place.

There were robust recruitment procedures in operation to promote people’s safety.

Staff were provided with relevant training, supervision and appraisal so they had the skills they needed to undertake their role.

People receiving support and their relatives felt staff had the right skills to do their job. They said staff were respectful and kind in their approach.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People’s care plans contained relevant information and had been reviewed to ensure they were up to date.

People were confident in reporting concerns to the registered manager and staff, and felt they would be listened to.

There were quality assurance and audit processes in place to make sure the service was running well.

The service had a full range of policies and procedures available to staff.

Further information is in the detailed findings below.

Rose Cottage is a nursing home providing personal and nursing care for up to 29 older people. Rose Cottage is situated at Halfway in a residential area of Sheffield. There is good access to public services and amenities. The accommodation is over three floors which are accessed by stairs or a lift. The majority of rooms are for single occupancy but the home does have one double bedroom. The gardens are landscaped and there is a car park.

Our last inspection of Rose Cottage was on 24 October 2013 and the service was found to be meeting the requirements of the regulations we inspected at that time.

This inspection took place on 10 November 2015 and was unannounced. This means the people who lived at Rose Cottage and the staff who worked there did not know we were coming.

There was a manager at the service who was registered with CQC. 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 were happy living at Rose Cottage and felt safe there. Staff told us they enjoyed working there.

Staff we spoke with had a clear understanding of safeguarding people and they were confident their managers would act appropriately to safeguard people from abuse.

There were enough staff to keep people safe and to meet people’s individual needs. Staff told us they received good training and support to make sure they had the right skills and knowledge for their job.

We found systems were in place to make sure people received their medicines correctly and on time. Medicines were stored appropriately and securely.

We saw and people told us there were enough staff were employed to keep people safe

Staff recruitment procedures were thorough and ensured people’s safety was promoted.

Care plans contained person centred information which meant staff had personal and medical information available to them. This ensured the person was supported in the way they preferred to meet their health and social care needs. People’s care plans also included comprehensive risk assessments which contained clear information for staff on how to manage and reduce these risks.

People knew how to raise concerns and make complaints. We saw that the registered manager took all issues seriously and responded appropriately.

We saw staff interactions with people were caring, and they treated people with dignity and respect. There was calm and relaxed atmosphere at Rose Cottage.

There were effective systems in place to monitor and improve the quality of the service provided. Regular audits were undertaken to make sure procedures were adhered to. Where any problems were identified the registered manager took action to resolve them.

During our visit we spoke with four people using the service, three relatives and 12 members of staff. We looked at four sets of care planning documentation and three staff files.

All of the people using the service and their relatives that we spoke with were positive about the home. Some comments from people included, “I love it here. Everything about it. I have no worries.” People said that they were treated with respect and their dignity was maintained.

People using the service and their relatives told us that care and treatment was planned and delivered in a way that ensured safety and welfare. A comment from a relative included, “They get well looked after”. A person using the service told us, “Staff know how to handle people and are skilled. They are lovely.”

All the people and relatives we spoke with said they had no concerns about abuse in the home. One relative told us, “It’s a safe environment."

We found that appropriate checks were undertaken before staff began work and there were effective recruitment and selection processes in place.

We found that that there was an effective quality monitoring system to analyse, identify and reduce risk through audit and incident reporting.

The manager told us resident meetings were to begin to encourage people to become involved and share their experiences of the service provided and delivered.

We saw that people’s privacy, dignity and independence was respected and that staff used a positive, friendly and kind approach with people. People told us they were treated with respect and staff listened to what they had to say.

People described the care they received and we found that the care, treatment and support provided met their needs. People said they felt well cared for. Comments included, “It’s sound. Couldn’t hope for much more. Staff are pretty good.”, “They go by the book (in regard to the food they should and shouldn't eat)” and “I’m happy with the care. If I wasn’t happy I’d find somewhere else.”

The premise was protected against the risk of it being unsafe or unsuitable, because appropriate checks were being maintained and maintenance of the premise was carried out on an ongoing basis.

A full employment history, together with a satisfactory written explanation of any gaps in employment to make sure they were suitable to work with vulnerable adults was not always evident before staff commenced employment.

People were confident that any complaints they had would be listened to, including when they needed to make a complaint.

We did not seek the views of people who used the service in relation to this outcome.

People told us the staff were very good and they looked after them well.

One person we spoke with told us, “Nothing is too much trouble for them”.

Relatives we spoke with told us they were very happy with the care their relative received and could not fault the staff. They informed us staff were always able to help when asked and knew what to do. They also told us people were well looked after and their needs were met.

We observed staff assisting people with their care. Staff were caring and spoke to people appropriately. One person told us “I’ve been here five years, I love it” “it’s changed a lot, staff have changed, but it’s coming back to normal like it used to be”. He told us that he’d enjoyed a trip to Clumber Park the day before our visit.

People were supported playing dominoes in the morning before lunch. They told us that they often do this and enjoy it. The staff member supporting people spoke to them in an appropriate and respectful manner. Drinks were served during the dominoes game. Staff took the time to make sure that people could have their choice of drink by making sure they were aware of all the available options. They also took the time to make sure that the drink was how they preferred it

People using the service told us they were generally happy with the service they received and we observed they appeared to be well cared for and cleanly dressed. One person told us “It’s lovely living here” “You know where you are, they help me”. Another told us “If you are ill they call the doctor”. However another told us “You look after yourself”.

A visiting relative told us their father was “Always lovely and clean”. The relative said they would talk to the acting manager if they had any concerns. Another told us the service did not appear “Quite as good as previously” however, we were told they had raised this with the provider and since then, the service appeared to have improved with “Staffing better”.

Staff told us there were limited activities at the moment due to some changes at the home but that bingo, cards, dominos, painting and play dough were available. We observed a game of throwing soft objects providing opportunities for gentle stimulation and exercise, however, one person told us they would like to get out more often but that the “Mini bus is stuck on the drive” and we observed a number of people asleep.

Relatives confirmed they would talk to the acting manager if they had any concerns. Staff told us there were policies and procedures available to help them protect people using the service from potential risk of harm and knew how to report any concerns should they need.

One person using the service said “staff are very good, coping with agency staff who don’t know what they are doing”. However, another said they had complained about cleaning in the past and that whilst they had received an apology for this, they told us “They keep advertising for staff, but (they’ve) been doing this as long as I can remember”.

Staff told us “I enjoy the job” and go to the manager and provider “If they had any problems and they would listen”. They said “Things were now more organised on the management side” and (that) things “Will gradually get better”. However others said they were reliant on agency staff as some staff were on holiday.

Staff told us they had now started having meetings in the home and one told us they had completed NVQ level 3 training, and a number of mandatory training courses. Another however said they “Would feel more confident with more training”.

People living in the home confirmed they were sometimes asked about improvements and we were told about plans to develop this more in the future.