This was an unannounced comprehensive inspection that took place on 20 December 2016.

Rose Cottage is a care home registered to provide accommodation for up to 12 older people. The accommodation is on two floors. There was a communal lounge and dining room where people could spend time together. At the time of this inspection there were 12 people using the service.

The service had 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 2008 and associated Regulations about how the service is run.

People were protected from the risk of harm because staff had a good understanding about what safeguarding meant and how to report it. They had undertaken training to recognise and respond to safeguarding concerns.

There were effective systems in place to manage risks and staff knew what action to take to minimise risk while still supporting people's freedom to make choices. The premises and equipment were checked and serviced regularly. Staff knew the correct action to take in the event of an accident or an emergency.

Peoples medicines were managed in a safe way so that people got their prescribed medicines at the right time and in the right way.

There were enough skilled and experienced staff to meet people's needs and keep them safe. Recruitment procedures were safe and made sure that as far as possible only staff with the right character and experience were employed.

Staff received the training and support they required to meet people's needs. Staff knew people well and provided care and support in the way that people preferred.

People were supported to have enough to eat and drink. The menu was varied and people were able to choose their meals. They said they enjoyed the meals provided. Risk of malnutrition was assessed and appropriate action taken when risk was identified.

Staff and managers had an understanding of the Mental Capacity Act (2005) and Deprivation of Liberty Safeguards (DoLS). Staff sought people's consent before delivering care and support. People were supported to make their own decisions.

People had access to the healthcare services they required. Staff knew how to recognise deteriorating health and who to report it to.

There was a varied range of activities on offer. People were able to follow their chosen religion and had their social and recreational needs met.

People knew how to make a complaint and felt confident they would be listened to and action would be taken.

We have made a recommendation about the management of complaints.

People and staff felt the service was well managed. The service was led by a registered manager who understood their responsibilities under the Care Quality Commission (Registration) Regulations 2009. The vision of the service was shared by the staff team and put into practice. There was a positive and open culture.

Systems were in place which assessed and monitored the quality of the service. This included obtaining feedback from people who used the service and their relatives.

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008 and to pilot a new inspection process being introduced by CQC which looks at the overall quality of the service. The inspection was unannounced.

Rose Cottage Rest Home provides care and support for up to 13 older adults. There are plans in place to extend the home to create further communal spaces for people to enjoy.

The service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service and shares the legal responsibility for meeting the requirements of the law as does the provider. At the time of our inspection a registered manager was in post.

People we spoke with told us they were satisfied with the care and support provided. They had developed good relationships with their care workers and told us they were treated with kindness and respect and felt safe using the service.

Staff had a good understanding of the needs of people they cared for and were positive about their role and the home. Staff recruitment procedures were robust and ensured that appropriate checks were carried out before commencing work. Staff received a thorough induction and on-going training to ensure they had up to date knowledge and skills to provide the right support for people. They also received regular supervision and appraisals in line with the provider’s policy. There were sufficient numbers of staff available to ensure people’s needs were being met.

People’s needs were assessed and plans were in place to meet those needs. People’s wishes and preferences were taken into account and recorded in care plans. Staff understood what people’s individual needs were and acted accordingly. Risks to people’s health and wellbeing were identified and plans were in place to manage those risks. People were supported to access healthcare professionals whenever they needed to and healthcare professionals we spoke with were positive about the quality of care being provided.

The manager was clear about their vision and aims for the home and had ensured this was understood by staff. They had continually taken action to develop and improve the service.

At the time of our inspection there were 13 people using the service. We spoke with three people who used the service, the relatives of three people using the service, all of the staff working at the home at the time of our inspection, and two health professionals who regularly visited the home.

People we spoke with who used the service were all generally happy living at the home. They were all complimentary about the staff employed at the home and described them as being very caring.

We spoke with the provider and four members of staff at the home, including the activities co-ordinator and the cook. Three members of staff told us that they felt they could benefit from having more staff at the home. One staff member said: "Sometimes we could do with an extra member of staff. Saturdays are busy." Another staff member told us: "It's a bit stressful sometimes. Sometimes we could do with an extra pair of hands." All of the staff told us they felt adequately trained to carry out their roles and that they could access training if they needed to.

The relatives we spoke to were all very complimentary about the care delivered at the home. One relative told us: "It's just like a home. It's like she's in her own home. Everyone is so caring." Another relative said: "We've been more than happy since she came here." None of the relatives we spoke with had any concerns about the care.

We spoke with five people who used the service. People’s comments were positive and included “it’s lovely”, “the girls are very kind” and “it’s homely and comfortable”.

We also spoke with a district nurse who was visiting at the time of our inspection. They told us the care provided was ‘outstanding’ and said that people always looked clean and well groomed. They also told us that staff were very proactive in seeking advice and support about people’s health.

We looked at the care plans and records of three people who used the service. We found people’s needs were assessed and care was planned and delivered in line with their individual plan.

We found medication to be handled appropriately and to be safely stored and administered. However, we found an anomaly with one person’s medication. The manager took action to investigate and remedy the issue on the day of our visit.

Staff received appropriate professional development; however the provider may find it useful to note that staff supervisions were not being recorded.

The provider had an effective quality assurance system.

We spoke with four people who used the service, three relatives of people who used the service, two cares and the registered manager.

People who used the service were complimentary about the home. They told us that they felt well looked after. They told us many things which included:

“It’s lovely here. Everything in my room is as I’d like it.”

“I don’t get bored.”

“Staff are attentive.”

“It’s very good here, I like it because there aren’t too many people here.”

“I wouldn’t want to be anywhere else. I’m very well looked after. I can’t give enough praise.”

Three relatives of people who used the service told us that they visited this and other homes before deciding that Rose Cottage was the most suitable place for their parents. All the relatives we spoke with told us that they and their relatives had been involved in the admission process and in subsequent reviews of care plans.

One relative told us that, “Staff are very good at ensuring people are hydrated.” She added, “I’d come here. Nothing is too much trouble for the staff.” Another relative told us, “I’m very happy about my father being here, we feel lucky that he is here.”

The registered manager told us that the aim of the service was to support people to lead “an independent and dignified life.” Carers told us that they knew and understood the needs of people who lived at the home because they had they had “grown to know the people through talking a lot with them.”