Roseacre is a care home which provides accommodation and personal care for a maximum of 40 older people. The service has a specialist unit which accommodates up to ten people living with dementia. The service does not provide nursing care and the provider was in the process of removing the regulated activities associated with nursing care. There were 30 people using the service at the time of our inspection.

The inspection took place on 17 January 2017 and was unannounced.

The service had a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

Roseacre was last inspected on 29 July 2014 when we had no concerns.

We made one recommendation as a result of this inspection. As such we asked the provider to consider adopting a more strategic oversight of falls so as to be more readily able to identify any themes or trends across the service.

Roseacre was a friendly and inclusive service that provided support to people in a ‘Home from home environment.’ Many people had lived at the service for a number of years and had built friendships and new lives within the service.

The service was well-led and people’s needs were met by a team of staff who worked effectively together. Sufficient staffing levels were maintained. Where temporary staff were used to cover staff vacancies, these were regular to the service and therefore they too had a good knowledge about people’s needs and preferences. The appropriate recruitment and ongoing monitoring and appraisal of staff had ensured that only suitable staff worked at the service.

Staff received training and support from the management team in order to deliver their roles and responsibilities in line with best practice. The leadership team had fostered an open culture and coached staff to deliver high standards of care.

The service had good systems in place to identify and manage risks to people and to maintain the safety of the service as a whole. People were further protected from the risk of abuse or avoidable harm, because staff understood their role in safeguarding them.

People had positive relationships with staff who took steps to ensure care was provided in a way that protected their privacy and dignity. People were encouraged and supported to both maintain and develop their independence and spend their time doing things that were meaningful to them.

People were actively involved in making decisions about their care and these choices were effectively communicated and respected by staff. Staff ensured appropriate consent was gained from people and delivered care in the lest restrictive way.

Each person was appropriately assessed and had an individualised plan of care which outlined how their needs would be met. People were involved at each stage of planning their care to ensure staff provided support in a way that met their needs, preferences and expectations.

People were supported to maintain good health and there were systems in place to ensure people received their medicines as prescribed. People had choice and control over their meals and were effectively supported to maintain a healthy and balanced diet.

People and their representatives were able to share their feelings and staff ensured that when people raised issues that they were listened to and people’s opinions were valued. Roseacre had an active residents’ group who were routinely consulted about proposed changes and developments for the service.

During our inspection in June 2013 we found shortfalls with the service. We carried out this inspection to check whether the provider had taken action to address these shortfalls. During this follow up inspection we spoke with the provider, registered manager and two members of staff.

We found the provider had ensured there was a contingency plan in place for foreseeable emergencies. Restrictors had been fitted to all windows in the home. Allocations had been changed for staff that ensured people were supported at meal times in both units.

People that we spoke with on the day told us they were very happy living at the home. We were told it felt very homely and there was always plenty to do. “The staff are very kind” one person told us.” Another told us “I love my room it’s just been decorated and I have an ensuite with a view of the gardens.”

People spoke positively about their care and support. Comments included "This is a good home and the staff are very caring", "I am very happy with my care", "the service provides a homely atmosphere".

People were able to choose their meals. People we spoke with said that they enjoyed their meals. Comments included,"The meals are good" and the service "Provides good home cooked meals".

People who used the service lived in a well maintained environment but window restrictors had not yet been applied to ensure people's safety and welfare.

We found people were cared for in a clean, hygienic environment. People we spoke with said that that they found the home clean

We found people were mainly cared for, supported by, suitably qualified, skilled and experienced staff but a needs analysis had not been undertaken to ensure there was always sufficient numbers of staff to meet people's needs.

We found that the provider had systems in place to monitor the quality of service that people receive.

We found that there was an effective complaints system in place. Comments and complaints people made were responded to appropriately.

We spoke with five people using the service. They all told us that were very happy living in the service. People said that their care plan was discussed with them.

People told us that the staff were kind and caring and staff respect their right to privacy.

We visited one living unit, which provided care and support for people with dementia. We observed good staff interaction taking place. People living there were observed to be happy and relaxed.

During this visit we spoke with twelve people who live in the service. People told us that the staff were all very kind and caring and that they respect their right to privacy.They said that staff always knock on their bedroom doors before entering.

People we spoke with said that if they require any assistance from staff they usually respond in a timely way.

People told us that they were able to personalise their room. Some people said that they were happy with the activities, which they could choose whether to attend or not. People spoke positively about the variety of meals provided. They told us the food was very good and they had a choice of menu.

We looked at three people’s plan of care. Two of these had been signed by people or their representative to confirm their agreement. However for one person this had not been signed by them. Most people we spoke with said that they were also not aware of their care plan.