Rosebank is a care home. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.

Rosebank Care Home has 26 beds providing accommodation and personal care to older people with a variety of support needs including those living with dementia. It is located in its own grounds in a residential area, close to Sheffield city centre. At the time of our inspection 24 people were using the service.

This inspection took place on 21 November 2017 and was unannounced. This meant the staff and registered provider did not know we would be visiting.

At the last inspection on 6 September 2016 we found medicines were not always safely and securely stored and there were discrepancies in the count of one person’s medicine. This was a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, in regard to Regulation 12: Safe care and treatment. The registered provider sent us a report of the actions they would take to meet the legal requirements of these regulations. We checked whether this regulation had been met as part of this inspection. We saw that sufficient action had been taken to meet the requirements of the regulation.

There was a manager at the service who was registered with the 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 and associated Regulations about how the service is run.

People living at the home and their relatives spoken with were very positive about their experience of living at Rosebank. They told us they, or their family member, felt safe and were happy.

Staff were aware of safeguarding procedures and knew what to do if an allegation was made or they suspected abuse.

We found systems were in place to make sure people received their medicines safely.

Staff recruitment procedures ensured people’s safety was promoted.

There were sufficient staff to meet people’s needs safely and effectively.

We did not find any concerns about the cleanliness of the service. This was supported by people and relatives we spoke with.

Regular checks of the building were carried out to keep people safe and the service well maintained.

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 made positive comments about the quality of food provided and told us their preferences and dietary needs were accommodated.

We saw staff had been provided with relevant training, supervision and appraisal so they had the skills they needed to undertake their role.

People were treated with dignity and respect and their privacy was protected. All the people living at Rosebank, their relatives and visiting health professionals we spoke with made positive comments about the care provided by staff.

We found people’s care plans and risk assessments were reviewed regularly and in response to any change in needs.

We saw people participated in a range of daily activities both in and outside of the home which were meaningful and promoted independence.

People said they could speak with the registered manager, registered provider or staff if they had any worries or concerns and they would be listened to.

There were effective systems in place to monitor and improve the quality of the service provided. Regular checks and audits were undertaken to make sure full and safe procedures were adhered to.

Staff, people living at Rosebank, their relatives and professionals said the registered manager was approachable and very supportive, and communic

This inspection took place on 6 September 2016 and was unannounced. This meant that the provider did not know we would be visiting. The service was last inspected in November 2013, and at that time was meeting the regulations we inspected.

Rosebank Care Home is a 26 bedded home providing residential care to older people with a variety of support needs including those with dementia. It is located in its own grounds in a residential area, close to Sheffield city centre. At the time of our inspection 24 people were using the service, many of whom were living with dementia.

There was a registered manager in place. 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 safely supported to access their medicines. However medicines were not always securely stored and there was a discrepancy in the count for one person’s medicines.

Risks to people arising from their health and support needs or the premises were not always assessed and plans were not always in place to minimise them.

A number of checks were carried out around the service to ensure that the premises and equipment were safe to use.

Staff understood safeguarding issues, and felt confident to raise any concerns they had in order to keep people safe.

The service monitored people’s levels of dependency and used this to assess staffing levels. A number of recruitment checks were carried out before staff were employed to ensure they were suitable. The service was in the process of recruiting new staff.

Staff received training to ensure that they could appropriately support people, and the service used the Care Certificate as the framework for its training.

Staff received support through regular supervisions and appraisals. Staff felt confident to raise any issues or support needs they had at these.

Staff had completed a range of training that enabled them to meet people’s assessed needs effectively.

The registered manager and staff had received Mental Capacity Act (2005) and the Deprivation of Liberty Safeguards (DoLS) training. At the time of inspection one person who used the service was subject to a DoLS authorisation. Care plans contained evidence of MCA assessments and consent. We have made a recommendation around MCA and DoLS.

The service worked closely with external professionals to support and maintain people’s health. Staff knew how to make referrals to external professionals where additional support was needed. Care plans contained evidence of the involvement of GPs, nurse practitioners, district nurses and other professionals.

The interactions between people and staff were cheerful and supportive. Staff were kind and respectful; we saw that they were aware of how to respect people’s privacy and dignity. People and their relatives spoke highly of the care they received.

Procedures were in place to support people to access advocacy services should the need arise.

Care plans were person centred and provided a lot of personal information that was relevant to that person. However care plans did not always capture people’s needs. We have made a recommendation regarding care plans.

People were supported to maintain a healthy diet, and people’s dietary needs and preferences were catered for. People told us they enjoyed the food although were not offered a choice. The cook did not fully understand how to fortify people’s meals and the picture menus did not match what food was on offer that day.

The service was in the process of employing a new activities co-ordinator. At the time of the inspection staff were arranging activities. People were happy with the activities on offer.

The service had a clear complaints policy that was applied when issues arose.

Before people received any care or treatment they were asked for their consent and the provider acted in accordance with their wishes. There were also appropriate arrangements in place where people did not have the capacity to consent to their care.

We observed staff caring for people and supporting them around the home in a gentle and respectful manner. As they went about their duties in the home, we observed staff stopping to chat with people and asking if they could help them with anything.

We checked files and records, and spoke with staff. We found that the provider did not have appropriate arrangements in place for gaining people’s consent to care and support. Subsequent to the inspection, the registered manager provided us with copies of forms that the provider used in relation to gaining consent or reaching best interest decisions. However, we did not see any of these in use on the day of the inspection.

People were cared for in a clean, hygienic environment. We carried out a visual inspection of the premises, and found that areas we checked were cleaned to a high standard.

The recruitment process each staff member had gone through showed that their suitability, skills and competencies had been assessed. Each staff member had been subject to reference checks and identity checks prior to appointment.

People’s personal records, staff records and other records relevant to the management of the home were accurate and fit for purpose.

During our inspection we spoke with five people currently residing at Rosebank Care Home. They told us they liked living at the home and we received comments such as “Living here is lovely, I’ve made a lot of friends”, “I’m quite happy here, the staff really look after you” and “They (the staff) always stop and have a chat with you”.

The people we spoke with told us that they felt safe and were treated with respect. People told us that they could choose what time they got up and what time they went to bed. One person told us “I can go out when I want to; I went out for the afternoon yesterday”.

Everyone we talked with spoke positively about the food and we received comments such as “The food is lovely” and “There is always plenty to eat and drink”.

No one we spoke with had any concerns or complaints and could not think of any areas where the home needed to improve. Everyone we spoke with felt confident to raise any concerns they may have with the manager or a member of staff.

We also talked with two relatives that were visiting the home and they spoke positively about the service and staff. They told us that they felt involved in their relatives care and that staff kept them informed of any changes. One person told us that the chef always offered to prepare a meal for them when they were visiting so that they could eat with their relative.