Rosemount is a residential care home which provides accommodation for up to 16 older people. Some of the people who used the service were living with dementia type conditions. The home is registered as a charity and has a board of trustees. It is located close to the centre of Consett and local amenities. At the time of our inspection there were 15 people using the service.

At our last inspection carried out in May 2015, the service was rated as “Good”. At this inspection we found the service remained “Good”.

This inspection was carried out on 30 May and 5 June 2017 and was unannounced.

The home had a registered manager in post. 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.

The staff had received consistent high praise from relatives and people who used the service for their caring approach. Relatives felt staff went the extra mile to support people. The staff formed good working relationships with the people they looked after but also genuinely cared about them. People felt they were well looked after.

Relatives described to us the exceptional support they had received from staff as people neared the end of their life.

We saw people and their family members were given opportunities to be involved in the service including a suggestions box, attendance at meetings and in providing information about their care needs.

We found people were cared for in an environment which was safe. Regular checks including fire checks were carried out in the home. Risk assessments were carried out and actions put in place to mitigate risks people faced.

Checks were carried out on prospective staff to see if they were suitable before they started working in the home. Staff were supported to develop their knowledge and skills by an induction, training, supervision and annual appraisals.

There were enough staff on duty. People were attended to promptly and supported without being rushed.

We saw regular cleaning was carried out in the home and everywhere was clean and tidy. Relatives confirmed this was the case.

Adaptations to the building had been made to incorporate en-suite bathrooms and toilets in people’s bedrooms. Funding had been raised to install a new nurse call system.

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.

Relatives and people who used the service made positive comments about the registered manager who was a visible presence in the home.

We found the provider and the registered manager used audits and surveys to monitor the quality of the service delivered and put in place actions to make improvements.

The trustees of the home held regular meetings to monitor the service. The registered manager was accountable in these meetings to the trustees who each had a role to support the running of the home.

Further information is in the detailed findings below.

During our inspection we asked the provider, staff and people who used the service specific questions; is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, their relatives, and the staff supporting them and from looking at records.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

People told us they were treated with respect and dignity by the staff. They said they felt safe. We found safeguarding procedures to be robust and staff understood how to safeguard the people they supported.

Systems were in place to make sure that managers and staff learned from events such as accidents and incidents, complaints, concerns, whistleblowing and investigations. This reduced the risks to people and helped the service to continually improve.

The home had proper policies and procedures in relation to the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards. The manager told us about an application that had been submitted. We also found relevant staff had been trained to understand when an application should be made, and how to submit one. This meant people were safeguarded as required.

The service was safe, clean and hygienic. Equipment was well maintained and serviced regularly therefore not putting people at unnecessary risk.

The registered manager set the staff rotas, they told us they took people’s care needs into account when making decisions about the staffing numbers, qualifications, skills and experience required. This helped to ensure that people’s needs were met.

Recruitment practice was safe and thorough. Policies and procedures were in place to make sure that any unsafe practice was identified; this helped to protect people who used the service.

Is the service effective?

There was an advocacy service available if people needed it, this meant people could access additional support when required.

People’s health and care needs were assessed with them, and they or their representatives were involved in writing their plans of care. Specialist dietary, social, mobility, equipment and dementia care needs had been identified in care plans where required. Some people said they had been involved and consulted about them and they reflected their current needs.

People’s needs were taken into account with signage and the layout of the service enabling people to move around freely and safely. The premises had been sensitively adapted to meet the needs of people with physical, memory and mental health impairments.

Visitors confirmed they were able to see people in private and that visiting times were flexible.

Is the service caring?

People told us they were supported by kind and attentive staff. We saw care workers showed patience and gave encouragement when supporting people. People commented, “I never feel rushed by the staff that help me, they help me to do things for myself”. A relative said, “I visit my relative almost every day and the staff are good at listening to any concerns that I raise and always respond appropriately."

People using the service, their relatives, friends and other professionals involved with the service completed an annual satisfaction survey. Where shortfalls or concerns were raised, we saw these had generally been addressed by the provider.

People’s preferences, interests, aspirations and diverse needs were recorded and care and support was provided in accordance with people’s wishes.

Is the service responsive?

People completed a range of activities in and outside the service regularly.

People we spoke with knew how to make a complaint if they were unhappy.

Is the service well-led?

The service worked well with other agencies and services to make sure people received their care in a joined up way.

The service had a quality assurance system. The records we looked at showed any shortfalls were addressed promptly. As a result the quality of the service was continuingly improving.

Staff told us they were clear about their roles and responsibilities. Staff had a good understanding of the ethos of the home and the quality assurance systems in place. This helped to ensure that people received a good quality service.

People and their representatives told us they were always consulted about their care and support needs. They said they were consulted about how their care needs were to be met.

Comments from people who used the service included, “The staff are very kind. The carers are very good, “Everything is good here. The staff are very nice.”

A visitor said, “I am very satisfied. I am happy with the care my relative is receiving." Another said, "The home is just wonderful."

A relative told us they felt very welcome to visit the home at any time. They said, “I couldn't fault the care. I live nearby and I can come and see my relative when I want to. This place is excellent and everyone is so friendly.”

People who used the service and their representatives said there were enough staff to meet their needs appropriately.

The provider operated an effective complaints system. We found people who used the service were aware of the complaints procedures, and they told us their comments and concerns were listened to and acted upon.

We also found the provider had an effective system in place to ensure all records were kept secure and remained confidential.

The arrangements for supporting people to make decisions about their daily lives and preferences were recorded in their care plans. Each person was supported to take appropriate risks to promote as much independence as possible.

Suitable arrangements were in place for people to take part in activities in line with their needs and preferences.

The relationships between staff and the people who lived there were good and personal support was provided in a way that promoted and protected their privacy and dignity.

Suitable arrangements were in place for handling complaints and for protecting people from abuse. One person told us they could share any concerns with the staff and felt their views were listened to. Another person said “This place couldn’t be faulted. I love living here because all my needs are taken care of and I feel safe.”

There was a stable and competent staff team who had the training, skills and experience to meet the specific conditions of the people who lived there.

“I have a lovely key worker, we always discuss everything together, she never does anything without asking me first, she and others always listen to, and respect my views”.

“I am fully involved in all aspects of my life here; they respect my wishes and accept what I say. I choose to come and live here because I knew that it had a good reputation. I have no complaints at all”.

“I think the support that I have here is wonderful, all my needs are met. Everyone is kind and caring”.

“I have plenty to keep me occupied, and I do as I want. I receive very good support”.

“It’s lovely here, I have made lots of friends, and all my needs are taken care of. They (the staff) listen to what I have to say, and they are very kind”.

“The meals are great, and the cooks are very good, they make lovely home made cakes”.

“I have no complaints, we get a three course meal each day, and we can have a choice of what we want”.

“The food is perfect”.

“Mealtimes are always a pleasure; we sometimes have a sing a long in the dining room with the staff”.

People told us that they always get their medicines at the right times.

“They (The staff) are very good at their jobs; nothing is too much for them”.

“I think they are hard workers, and they always have time to chat and we have a laugh together”.

“They are very experienced, they know what they are doing, and they do it properly”.

This inspection took place on 18 May 2015 and was unannounced. This meant the provider was did not know we were inspecting the home at that time.

We last inspected Rosemount on 22 April 2014 and found it was compliant with our regulations.

Rosemount is registered with the Care Quality Commission to provide care for up to 16 elderly people. The home does not provide nursing care. Rosemount is a registered charity and has a board of trustees that oversees the managements of the home. At the time of our inspection there were 14 people living in the home. The provider had recently altered the first floor accommodation to create two single bedrooms which was previously a very large single bedroom.

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. During our inspection we found the previous registered manager had left the service and had deregistered with CQC and a new manager had been appointed . On the day of our inspection the new manager had been in post for six weeks and was now registered with CQC. She was previously the deputy manager of the service for a number of years.

We found staffing levels at the home were appropriate for the number of people living there.

We found people’s medicines were well managed.

We saw the home had in place personal emergency evacuation plans displayed close to the main entrance and accessible to emergency rescue services.

We found the home had robust cleaning schedules in place to prevent the spread of infection.

The provider had worked within the Mental Capacity Act 2005. We saw that all people living in Rosemount had undergone consent to support’ and Mental Capacity Act assessments to identify their capacity to consent to their care. We also saw Deprivation of Liberty Safeguards were in place.

We observed staff speaking with people in kind, respectful and reassuring ways.

People told us they felt their dignity and privacy were respected by staff.

We saw a notice board on which was displayed information about the activities for that week. During our inspection we found lots of various activities taking place, for example one to one activities and group activities such as hoopla.

We found the provider had audits in place to measure and monitor the quality of the service.

We saw the provider had in place a complaints policy in place and this was clearly displayed for people to see.