About the service: Rosevilla is a nursing home that was providing personal and nursing care to 32 people at the time of the inspection.

People’s experience of using this service:

People received safe and effective care from staff who were well trained and supported to meet their needs. People felt safe and they were protected from the risk of abuse and avoidable injuries.

People were treated with kindness and compassion by staff who knew them well and catered for their preferences. People’s privacy and dignity was respected and their independence was encouraged.

People enjoyed having access to activities but appreciated that they could spend time alone when they wanted to and this was respected by staff. People and relatives were involved in the planning and review of their care.

People’s views were sought and listened to and they were involved in planning and reviewing their care.

Some improvements were required to ensure that all systems to monitor the quality of care were effective, and picked up on any areas for improvement.

The management team and provider promoted a positive culture and learning was encouraged and promoted.

The service met the characteristics of Good in most areas;

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection: At the last inspection the service was rated Requires Improvement (report published 13 December 2017).

Why we inspected: This was a scheduled inspection based on previous rating.

This unannounced inspection took place on 7 November 2017. At our previous inspection in January 2017 we found that the service was not always safe, effective, caring, responsive or well led and we found three breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. At this inspection we found that improvements had been made and the provider was no longer in breach of the three regulations. However further improvements were required and we found two new breaches of Regulations.

This is the second consecutive time the service has been rated as requires improvement. You can see what action we told the provider to take at the back of the full version of the report.

Rosevilla provides accommodation, personal and nursing care for up to 40 people. 10 places at the service were for people who required rehabilitation following a stay in hospital. At the time of the inspection 36 people were using the service.

There was 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.

Lessons were not always learned and risks reduced following incidents and accidents which could have resulted in harm. Prompt action was not always taken to respond to people's individual changing needs.

People's medicines were managed safely, however further information was needed to inform staff as to when people may require their medication.

The principles of the MCA were not being consistently followed to ensure that people who lacked the mental capacity to agree to their treatment were supported to do so in their best interests.

People's needs and choices were assessed, however further information was required to ensure people's individual diverse needs were identified and responded to.

People's dignity was not always maintained and people were not always involved and offered choices about their care.

Statutory notifications had not always been submitted and the registered manager did not follow current legislation to support people to make decisions.

People were protected from the risk of infection as safe infection control measures were in place.

People were protected from the risk of abuse as staff and the registered managers followed the safeguarding procedures if they suspected abuse.

There were sufficient numbers of suitably trained staff to meet the needs of people who used the service. Staff received training and support to fulfil their roles.

People received health care support when they became unwell or their needs changed and they were supported to eat and drink sufficient amounts to remain healthy.

Staff worked together with other agencies to ensure that people's needs were met effectively.

The environment had been adapted to meet people's individual needs and preferences.

People were enabled to be as independent and people told us that staff were kind and caring. People felt able to raise concerns and any complaints were acted upon.

People's end of life wishes were gained and staff worked with other agencies to ensure people received dignified care at this time.

The systems the provider had in place were improving the service and there were further plans to improve the quality of care for people. People and staff liked and respected the registered manager.

This unannounced inspection took place on 13 January 2017. We found that the service was not consistently safe, effective, caring, responsive or well led. We found several breaches of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we have taken at the end of the report.

There was 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.

Rosevilla nursing home provides nursing care for up to 40 people. Six of the places at the service provided people with short term care of a period of up to three weeks. These places offered rehabilitation following a hospital discharge.

People's medicines were not always managed safely. Risks of harm to people were assessed however precautions were not always put in place to minimise these risks.

The principles of the Mental Capacity Act 2005 were not always followed as people who lacked the capacity to consent to their care at the service were not supported to consent in their best interests.

People were not always treated with dignity and respect and their right to privacy was not always considered.

People's care records did not always reflect people's current needs and measure progress towards agreed goals.

The systems the provider had in place to monitor and improve the service were not always effective.

People were supported by sufficient staff to meet their needs safely, who had been recruited using safe recruitment procedures to ensure they were of good character. Staff told us they felt supported and received training to be able to fulfil their roles.

People knew how to complain and had confidence that their complaints would be dealt with and there was a range of hobbies and interests available to people if they chose to participate in these.

People had a choice of foods and special diets were catered for. People had access to a range of health care agencies if they became unwell or their needs changed.

People who used the service and the staff told us that the registered manager was supportive and approachable. The provider had continued plans in place to improve the environment for people.