The inspection was unannounced and took place on 25 July 2017. At our previous inspection in March 2017 the service was not meeting legal requirements relating to Safe care and treatment. Following that inspection the provider had sent us their action plan and at this inspection we found that significant improvements had been made.

Rowallan House is registered to provide accommodation for persons who require nursing or personal care for 41 older people, some of whom have dementia. At the time of the inspection there were 34 people using the service.

The service had a registered manager in place. 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.

Staff stored, administered and audited medicines to ensure that people received their medicines as prescribed by their doctors. People and their relatives felt that the service was safe. Each person had a care plan and risk assessment, which were regularly reviewed. People could move into the service only if there were suitable facilities to meet their needs. This ensured that people who moved into the service had appropriate facilities to meet their needs.

The staff recruitment processes were robust. This allowed people to be supported by staff who were properly checked and had the right knowledge and experience to deliver care. The training programmes staff attended were varied and relevant to their roles, and included adult safeguarding and Mental Capacity Act 2005. Staff also had support and supervision from management. We noted they had read the provider's policies and procedures and were confident to manage matters relating to adult safeguarding, whistle blowing and complaints.

People were confident that they had access to health care. A GP visited the service at least once a week to review people's medicines. Staff referred people to specialist healthcare providers as and when required. People had nutritious food and fluids.

Staff had good relationships with people living in the service and we observed caring and positive interactions. Staff respected people’s privacy and encouraged them to be as independent as possible. There were arrangements in place to be engaged with various activities.

The service was clean and tidy, and arrangements were in place for controlling infections and using appropriate equipment to ensure people's health and safety was not at risk.

The provider had good systems in place to ensure that people and their relatives' views about the service were listened to and acted on. The feedback the provider sought from people and relatives and the complaints procedure allowed people to share their views to influence the quality of the service.

The inspection was unannounced and took place on 2 March 2017. At our previous inspection on 15 July 2015, we rated the service Good. However, we identified one area that required an improvement. This was in relation to the recording and safe administration of medicines. Following that inspection the provider sent us their action plan which set out how the intended to make improvements. During this inspection, we found that medicine recording, administration and storage remained issues which put people's health and wellbeing at risk.

Rowallan House is registered to provide accommodation for persons who require nursing or personal care for 41 older people some of whom have dementia. At the time of the inspection there were 33 people using the service.

The service did not have a registered manager. However, there was an acting manager who was yet to apply to register with the Care Quality Commission. 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.

People told us they felt safe in the service and that staff treated them with respect and dignity. Staff were kind, compassionate and friendly when interacting with providing care. There were various systems in place which promoted people's safety. For example, people's risk assessments were completed and reviewed, equipment was regularly tested and enough staff were provided to ensure people received care that they needed.

Staff supported people to have access to health care. Health professionals came to the service and referrals were made for people so that they could receive medical treatment. The food provided at the service was nutritious and reflected people's preferences.

Staff were supported by the management and received regular supervision and training. They knew what adult safeguarding meant and how they could apply it in practice. They also had good knowledge about the Mental Capacity Act 2005 (MCA) and how to apply it within their role. The provider did not always follow their staff recruitment system in practice. We have made a recommendation to improve this.

We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We have served a warning notice in respect of this breach. You can see what actions we told the provider to take at the back of the full version of the report.

The inspection was unannounced and took place on 25 July 2017. At our previous inspection in March 2017 the service was not meeting legal requirements relating to Safe care and treatment. Following that inspection the provider had sent us their action plan and at this inspection we found that significant improvements had been made.

Rowallan House is registered to provide accommodation for persons who require nursing or personal care for 41 older people, some of whom have dementia. At the time of the inspection there were 34 people using the service.

The service had a registered manager in place. 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.

Staff stored, administered and audited medicines to ensure that people received their medicines as prescribed by their doctors. People and their relatives felt that the service was safe. Each person had a care plan and risk assessment, which were regularly reviewed. People could move into the service only if there were suitable facilities to meet their needs. This ensured that people who moved into the service had appropriate facilities to meet their needs.

The staff recruitment processes were robust. This allowed people to be supported by staff who were properly checked and had the right knowledge and experience to deliver care. The training programmes staff attended were varied and relevant to their roles, and included adult safeguarding and Mental Capacity Act 2005. Staff also had support and supervision from management. We noted they had read the provider's policies and procedures and were confident to manage matters relating to adult safeguarding, whistle blowing and complaints.

People were confident that they had access to health care. A GP visited the service at least once a week to review people's medicines. Staff referred people to specialist healthcare providers as and when required. People had nutritious food and fluids.

Staff had good relationships with people living in the service and we observed caring and positive interactions. Staff respected people’s privacy and encouraged them to be as independent as possible. There were arrangements in place to be engaged with various activities.

The service was clean and tidy, and arrangements were in place for controlling infections and using appropriate equipment to ensure people's health and safety was not at risk.

The provider had good systems in place to ensure that people and their relatives' views about the service were listened to and acted on. The feedback the provider sought from people and relatives and the complaints procedure allowed people to share their views to influence the quality of the service.

At the last inspection of this service which took place on 18 September 2013, we found that people's care and treatment was not planned and delivered in a way which met people's needs.

At this inspection we found that people's needs were assessed and their care and treatment was planned and delivered in line with their individual care plan. People and their relatives told us that their health and welfare needs were met. One person said "they look after me fine." Another person told us "everything is ok. I am fine here." A relative said "they are very respectful and treat her (mother) with dignity. When I leave here I know she is being looked after, I have no worries."

We also found at our previous inspection that the provider had not notified the Care Quality Commission (CQC) of all incidents which had occured in the home as required by the CQC (Registration) Regulations 2009. At this inspection we found that all notifiable incidents were reported to the CQC. Appropriate follow up action had been taken by the manager to ensure the service was safe and effective.

People told us that they were treated with respect by the staff. One of the people we spoke to told us "I like living here.The staff are nice and helpful." Others told us that the staff were "kind" "helpful" and "joked" with them.

People who use the service and their relatives were satisfied with the care and support provided at the service. A relative said "there is always a happy and caring atmosphere here. Everybody from the care staff, cook handyman and laundry lady are involved in a person's care which is nice to know. It is very homely." People were supported to access health and social care professionals when required. People who used the service and their families told us they were involved in making decisions around their care and support planning. We found that although basic care plans were in place setting out how to meet people's needs there was a discrepancy between information contained in care plans and the actual care provided to people. This meant that people were at risk of not always receiving the care and support they needed. The service had appropriate staff recruitment procedures in place. People told us that they felt safe with the staff and they would raise any complaints or concerns with the manager or their relative. The provider had not notified the Care Quality Commission of all incidents which had occurred in the home as required under the Care Quality Commission Regulations (2009).

People were supported to access health and social care professionals when required with their consent. A relative said "the home have tried to take her for various treatments, to see the dentist, optician and chiropodist but she refuses to go sometimes and they can't force her." People were happy with the care that they received. One person told us “the staff are very kind and helpful.They care about us and we have choice." People said they were involved in making choices about their care and the choice of food and drink that was provided. They told us that they got enough to eat and drink and that the food was of a good quality. We observed people having lunch at the home which was a relaxed and social event with staff discreetly offering assistance to people if needed. A relative said, "They spend time with people and seem quite kind and genuine." Another said "I have no worries about dad, knowing he is at Rowallan has taken a weight off my mind otherwise I would have found it difficult to cope." A healthcare professional said "it's the best home we go to in the area and that is due to the staff."

People living at the home told us that they were happy with the carers and the care they provided. Some of the comments received included, "I can’t fault them at all.” “The staff are kind and they look after us well.” “They respect us and come to help us whenever we press the buzzer.” “The food is really good and I have put on weight since I came here.”

A relative spoken to said, “I can’t speak highly enough of the home, his room is clean, they always accommodate his needs and wishes.” “I haven’t got any complaints.”

Another relative said, “Good staff, good food, good care. We can’t fault anything and we have peace of mind.”