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Inspection carried out on 10 January 2018

During a routine inspection

We carried out this unannounced inspection on 10 January 2018. Our last inspection of the home was carried out in August 2015. At that inspection we rated the service as good. At this inspection in January 2018 we found the service remained good.

Rosehill House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The home provides personal care and accommodation for up to 23 older adults including people living with dementia. Accommodation is provided in five double and 13 single rooms, all with en-suites. Communal rooms are situated on the ground floor of the home. The home does not have a dining room. CCTV is used in some areas of the home. At the time of our inspection 18 people were living in the home.

There was a registered manager employed in the home. 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 environment was well-maintained and the atmosphere was relaxed and homely.

There were processes and practices in place to keep people safe. People told us they felt safe living in Rosehill House and with the staff who supported them. Hazards to people’s safety had been identified and managed.

People were supported by staff who knew them well and were focussed on promoting their independence and well-being. There was a stable staff team who had the skills and knowledge to meet people's needs. The service had a programme of training which ensured staff had up to date guidance and information.

The staff knew how to identify and report abuse and to identify any changes to a person’s condition that would require attention. Robust systems were used when new staff were employed to ensure they were suitable to work in the home.

People received the support they required to maintain good health and medicines were handled safely. A feature of the home was the partnership working with external healthcare professionals. Healthcare professionals described the home as “a delight to work with” and staff competence in managing health conditions had “taken a big step up in the last couple of years”. The home received high praise from NHS teams for people in the home staying pressure sore free for over two years and this was described by this team as a “fantastic achievement.”

People were supported to have maximum choice and control of their lives; the policies and systems in the service supported this practice. They were involved in planning their own support and which activities they wanted to take part in. There was a full programme of activities for people to take part in and people were supported to follow individual interests and hobbies.

We made a recommendation about assessing people’s capacity to make decisions and to take this into consideration in the use of CCTV cameras.

Staff were caring and treated people with dignity and respect. People were provided with meals and drinks that they enjoyed. The staff were knowledgeable about the support people required to enjoy their meals and drinks safely and this was provided.

The registered manager and senior staff team carried out checks on the premises and quality of the service, including seeking people's views, to ensure people received a high quality, safe service that met their needs. The management structure in the home had been strengthened since the last inspection and this had led to improvements in the service, such as care planning and the thoroughness of audits.

Further information is in the detailed findings below.

Inspection carried out on 29/05/2015

During a routine inspection

This was an unannounced inspection that took place on 29th May 2015.

Rosehill House is registered to provide accommodation and personal care for up to 23 people. It is a listed Georgian property set in its own grounds near to Whitehaven. Accommodation is provided in five double and 13 single rooms, all with en-suites. Communal rooms are situated on the ground floor of the home. The home does not have a dining room.

The provider is also the registered manager. 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.

Staff in the home were aware of their responsibilities in keeping vulnerable people free from harm and abuse.

The provider ensured that she completed risk assessments and managed any risks to individuals.

Staffing levels were suitable and people said the team were able to meet their needs.

Staff were recruited in a safe way.

There were suitable arrangements in place if there were any staffing matters of a disciplinary nature.

Medicines were managed correctly.

We saw that people were asked their consent and that the staff were aware of individual rights. No one was being deprived of their liberty.

Staff were given suitable induction, training, supervision and appraisal.

People told us they were satisfied with the food provided.

We saw that there had been some improvements to the environment and the provider agreed to our recommendation to purchase some small dining tables.

We looked at care plans and found that these were detailed and up to date and based on sound assessments. People were involved and aware of their own plans.

People told us they were satisfied with the range of activities and outings on offer. Regular church services were held in the home.

We spoke to people on the day who felt comfortable making complaints both informally and formally. We had some contact after the inspection with people who did not feel able to complain directly. We recommended that the provider look at the arrangements in place for people and their families to make complaints in a safe way.

The registered provider was suitably trained and experienced. There was a newly appointed deputy who would support her in the role. The senior care team were aware of their responsibilities as shift leaders. Staff knew how the home was managed and were comfortable with the arrangements in place.

The provider promoted a culture of openness and transparency where the focus was on the needs of people in the home. Staff felt that they could question decisions and their views were taken into account. People in the home were consulted and told us their wishes were respected.

Consultation with people in the home and their relatives was part of the quality assurance system. We saw evidence to show that there were regular quality audits of all aspects of the service. Changes had been made as a result of monitoring quality.

Partnership working with health colleagues had improved and new ways of communication had been developed.

Inspection carried out on 11 January 2014

During a routine inspection

People we spoke with told us they were happy living at Rosehill Residential Care Home and said the staff in the home provided a good standard of care. People made many positive comments about the staff employed in the home and the meals provided. They told us they made choices about their lives and the decisions they made were respected.

The home had created a friendly, lively and welcoming atmosphere. People told us things like, �The staff can�t do enough for you. They know me very well.� Another said, �I really like being here, the staff are so kind.� And �The food is very good with lots of choices, all homemade.�

We were told that staff were very attentive and knew their needs and care requirements. We judged that there were sufficient staff to meet the needs of the people living there. One person told us: �The staff are very attentive, they always come very quickly when I need assistance.�

The provider had recently improved the way it monitored the health, safety and welfare of people who use the service and others. We found that the premises were maintained to an appropriate standard of cleanliness and hygiene.

While people living in the home, staff and visitors were protected against the risks of unsafe premises, the design and layout of the home was not fully meeting people's needs. The lack of a dining room and the layout of the main lounge was not conducive to promoting dignity or for carrying out basic daily living such as eating a meal.

Inspection carried out on 13 April 2012

During a routine inspection

People who use the service told us the staff were very kind and treated them well. They told us they felt safe and liked living at the home. People told us they had been given plenty of information about the service being provided to enable them to a make an informed choice about whether the home was the right place to meet their needs. We were told that staff were very attentive and knew their needs and care requirements.

One person told us: �The staff are very attentive, they always come very quickly when I need assistance.�

Another said: �This is the best place for anyone, you couldn�t find a better place.�

A relative told us �Staff and the owner are very approachable � they will always sort out my problems.�

Another relative told us: �My mum loves it here � she doesn�t want to go home.�

Reports under our old system of regulation (including those from before CQC was created)