This inspection took place on 28 June and 5 July 2018 and was unannounced.

Rockingham House is registered to provide residential care for up to 26 older people. The service 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.

The service is a converted and extended town house and accommodation is provided across three floors. At the time of our inspection, there was 21 mainly older people using the service.

At our last inspection, we rated the service ‘Good’ overall. At this inspection the evidence continued to support the rating of Good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

The service had a registered manager. A registered manager is a person who has registered with the 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. They had been the registered manager since July 2015. They were supported by senior care workers and a director of care in the management of the service.

During the inspection people who used the service consistently told us they felt safe at Rockingham House. Staff were safely recruited and enough staff were deployed to make sure people’s needs were met in a timely and safe way.

Staff had a good understanding of people’s needs and very detailed risk assessments were in place to guide them on to how to provide consistently safe care. The registered manager closely monitored any accidents and incidents that occurred to identify any actions that could be taken to prevent a reoccurrence and keep people safe. Medicines were stored, recorded and administered safely.

The environment was clean and well maintained. Work was planned to replace carpets and renovate certain areas to develop a more dementia friendly environment. We spoke with the registered manager about developing environmental risk assessment to ensure it covered potential risks relating to single paned glass in windows. The provider acted to address this.

Staff received regular training and we received positive feedback about the effective care and support they provided. The registered manager used supervisions and an annual appraisal to support staff’s continued professional development.

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. The registered manager had a very good understanding of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS). Staff provided effective support to help people make decisions and records clearly evidenced people’s rights were protected when they lacked mental capacity.

People gave positive feedback about the food provided and staff supported people to make sure they ate and drank enough. Staff worked closely with healthcare professionals to make sure the care and supported met people’s needs and they received medical attention when necessary.

Staff were very kind and caring. They provided attentive care and support in a respectful and compassionate way. People told us staff maintained their privacy and dignity. People had choice and control over their daily routines and staff respected people’s decisions.

Staff provided person-centred care and support. They knew people well and were responsive to their needs. People’s care plans were very detailed and person-centred and supported staff to provi

This inspection took place on 20 January 2015 and was unannounced. We last inspected the home on 24 April 2014. At that inspection we found the home was meeting all the regulations we inspected.

The home provides personal care for up to 26 older people. Rockingham house is a detached property with an extension to the ground floor. The home is accessible with ramped access and a passenger lift. Accommodation is provided in single roomed accommodation and is set over three floors. The home is situated close to a range of community facilities.

There was no registered manager in post at the time of our inspection, however, there was an acting manager in charge of the home and the post for a registered manager had been advertised. 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.

Rockingham House provided good care and support for the people that lived there.

The service was safe. People spoke positively about the home and those we spoke with said they felt safe. Staff recruitment processes included carrying out appropriate checks to reduce the risk of employing unsuitable people. Staff had received training with regard to safeguarding adults and were able to demonstrate they knew what to do in the event of suspected abuse.

The home had safe systems in place to ensure people received their medication as prescribed; this included regular auditing by the home and the dispensing pharmacist.

Staff were assessed for competency prior to administering medication and this was reassessed regularly.

New staff had received relevant training which was targeted and focussed on improving outcomes for people who used the service. This helped to ensure that the staff team had a good balance of skills, knowledge and experience to meet the needs of people who used the service.

Staff followed the principles of the Mental Capacity Act 2005 to ensure that people’s rights were protected where they were unable to make decisions.

We saw staff were attentive and respectful when speaking with or supporting people.

People looked well cared for and appeared at ease with staff. The home had a relaxed and comfortable atmosphere.

People's needs were assessed and met in accordance with their wishes. We saw evidence of the service ensuring people were able to continue with interests and hobbies.

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

People using the service, their relatives and other professionals involved with the service completed an annual survey. This enabled the provider to address any shortfalls and improve the service.

The service had a quality assurance system, and records showed that identified problems and opportunities to change things for the better had been addressed promptly. As a result we could see that the quality of the service was continuously 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. They told us the manager was supportive and promoted positive team working.

We were accompanied by an expert by experience (ex by ex) at this inspection. They spoke to people who used the service and visitors. People told them "Staff are very nice and friendly, couldn't speak more highly of them" and a visitor said "If their relative needed a doctor the home would get one and let them know". People did express concerns that they often had to wait for attention from the staff because they always seemed busy.

We saw that staff had completed training in the Mental Capacity Act (2005) (MCA) and they understood the principles of carrying out assessments to determine people's capacity to understand the decisions they were making. This meant that when people were unable to make their own decisions, other people made decisions in their best interest.

We saw that the home assessed people's care needs and developed care plans which were reviewed with risk assessments in place. We saw that staff had training in caring for people with a dementia and that when necessary care plans took account of people's dementia care needs. This meant that people received the care they needed.

The home handled medication safely to protect people's health.

The home monitored the quality of it's service through surveys and internal systems so that improvements could be identified and put in place.

We spoke to nine people in the home and they told us that they could follow their own routines during the day. They told us that the staff were extremely busy and if they spent time in their rooms then they rarely saw any staff and often felt lonely. People told us that if had any concerns they would tell the manager. People told us that the staff always treated them with dignity and respect. People told us that if they had any concerns they would tell the manager.

We spoke to two visitors and a health care professional and they told us they took their concerns to the manager. They also told us they were kept informed of any changes in the care needs of their relatives. A visiting health care professional told us that the manager was encouraged to contact them for any advice. They said they worked well together and staff followed the health care plans when they were in place.

Staff spoken with were unclear as to their responsibilities if someone alleged abuse was taking place. Staff told us they had not received any training in safe guarding adults, the Mental Capacity Act or in Deprivation of Liberty. Staff also told us they try to ensure that people's dignity and human rights are respected throughout the care planning process. They told us that they have regular supervision and said the manager was very supportive and organised training on request. Staff also told us they don't always have time to spend on social activities with people using the service.