Rosebank Care Home is an independently owned residential care home providing care and support for up to 28 older people. Rosebank specialises in providing care to people living with dementia. On the day of our inspection 25 people were living at the home.

At the last inspection, the service was rated Good.

At this inspection we found the service Outstanding.

Why the service is rated Outstanding:

The service continued to provide support in a very caring way. People were supported by an established, motivated and well trained staff team. Staff supported people with kindness and compassion, respected people as individuals and treated them with dignity. People were fully involved in decisions about their care needs and the support they required to meet those needs. Staff knew the people they supported on a personal level and used this knowledge to improve people’s lives.

The service continued to be very responsive to people's needs and ensured people were supported in a personalised way that improved their wellbeing and quality of life. People's changing needs were responded to promptly and effectively, in collaboration with health care professionals. This had a positive impact upon their lives. People had access to a variety of activities that met their individual needs and were tailored to their preferences. The service maintained strong links with the local community where people actively engaged with community choirs, coffee mornings and other events.

The service was led by an experienced and highly committed registered manager who promoted a service that put people at the forefront of all the service did. The atmosphere at the home was warm, friendly and welcoming. There was a very positive and inclusive culture that valued people, relatives and staff and promoted a caring ethos. A strong team culture existed in the home which included all staff, management and the provider, who provided strong support and leadership for the team. The registered manager and staff strived to continually look for ways to improve people’s lives.

People remained safe living in the home. There were sufficient staff to meet people's needs and staff had time to spend with people. Risk assessments were carried out and promoted positive risk taking which enable people to live their lives as they chose. People received their medicines safely.

People continued to receive effective care from staff who had the skills and knowledge to support them and meet their needs. People were supported to have choice and control of their lives and staff supported them in the least restrictive way possible; the procedures in the service supported this practice. People were supported to access health professionals when needed and staff worked closely with people's G.P's to ensure their health and well-being was monitored.

This inspection took place on the 9 December 2015 and was an unannounced inspection.

Rosebank Care Home is a residential care home providing care and support for up to 28 older people. Rosebank specialises in providing care for people living with dementia.

At the last inspection on the 3 June 2015 the service was rated as ‘Good’. After that inspection we received concerns relating to an accident at the home. As a result we undertook a focussed inspection to look into these concerns. This report covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Rosebank Care Home on our website at www.cqc.org.uk .

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.

The service was safe. Where people were identified as being at risk of falls, risk assessments were in place. Risks to people were assessed in relation to the main staircase. Risk assessments were regularly reviewed.

Staff were aware of the risks to people and followed guidance to reduce the risk. Staff were briefed and kept up to date through handover’s and meetings and were knowledgeable regarding keeping people safe. Staff had also received training in moving and handling and the management of risks.

Stair gates had been fitted to the main staircase which were safe and secure. People and staff were briefed on procedures for use of the stairs and we saw they were familiar with these procedures.

Systems to monitor and review people’s safety were effective. Systems to notify the relevant authorities regarding safety were also in place.

The registered manager had led by example, maintaining the homes open, honest and caring culture. People and staff were supported through meetings, sharing knowledge, information and learning.

This inspection took place on the 3 June 2015 and was an unannounced inspection. At the last inspection on 10 May 2013 the service had met all of the outcomes we inspected.

Rosebank Care Home is a residential care home providing care and support for up to 28 older people. Rosebank specialises in providing care to people living with dementia.

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.

People told us staff knew how to support them. Comments included; “I cannot speak too highly of the staff, they do know how to look after me, no problems” and “They have regular training here; they look after me very well”. Staff had the training and support to meet people’s needs and support them safely.

Staff understood the needs of people, particularly those living with dementia, and provided care with kindness and compassion. People spoke positively about the home and the care they received. Staff took time to talk with people and provide activities such as and arts and crafts, games and religious services.

People were safe. Staff understood how to recognise and report concerns and the service worked with the local authority if there were any concerns. People received their medicines safely as prescribed. Staff assessed risks associated with people's care and took action to reduce risks.

The registered manager and staff were aware of their responsibilities under the Mental Capacity Act 2005 (MCA) which governs decision-making on behalf of adults who may not be able to make particular decisions themselves. People’s capacity to make decisions was regularly assessed.

People told us they were confident they would be listened to and action would be taken. The service had systems to assess the quality of the service provided in the home. Learning was identified and action taken to make improvements which improved people’s safety and quality of life. Systems were in place that ensured people were protected against the risks of unsafe or inappropriate care.

All staff spoke positively about the support they received from the registered manager and the owner. Staff told us they were approachable and there was a good level of communication within the home. People knew the registered manager and spoke to them openly and with confidence. The owner’s vision of a service “That puts people’s care before anything else” was evident.

People were treated with dignity and respect. We spoke with six people. One said “they’re all lovely to me”. We observed care workers offering people a choice of food and drink and supporting people in their activities. We spoke with three relatives. One said “we’re consulted on everything”, another said “the standard of care is excellent”.

We looked at three peoples’ files which contained person centred care plans and relevant risk assessments. Where risks had been identified, such as a high risk of falls, people were referred for specialist advice and preventative measures had been put in place. Risk assessments had been referenced in the individual care plans to enable staff to clearly identify what care and treatment to provide.

We spoke with three members of staff who said they felt well supported by the service. We saw evidence in staff files of regular training, supervision and appraisal. One care worker said “I love working here”. Staff kept daily records for each person which detailed how they met people’s emotional and psychological needs as well as what activities they had supported people with.

The service sought feedback via an annual satisfaction survey to people, relatives and staff. We saw there was an audit plan in place. We looked at a recent infection control audit which had resulted in an action plan with changes to procedures and equipment.

During our visit we spoke with four people who told us about their experience of living in the home. We were also able to observe care and the interactions between staff and people using the service.

People we spoke with told us they were happy living in the home and commented that it was “a great place”. We saw staff interacting with people in a respectful manner and supporting them with moving independently around the home. We saw a wide range of activities and social events on offer, including coffee mornings and library visits in the local community. We observed people actively involved in a memory game during our visit.

Staff we spoke with displayed they had a good understanding of the people that they provided care for. We had minor concerns that the care plans did not contain sufficient detailed information to ensure that personalised care would consistently be delivered. We saw evidence of involvement of a range of healthcare professionals in peoples’ care. Healthcare professionals that we spoke with were complimentary about the home. We observed that medication was stored, administered and recorded appropriately.

We had minor concerns regarding the process of obtaining and recording consent from people who use the service and share a double occupancy room. We also had minor concerns that the provider did not have systems in place to identify, assess and manage risks associated with the health and welfare of people who used the service.

People we spoke with told us that they knew of the home and some had chosen it themselves. People we spoke with were either from the locality or had relatives living nearby. People liked the home and told us that the staff were ”first class “ and “ kind and caring “. People we spoke with did not feel that their care was rushed.

People told us that care was given in a dignified manner in the privacy of their own room. People liked the food and the variety. People were asked what they wanted to eat on a daily basis. There was always a choice. Relatives and friends were made welcome and there were no set visiting times. People told us they had access to health services and could either go to the surgery or see the doctor in the home.