About the service:

Rosebridge Court is a modern purpose-built care home which provides support for up to 46 people who require residential care, general nursing, dementia nursing or have a mental health diagnosis. At the time of the inspection there were 43 people living at Rosebridge Court.

People’s experience of using this service:

People told us that they felt safe. We saw systems were in place to ensure people remained safe, and any safeguarding concerns were reported to the relevant authorities and investigated. Risks were identified, and steps taken to mitigate generic, individual and environmental risks.

Medicines were well managed, and the home was clean. Staff were attentive to infection prevention and control measures.

There were enough staff on duty. Staff had time to spend with people and were inclined to do so. When recruiting new staff appropriate steps were taken to ensure they had the right qualities and attributes to work with vulnerable adults.

We found good communication with local authority and health service commissioners, including good pre-assessment of need. People settled well into the service and care plans reflected their needs. Where people were unable to consent to their care and treatment appropriate assessments were undertaken. People were offered choices about how they wanted their care and support to be delivered.

Care was person centred, and people were relaxed, content and well cared for. Staff were vigilant to need, and we found examples where staff would explore the underlying causes of change in behaviour. Care records provided staff with instruction to meet need in a person-centred way.

There was a registered manager in place, who promoted a good homely and friendly atmosphere where people were friendly to one another and families welcomed as part of the service. The registered manager was respected, highly thought of by staff, and approachable. Staff, people and their relatives had a say in how the service was run and told us that they felt their views were taken into consideration.

Rating at last inspection:

Our last inspection of Rosebridge Court was in September 2016. The overall rating was ‘Good’, and the report was published on 13 October 2016.

Why we inspected:

This inspection was part of our scheduled plan of visiting services to check the safety and quality of care people received. Inspection timescales are based on the rating awarded at the last inspection and any information and intelligence received since we inspected. As the previous inspection was Good this meant we needed to re-inspect within approximately 30 months of this date.

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

We carried out an unannounced inspection of Rosebridge Court on 22 and 23 September 2016.

The home was last inspected on 30 July 2014, when we found the service to be compliant with all the regulations we assessed at that time.

Rosebridge Court is a modern purpose built care home which provides support for up to 46 people that require either; residential care, general nursing, dementia nursing or have a mental health diagnosis. At the time of the inspection there were 45 people living at Rosebridge Court.

The home is divided into two separate units, each one catering for a specific client group. Allendale unit on the ground floor largely provides support to people requiring mental health care, whilst the Darby unit on the first floor, caters for people requiring residential or nursing dementia care. Both units have spacious lounge areas, separate dining rooms and an activity room. They have a range of well-equipped bedrooms, including some with assistive technology; all are en-suite with views across the garden.

At the time of the inspection the home had a registered manager. ‘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.’

We saw that the home was clean and had appropriate infection control processes in place. Daily, weekly and periodic cleaning schedules were in place and up to date. A ‘cleaning specification’ document was used to record the task, equipment and cleaning material required, any hazards associated with the task, what PPE was required and the method of cleaning.

All the people we spoke to told us they felt safe. Relatives expressed no concerns about the safety of their family members and were complementary about the level of care provided. The home had appropriate safeguarding policies and procedures in place, with detailed instructions on how to report any safeguarding concerns to the local authority. Staff were all trained in safeguarding vulnerable adults and had a good knowledge of how to identify and report any safeguarding or whistleblowing concerns.

Both the registered manager and staff we spoke to demonstrated a good knowledge and understanding of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS), which is used when someone needs to be deprived of their liberty in their best interest. We checked whether the service was working within the principles of the MCA, and whether any conditions on authorisations to deprive a person of their liberty were being met. We found that the provider had followed the requirements in the DoLS and related assessments and decisions had been appropriately taken.

We saw medicines were stored, handled and administered safely and effectively. All necessary documentation was in place and was completed consistently. Staff responsible for administering medicines were trained and had their competency assessed annually.

Staff spoke positively about the training available. We saw all the staff had completed a comprehensive induction programme and on-going training was provided to ensure skills and knowledge were up to date.

Staff confirmed they received regular supervision and annual appraisals, which along with the completion of monthly team meetings, meant they were supported in their roles.

Meal times were observed to be a positive experience, with people being supported to eat where they chose. Staff engaged in conversation with people and encouraged them throughout the meal. We saw drinks were available in all communal areas throughout the home and people were supported and encouraged to drink on a regular basis, with detailed fluid monitoring in place.

Throughout the inspection we observed positive and appropriate interactions between the staff and pe

We considered all the evidence we had gathered under the outcomes we inspected. We used the information to answer the five questions we always ask;

Is the service safe?

Is the service effective?

Is the service caring?

Is the service responsive?

Is the service well led?

This is a summary of what we found-

Is the service safe?

We looked at the training matrix and saw staff members had undergone training related to the safeguarding of vulnerable adults. One person who used the service told us, "Oh yes, the staff are lovely. I feel really safe here."

All accidents and incidents were recorded on the provider`s Datix system. These were reviewed regularly by staff members in the health and safety department. If any patterns were identified the incident was passed back to the manager for further investigation.

Deprivation of Liberty Safeguards (DoLS) become important when a person is judged to lack the capacity to make an informed decision related to their care and treatment. An application for a DoLS had been made in July 2014. We saw the required procedure had been followed and the application forms had been completed appropriately.

Is the service effective?

There was an advocacy service available at the care home. On the day of our inspection, an advocate visited the home and told us, "We are available and can be contacted quite easily."

We looked at six care plans and all had been signed by the person who used the service or a family member. This helped ensure the person was involved at the time of assessment and their choices and preferences had been recorded.

Is the service caring?

We spent time in communal areas which included the dining room at lunch time. We saw staff members providing choices to people in a patient, caring manner. Three people needed help eating their meals and we saw staff supporting them in a dignified manner. This helped ensure people received the nutrition they required.

People`s choices had been recorded during their pre-admission assessment and we saw care and support was provided in accordance with their wishes.

Is the service responsive?

During our inspection, we saw people taking part in several activities with staff members in attendance. We were told people would be supported to attend church services of their choice if they so wished.

People we spoke with, including family members were aware of the complaints procedure at the care home. We observed the last complaint that had been recorded and saw it had been resolved to everyone`s satisfaction.

Is the service well-led?

Rosebridge Court work well with other agencies and professionals which helped ensure people who used the service received appropriate care and support when they needed it.

The care home had procedures in place that monitored the quality of service provided to people. This helped ensure the service continued to improve. Staff members were aware of their roles and responsibilities which helped ensure people received a good quality of care.

We spoke with fourteen people who lived at Rosebridge Court and also used observational practices to ensure the people who could not speak to us were in receipt of appropriate care and support.

People said they were happy with their care. Comments included " Staff are good to me", "staff are kind and helpful", "staff are wonderful" and "staff make me happy."

People we spoke with said they felt fully supported by the care staff. Comments included " staff are very nice to me”, “the staff are great" and "staff do a very good job, they are nice people who help us a lot." They told us they felt safe in the home and would tell staff if they were unhappy.

Staff spoken with said they felt well trained and supported in the role and felt valued for their input. Staff said they enjoyed being a part of the team. They said the manager held regular team meetings which enabled staff to share their knowledge and experiences and receive updated information.

We observed a visible presence of staff all across the home, residents knew their names and staff knew theirs. There was constant conversation with residents including the use of gentle humour. A nice atmosphere was apparent. There seemed to be a great deal of mutual respect between residents and staff. During discussions staff identified they knew the care and support needs of each person and provided care and support as appropriate.

We spoke with eight people who lived at the home who said they felt at home at Rosebridge Court and were given choices about their daily life. We also spoke with six people's relatives. They told us that that the service always gave them information to advise when there had been any changes in the person's needs and wishes. One person told us "they liaise with us before, during and after we have visited." Other comments included "we are kept informed of everything that goes on here", "staff give us clear information about the services provided in this home. It is a really good home."

People told us that they liked the staff. Comments included "yes they are nice" , they are great", "staff treat us very well and we like them all."

Relatives of the people who lived in the home told us positive things about the staff team. Their comments included "always someone to talk to if you ring up"; "staff are extremely good"; "they meet my relatives needs very well", "very well managed home."