This inspection took place on 6 November 2018 and was unannounced.

Rosedale Care Home 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. Rosedale Care Home is registered to accommodate 20 older people, some of whom are living with dementia. At the time of our inspection there were 20 people living in the home.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the overall 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.

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.

Staff had a good understanding of abuse and the safeguarding procedures that should be followed to report abuse and incidents of concern. Risk assessments were in place to manage potential risks within people’s lives, whilst also promoting their independence.

The staff recruitment procedures ensured that appropriate pre-employment checks were carried out to ensure only suitable staff worked at the service. Good staffing levels were in place. Staffing support matched the level of assessed needs within the service during our inspection.

Staff induction training and on-going training was provided to ensure they had the skills, knowledge and support they needed to perform their roles. Specialist training was provided to make sure that people’s needs were met and they were supported effectively.

Staff were well supported by the registered manager and senior team, and had regular one to one supervisions. The staff we spoke with were all positive about the senior staff and management in place, and were happy with the support they received.

People's consent was gained before any care was provided. 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

Staff treated people with kindness, dignity and respect and spent time getting to know them and their specific needs and wishes. Care plans reflected people’s likes and dislikes, and staff spoke with people in a friendly manner. Our observations during inspection, were of positive and friendly interactions between staff and people.

People were involved in their own care planning and were able to contribute to the way in which they were supported. People and their family were involved in reviewing their care and making any necessary changes.

A process was in place which ensured people could raise any complaints or concerns. Concerns were acted upon promptly and lessons were learned through positive communication.

The provider had systems in place to monitor the quality of the service. Actions were taken and improvements were made when required.

This inspection took place on 5 April 2016 and was unannounced. When we last inspected the service in December 2013 we found that the provider was meeting the legal requirements in the areas that we looked at.

Rosedale is a residential home in Luton providing care and support to older people, some of whom are living with dementia and physical disabilities. At the time of our inspection there were 20 people using the service.

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 were kept safe and protected from risk of avoidable harm. Staff understood the process to follow if they needed to report any concerns or suspected abuse. Risk assessments were robust and detailed and included control measures to minimise and manage risk effectively. There were enough staff available to meet people’s needs and keep them safe. A robust recruitment policy was in place so that staff employed to the service had the skills and character required for the role. People’s medicines were managed and administered safely by trained members of staff.

Staff received a range of training that was relevant to their role and supported them to develop their skills and competencies. They received a regular programme of supervision and performance review from management and had opportunities to pursue professional qualifications. Staff understood the principles of the Mental Capacity Act 2005 and associated Deprivation of Liberty Safeguards (DoLS). People gave consent to receiving support from the service and consideration had been given to the ways in which people could consent to different aspects of their care. People’s healthcare needs were identified and the service worked with other healthcare professionals to support people’s health and well-being. People’s dietary needs were identified and the service offered them a choice of food and drink based on their individual preferences.

Staff demonstrated a kind and caring attitude towards people and provided care that was consistent and person-centred. The service created a pleasant atmosphere where friends and relatives were encouraged to visit and spend time with people in their home. People were treated with dignity and respect and had their right to privacy observed.

People had care plans in place which detailed their needs, choices and preferences. These were subject to regular review and created with the involvement of the person and their relatives. Where people’s needs changed, these were reflected in their care plans. There was an activities co-ordinator in the service who arranged a variety of activities and events in the home. People understood how to make complaints, and their grievances were handled and resolved effectively.

People, their relatives and staff were positive about the management of the service and felt supported and listen to. The manager had robust systems in place for quality monitoring and identifying improvements that needed to be made across the service. Questionnaires were sent out to all those involved with the service to gain their feedback and views. Regular staff meetings took place to give staff the opportunity to contribute towards the development of the service.

We visited Rosedale Care Home on 12 December to review improvements made in the home, following concerns identified at the previous inspection on 28 August 2013.

During our inspection we found that the provider had made improvements to the systems designed to prevent, detect and control the spread of infection. This meant we found that appropriate standards of cleanliness were being maintained within the home. In addition, we found that areas of the home that had been in need of attention had been repaired and/or replaced.

Staff training records we looked at during the previous inspection showed that staff had not completed or were not up to date with essential training within the timeframe set by the provider. The staff training records that we looked at during this inspection showed that all staff had either completed or were booked to complete essential training such as health and safety, first aid, safeguarding of vulnerable adults, moving and handling and medication administration.

When we visited Rosedale residential home on 28 August 2013 we spoke with three of the 13 people using the service, two visiting relatives and three staff. People told us they were happy with the care and support they received from staff. One person told us: “The staff are very nice. If I say I don’t want something they don’t try to force me. They respect my decision.”

We observed that people were offered support at a level which encouraged independence and assured their individual needs were met.

Care plans showed that people and their families had been involved in the development of their care plans. This was confirmed in discussions we had with people using the service.

We found that although most areas of the premises were clean there were some areas that were not being cleaned properly. We found that some processes designed to prevent and control the risk of infection were lacking. Some areas of the home were in need of attention and repair.

Training records showed that essential training for some staff needed to be updated to ensure people were not at risk of unsafe or inappropriate care and treatment.

The people who were living at Rosedale Care Home when we visited on 12 July 2012 had varied levels of verbal communication, however they were all able to demonstrate through speech, facial expressions and gestures that they were satisfied with the care and support they received. Three told us that they were looked after well, one saying ‘it is very good’. and that ‘‘staff try’’.

Relatives visiting people at Rosedale spoke highly of the staff, one saying that they were ‘‘brilliant’’. A visiting professional told us that they were impressed that staff at Rosedale had listened to guidance on oral hygiene and implemented this, to the benefit of people living at Rosedale.