The inspection took place on 27 and 29 November 2018. The first day of our inspection visit was unannounced.

Rosedale Retirement Home is a 'care home'. People in care homes receive accommodation and nursing or personal care as a 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 is registered to provide accommodation and personal care for a maximum of 24 older people, some of whom are living with dementia, within one large adapted building. At the time of our inspection there were 16 people living at the home.

At the time of our inspection, the registered manager had been away from the home for about one month. In their absence, we met with the directors, one of whom was overseeing the day-to-day management of the service, with the support of a registered manager from an associated 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.

Staff did not always handle and administer people’s medicines in line with good practice. Medicine expiry dates were not consistently monitored. Staff did not always follow the provider’s risk assessments to minimise risks associated with people's access to the home's laundry. The provider completed pre-employment checks on prospective staff to ensure they were safe to work with people. However, they had not carried out a risk assessment in relation to the renewal of staff members’ DBS checks.

The provider had assessed, reviewed and put plans in place to manage the risks associated with people’s individual care and support needs, including the risk of falls or skin breakdown. People felt safe living at the home, and understood how to raise any concerns about their own or others’ safety with staff and management. Staff recognised their individual responsibilities to protect people from abuse and discrimination. They understood the different forms and potential signs of abuse to look out for. The provider monitored staffing levels in line with people’s care and support needs. The provider had taken steps to protect people, staff and visitors from the risk of infections. This included providing staff with appropriate personal protective equipment for their use.

Prior to people moving into the home, the registered manager or a senior care staff member met with them to assess their individual care and support needs. Staff had received training in, and understood, the need to avoid any form of discrimination when assessing or meeting people's care needs. Staff and management worked with a range of community health and social care professionals to promote people’s health and wellbeing. On starting work for the provider, staff completed the provider's induction training to help them settle into their new roles and understand people’s individual needs. After their induction, staff received further training to give them the skills and knowledge needed to succeed in their roles.

Staff supported people to have a balanced diet, and helped them choose what they wanted to eat and drink each day. Any specific needs or risks associated with people’s eating and drinking were assessed, reviewed and plans put in place to manage these. Staff and management helped people access professional medical advice and treatment when they were unwell. The home environment provided people with sufficient communal space to eat in comfort, participate in activities and receive visitors. The provider had plans in place to create a more dementia-friendly environment. Staff understood the need to respect people’s rights under the Mental Capacity Act 2005, and to support their day-to-day decision-making.

People were supported to have

Rosedale Retirement Home is located in Ross-on-Wye, Herefordshire. The service provides accommodation and care for up to 24 older people, some of were living with dementia. On the day of our inspection, there were 17 people living at the home.

The inspection took place on 13 May 2016 and was unannounced.

There was a registered manager at this home. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered providers and registered managers 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’s individual needs and risks were known and managed by staff. Staff's attitudes and behaviours towards people were monitored by the registered manager and disciplinary action taken where necessary. Staff knew when to refer concerns regarding people’s safety to the local authority. People received their medicines from trained and competent staff, and as prescribed by their GP.

People’s privacy was respected and staff knew the importance of maintaining people’s dignity. People enjoyed positive and caring interactions with staff. People and their relatives were involved in the planning of their care.

People had access to a range of health professionals and staff knew when to request specialist input. People’s nutritional needs were known by staff, and people benefited from flexibility in how their meals were provided. People were provided with choices about how they received their care, and their consent was sought before assisting with personal care or giving medicines.

People's individual needs, interests and preferences were known by staff. Staff were alert to people's changing needs and these were responded to. People were involved in decisions about their care and in the running of their home. People knew how to complain if they were unhappy with the care they received.

People knew who the registered manager and provider were and were encouraged to give feedback on the service. Where people had made suggestions, these had been acted upon. The registered manager and provided monitored the quality of care provided to people and carried out monthly checks to ensure people were being cared for safely and that their needs were being met.

Rosedale provided care for older people, who may also have a dementia related illness. During this inspection we spoke with six people who used the service, two relatives, the provider, the deputy manager and two staff. People we spoke with were complimentary about the care and support that they received. One person said: “I am quite content here”.

We found that proper steps had been taken to ensure that individualised care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare. People were asked about their preferences about their care so they felt involved in their care and treatment.

Staff had been recruited in an appropriate way. We found that thorough checks had been undertaken before staff started work at the home to ensure they were suitable to care for vulnerable people.

The provider had a system of audits in place to enable them to monitor the quality of the service provided and ensure that people received appropriate care and treatment.