About the service:

Rosedene Residential Care is a residential care home that accommodates up to 21 older people. At the time of the inspection 19 people were living at the service.

People’s experience of using this service:

• The service continued to be exceptionally caring. Staff had worked continuously to further develop the service and the effective area was now outstanding. As a result, it provided an exceptional service which benefited people and their loved ones.

• People living at Rosedene continued to receive an outstanding service. They lived fulfilled lives and were supported by staff who valued them as individuals and went the extra mile to make sure they were as happy and healthy as possible.

• Staff recognised that people were the experts in their own care and involved them in everything that happened at the service. Everyone had opportunities to be involved in the day to day running of the service, such as completing domestic tasks and felt valued for their contribution.

• People were supported to continue to take risks and planned this with staff be as independent as possible while remaining safe. Everyone said they felt safe at the service and their privacy was maintained.

• People and their loved ones were treated with genuine kindness, dignity and compassion. They treated staff in the same way and showed a keen interest in important things which happened in their lives.

• There was family atmosphere where everyone was welcomed and valued for their knowledge, skills and experiences.

• 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.

• People’s needs were assessed in innovative ways to ensure staff had all the information they needed to support people to plan their care effectively.

• People continued to have control over their medicines and received them when they were needed.

• The service worked in partnership with health and social care professionals to maintain and improve people’s physical and mental health and wellbeing.

• People and their loved ones had discussed their preferences around end of life care.

• People were valued members of their local community and enjoyed frequent trips out. They were involved in the everything from the weekly food shop to theatre and boat trips.

• People made decisions with staff about design, refurbishment and redecoration of the building and grounds to make sure it truly met their individual needs. Environmental risks continued to be effectively managed.

• There were enough skilled staff available to spend time with people and meet their individual needs. People told us they were never rushed and staff responded promptly to requests for assistance.

• Staff received consistent and effective support from the management team. They were motivated and worked as a team to provide personalised care.

• People knew how to make a complaint and told us they worked with staff to address any concerns they had.

• People were asked for their views about the service and any suggestions daily and these were used to develop the service.

• The management team worked hard to keep up to date with good practice and challenge their own practice to continuously improve the service.

Rating at last inspection:

Outstanding (last report published 20 August 2016)

Why we inspected:

This was a planned inspection based on the rating at the last inspection.

Follow up:

We will continue to monitor this service and plan to inspect in line with our re-inspection schedule for those services rated Outstanding.

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

This inspection was carried out on 13 and 15 July 2016 and was unannounced.

Rosedene Residential Care provides accommodation and personal care for up to 23 older people, some of whom may be living with dementia. The service is a large converted property. Accommodation is arranged over two floors and stair lifts are available to assist people to get to the upper floor. The service has 17 single bedrooms and one double bedroom that people could choose to share. Seven bedrooms had ensuite toilets. There were 18 people living at the service at the time of our inspection.

A registered manager was leading the service, supported by a deputy manager. The registered manager was also the registered provider for the service. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the care and has the legal responsibility for meeting the requirements of the law. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements of the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People and their relatives told us that staff were “Very caring”, “Very good”, “Very friendly” and “Very kind people”. One person told us, “I think I couldn’t have it better, it’s like being at home in a family”. Another person said, “I think the service is outstanding, they go above and beyond”. Staff treated people with dignity and respect at all times. One person told us, “They are so patient with me, I never feel like a burden.”

People were involved in all areas of the service, including planning the menus, the decoration and day trips. They told us they had the choice to continue to do domestic tasks they had done at home if they wanted to. People told us they enjoyed dusting their bedrooms, laying the tables and folding laundry. One person did the garden and other people made sure the pet cat was fed.

The registered manager supported staff to provide a good level of care and held them accountable for their practice. Staff were clear about their roles and responsibilities and were motivated to provide the support and care that each person wanted. Checks on the quality of all areas of the service had been completed to make sure they were of the standard the registered manager required. Action was taken quickly to address any shortfalls found.

People told us there were enough staff, who knew them well, to meet their needs. People’s needs had been considered when deciding how many staff were required on each shift and people told us staff responded quickly to their requests for help. Staff worked as a team to meet people’s needs.

Recruitment systems were robust. Checks had been completed to make sure staff were honest, trustworthy and reliable. Disclosure and Barring Service (DBS) criminal records checks had been completed. The DBS helps employers make safer recruitment decisions and helps prevent unsuitable people from working with people who use care and support services.

Staff had completed the training and development they needed to provide safe and effective care to people and held recognised qualifications in care. Plans were in place to refresh staff skills regularly and further develop them in their role. The registered manager met regularly with staff to discuss their role and practice.

Plans were in place to keep people safe in an emergency, including plans to evacuate people from the building. Staff practiced these regularly. Staff knew the signs of possible abuse and were confident to raise concerns they had with the registered manager or the local authority safeguarding team.

People’s care was planned and reviewed with them to keep them safe and help them be as independent as possible. Possible risks to people had been identified and action had been agreed with people to keep them safe, while supporting them to be independent. One person told us, “The staff only help me out onl

There were 17 people using the service at the time of our inspection. We met and spoke with many of them. Everyone we spoke to said they were happy living there. One person told us, “The staff are very good, some are exceptional”.

People told us they were able to make choices about how, when and where their services were provided and they were supported to remain independent. One person told us, “Staff make you feel confident that there is always someone on call to help you”. People described the choices available to them.

We found that most of the staff had worked at the service for many years and knew people well. People told us that staff were kind and caring. We observed staff providing support to people at their own pace. One person who was worried about walking was encouraged by staff who told them, “Take as long as you need”. Another person told us that when they had had a health problem the manager had obtained appropriate medical support for them in a timely way.

People told us that they felt safe and well looked after. They looked comfortable and at ease with each other and staff. We saw people chatting to each other in a relaxed way. One person told us, “Everyone is very nice and very friendly”. People said they felt confident to raise any concerns with the management team and thought that they would deal with them promptly.

One person told us, “We are well looked after”, other people we spoke to agreed with what we had been told. People said that staff had the skills and experience to meet their needs. Records we saw demonstrated that staff had completed a variety of training and staff confirmed that they had the opportunity to complete continued professional development.

People told us they chatted to the manager and other staff about the service often and that the manager acted upon what they had said to improve the service.