Rosehill Hose is a privately owned ‘care home’ that provides accommodation for a maximum of 30 adults, of all ages with a range of health care needs and physical disabilities. At the time of the inspection there were 29 people living at the service. 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.

Rosehill House is situated in Par, near the town of St Austell. It is an older style property with an extension. Accommodation is offered on two floors, which are connected by a shaft lift and stairs. There is a range of aids and adaptations in place to meet the needs of people living there. There were people living at the service who were living with dementia and were independently mobile. On the ground floor there are two lounges and a dining area. The majority of bedrooms are for single occupancy, some have en-suite facilities and others share bathroom facilities. There was a garden which people could use.

This unannounced comprehensive inspection took place on 1 December 2018. At the last inspection, in January 2016 the service was rated Good. At this inspection we found the service remained Good.

On the day of the inspection there was a calm, relaxed and friendly atmosphere in the service. We observed that staff interacted with people in a caring and compassionate manner. People told us they were happy with the care they received and believed it was a safe environment. One commented, “It’s been amazing here, staff are great, food is great, I have received so much support”. Relatives and health and social care professionals echoed this view.

We spent time in the communal areas of the service. Staff were kind and respectful in their approach. They knew people well and had an understanding of their needs and preferences. People were treated with kindness, compassion and respect. A visitor commented, “No matter when I come, I’m always welcomed, the staff are always smiling, it’s always clean, and my friend is just so well cared for here.”

The service was comfortable and appeared clean. People’s bedrooms were personalised to reflect their individual tastes.

Care plans were well organised and contained personalised information about the individual person’s needs and wishes. Care planning was reviewed regularly and whenever people’s needs changed. People’s care plans gave direction and guidance for staff to follow to help ensure people received their care and support in the way they wanted. Risks in relation to people’s care and support were assessed and planned for to minimise the risk of harm.

Some people were at risk of becoming distressed or confused which could lead to behaviour which might challenge staff and cause anxiety to other people. Care records contained information for staff on how to avoid this and what to do when incidents occurred.

People were protected from abuse and harm because staff understood their safeguarding responsibilities and were able to assess and mitigate any individual risk to a person’s safety.

Accidents and incidents that took place in the service were recorded by staff in people’s records. Such events were audited by the manager. This meant that any patterns or trends would be recognised, addressed and the risk of re-occurrence was reduced.

Information about people’s care would be shared at daily handovers to ensure consistency of care practice could then be maintained. This meant that there were clearly defined expectations for staff to complete during each shift.

People's rights were protected because staff acted in accordance with the Mental Capacity Act 2005. The principles of the Deprivation of Liberty Safeguards (DoLS) were understood and applied correctly.

Meals were appetising and people were offered a choice in line with their dietary requirements and preferences. Where necessary staff monitored what p

Rosehill House is a care home that can accommodate up to 30 older people, some of whom have a diagnosis of dementia. On the day of the inspection there were 29 people using the service.

We carried out this inspection on 25 January 2017. At the last inspection, in November 2014, the service was rated Good. At this inspection we found the service remained Good.

People who were able to talk to us about their view of the service told us they were happy with the care they received and believed it was a safe environment. People and their relatives commented, “It’s fine here, I am very happy” and “We are very happy with the home.”

Where people were unable to tell us about their experiences we observed they were relaxed and at ease with staff. People had good and meaningful relationships with staff and staff interacted with people in a caring and respectful manner. Comments from people about staff included, “Staff are lovely” and “Staff are good.” A healthcare professional said, “Staff have good communication skills.”

People were able to take part in a range of activities of their choice. Where people stayed in their rooms, either through their choice or because they were cared for in bed, staff spent one-to-one time with them. This helped to prevent them from becoming socially isolated and promoted their emotional well-being.

There were sufficient numbers of suitably qualified staff on duty and staffing levels were adjusted to meet people’s changing needs and wishes. Staff completed a thorough recruitment process to ensure they had the appropriate skills and knowledge. Staff knew how to recognise and report the signs of abuse. Staff ensured people kept in touch with family and friends. Relatives told us they were always made welcome and were able to visit at any time.

Safe arrangements were in place for the storing and administration of medicines. People were supported to take their medicines at the right time by staff who had been appropriately trained.

Staff supported people to access to healthcare services such as occupational therapists, GPs, community nurses and chiropodists. Comments from healthcare professionals included, “Staff work well with us, they always follow any instructions we give”, “The home is quick to report any concerns about people’s health needs” and “The monitoring of people who are cared for in bed is very good and the incidents of pressure sores are extremely low.”

People received care and support that was responsive to their needs because staff were aware of the needs of people who lived at Rosehill House. Care records were up to date, had been regularly reviewed, and accurately reflected people’s care and support needs. Details of how people wished to be supported were personalised to the individual and provided clear information to enable staff to provide appropriate and effective support. Any risks in relation to people’s care and support were identified and appropriately managed.

There was a wide range of meals on offer and staff were knowledgeable about people’s likes, dislikes and dietary needs. People told they enjoyed their meals. People and their relatives said, “The meals are excellent”, “The food is lovely” and “Mum enjoys the food.”

Management and staff had a good understanding of the Mental Capacity Act 2005 (MCA) and how to apply the principles of the MCA in the way they cared for people.

There was a management structure in the service which provided clear lines of responsibility and accountability. Staff had a positive attitude and the management team provided strong leadership and led by example. Comments from staff included, “I absolutely love working here”, “This is the best home I have worked in” and “We are a great staff team. For all of us this isn’t a job, it’s just like looking after someone in our own family.”

People and relatives all described the management of the home as open and approachable. One relative told us, “We are very happy with the home. We look

Rosehill House Residential Home is a care home which is registered to provide personal care for up to a maximum of 30 older people. On the day of the inspection there were 29 people living in Rosehill House. Some people living in the home had a diagnosis of dementia.

There was a registered manager in post who was responsible for the day-to-day running of the 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 and associated Regulations about how the service is run.

We carried out this unannounced inspection of Rosehill House Residential Home on 25 November 2014. We last inspected the home in May 2013. At that inspection we found the service was meeting all the essential standards that we assessed.

On the day of our inspection there was a calm and relaxed atmosphere in the home and staff interacted with people in a kind and sensitive manner. There was a stable staff team who had a good knowledge of each person’s needs. People and visitors spoke well of staff and said staff had the right knowledge and skills to meet people’s needs. People were encouraged and supported to maintain their independence. They made choices about their day to day lives which were respected by staff.

People told us they felt safe living at the home and with the staff who supported them. People told us; “I am fine here” and “I am safe”. Visitors also said they felt the home was a safe place for people to live. Visitors said; “we are lucky to have found such a nice home”, “no concerns about the home at all” and “we are more than happy with the home it is better than others we visited”.

Staff had received training in how to recognise and report abuse. All were clear about how to report any concerns and were confident that any allegations made would be fully investigated to help ensure people were protected.

People and their families were given information about how to complain. People told us they knew how to complain but said they had never had any reason to complain. They told us the registered manager and staff were so good at asking for their views and listening to what they wanted that any situations that might give cause for concern had not occurred.

People were well cared for and were involved in planning and reviewing their care. There were regular reviews of people’s health and staff responded promptly to changes in need. Staff had good knowledge of people including their needs and preferences. Staff were well trained; there were good opportunities for on-going training and for obtaining additional qualifications.

People’s privacy was respected. Staff ensured people kept in touch with family and friends. Visitors told us they were always made welcome and were able to visit at any time. People were able to see their visitors in communal areas or in private.

There were internal and external activities on offer. People told us they could take part in singing sessions, board games, bingo and quizzes. External entertainers provided exercise sessions and music sessions twice a month. Staff spent one-to-one time talking and reading with people throughout our inspection. Staff supported people to maintain a balanced diet appropriate to their dietary needs and preferences. People were able to choose where they wanted to eat their meals, in either a lounge, dining room or in their bedroom. People were seen to enjoy their meals on the day of our visit.

Staff supported people to be involved in and make decisions about their daily lives. Where people did not have the capacity to make certain decisions the home acted in accordance with legal requirements under the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards.

There was a management structure in the home which provided clear lines of responsibility and accountability. People told us the registered manager and deputy manager were very approachable and regularly asked them for their views of living in the home.

We were told by the manager that all staff had now been recruited in a professional manner and found to be suitable for employment at Rosehill Care Home.

We were also told that the Safeguarding policy had been updated. A flow chart to indicate the reporting process, should abuse occur, was on display in the home. Staff confirmed they had knowledge of this.

Some of the people who used the service were not able to comment in detail about the service they received due to their healthcare needs. We spoke to two visitors who told us they were pleased their relatives lived at Rosehill Care Home. We spoke to six people who used the service and spent time observing people and staff during the day. We saw people’s privacy and dignity was respected and staff were helpful. We saw people chatted with each other and with staff.

During our observations we saw staff help two people to mobilise. We also saw staff conversed with people when they were delivering personal care. We saw people talked to each other in the lounge areas.

We witnessed staff interactions with people which were positive. People told us staff answered call bells promptly. One person said the staff were “polite and friendly”. Another person said,”I am very happy here, no complaints”. People told us the food was good and they were offered choices. We were told visitors were welcome. One person said, “I can go to bed when I want, if I wanted to go out someone would take me”. Another person told us they were involved in the planning of their care.

We heard care workers ask people what they would like to do and they gave them ideas if people could not make a choice.

We observed interactions between staff and people who used the service Staff communicated with people in a friendly, warm, polite and respectful manner.

People who used the service told us and we observed that they were enable to make choices on how they spent their day. Care plan documentation identified people's preferences and through our observations we saw that staff were aware of these.

People who lived at Rosehill House told us that staff were kind and helpful. People told us that they were pleased with the care that they received from the staff. Staff told us that they liked to work at Rosehill House.

The training and supervision provided to staff was not up to date. Some staff members had not received sufficient training at Rosehill House to ensure that people who used the service continued to receive a quality care service.

We observed that all areas of the home were clean, hygienic and odour free.

We spoke with some people who were able to talk to us about the service and about how they make choices in the care they receive. They told us that they have the opportunity to express preferences and make choices. There is a stable team of care workers that work hard to meet the needs of the people that live there. Comments received from people that live at Rosehill House confirm their confidence in the care workers and the manager. People said they were satisfied with the care provided and the kindness and politeness of the care workers.

A representative from the Department of Adult Care and Support (DACS) told us that “there are no current concerns about this service”.