This inspection took place on 9 and 12 February 2018 and was unannounced. Rosewarne Care 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.

Rosewarne Care accommodates up to six people who have learning disabilities. Four people were using the service at the time of our inspection. The service is situated in a semidetached property with an enclosed outdoor space in a rural location on the outskirts of Camborne.

The service 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. The service is a family run business and support is provided in a domestic style. The registered manager is also one of the registered providers and is responsible for meeting people’s day to day support needs. The registered manager was supported by a team of three part time care staff and an office administrator.

People were relaxed and comfortable at Rosewarne care and told us, “It’s very nice here” and “I am happy living here.” Staff had received safeguarding training and understood their responsibilities in relation to protecting people from abuse and harm. The registered manager had responded appropriately to an incident that had occurred and acted to ensure people were protected from discrimination.

The registered manager and staff knew people well and understood their individual care and support needs. People enjoyed the company of their support staff and there was a relaxed, comfortable and homely feel to the service. People approached staff for support without hesitation and staff responded immediately to address people’s needs. One person told us, “[The staff] are all kind.” Staff told us they enjoyed their role and took pleasure in describing people’s achievements.

Staff were well motivated and told us the registered manager, who they worked alongside every day, provided effective leadership. Staff told us, “Most of the time the registered manager is here and she is always on the end of the phone if you need her, It’s a great place to work” and “You have nothing to be worried about”.

Information was stored securely and there were systems in place to monitor the service’s performance, gather people’s feedback and identify where improvements could be made. All Firefighting equipment had been regularly serviced and utilities had been regularly tested by appropriately skilled contractors.

People’s medicines were managed safely. Medicine administration records had been accurately completed and staff had been provided with appropriate guidance on the use of as required medicines.

Registered manager and staff team were sufficiently skilled to meet people’s care and support needs. Rotas showed there were enough staff available to meet people’s needs and staff told us, “There is always somebody here.” Although the service had not recently recruited new members of staff appropriate induction procedures were available. Staff records showed all necessary pre-employment checks had been completed for existing staff before they were permitted to provide care.

Detailed assessments of people’s needs were completed before they moved into the service. This was done to ensure the service could meet the person’s needs without impacting on people already using the service. The assessments process included visits to the person’s home and the person visiting the service to meet staff and other residents. People’s initial care plans were based on information gathered during the assessment process combined with background information from commissioners and

We inspected Rosewarne on 6 October 2015. This was an announced inspection. We told the provider two days before our inspection visit that we would be coming. This was because we wanted to make sure people would be available to speak with us. The service was last inspected in January 2014. We found the service was meeting legal requirements at that time.

Roswarne provides care and accommodation for up to six people who have a learning disability. There were four people living at the service during this inspection visit.

The service is situated on the edge of Camborne but with transport available to attend community facilities and events. The service is a two storey house of a domestic nature. There were a number of aids and adaptations for a person requiring more support with their personal care and mobility.

The service had a registered manager in place. 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.

The registered providers and registered manager were supporting people using the service at the time of the inspection visit. There was a current recruitment process taking place in order to increase staffing levels due to recent changes in the staff team. During this time the registered providers and manager were supported by two volunteers who had the necessary recruitment checks in place. Throughout the report people supporting people will be referred to as staff.

People were supported to lead full and varied lives within the boundaries of their physical and mental capabilities. They were supported to engage in a wide variety of activities. People told us, “I work at the nursery [garden], yes I like it very much” and, “I go out every day. I like being busy and I help out when I can”. Another person told us, “I go into town and I like playing bingo. I win sometimes”.

People were treated with kindness, compassion and respect. Staff were seen to take time to speak with the people they were supporting. We saw many positive interactions and people enjoyed talking with staff. For example one person liked to help in the kitchen. They were supported to do this with supervision so they were safe. Comments included; “I’ve not been here long but I like it a lot. [The manager’s name] helps me with everything I need here”. Also, “[The manager’s name] is very kind to me”.

Staff were very familiar with what support and care people needed. People were supported to make meaningful decisions about their lives and staff respected those decisions and wishes. For example, some people liked to smoke. The registered manager advised people of the risks associated with this, but respected their decision to smoke as people had the capacity to make that decision for themselves. One person said, “I know it’s bad for me but I enjoy it”.

People told us they felt safe living at Rosewarne. One person said, “Yes, I feel very safe because they [staff] keep an eye on me”. Arrangements were in place to protect people from abuse and unsafe care.

The registered manager understood the requirements of the Mental Capacity Act (2005) and the associated Deprivation of Liberty Safeguards. However there were no people using the service who lacked mental capacity and therefore there were no restrictions in place which might challenge their human rights.

People had a choice of meals, snacks and drinks, which they told us they enjoyed. People had been included in planning menus and their feedback about the meals in the service had been listened to and acted on. Mealtimes were a social experience, with people sharing conversation between themselves and staff. One person told us, “I really like cooking and we talk all the time about what we are going to have to eat”.

People who actively communicated with us told us they were involved in their care planning and reviews. People had individual care plans, detailing the support they needed and how they wanted this to be provided.

Care records contained specific information to guide staff who were supporting people. Life history profiles about each person were developed. The information was in written format as most people had a level of literacy, however the registered manager recognised that where people required other formats for communication they would be made available so the information was more meaningful for people.

There was a system of quality assurance checks in place. People were regularly consulted about how the home was run.

We made an unannounced inspection on Rosewarne Care home on 29th January 2014. We spoke with all of the people who currently live at the home. We also spoke with the registered manager and one member of support staff who was working during the inspection.

People told us they were happy living at Rosewarne Care home. We saw people moved about the home without restriction and were at liberty to choose how they spent their time. One person told us they were looking forward to walking into the local town. Another person shared with us that they had been unable to attend their work placement that day due to a back injury but would hopefully return the following day.

We saw there was appropriate referral and care planning documentation used in respect of people who lived at the home. We looked at a range of care documentation which supported the view that people’s needs were well understood and staff acted with respect and care in supporting people appropriately. We saw people were involved in making decisions about their lives at Rosewarne Care home including how they spent their time.

We saw the premises was of a suitable design and layout and there were appropriate maintenance arrangements and risk assessments in place to protect the people who lived at the home.

We followed up on the system of recruitment and training of staff at Rosewarne Care which had been identified as non-compliant at the last inspection. We saw the registered providers and home manager had undertaken work to ensure all records were now up to date. A new system for identifying and following up on references for potential employees was now in place. We checked training records for staff and saw areas identified at the last inspection as in need of updating had been completed.

We spent a day at the home and spoke with three people who used the service. We also spoke with the registered manager and two members of care staff. People told us they were happy with the care they received and that staff were kind and helpful. One person told us, “I like living here. It’s very nice”.

We saw there was appropriate referral and care planning documentation used in respect of people who lived at the home. We looked at a range of care documentation which supported the view that people’s needs were well understood and staff acted with respect and care in supporting people appropriately. We saw people were involved in making decisions about their lives at Rosewarne Care including how they spent their time. People told us they felt ‘in charge’ of their own lives and they were happy to be so. We were shown how people had personalised their rooms and people told us they were happy with their rooms.

We saw the home was clean and welcoming. The management operated effective systems which ensured appropriate standards of cleanliness and hygiene were adhered to.

We reviewed the system used by the registered managers to recruit staff members. We saw that there was inconsistency in the methods used to take up references and in one instance reference documents were not available for inspection. In a second instance, where a telephone reference had been conducted, there was a lack of records available to substantiate this.

We talked with staff and reviewed rota arrangements for staffing the service and were satisfied there were sufficient numbers of staff employed at the home.

The three people we spoke with said they liked living in the home. They said the food was good and there were plenty of activities and things to do. One person said:"I'm happy here." Another person said :"Everybody is kind to me."

We found people were involved in making decisions about their care and treatment however information was not always made available to them in an appropriate form such as the complaints procedure and service user guide.

Staffing arrangements were not in place to ensure suitable care and support was provided over twenty four hours to ensure the safety and well being of people who lived in the home.

Staff received professional development and training however there was not a formal system of supervision and appraisal to help ensure high standards of care.

We spoke to all the people who currently use this service. Everybody said they were happy with the service provided. They said staff were supportive and helpful. They were happy with the accommodation provided. No concerns were raised or improvements suggested by the people who we spoke to.