The inspection visit took place on 11 January 2017 and was unannounced.

This is a residential care home for up to 24 people. The home is situated along the promenade near St Annes town centre. The service offers short to long term care. Private parking facilities are available. At the time of the visit there were 20 people who lived at the home.

At the last inspection in July 2014 the service was rated Good. At this inspection we found the service remained good.

The registered manager had systems in place to record safeguarding concerns, accidents and incidents and take appropriate action when required. Recruitment checks were carried out to ensure suitable people were employed to work at the home. Our observations and discussions with staff and people who lived at the home confirmed sufficient staff were on duty.

The registered manager understood the requirements of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). This meant they were working within the law to support people who may lack capacity to make their own decisions.

Risk assessments had been developed to minimise the potential risk of harm to people who lived at the home. These had been kept under review and were relevant to the care and support people required.

Care plans were in place detailing how people wished to be supported. People who received support or where appropriate their relatives were involved in decisions and consented to their care.

Staff responsible for assisting people with their medicines had received training to ensure they had the competency and skills required.

We observed regular snacks and drinks were provided between meals to ensure people received adequate nutrition and hydration. Comments from people who lived at the home were all positive about the quality of meals provided. One person said, “I must say the food is top notch.”

We found people had access to healthcare professionals and their healthcare needs were met.

People who lived at the home told us they were encouraged to participate in a range of activities that had been organised. Entertainers were arranged on a regular basis.

People who used the service and their relatives knew how to raise a concern or to make a complaint. The complaints procedure was available and people said they were encouraged to raise concerns.

The registered manager used a variety of methods to assess and monitor the quality of the Rosewood Lodge. These included regular audits of the service and staff and resident meetings to seek the views of people about the quality of care being provided.

We spoke with a range of people about the home. They included the owner, the senior carer in charge, staff, relatives and people who lived at the home. We also had responses from external agencies including social services and the environmental health agency. This helped us to gain a balanced overview of what people experienced living at Rosewood Lodge.

We were able to speak with residents during the day of the inspection about their care and support. People we spoke with told us they could express their views and were involved in discussions about their care. They told us they felt listened to when discussing their care needs. Comments from residents included, “Lovely home supported by kind and attentive staff and manager.”

We spent time in communal areas of the home. This helped us to observe the daily routines and gain an insight into how residents care and support was being managed. We observed staff treated people with respect and provided support or attention as people requested it.

During our inspection we contacted the Lancashire contracts monitoring team. They told us they currently had no concerns with the service being provided by the home.

People told us what it was like to live at this home and described how they were treated by staff and their involvement in making choices about their care.

They also told us about the quality and choice of food and drink available. This was because this inspection was part of a themed inspection programme to assess whether older people living in care homes are treated with dignity and respect and whether their nutritional needs are met.

The inspection team was led by a Care Quality Commission (CQC) inspector and a practicing professional.

We talked with four staff and several people who live at the home as well as family members.

We looked at the person centred plans for four out of the 23 people who lived at the home to see how their needs should be met.

We found that all the people who lived at the home were supported and encouraged to maintain their independence and family contacts. We also observed lunchtime. People living at the home told us that they were satisfied with the food provided by the home and if they didn't like something they would be offered an alternative and this would be provided.

On the day of our visit we saw that people were involved in individual and a group activity.

People living at the home told us that they felt safe at the home. They told us they had no concerns or complaints about their care other than the availability of staff at time. We observed that people living at the home were able to make their own decisions and indicate if they were dissatisfied with anything.

Records in relation to nutrition and health care needs were always not up to date or reviewed with families or advocates. We saw records were kept securely.

We spoke to the manager,staff, relatives visiting, and received comments from other professional agencies such as social services and the environmental health agency. Responses we received were positive and reflected how the home is run in the best interest of the people who live at the home.

Comments from people living at the home about there experiences, and support they receive included, “ My first visit here I felt comfortable". Also "The staff and manager are caring people who always have time for you".We spoke to relatives who were visiting the home for the first time and they said, "The staff are so kind and made us feel so welcome".

We spoke to staff members individually and they spoke about respecting people who live at the home and treating people with dignity. One staff member said, "We encourage people to be as independent as they can and always respect the individual".

Staff know about resident's needs and we talked about individual care and what support people need. Care records confirmed what staff told us and they have a knowledge of individual care, social and cultural needs of people living at the home so that they are not disadvantaged in any way. One relative we spoke to said,"Any problems with mum's health and they are straight on it".

People who live at the home we spoke to only said good things about the quality of food. Comments included, " I have my breakfast in my room the staff dont mind". Also, " We are fortunate to have a good cook".

As part of the review process we spoke to Social Services for there view of how the home operates, and they told us they had no concerns in respect of the delivery of care or any 'safegurding issues'.

We spoke to a group of residents in the lounge area, how they liked the building and layout of the home, one said, "Its lovely the furniture is comfortable and homely".

All the people we spoke to said good things about the staff and the way they are treated, comments included, "Nothing is to much trouble for them". Also, " Caring people". One relative spoken to said, "The staff are all nice and helpful".

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008,  and to pilot a new inspection process being introduced by CQC which looks at the overall quality of the service.

The last inspection of this service was carried out on 9th April 2013. The service was found to be fully compliant during that inspection. This inspection was unannounced.

Rosewood Lodge is registered to provide personal care and accommodation for up to 24 people. Services are provided to older people who may also be diagnosed with a dementia related condition. The home is located on the Promenade, close to St Annes town centre. There is a registered manager in place at the service. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider.

Throughout the inspection, we consulted a variety of people, including people who used the service, their relatives, staff with various roles and a number of community professionals. The majority of people we spoke with expressed very positive views about the service and spoke highly of staff and managers.

People told us they experienced safe and effective care at Rosewood Lodge and expressed satisfaction with daily life at the home. Community professionals reported positive relationships with the service and felt staff were professional and cooperative.

Risks that people faced in relation to their health and wellbeing were understood and there were plans in place to keep them safe. Staff had a good understanding of people’s daily care needs and where necessary, ensured that people who used the service had access to community health care and support.

There were clear safeguarding procedures in place to help ensure that people were protected from harm and potential abuse. The manager and staff had a clear understanding of the procedures and were aware of the action to be taken to safeguard people who used the service.

People’s human rights were respected. Where concerns were identified about the capacity of a person who used the service to consent to any aspect of their care, the key requirements of the Mental Capacity Act 2005 were put into practice to ensure people’s best interests were protected.

People were provided with safe and comfortable accommodation. Equipment and facilities were well maintained and regularly checked, which helped to protect the safety and wellbeing of people who used the service.

People who used the service received their care from well trained, well supported staff. The manager ensured that staff at the service had the skills and knowledge to carry out their roles and received regular supervision.

People told us they received their care from a kind and caring staff team. People felt their privacy and dignity was respected and that they and their relatives could express views about things that were important to them.

The manager was able to demonstrate that the views of people who used the service and other stakeholders were encouraged and welcomed. We saw a number of examples of changes and developments within the service, which had been made as a result of people’s suggestions and comments.

There were processes in place to ensure that all aspects of the service were regularly checked and monitored, both by the manager and the provider of the service. This meant that any areas for development could be identified and addressed. Accidents, complaints and untoward incidents were carefully monitored and analysed to ensure any recurring themes or patterns were identified and investigated.  

There was an open culture within which people who used the service and other stakeholders were comfortable in raising any concerns. People had confidence that any concerns they did raise, would be dealt with appropriately by the manager of the home.