We carried out a comprehensive inspection of Rosina Gardens in February 2017. After that inspection we received concerning information about the sustainability of staffing levels at the service. We carried out a focussed inspection in May 2017 to check that there were enough staff to support people at this service. We found that there were. We received further concerning information about staffing levels again in July 2017. As a result we undertook this unannounced focused inspection on 13 July 2017 to look into these concerns and check there were enough staff to support people. This report only covers our findings in relation to these concerns. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Rosina Gardens on our website at www.cqc.org.uk.

Rosina Gardens provides rehabilitation and recovery care for up to 14 adults who have mental health issues. There were 10 people using the service at the time of this inspection.

At this inspection we found there were enough staff to support people with their needs. Staffing levels continued to be maintained at a consistent level. Senior staff monitored staffing levels daily and could utilise additional staff to cover any unexpected gaps, should these arise. Staff were committed to the people they looked after and told us they wished to continue supporting people living at Rosina Gardens.

There was no registered manager for the service at the time of this inspection. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

There were interim arrangements in place to adequately cover the day to day management of the service. The senior staff team were clear about their management responsibilities and duties, including notifying CQC about events or incidents that occurred at the service. Staff said the senior staff team were accessible and supportive and they could speak with them at any time if they had any issues or concerns.

The senior staff team were working with the local authority and commissioners to ensure there was stability and continuity at the service. They had plans in place to ensure there were enough resources, at the time of this inspection, to ensure the service could be adequately maintained and people continued to have their needs met.

We will continue to monitor the situation and are working closely with the senior staff team and the local authority to ensure people remain safe.

We carried out an unannounced comprehensive inspection of this service on 27 and 28 February 2017. After that inspection we received anonymous concerns that staffing levels were not sustainable and that this could be unsafe. As a result we undertook a focused inspection to look into this concern and check that there were enough members of staff to keep people safe. This report only covers our findings in relation to this topic. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Rosina Gardens on our website at www.cqc.org.uk

We undertook a focused inspection on 05 May 2017 to check staffing levels remained safe. We found there were enough staff to meet people's needs and safeguards were in place to access additional staff support should the need arise. We will continue to monitor the situation and are working closely with the local authority to check that people remain safe.

We visited Rosina Gardens on 27 and 28 February 2017. The inspection was unannounced.

Rosina Gardens provides rehabilitation and recovery care for up to 14 adults who have mental health issues.

The service had a registered manager until September 2016. A replacement manager had not been recruited at the time of the inspection. 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.

People told us they felt safe. The service had appropriate policies and procedures for safeguarding. Staff understood their personal responsibilities to recognise and report any suspicions of abuse. We found a number of areas of concern in relation to the environment and infection prevention and control. Medicines were not always managed safely. Risk assessments were in place for people using the service and provided staff with guidance to provide safe and appropriate care and support. There were sufficient numbers of staff to meet people’s needs. Good staff recruitment procedures were in place.

We found gaps in some areas of training and refresher training. People were supported for by staff who had the knowledge and skills they needed to deliver effective care. Staff were supported to obtain further, relevant qualifications. Staff were aware of the provisions of the Mental Capacity Act and Deprivation of Liberty Safeguards. People were supported to have a healthy diet and to maintain good health.

People told us staff were supportive. People were supported to express their views and be involved in the planning and delivery of their care and support. Staff respected people’s dignity and privacy and treated them with respect. People were also encouraged and supported to be independent.

People received person centred care that was focussed on their needs. Support plans and risk assessments were developed with people using the service enabling staff to deliver safe and appropriate care and support. People were encouraged to take part in activities to reduce the risks of social isolation and to enhance their lives. The service regularly obtained feedback about people’s experiences of the service. The service had appropriate processes for dealing with complaints.

Systems to assess and monitor the quality of the service were not always effective as they did not always identify or address areas requiring improvement such as training. Staff meetings were held every month giving staff the opportunity to feedback their thoughts about the service. Records relating to the provision of care were up to date, appropriately stored and fit for purpose.

In relation to the concerns we have identified you can see the action we have told the provider to take at the end of the full version of the report.