The inspection took place on 29 November 2017and was unannounced.

Dudbrook Hall is a ‘care home’. 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. Dudbrook Hall is registered to provide accommodation and personal care to up to 43 people in one building, across two floors. At the time of our inspection there were 42 people living at the service some of whom were living with dementia.

There was a registered manager in post. 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.

Risks to people had been assessed with guidance in place for staff to manage risk. Staff showed a good awareness of risks to people and knew what to do to keep people safe. Staff had received training in how to safeguard people from abuse and knew the signs to look for and how to report any concerns.

Medicines were managed safely by staff who had been trained and assessed as competent to administer medicines. Good infection control practices were observed and the service was clean and free from odours.

Staff had been recruited safely. There were sufficient staff deployed to safely meet people's needs and preferences.

The service provided excellent support to staff to ensure they had the skills and experience to support people effectively. Good quality training and supervision was in place to monitor staff competence and support staff to develop professionally.

The registered manager was enthusiastic and innovative which resulted in improved outcomes for people who used the service.

People were supported to have enough to eat and drink which met their health needs and preferences. The service supported people to access a range of healthcare professionals to maintain their health and wellbeing.

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.

Staff were kind and caring, listened to people and provided them with care and support the way they wanted it. People's independence was supported and encouraged. Staff treated people with dignity and respect and people's privacy was respected. Visitors were made welcome at the service which helped people maintain important relationships.

The service treated people as individuals and provided care and support that met their needs and wishes. Staff knew people well and respected people's routines and preferences.

Activities and events were organised which reflected peoples choices and interests. People were asked for their opinion and this used to provide opportunities for meaningful engagement.

People were supported to express their wishes regarding end of life care and these were documented and respected.

There were systems and processes in place to respond to complaints. We saw complaints were investigated thoroughly and were well managed to achieve resolution.

The management team and provider showed a commitment to providing good quality care and seeking ways to continuously improve the service.

The positive values of kindness, empathy, respect and person-centredness were shared by staff and management and were put into practice.

Staff felt well supported by the manager and provider and appreciated their hands-on approach which created a strong sense of teamwork.

People, relatives and staff were all included in the running of the service. Their opinion was actively sought and acted upon to drive improvements.

The inspection took place on 25th August and was unannounced.

Dudbrook Hall is residential care home registered to provide accommodation for 43 older people who require personal care. There were 42 people living at the home on the day of our inspection.

The home had a registered manager who had been registered since January 2011. 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.

People told us they felt safe and well cared for at the service and that staff responded to requests for assistance quickly.

Risks were assessed and monitored safely however improvements were required regarding how risks were recorded to make information easier to find.

Improvements were required in respect of medicine management to ensure that records were accurate and that people received their medicines as prescribed.

Infection control practices required improvement in some areas to protect people from the risk of infection.

Staff understood their responsibilities to protect people from abuse and were aware of the signs to look for and reporting process if they suspected someone was at risk of harm.

There were sufficient numbers of staff who had been recruited safely and had the relevant skills and knowledge to effectively meet people’s needs.

Where people experienced difficulties with decision-making, they were supported appropriately in accordance with current legislation.

The service was meeting the requirements of the Deprivation of Liberty Safeguards (DoLS). Appropriate mental capacity assessments and best interest decisions had been undertaken. This ensured that any decisions taken on behalf of people were in accordance with the Mental Capacity Act (MCA) 2005, DoLS and associated codes of practice.

A choice of food and drink was available that reflected peoples nutritional needs, and took into account their preferences and any health requirements. However, the dining experience for people required improvement as people experienced delays in receiving meals and did not always have access to the help they required to support them with eating.

People were supported to maintain their health and had regular access to wide range of healthcare professionals.

The home had a warm and friendly atmosphere which people, relatives and staff valued. Staff had positive relationships with people who used the services and knew them well.

Staff knew people well and supported them to with maintaining their independence. People and their relatives told us staff treated them or their relative with kindness and respected their privacy and dignity.

The care and support provided met people's individual needs and preferences. People, or their representatives, where appropriate, were involved in making decisions about their care and support and felt listened to and included.

People were encouraged to follow their interests including religious practices and beliefs and were supported to keep in contact with and maintain positive relationships with their family and friends.

There was a registered manager in post who promoted the organisations values of upholding people’s dignity, treating people with respect and supporting their independence.

Staff enjoyed working at the service and felt that they were included in the running of the home and that their views were valued.

There were systems in place to ensure the quality and safety of the service and to drive improvements and respond appropriately to complaints and feedback.

People and their representatives were involved in how the service was run and their opinions were actively sought through satisfaction surveys and regular meetings.

This inspection took place on 8 October 2014.

Dudbrook Hall is registered to provide accommodation for 43 older people who require personal care. There were 43 people living at the home on the day of our inspection, although three people were in hospital at the time.

The home had a registered manager who had been registered since January 2011. 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.

People felt safe living in the service and were cared for by staff who treated them with kindness and respect. There were enough staff available to meet people’s needs and give them support that was caring and personalised. Recruitment procedures were thorough and medicines were safely managed and recorded.

Assessments of people’s capacity to make decisions about their care had been completed and people’s rights were protected. People were supported to have as much independence as possible while keeping safe. People and those acting on their behalf were involved in making decisions about their care and support. People’s healthcare needs were well managed.

People liked the food and were offered choices. Specific dietary needs were catered for. People were supported and encouraged to eat their meals in a caring and respectful way. Staff were well trained and supported to undertake their roles.

The home was well led and managed to ensure people’s well being and safety. People regularly saw the manager around the home and knew her by name, as she did them. The management team had systems in place to listen to people’s views and to monitor and improve the quality of the service.

We spoke with three people who used the service during our visit of 31 July 2013 and also spent time observing the care and support provided to people. People told us they received good care at Dudbrook Hall. One person said, “What can I say? They do everything I need and look after me well. Another person told us, “I do not regret coming. I am quite happy here.”

We looked at the care records for four people who used the service. We found that people’s care needs were assessed and monitored and they received care that met their needs.

People were provided with a choice of suitable and nutritious food and drink. We spoke with three people who used the service who confirmed they had plenty to eat and drink and were given choices.

There were arrangements in place to minimise the risk of abuse or harm to people who were using the service.

People were supported by enough staff to meet their needs. We found that the staff team was well organised and effectively led to ensure people who used the service received the care they needed. A relative described the staff as "...excellent", and a person who used the service told us that the staff were "...kind".

The provider had an effective system in place to identify, assess and manage the risks to the health, safety and welfare of people using the service and others. People had opportunities to comment on the service provided and their views were listened to an acted upon.

We found that people received care and support that met their needs. We spoke with four people who used the service and a visitor. They all told us they were satisfied with the care provided. One person said, “I feel this is a very good home and I am well cared for. There are regular staff and they are caring, they chat and I have been able to build friendships.” A visitor said, ”Staff are very nice, they are always talking to people and are really attentive. We are happy with the home and the care that [person] received since being here.”

People we spoke with told us they were happy with the arrangements made for their medicines. People also told us that they were able to make decisions and retain their independence where they wanted to and felt respected at the home.

People were cared for by staff who had had appropriate checks undertaken before they began work. This helped to ensure that only suitable people were employed to care for people who used the service. One person said, “The staff are lovely, they are very patient with people and treat them so nicely and respectfully.”

People were given clear information on how to raise comments or complaints. People we spoke with felt that the staff and management team were approachable and available. This helped them to feel confident to express their views. One person said, “I would feel able to say if I was not happy, I could complain. I am sure they would listen to me, but everything is fine.”

We did not speak with people who use the service about medication management or staff recruitment at this visit. At our last visit in February 2011, people using the service told us that staff helped them with their medication when they needed it.

People living at Dudbrook Hall told us that they were involved in decisions, their views were listened to and they were treated with dignity and respect. One person said, in relation to personal care, “They are very discreet about things”. Another person told us “I can do some things myself and nobody interferes with that”.

People using the service said they experienced good care and healthcare and had a range of social activities available. They explained that they could choose whether or not to join in and could spend time alone in their room pursuing their own interests if they preferred. One person with whom we spoke told us "I get very good care". A visitor with whom we spoke told us "It is much, much better here, I am very happy with it. The care is very good here".

We also received positive comments about food and drinks at the home. One person using the service said that the meals “Are regular, varied and plentiful - they are quite good really”. Another person said “The food is very good”. People using the service also told us that they were offered choices of food and drinks and also where they took their meals. One person said "There are at least two choices at mealtimes, different drinks are always available and you always have a properly sealed bottle of water in your room".

People using the service told us they felt safe at Dudbrook Hall. One person said “I feel safe here. When I hear what’s going on in the outside world – I am glad I am here”. People using the service also told us that they were comfortable at the home and were able to bring some of their own possessions to make it more homely and personalised. One person with whom we spoke said “I have a lovely room and brought some of my own things”. Another person said “I am as comfy as can be”.

People using the service told us that there were enough staff to support them with their needs. A person with whom we spoke commented "When you buzz they come, they are very good that way". People felt well looked after by the staff at Dudbrook Hall. One person with whom we spoke said "The staff are very good, I never regret coming here. They are friendly and I get on well with all the carers." A visitor with whom we spoke said "people are very nice in here and the staff are very kind".

People told us that they felt able to talk to staff about any issues they had. A person using the service told us “They do everything for you here to make it good”. A visitor said “I asked and it happened”. People using the service also felt confident to raise any concerns or tell someone if they were not happy with something. One person said “we are told that if we are worried or concerned to let them know and one of the chiefs will come and sit and talk with you about it”.