This was a comprehensive inspection which took place on 14 August 2018 and was unannounced. Dudwell St Mary is a ‘care home’ that provides personal and nursing care for up to 74 people, on the day of inspection there were 57 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. The service is two adapted buildings, with private bedrooms, shared communal areas and bathrooms. Some people living at the service were living with dementia, frailty or chronic health conditions.

The service did not have a registered manager in post on the day of our 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. However, we saw documentation that a manager had been appointed and was due to start at the service. We were told that the manager would register with the CQC. Day to day charge of the home was carried out by an acting manager.

At our last inspection we rated the service Good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection. At this inspection we found the service remained Good.

People remained safe. Staff had a good understanding of safeguarding and there were systems and process in place to keep people safe. There were robust systems in place to manage, administer, store and dispose of medicines. The provider ensured staff were suitable to work at the service before they started. We observed people’s needs being responded to in a timely manner. The service was clean and infection control procedures followed.

People’s needs and choices were assessed prior to people moving into the service, and they were supported to have maximum choice and control of their lives. Staff continued to support people in the least restrictive way possible. People continued to enjoy a balanced diet and remained supported to access healthcare services as and when needed.

Care continued to be personalised to meet the needs of individuals including their care, social and wellbeing needs. The provider ensured there were systems in place to deal with concerns and complaints. End of life care was considered at the service and people’s wishes were documented in their care plans.

We observed positive interactions between people and staff, staff knew people well and had built trusting relationships. People’s independence continued to be promoted, staff supported people in a dignified manner and people’s privacy continued to be respected.

The home remained well-led and robust and effective quality assurance systems and processes were in place to assess, monitor and drive improvements in the quality of care people received. People, staff and relatives remained engaged and involved in the service provided. The culture of the home continued to be positive and respected people’s equality, diversity and human rights.

Further information is in the detailed findings below.

We spoke with the Head of Unit for Memory Lane who was acting deputy manager on the day of our inspection. We also spoke with the regional manager, the administrator, five members of nursing, care, and catering staff. We spoke with six people who lived in the service and two of their relatives.

We found that people were provided with a clear statement relevant to the fees, terms and conditions prior to the start of the service, and were given time to consider whether they wished to proceed with their residency, care, treatment and support. One relative of a person who lived in Dudwell St Mary told us, "The agreement of residency and the fees were clear from the beginning".

We looked at twelve sets of records for people who used the service and observed that the care that was provided was planned and delivered in line with their individual care plan. These were comprehensive, reflected individual care needs accurately and had clear action plans in place. A relative stated, "My mother is extremely well looked after". Another relative said, "The family is involved, we can share our concerns if we have any and we look at what can be done together, it works really well".

We observed lunch being served in both buildings. The food that was provided appeared hot, nutritious, well presented and in sufficient amounts. Menus were varied and alternatives were offered and facilitated. People told us, "It was delicious, it always is", and "I thoroughly enjoyed lunch today".

We found that the service took measures to prevent risk of infection and cross contamination. A member of staff was the lead in infection control and checks were carried out to ensure cleanliness and disinfection of the premises and equipment. A relative we spoke with told us "The cleaners are very efficient".

We found that staffing levels were planned according to people's levels of dependency. There were one care or nursing staff per five persons who used the service. We spoke with the staff who told us, "There are enough of us, we meet the residents' needs". People we spoke with told us, "They always come quickly when I press my cord bell, and there are plenty of them about".

During our visit we talked to staff, two relatives and eight residents who said the home supported people to be independent wherever possible. People told us they felt involved about how they wished to have care and support delivered and were given clear information on a daily basis regarding their care and treatment. They told us their preferences were always accommodated and they described a relationship of trust with staff and felt they were being listened to. One person said “This is such a nice home and everyone works hard to look after us.”

A person who was staying at the home for a period of respite told us “I love it here it I have so much fun and the staff are very kind”. He told us “Everyone is helpful day or night”.

Relatives that we spoke with stated that staff were gentle and made every effort to involve the family with their relatives care.

This inspection took place on 15 and 16 July 2015 and was unannounced.

Dudwell St Mary is a residential care home which can provide personal and nursing care for up to 74 people. The home comprises two separate buildings, Dudwell House and St Mary’s House.

There was a manager in post who was registered with the Care Quality Commission (CQC). They had overall responsibility for both buildings. 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 at Dudwell St Mary. We found that enough staff were on duty to meet people’s needs even though some people and staff had a different view of the level of staffing.

Staff had the required skills and abilities to meet people’s needs. They received regular training, supervision and appraisals to maintain their performance and promote their development.

Staff treated people with kindness and respect. Staff spoke with people in a dignified way and knew how people liked to receive care. People told us they liked the staff and were always treated with respect and dignity.

People received care that was responsive to their needs by thorough assessment and reviews of care plans, involving people or their relatives.

People had their health needs met quickly and staff had followed advice from health professionals that had improved people’s well-being. People were given a choice of food and drinks and were supported to eat and drink sufficient amounts.

People were involved in choosing activities, menus and the décor of their rooms. Although activities were available and most people enjoyed these, a few people felt there was less to do. We have made a recommendation about this.

People and their relatives told us they could make a complaint and that the provider would address their concerns.

People were encouraged to comment on the service through surveys and questionnaires provided to influence how the service was developed.

Staff we spoke with had received training on the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS). This legislation sets out how to proceed when people do not have capacity and what guidelines must be followed to ensure people’s freedoms are not restricted.

Records showed that the Care Quality Commission (CQC) had been notified, as required by law, of all the incidents in the home that could affect the health, safety and welfare of people.

The manager understood when an application should be made.

Contingency plans were in place, including arrangements for alternative accommodation in the event of an emergency. People were risk assessed to ensure they received appropriate support to be safe in the event of an evacuation of the home.