Dunley Hall and Ryans Court 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. Dunley Hall and Ryans Court provides short and long-term accommodation and care for up to 35 people. There were 29 people living at the home at the time of our visit.

At the last inspection in January 2016 the service was rated Good. At this inspection we found the service remained Good. The evidence continued to support the rating of good and there was no evidence or information from our inspection and on-going 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.

A registered manager was not in place at the time of our inspection, however, the provider was taking reasonable steps to address this. 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 continued to be cared for in ways which took their individual safety and risks and lifestyle choices into account. Staff understood risks to people’s safety and tailored the support they provided so people’s safety and well-being was enhanced.

There was enough staff to care for people and checks were made on the suitability of staff before they were recruited. People were supported to have the medicines they needed and checks were made to ensure these were administered as prescribed. Processes were in place to reduce the chance of people having infections. Staff reflected on people’s safety needs. This included learning from any untoward incidents.

People’s care needs were considered before they moved into the home and their care planned accordingly. Staff worked with people’s relatives and other health and social care professionals so informed decisions would be made about meeting people’s care needs.

People told us staff knew how to care for them. We found staff were provided with opportunities to develop their skills and knowledge, so they could provide the support people living at the home needed.

Staff acted to ensure people had enough to eat and drink so they would remain well. People and their relatives were complimentary about the choices of meals provided. Staff worked across organisations to ensure people were supported to see health specialists when required. This helped to ensure people had good well-being and health.

People are supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice.

Caring relationships had been developed between people and the staff supporting them. We found staff knew what was important to people, and spent time chatting with them about what mattered to them. People were encouraged to make their own decisions about the care they wanted. People’s right to dignity and privacy was understood and promoted by staff.

People’s care was planned to reflect their unique preferences, lifestyle choices and needs. Staff supported people to make their own decisions about their lives and care. The views of friends and family and other health and social care professionals were considered when people’s care was planned. This helped to ensure people’s care was planned in the best way for them.

Systems were in place to encourage people to raise any concerns or complaints they may have. Where complaints were made, these were resolved quickly, so people would continue to enjoy living at the home.

People were encouraged to provide their view

The inspection took place on 19 January 2016 and was unannounced.

The home provides accommodation for a maximum of 35 people requiring personal care. There were 31 people living at the home when we visited. A registered manager was in post when we inspected the service. 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 living at the home. Care staff understood what was needed to keep people safe. Staff had received training and knew who their concerns could be shared with.

People received their medicines at they had been prescribed. Regular checks of people’s medicines by both the pharmacy and the registered manager, ensured errors were kept to a minimum.

Staff told us they felt supported by having access to training and having supervision meetings that allowed them to discuss issues that were important to them. Staff were also given feedback in their supervision meetings which meant they were able to improve on areas that had been identified that required attention.

People’s consent was appropriately obtained by staff. People who could not make decisions for themselves were supported by staff within the requirements of the law. The registered manager had taken the appropriate action to ensure they met the requirements of the law.

People enjoyed their food. People were offered choices at mealtimes and were supported to have drinks whenever they chose.

People’s health needs were assessed regularly and care staff understood how they should care for people. Staff told us they spent time with people and understood how to care for them by getting to know them.

People liked the staff who cared for them. People’s privacy and dignity were respected by staff and the management team at the home. People’s individual circumstances and individual requests were responded to by staff. Staff showed warmth and care towards people.

People were supported to take part in activities they liked or had an interest in. Staff supported people to maintain individual as well as group interests. Staff knew people’s likes and dislikes and how they liked to spend their time.

People responded warmly to the registered manager. Staff were positive about the registered manager and felt part of a team. Staff felt able to contribute ideas as well as ask for help for when they needed support or guidance.

People’s care was regularly checked and reviewed by the registered manager. The registered manager understood the registered provider’s expectation of the standard of care to be delivered. Both worked together to ensure people’s individual objectives for their care could be recorded and updated based on their circumstances.

31 people were living at the home when we inspected. We talked with six people who used the service. We also spoke with the acting manager, the floor manager and two care workers. During our inspection we observed how staff interacted with people and responded when they were asked to do something.

People that we spoke with told us that they were happy with the home and the staff. One person told us; “I have no complaints whatsoever". Another person said; "They look after me well".

Staff knew about the needs of the people they were caring for. We looked at care plans for four people and found that these contained varying levels of guidance for staff on how to meet people's needs. We saw that people’s needs were reviewed regularly and other professionals had been asked to attend it they had any concerns about people's health needs.

People told us that they felt safe living at the home and knew who to speak to if they had any concerns. Staff had received training on how to recognise signs of abuse and knew how to report concerns.

We saw that staff were supported to be trained to an appropriate standard although some parts of their training had not been refreshed recently.

We looked at records which showed that the provider was regularly monitoring the quality of its service.