The inspection took place on 23 May 2017. St Mary’s House is a residential care home that provides care and support for up to 17 people. On the day of the inspection, 16 people were living at the home. St Mary’s House provides support for people living with varying stages of dementia, diabetes, mental health needs and long term healthcare conditions. The provider, Grace and Compassion Benedictines, is a Christian organisation and the home is connected to a convent. The home is run by the Sisters and care staff who work alongside each other. The home is open to people of any or no religious beliefs.

The home had a registered manager in post. They were not present on the day of the inspection but the provider’s Director of Care was at the home. 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.

At the last inspection on 9 April 2015 we identified some areas of practice that were not consistently safe. At this inspection we found that these concerns had been addressed and were now meeting the required standards. Staff were clear about their responsibilities with regard to keeping people safe and risks were identified, assessed and managed effectively.

People were receiving their medicines and there were enough staff on duty to care for people safely. One person told us, “I feel safe all the time, the carers look after me.” A relative said, “I know I can leave my dad here and not worry at all, I have no concerns for his welfare”.

Staff were receiving the training and support they needed to carry out their roles effectively. People had confidence in the skills of the staff and felt they were well trained. One person said, “They always seem to be training for something, so I’m very happy they can look after me”. Staff had a clear understanding of their responsibilities with regard to the Mental Capacity Act (MCA) 2015 and sought consent from people before providing care. People were supported to access the health and care services they needed.

People were receiving the food and drink they needed. They spoke very highly of the standard of the food at St Mary’s House. One person said, “Food is very good, of top hotel standard,” another person said, “The food is excellent, (the chef) could leave and open her own restaurant.”

People and their relatives told us they were very happy with the care they received. They spoke highly of the staff, describing positive relationships and a kind and caring approach. One person said, “I love the staff, they look after me well, and are interested in what I say.” Staff treated people with respect and maintained their privacy and dignity. People told us they had been involved in planning their care and felt that their views were listened to.

There was a range of activities organised on a daily basis and people told us that they enjoyed participating. Staff encouraged and supported people to follow their interests and to maintain relationships that were important to them. One person had given up art but staff persuaded them to try taking it up again and they were participating in the art class regularly. They told us they, “Really love the class.” There was a complaints system and people knew how to raise any concerns. They said they would feel comfortable to do so but had not needed to do so.

People, relatives and staff spoke highly of the management of the home. One person said, “I cannot think of anything that could be improved, they do an excellent job, they do everything well.” A relative said, “I honestly can’t praise it enough. The staff respect each other and work as a team all the time.” A staff member said, “I think it’s very well led. I wouldn’t have stayed here so long if I thought differently

During our visit we saw that people were being treated with dignity and respect and people's independence was encouraged. People were spoken to in a respectful way. People we spoke with told us that the staff were polite, friendly and helpful and that their privacy was respected whilst they were supported to maintain their independence. One person told us they thought the service was 'wonderful' and that 'staff treat me respectfully'.

We saw that people experienced safe and effective care based on detailed care plans and risk assessments that met individual needs.

People using the service were protected from abuse as they were supported by a staff team who had appropriate knowledge and training in safeguarding adults. People told us that if they had any concerns they would report them to the manager.

Staff we spoke with and records we reviewed, demonstrated that staff were suitably experienced and skilled to support people living in the home. A staff member told us that they 'enjoy the work' and that the manager is 'helpful and understanding'.

The provider had effective systems in place to monitor and assess the quality of the service.

During our visit we spoke with five people who live in the home and one visitor. We spoke with three members of staff, including the manager, a nurse and a care assistant, and one volunteer. We looked at the records of three people. We looked at the responses to a recent satisfaction survey which gave us additional information about the views of people who used the service.

The people we spoke with were happy living at St Mary's House. hey told us that they were able to make choices about the care they received, and that staff looked after them well. One person said "It's very good here", and another said "I always say I feel content here". The visitor we spoke with said that their relative received good care at the home.

The staff we spoke with had a good understanding of the needs of the people who lived at the home, and received the training and support they needed. They prioritised the privacy and dignity of people, and supported people to be independent.

We spent time observing the care provided to people living in the home. We saw that staff had a good rapport with people, and spent time talking and listening to them. Staff understood people's needs well. There was a friendly, happy atmosphere in the home.

The manager said that the house had been refurbished over the last two years. The house and people's rooms were clean and well-presented. There were effective systems for assessing and monitoring the quality of service provision in place.

We inspected St Mary’s House on the 9 and 10 April 2015. St Mary’s House is a residential care home that provides care and support for up to 22 people. On the days of the inspection, 17 people were living at the home. The age range of people varied between 70 – 100 years old. St Mary’s House provides support for people living with varying stages of dementia, diabetes, mental health needs and long term healthcare conditions.

In 1954, St Mary’s House was founded by Mother Mary Garson. Mother Mary Garson was motivated by compassion for some old people she visited who were living in squalid conditions unable to look after themselves. She felt compelled to do something about this situation and set up St Mary’s House in Brighton where people could be cared for in a loving surrounding. Receiving the anonymous gift of exactly the money she required for the deposit on a house convinced her that this was God’s will for her. In 1978, St Mary’s House became part of the Grace and Compassion Benedictine family (provider).

Grace and Compassion Benedictine family follow the rule of St Benedict who lived in the 5th century. The rule is centred on Christ and aims at a balanced life of serenity and wholeness. The main work of the Benedictine family is hospitality particularly in the care of the old, the sick and the poor. The home is run by Sisters and care staff who work alongside one another. Next door to the home is the Sisters convent. A chapel is on also on site which is open to the public on Sundays.

A registered manager was 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 and associated Regulations about how the service is run.

People’s needs had been assessed and individual holistic care plans developed. However, where someone was assessed at being high risk of falls or skin breakdown, documentation failed to reflect what actions were required to safely meet the person’s needs or reduce the risk of any harm occurring. Despite concerns with documentation, we saw that people received the care they required. However, we have identified this as an area of practice that needs improvement.

Staff had received safeguarding adults training and had a firm understanding of what constituted adult abuse. However, staff were not clear on how to raise a safeguarding concern. We have identified this as an area of practice that needs improvement.

People who lived at the home and their relatives were encouraged to share their opinions about the quality of the home to make sure improvements were made when needed.

The Sisters and care staff referred people to other health professionals for advice and support when their health needs changed. Staff supported people with kindness and compassion. Staff reassured and encouraged people in a way that respected their dignity and promoted their independence. Staff understood the importance of gaining consent from people before delivering personal care.

People and their relatives felt people were safe and well cared for. People were cared for, or supported by, sufficient numbers of suitably qualified and experienced staff. New staff received induction, training and support from experienced members of staff. Staff felt supported by the registered manager and spoke highly of their leadership style.

Staff offered people a wide range of choices for meals. Risks to people’s nutrition were minimised because staff understood the importance of offering appetising meals that were suitable for people’s individual dietary needs.

Medicines were stored in line with legal requirements and people commented they received their medicines on time. People’s social and emotional needs were met through a range of social activities and opportunities for social engagement. Staff understood and recognised people’s religious and spiritual needs and provided support to ensure those beliefs were upheld and maintained.