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Inspection carried out on 5 March 2019

During a routine inspection

About the service: Dulas Court is a residential care home that can provide personal care and support to a maximum of 31 people. The service was providing personal care to 20 people aged 65 and over at the time of the inspection.

People’s experience of using this service: The provider and management team were extremely good at planning and delivering care that was tailored to people’s individual needs and preferences. People’s care plans truly reflected their individual needs, interests, wishes and aspirations. There was a thoughtful and inclusive approach to organising interesting and meaningful occupations and activities for people, which enhanced the quality of their lives. The provider employed a physiotherapist to support people enhance their mobility and an Admiral Nurse to provide support and guidance to people living with dementia.

The provider had developed a culture of continual improvement and learning to ensure people received a quality service. They placed great emphasis on staff development and introduced creative ways to achieve a positive, learning experience for them. There were good monitoring systems in place to ensure the provider and senior management team had full oversight of the service. However, there were some management issues that were raised and addressed during the inspection. These were the replacement of locks on the sluice and store rooms, and cupboards that were accessible to people; one cupboard was used to store information that was confidential.

People felt safe and were able to raise concerns. The registered manager and staff team provided safe care for people. They knew how to safeguard people from abuse and managed risk in ways that ensured people continued to follow their lifestyle choices as much as possible. There was sufficient staff available to meet people’s needs and they had been recruited in a safe way.

People received their medicines as prescribed and were supported to access health professionals when required. People’s nutritional needs were met and they received a varied and nutritional diet. People told us they enjoyed their meals. People were supported to make their own choices and decisions as much as possible. When people lacked capacity, the provider and registered manager worked within mental capacity legislation and consulted with relevant people on important decisions made in their best interest.

The care staff respected people’s privacy and dignity. The approach of staff was caring and considerate. Staff received training, supervision and support that helped them to feel confident when supporting people. The environment was very clean and tidy and was suitable for people’s needs.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection: Outstanding (report published 31 August 2016).

Why we inspected: This was a planned inspection based on the previous rating.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.

Inspection carried out on 18 July 2016

During a routine inspection

This inspection was carried out on 18 July 2016 and was unannounced.

Dulas Court provides accommodation and personal care for up to 31 people. At the time of our inspection there were 22 people living at the home and one person receiving respite.

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 and associated regulations about how the service is run.

People received person centred care that maintained their health and wellbeing. People were supported to maintain their hobbies and interests and people’s abilities and skills were recognised and promoted.

People were treated with dignity and respect. People had good relationships with staff. The provider supported people to be part of the wider community.

Staff had good support and training to enable them to meet the need of the people living at the home. There were sufficient numbers of experienced and well trained staff to ensure people were supported safely and people’s health needs responded to quickly. Medicines were managed safely and people received their medicines in line with their prescription.

The service responded effectively to people's needs and preferences. People were supported by staff that knew the needs of the people they supported. The service was responsive and well managed. People knew the registered manager and the provider. People were actively involved in the running of the home through regular meetings. They felt that if they had any concerns they were able to speak with the registered manager or provider. The provider welcomed people's views and opinions and acted upon them.

People felt safe and knew how to raise concerns. Staff felt comfortable to raise any concerns about people’s safety and understood about how to keep people safe. People were supported to take positive risks. Where risks had been identified the risk had been assessed and action taken to reduce any risk.

People enjoyed the food and had the support they needed to enjoy their food and drinks safely. People were able to make choices about the food and drink they wanted. There was a choice of freshly prepared nutritious food. Where needed steps were taken by the provider to improve people’s nutrition.

People's health needs were monitored and changes were made to people's care in response to any changes in their needs. People had access to other health professionals and were referred to them by the registered manager if there were any concerns about their health needs.

The provider was innovative in the use of new technology and adaptations to minimise the impact of dementia on people’s independence and wellbeing.

There were a range of audits and checks to make sure that good standards of care and support were maintained. Feedback from the people and relatives was gathered on a regular basis and where any actions were identified these were actioned quickly.

There were strong links with the local community that promoted positive approaches to the people that lived there.

Inspection carried out on 6 September 2013

During a routine inspection

In this report the name of a registered manager appears who was not in post at the time of the inspection. Their name appears because they were still a Registered Manager on our register at the time.

People told us that they were happy with the care and support provided at Dulas Court. They told us, "It's really very good here, I don't think you could better it" and another said, "It's just like normal life, you can do what you like here".

Staff made sure that people were making decisions for themselves as far as they were able. Staff knew how to ensure that decisions were made in people's best interests when anyone was unable to make decisions for themselves.

People told us that they felt safe at the home and were confident that staff knew how to support them. Records showed that staff had received training to prepare them for their work.

People knew how to raise any concerns. They told us, "I've never needed to complain about anything here" and, "It's so good here that I can't think what you could complain about".

Inspection carried out on 14 May 2012

During a routine inspection

We spent time at the home watching to see how staff supported people, and talking with people about life at Dulas Court. We spoke with four people living at the home who were able to tell us about life there, and we also looked at care records.

We saw that staff were kind and caring when they provided support for people. Staff were respectful in the way they spoke with people. Staff had a good knowledge of the people they were caring for. They also showed empathy and were sensitive in the way they talked about people.

We saw records of residents’ meetings, and these showed that people had made suggestions about ways in which the home could improve the service. Later records showed that some of these improvements had been put into place, and that people appreciated being listened to.

People were very positive about the way that staff cared for them. One person told us “they’re very good, very kind” and another said “we’re well looked after here”. Some people said that they felt that there were not always enough staff. Comments included “they get very busy and then they don’t have much time” and “they don’t have time to do the little extras any more”.

There was evidence that the risks associated with care provided to people living at the home had been assessed and managed effectively.

Inspection carried out on 13 March 2012

During an inspection in response to concerns

People told us that they were happy living at Dulas Court. They described it as “a good place to be” and told us that the staff were “wonderful”, “very kind” and “really good to us all”.

People were receiving care and support which met their needs, and staff had a good knowledge of each person’s individual needs and preferences.

There were some shortfalls in the management of medication, which increased the risks of errors occurring.

Reports under our old system of regulation (including those from before CQC was created)