28 September 2018
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
This was a comprehensive inspection which took place on 14 August 2018 and was unannounced. An inspector and an expert by experience visited the service. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of service. The expert by experience had experience of caring for older people and people with dementia.
Before the inspection we reviewed information relating to the service including notifications sent to us by the provider. A notification is information about important events which the provider is required to tell us about by law. We also used information the provider sent to us in the Provider Information Return (PIR). This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make.
We spoke with the acting manager, regional director, a registered nurse, four members of staff, the activities co-ordinator and the chef. We spoke five people and seven visiting relatives to gain their views and experiences of the service.
We spent time observing care and used the short observational framework for inspection (SOFI), which is a way of observing care to help us understand the experience of people who could not talk with us. We spent time looking at records, including four people’s care records, four staff files and other records relating to the management of the service, such as policies and procedures, training records and audit documentation. We also ‘pathway tracked’ the care for two people living at the service. This is where we check that the care detailed in individual plans matches the experience of the person receiving care. It was an important part of our inspection, as it allowed us to capture information about a sample of people receiving care.
28 September 2018
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.