We carried out an unannounced inspection on 14 March 2017.

Dukeminster Court provides accommodation and personal care with nursing for up to 75 elderly people, some of who are living with dementia. At the time of this inspection there were 70 people living at the home

The service has a registered manager in place. 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.

During our previous inspection undertaken on 16 June 2016, we identified concerns in relation to medication. The provider sent us an action plan and told us that they had taken immediate action to make the necessary improvements. During this inspection we found that the required action had been taken. The provider had created robust processes to ensure that peoples medication was always available in the home.

There were risk assessments in place that gave guidance to staff on how risks to people could be minimised and how to safeguard people from the risk of possible harm.

There were enough staff available to support people to be safe in the home.

The provider had robust recruitment processes in place. Staff understood their roles and responsibilities and would seek people's consent before they provided any care or support. Staff received supervision and support, and had been trained to meet people's individual needs.

People were supported by caring and respectful staff who knew them well. Staff were given the opportunity to get to know the people they supported through keyworker roles.

People's needs had been assessed, and care plans took account of their individual, preferences, and choices. Staff supported people to maintain their health and well-being.

Feedback was encouraged from people and the registered manager acted on the comments received to continually improve the quality of the service. The provider had effective quality monitoring processes in place to ensure that they were meeting the required standards of care. There was a formal process for handling complaints and concerns which were investigated and resolved in a timely manner.

This inspection was carried out on 17 and 30 June 2016 and was unannounced.

Dukeminster Court provides care and accommodation for up to 75 people, some of whom are living with dementia. At the time of our inspection there were 68 people living at the home.

The home had a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

The processes in place to manage people’s medicines were not always effective. Although most medicines were provided by the pharmacy in pods on a monthly cycle, where this was not the case people’s medicines had run out on a number of occasions. This could have had a detrimental effect on their health and well-being.

Staff were aware of the safeguarding process. Personalised risk assessments were in place to reduce the risk of harm to people, as were risk assessments connected to the running of the home, and these were reviewed regularly. Accidents and incidents were recorded and the causes of these analysed so that preventative action could be taken to reduce the number of occurrences.

There were enough skilled, qualified staff to provide for people’s needs. The necessary recruitment and selection processes were in place and the provider had taken steps to ensure that staff were suitable to work with people who lived at the home. People who lived at the home took part in the selection process for new staff. Staff received training to ensure they had the necessary skills to care for and support the people who lived at the home. They were supported to develop additional skills that would enable them to deliver a higher quality of care. Staff had regular supervisions and appraisals during which they could discuss their training and development needs.

People had been involved in determining their care needs and the way in which their care was to be delivered. Their consent was gained before any care was provided and the requirements of the Mental Capacity Act 2005 and associated Deprivation of Liberty Safeguards were met.

People enjoyed the food that was available to them and had a variety of nutritious food and drink. If they did not like what they were offered at meal times they were provided with alternative food. People at risk of malnutrition or dehydration were monitored and where appropriate fortified food and drink was given to them.

Staff were kind and caring and protected people’s dignity. Staff treated people with respect and supported them in a way that allowed them to be as independent as possible.

There was an effective complaints system in place. Information was available to people about how they could make a complaint should they need to about the services provided at the home. People were assisted to access other healthcare professionals and services to maintain their health and well-being.

People and staff were encouraged to attend meetings with the manager at which they could discuss aspects of the service and care delivery. People were asked for feedback about the service to enable improvements to be made. There was an effective quality assurance system in place.

During this inspection we identified that there had been a breach of Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 as people’s medicines were not always managed appropriately. You can see what action we told the provider to take at the back of the full version of the report.