The inspection took place on 16 January 2017 and was unannounced.

St Winefrides Residential Home is a large, detached, older style property situated close to the town centre of Littlehampton. It is registered to provide accommodation and care for up to 24 older people living with dementia. At the time of our inspection there were 19 people living at the home. Eighteen bedrooms were of single occupancy and three were shared. Communal areas included a large sitting room, a lounge used by people wishing for a quieter environment, known as the ‘quiet lounge’. The ‘quiet lounge’ overlooked an accessible garden to the rear of the property. There was also sitting areas in the corridors to allow people to sit and rest when needed. The home also had a dining room.

The service had two registered managers 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 and associated Regulations about how the service is run. Both registered managers were available on the day of our inspection.

Staff were trained in adult safeguarding procedures and knew what to do if they considered people were at risk of harm or if they needed to report any suspected abuse. People told us they felt safe at the home.

Systems were in place to identify risks and protect people from harm. Risk assessments were in place and reviewed monthly. Where someone was identified as being at risk, actions were identified on how to reduce the risk and referrals were made to health professionals as required.

Accidents and incidents were accurately recorded and were assessed to identify patterns and triggers. Records were detailed and referred to actions taken following accidents and incidents.

Policies and procedures were in place to ensure the safe ordering, administration, storage and disposal of medicines. Medicines were managed, stored, given to people as prescribed and disposed of safely.

There were sufficient staff to meet people's needs and keep them safe. The registered manager used a dependency tool to determine staffing levels. This information was reviewed following falls or changes in a person's health condition, which might increase, or change people's dependency level.

Safe staff recruitment procedures ensured only those staff suitable to work in a care setting were employed.

Staff had received a range of training and many had achieved or were working towards a National Vocational Qualification in Health and Social Care. Staff attended supervision meetings with the registered manager at least six times per year.

The Care Quality Commission monitors the operation of the Mental Capacity Act (MCA) 2005 and the Deprivation of Liberty Safeguards (DoLS) which applies to care services. The members of the management team and care staff we spoke with had a full and up to date understanding of the MCA and DoLS. These safeguards protect the rights of adults by ensuring that if there are restrictions on their freedom and liberty these are assessed by appropriately trained professionals. We found that appropriate DoLS applications had been made, and staff were acting in accordance with DoLS authorisations.

People had sufficient to eat and drink and were offered a choice throughout the day. They had access to a range of healthcare professionals and services.

The home had been decorated and arranged in a way that supported people living with dementia.

Staff were caring, knew people well, and treated people in a dignified and respectful way. Staff acknowledged people's privacy and had developed positive working relationships with people. Relatives spoke positively about the staff at St Winefrides Residential Home. Staff listened and acted on what people said and there were opportunities for people to contribute to how the service w

Due to their disabilities many of the people accommodated were not able to tell us about their experiences. To help us to understand the experiences people have we used our Short Observational Framework for Inspection (SOFI) tool. This tool allows us to spend time watching what was going on in a service and helps us to record how people spent their time, the type of support they get and whether they have positive experiences.

We spent 30 minutes watching care and support provided to four people who sat in the lounge waiting for lunch to be served. People were falling asleep in their chairs. Two people were watching television and talked to each other. The atmosphere was calm and relaxed. A member of staff was present throughout this period. They sat with people whilst writing in records.

We also spoke with a relative who was visiting the care home. They confirmed they were very satisfied with the care provided. For example they told us,” The care is good. The staff know what they are doing. I believe they are competent.”

We also gathered evidence of people's experiences of the service by looking at a selection of records and talking with members of staff. We found that people's care needs were being managed safely by the service and that staff had a good understanding of their roles and responsibilities.

Due to their disabilities many of the people accommodated were not able to tell us about their experiences. To help us to understand the experiences people have we used our Short Observational Framework for Inspection (SOFI) tool. This tool allows us to spend time watching what was going on in a service and helps us to record how people spent their time, the type of support they get and whether they have positive experiences.

We spent 30 minutes watching care and support provided to five people when they were being served coffee and tea during the morning. We found that people had positive experiences. We were informed that a Christmas party had been organised the evening before by the provider for people, their relatives and for staff. This meant that people we observed were quiet and were falling asleep. The care staff on duty knew what support each person needed and they respected their wishes if people wanted to be left on their own.

As we were unable to speak to people using the service, we gathered evidence of people's experience of the service by reviewing the comment and complaints log. We found that people's experiences were positive. A relative commented, "We are very grateful that our relative came to St Winefrides and they were looked after so well." A second relative commented, "All the staff seemed to genuinely care about my relative's welfare and went out of their way to make sure my relative was happy."

People told us that they like living at the home and that they were happy there. People told us that the staff were kind and caring.

People told us that their needs were me by the staff at the home. People said that they had no concerns and told us that there was always someone around to provide help and support.

Comments included the following: ‘I am happy here’, ‘the staff are very nice’, I have all the help I need’ and ‘I am very comfortable living here’.

People said that they did not have any complaints about the service and that if they did they would speak to the staff.

We spoke with one visiting healthcare professional who told us that in their opinion the care provided was good. They also told us that the home was proactive and always asked for help if and when it was needed.