The Manor House Whickham

We found the following examples of good practice.

The home had comprehensive policies and procedures to manage any risks associated with the COVID-19 pandemic. This included the management of people with a COVID-19 positive diagnosis. They had enacted these to support them in delivering a safe service during an outbreak of COVID-19 and had actively mitigated any risks to keep residents and staff safe.

People living in the home and their relatives were supported via alternative forms of maintaining social contact when visiting had to be limited to manage an outbreak of COVID-19. This included video calls, use of a visiting pod and visiting in communal gardens.

A programme of regular COVID-19 testing for both people in the home, staff, essential carers and visitors to the home was implemented. All visitors, including professionals were subject to a range of screening procedures, including taking of temperature, showing evidence of vaccination and a negative lateral flow test before entry into the home was allowed.

There was an ample supply of PPE for staff and any visitors to use. Hand sanitiser was readily available throughout the service. Staff had received updated training on the use of PPE and we observed staff wearing it correctly during out inspection. Clear signage and information was in place throughout the home to remind staff of their responsibilities.

The home had implemented and maintained an enhanced outbreak cleaning regime since the start of the pandemic, irrespective of the infection status within the home.

The Manor House Whickham accommodates up to 74 people with residential and nursing care needs in a purpose-built building. 73 people were using the service at the time of the inspection. Some of the people were living with a dementia type illness.

People’s experience of using this service and what we found

Without exception all people and family members were extremely positive about the caring nature of the service provided. They told us staff were “sensitive” and made people feel “special”. There were numerous examples where people described staff consistently acting in caring ways above and beyond their role. Staff demonstrated empathy and a real understanding of people’s needs.

Respect for diversity was evidenced in the home and people were supported with their religious or spiritual needs. Promoting independence was thoroughly embedded into the service.

People and family members told us the service was extremely person-centred and welcoming. Staff were highly motivated and told us that the leadership of the service was exceptional. There were consistently high levels of constructive engagement with people, family members and staff. People and staff were empowered to make decisions and contribute to the running of the home.

There was a strong emphasis on continuous improvement and the service incorporated best practice guidance. The service had forged and maintained excellent links with health and social care professionals and the local community. These had a demonstrably positive impact on the emotional wellbeing of people using the service and also meant the local community became more a part of the service. This was exceptional.

Risks were well managed. The provider learned from previous accidents and incidents to reduce future risks. The registered manager understood their responsibilities about safeguarding and staff had been appropriately trained. Arrangements were in place for the safe administration of medicines.

There were enough staff on duty to meet the needs of people. The provider had an effective recruitment and selection procedure and carried out relevant vetting checks when they employed staff. Staff were suitably trained and received regular supervisions and appraisals.

People’s needs were assessed before they started using the service. People were supported to have maximum choice and control of their lives, and staff supported them in the least restrictive way possible. The policies and systems in the service supported this practice.

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

Rating at last inspection

The last rating for this service was good (published 11 January 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

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

The Manor House Whickham provides accommodation, nursing and personal care for up to 74 people, including people living with dementia. There were 68 people accommodated there on the day of our inspection.

The service had a registered manager in post. A registered manager is a person who has registered with the 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.

People told us they felt safe and were well cared for. Staff took steps to safeguard vulnerable adults and promoted their human rights. Incidents were dealt with appropriately, which helped to keep people safe.

The accommodation provided was to a very high standard, with a variety of pleasantly decorated and well-furnished lounges and seating areas. The building was safe and well maintained. The property was purpose built and adaptations had been made and additional signage provided to improve safety and highlight potential hazards. Other risks associated with the building and working practices were assessed and steps taken to reduce the likelihood of harm occurring. The home was clean throughout.

We observed staff acted in a courteous, professional and safe manner when supporting people. Staffing levels were sufficient to safely meet people’s needs. The provider had a robust system to ensure new staff were subject to thorough recruitment checks.

Medicines, including topical medicines (creams applied to the skin) were safely managed.

As The Manor House Whickham is registered as a care home, CQC is required by law to monitor the operation of the Deprivation of Liberty Safeguards (DoLS) and to report on what we find. We found appropriate policies and procedures were in place and the deputy manager was familiar with the processes involved in the application for a DoLS. Arrangements were in place to assess people’s mental capacity and to identify if decisions needed to be taken on behalf of a person in their best interests. People’s mental capacity was considered through relevant areas of care, such as with medicines and distressed behaviour. Where necessary, DoLS had been applied for. Staff routinely obtained people’s consent before providing care.

Staff had completed safety and care related training relevant to their role and the needs of people using the service. Further training was planned to ensure their skills and knowledge were up to date. Staff were well supported by their managers and other senior staff. Staff performance was assessed annually and objectives set for the year ahead.

People’s nutritional and hydration (eating and drinking) status was assessed and plans of care put in place where support was needed. People’s health needs were identified and external professionals involved if necessary. This ensured people’s general medical needs were met promptly. People were provided with assistance to access healthcare services.

Staff displayed an attentive, caring and supportive attitude. We observed staff interacted positively with people. We saw that staff treated people with respect and explained clearly to us how people’s privacy, dignity and confidentiality were maintained.

Activities were offered within the home on a group and one to one basis. Adaptations had been made to the home to provide a calm and comfortable environment for people living with dementia. Staff understood the needs of people and we saw care plans and associated documentation were clear and person centred.

People using the service and staff spoke well of the home’s managers and they felt the service had good leadership. Good communication was evident between staff working different shifts. We found there were effective systems to assess and monitor the quality of the service, which included feedback from people receiving care and oversight from external managers.

We found the provider used a recognised tool to assess people's risk of poor nutrition. We undertook observations over the lunchtime period and saw people were supported, to varying degrees, with their eating and drinking.

We found there were enough staff to meet people's needs. Family members commented staff had spent a lot of time getting to know people and were particularly observant to enable them to pick up on people's needs quickly. One person commented 'Staff are excellent and look after you well'.

People had opportunities to express their views about the care they received. The provider had a comprehensive system of audits in place to identify gaps in care delivery. People and their relatives said they were happy with the care they received. One person commented; 'There are no problems at all in here.'

We found care records were not always accurate or fit for purpose. Care plan evaluations lacked sufficient detail to enable an understanding of action taken to respond to people's changing needs.

The people we talked with told us about how they maintained or developed their life skills. All of the people we met spoke very highly of the staff team. Their comments included 'staff are very capable and all are qualified' and "staff are all very good .

We found that staff had a good understanding of the medication procedure and all staff had completed safe handling of medicines training.

People who use the service told us they were happy with the care that staff provided. We saw that appropriate checks were undertaken before staff began work.

People told us that they were aware of the complaints system, understood how to complain if they were unhappy with their care and felt confident about complaining if they needed to.