Background to this inspection
Updated
1 June 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 and to look at the overall quality of the service.
This inspection took place on 1 May 2018 and was unannounced. The inspection team consisted of an inspector and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service. One inspector returned to the service on 4 May 2018 to complete the inspection and to provide feedback to the registered manager.
Before the inspection we reviewed the information we held about the service and the service provider. The registered provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We looked at the notifications we had received for this service. Notifications are information about important events the service is required to send us by law.
Throughout our inspection we spent time observing care at the service and we spoke to five people. We talked with one visiting health professional. We also obtained feedback from two relatives by phoning them. We also spoke with the registered manager, operations manager, the deputy manager, the trainer, one team leader, one care leader, one care assistant, the maintenance man, the activity coordinator and the chef.
We looked at records, which included three people’s care records and medication administration records (MAR). We checked recruitment, training and supervision records for three staff. We also looked at a range of records about how the service was managed. Following the inspection we contacted a number of external health and social care professionals and commissioners to obtain their views about the service.
Updated
1 June 2018
We inspected this service on 1 and 4 May 2018. The first day was unannounced and the second day was announced. Manor House is a 70 bedded 'care home'. 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 comprises of two floors, each of which have separate adapted facilities. On the day of our inspection there were 19 people occupying ground floor unit.
This was our first inspection at the service since the current registered provider took this service over in March 2017. The new provider made a decision that the service will only continue to provide accommodation with personal care and they ceased delivery of nursing care in January 2018. When people had nursing needs, such as management of diabetes, these were met by the local district nurses’ team.
At this inspection we found the service was Good in all domains and Good overall.
There was a registered manager running the service. 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.
Manor House had a clear management structure supported by a team of committed staff. Following the departure of nursing staff a new senior team including a new deputy manager and team leaders has been recruited. The provider ensured additional support such as medicines training was provided to staff, so the transition to medicines being managed by senior carers was smooth. Feedback from people, families, professionals, and staff reflected the changes at the service had been managed well and did not have any impact on quality of care delivered to people.
People and relatives were encouraged to raise their opinions and they were listened to. The team aimed to provide a good quality of care and the registered provider had systems to monitor the quality of the service provided to review and improve if needed.
People were safe. Staff knew how to report safeguarding concerns and they were confident any concerns would have been promptly escalated by the management. People’s care files contained risk assessments surrounding people’s well-being and individual conditions. Where people had been identified as at risk, management plans guided staff on how to keep the person safe.
People were supported by sufficient number of suitable skilled staff and received support in an unhurried manner. Staff received good support and complimented the provision of training.
The Care Quality Commission (CQC) is required by law to monitor the operation of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS) and report on what we find. 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. People’s rights to make their own decisions were respected.
People were supported to meet their health and well-being needs. The team worked with external health and social care professionals where required. People were supported to maintain a good diet. People were supported appropriately by trained and competent staff to take their medicines as prescribed.
The service was caring and people’s individual needs, including equality and diversity needs were respected. People were provided with a choice of activities, according to their needs, choices and preferences. These included one to one or group activities, outings and maintaining links with the local community.
People received support that met their needs and staff knew people’s needs well. The provider identified people’s care plans needed improving and we saw the team was in a process of updating these to a new format. There were systems to manage complaints appropriately and people knew how to raise concerns.