The Manor House Thurloxton

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 63 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider did not always make sure people’s care and treatment were effective because they did not always review their needs with them.People had care plans and told us they were asked questions about their care. The deputy manager regularly spent time with people to see if they had any concerns. However, staff did not regularly review care plans to ensure they were up to date. During the first site visit, we saw 1 person’s care plan had not been reviewed since 2022. When we returned for a second visit, care plans had been reviewed by the deputy manager. Relatives told us they were involved in initial assessments but not in any reviews, this meant improvements were required to ensure people’s current needs and wishes were included in their care plans.

The provider did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them. People did not always receive care based on robust assessment of their individual needs.

Where people were identified at risk of skin breakdown, appropriate clinical tools were not used to assess the level of risk. This was not in line with best practice guidance and increased the risk of people’s individual care needs not being consistently met.

Relevant information about people’s dietary requirements was not always clear. Staff gave inconsistent feedback about 1 person’s food texture needs which was not in line with their care plan. This increased risks to people. We discussed this with the deputy manager who agreed to obtain additional guidance from the relevant healthcare professionals.

People enjoyed their meals, 1 person told us, “Staff are good cooks." Lunch was served at people’s pace, with choices offered. People could have access to drinks and snacks anytime.

The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services. People had plans which contained vital information to share with healthcare staff, to support continuity of care. People were positive about teamwork at the home. One person said, "I think staff very much work together." The deputy manager told us the service had good relationships with the local GP and district nurse team. This meant people experienced continuity of care.

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.

People were encouraged to remain active. People were able to go on walks in the local area.

We observed staff encourage people to walk. People were supported to attend regular health appointments for example audiology, optician and chiropody. One person told us, "[Deputy manager] is very good with appointments." One person was being supported to access physiotherapy for their mobility. There were stimulating activities that people enjoyed doing together. One person told us, "I like seeing other people." We observed people had choices of food and fluids. This meant people were supported to maintain their health and wellbeing.

The provider ensured that outcomes were positive and consistent, and met expectations of people themselves. People experienced positive outcomes which promoted their independence. People regularly accessed their local community; some did this independently. One person told us due to the support and encouragement from staff they, “Still feel able to give back to the community.” This had a positive impact on their sense of purpose and wellbeing.

One person was supported to go on a seaside holiday independently, which they enjoyed.

Staff monitored people’s weight. However, not all clinical aspects of care were regularly monitored, such as bowel movements and skin integrity increasing the risk of harm to people. The deputy manager began to immediately act on our feedback and reviewed their documentation.

The provider did not always tell people about their rights around consent and did not always respect their rights when delivering care and treatment. Where people may have lacked capacity to make decisions, the Mental Capacity Act 2005 (MCA) was not always consistently followed.

We found that CCTV and other monitoring equipment were used without relevant capacity assessments and best interest decisions in place for 1 person.

Staff did not receive training in MCA and DoLS although they were supporting people who were unable to consent to aspects of their care and support.

However, people told us that staff respected their choices and did not force care interventions. One person said, "Staff always ask for permission." Staff emphasised that people should oversee their own care and told us how they seek consent. One staff member said, “Always ask them [people] for permission first.”