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Inspection carried out on 25 February 2020

During a routine inspection

About the service

Manor House is residential care home providing personal care for up to 47 people aged 65 and over some of whom may be living with dementia. At the time of the inspection, 36 people were living in the service.

The care home is made up of two units, Manor Lodge a purpose-built extension and the older Manor House. There are some bedrooms on the first floor accessed by a lift. All communal areas, such as lounges, or dining rooms are on the ground floor.

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

People and relatives felt safe with the service. There were enough trained and competent staff to meet people’s needs. Risks were assessed, and staff understood how to manage them to prevent harm occurring. People received their medicines as prescribed. If things went wrong for example when people had accidents or other incidents, these were reviewed, and systems put in place to safeguard people in the future.

There was a thorough, holistic assessment process which ensured the service was able to meet people’s needs when they moved into the home. Mealtime experiences were positive, staff understood people’s dietary requirements and all food was freshly prepared. The premises had been adapted to people’s needs both physically, with wide corridors and handrails as well as appropriate signage to help people orientate themselves around the home. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Relatives and people told us staff were kind and helpful. One relative told us, “Staff are passionate about working with older people.” Staff spent time to get to know people well, they knew people’s histories and were aware of people’s wellbeing. They could spot signs that people were not well if they were unable to communicate. Staff promoted people’s independence, privacy and dignity.

Care was personalised to people’s needs. The service monitored, and staff were updated, when people’s needs changed. There were communication plans in place to support people’s communication where they had difficulties. There was a full activities programme which aimed to reduce people’s isolation either in groups or on a one to one basis. The service was skilled at caring for people at the end of their life. Staff had been trained and made sure that additional support was offered at this time, both to the individuals themselves as well as keeping in contact with relatives.

The service was well managed. People, relatives and staff were positive about the management of the service and the input from the provider. Managers were described as open, accessible, and supportive. Managers understood their roles and there were robust systems in place to monitor the quality of care provided. Relatives and people were involved in the service through regular contact with the provider and there was an annual questionnaire used to gather people’s views. The provider had an ongoing process to improve the service in response to feedback, learning, and new information based on best practice advice. The action plan was delivered and monitored through supervisions with the manager.

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 15 August 2017).

Why we inspected

This was a planned inspection based on the previous rating.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Manor House on our website at www.cqc.org.uk.

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.

Inspection carried out on 13 July 2017

During a routine inspection

The inspection took place on 13 July 2017 and was unannounced.

Manor House is a residential care home for up to 47 older people, some of whom are living with dementia. The home’s Statement of Purpose needs revising to reflect that. The service is made up of two units, Manor Lodge a purpose built extension, and the older Manor House. There are some bedrooms on the first floor accessed by a lift. All communal areas, such as lounges or dining rooms, are on the ground floor.

At the last inspection, the service was rated Good. At this inspection, we found the service remained Good.

Why the service is rated Good:

Staff continued to protect people from the risk of harm and abuse and understood their obligation to report any concerns or suspicions about this. The management team assessed risks to people's health and welfare and staff took action to minimise these. There were enough staff to support people safely with their care. Staff were recruited in a way that contributed to protecting people from the employment of staff who were not suitable to work in care services. Medicines were managed in a safe way so that people received them as the prescriber intended.

Staff continued to support people competently. They supported people to have choice about their care. People were supported to have choice and control of their lives and in the least restrictive way possible. Staff training and guidance supported this practice. People had a choice of enough to eat and drink and staff supported them to do so if they needed assistance. Staff monitored people who were at risk of not eating or drinking enough and ensured people could access advice about this and other aspects of their health and welfare.

Staff continued to develop warm and compassionate relationships with people and supported them in a caring way. They respected people's privacy and dignity and encouraged people to be as independent as they could be. Staff took prompt action to offer reassurance and support when people were anxious or distressed. People were able to receive visits from friends and family when they wished, and could involve them in discussions about care if they wanted to.

Staff continued to deliver care that was responsive to people's preferences and wishes as far as practicable. Staff knew about people's backgrounds and interests so that they could support people with their hobbies and recreation as well as engaging with them in suitable conversations. People were confident that any complaints they had would be listened to and responded to.

The service continued to be well-led. There was a registered manager in post. In the temporary absence of the registered manager, the directors had appointed an acting manager with considerable experience of working at the home. The directors were providing additional supervision and support from a registered manager in another service to ensure stability and continuity of standards of care. There were effective systems for checking and monitoring the quality and safety of the service, which took into account people's views.

Further information is in the detailed findings of the report.

Inspection carried out on 27 February and 2 March 2015

During a routine inspection

This inspection took place on 27 February and 2 March 2015. It was unannounced and carried out by one inspector.

Manor House provides care and accommodation for up to 47 older people, some of whom may be living with dementia.

There is a registered manager in post. 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.

There were enough staff to support people safely and staff knew what to do if they suspected someone may be being abused or harmed. Recruitment practices were robust and contributed to protecting people from staff who were unsuitable to work in care. Medicines were managed and stored properly and safely so that people received them as the prescriber intended.

Staff were well trained and understood how to meet people’s needs. They understood the importance of gaining consent from people before delivering their care or treatment. Where people were not able to give informed consent staff and the management team ensured their rights were protected.

People had enough to eat and drink to meet their needs and staff assisted or prompted people with meals and fluids if they needed support. Staff also made sure that people who were becoming unwell were referred promptly for advice about their health and welfare.

Staff treated people with warmth and compassion. They were respectful of people’s privacy and dignity and offered comfort and reassurance promptly when people were distressed or agitated.

The care that people received was focused on the individual person and not task orientated. Staff showed a high level of commitment to understanding and responding to each person’s needs, preferences and histories so that they could engage meaningfully with people. They were skilled at responding to people who were living with dementia, showing insight into the way some people may respond and why. Activities were planned in a way that took into account people’s interests and experiences.

Staff understood the importance of responding to and resolving concerns quickly if they were able to do so. Staff also ensured that more serious complaints were passed on to the management team for investigation. People and their representatives were confident that any complaints they made would be properly addressed by the manager or provider.

The service had good and consistent leadership. The provider and manager took responsibility for monitoring the quality and safety of the service and asked people for their views so that improvements were identified and made where possible. They sought out information from other sources and services to see what would be of benefit in improving the service people received at this home. There was a minor oversight in relation to some incidents which needed to be notified to the Care Quality Commission and had not been. This was put right following discussions with the manager. Staff were clear about their roles and well-motivated.

Inspection carried out on 17 September 2013

During a routine inspection

We spoke with people about living at Manor House and observed the interaction between staff and people living in Manor Lodge. For the most part people were happy living at this home although two people spoke about the limitations they experienced of living at Manor House. One person told us, "I enjoy living here. I have my own room and had new furniture in it for when I moved in." People were complimentary about the staff at the home and one person said, "The staff are lovely and they are always about. They help me when I need it." A visitor told us, "They [the staff] are very friendly."

People received the care they needed and care plan records were up-to-date and kept under review. Care records showed that the service co-operated well with other health professionals and we noted that referrals were made appropriately and in a timely way.

All areas of the home were clean, tidy and free of unpleasant odours. Arrangements were in place to deal with any potential outbreaks of infection. Hand washing facilities were available throughout the home and the laundry contained sufficient appropriate equipment to ensure that all items were thoroughly clean.

Staff files contained the information we would expect to find that included robust recruitment procedures to ensure that only appropriate staff were employed to look after vulnerable people. Other records looked at were in good order, clearly written and up-to-date. Appropriate storage facilities were available for all records including those that needed to be kept confidentially.

Inspection carried out on 7 December 2012

During a routine inspection

Manor House had recently been extended and a purpose built dementia unit, named Manor Lodge, had been completed. Admissions to Manor Lodge had just started so very few people were living there at the time of our inspection. We observed how people were cared for and spoke with them where possible so that we could understand what it was like for people living at this home.

People told us they liked living at Manor House and that they felt well cared for. One person said, "I have no complaints at the moment, it's very good here." Another person told us, "I just press the button and they come straight away." We saw that people could spend their time where and with whom they chose. Staff were interacting in a friendly and supportive way. People living in Manor Lodge were given time and support to do what they wanted. People were seen moving freely about all parts of the home. We were told by people living in the home that they felt safe and we could also see that they were relaxed

The service had medicine practices in place that kept people safe. Staff were trained so that they provided the care and support that people needed safely. People said that staff were competent and understood how they wanted and needed to be cared for.

People told us they knew how to complain and that they felt able to do so if necessary. Procedures were in place to obtain people's views so that the home could continue to improve the experiences of people living there.

Inspection carried out on 29 December 2011

During a routine inspection

People we spoke with during our visit on 29 December said that they were, "Quite happy" living in Manor House.

One person told us that they had chosen to live in Manor House but still visited their family on occasions. Another person told us how they needed quite a lot of help and support but that the staff were excellent and; "look after me very well".

One person told us that the staff knew how to look after them very well and that they felt happy and safe living in Manor House. This person also told us how they really enjoyed being able to watch all the building works going on outside and: "Some of the things I've seen have really made me laugh"

One person we spoke with told us that they thought there were enough staff at Manor House and added: "I never have to wait long if I need anything."