Longhope Manor

The service had a registered manager as required, who was also one of the two registered providers. 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 2008 and associated Regulations about how the service is run. Both providers were present during the course of our inspection.

At the last inspection in December 2015, the service was rated Outstanding. At this inspection, we found the service remained Outstanding.

Why the service is rated Outstanding:

The service has not only sustained the outstanding model of care and support provided to people, but built on this and made further improvements both to people's living environment and their social and leisure opportunities. The vision and values of the home were founded on widening and expanding people's experiences and ensuring they could lead fulfilled and enjoyable lives. There remained a strong focus on choice, control, independence and empowerment.

The provision of a new village clubhouse gave people access to facilities including spa treatments educational and recreational classes, use of the internet and also a restaurant for people to book and dine out. People were able to enjoy a range of hobbies and interests, whilst also having the opportunity to develop skills and interests they had not previously explored.

People consistently commented on how happy they were living at Longhope Manor and particularly commented on the lack of restrictions, the staff and providers' attention to detail, and the positive relationships they had with all staff.

There was an inclusive approach at the home which promote equality and diversity through respectful and gentle challenging of people's misconceptions and prejudice.

Further ways of promoting people's independence had been found since our previous inspection. Dignity and respect underpinned the staff and providers' daily practice.

Food, mealtimes and eating well were treated with the utmost importance and people enjoyed variety and choice in their meals and drinks, including how and when they wished to eat.

People continued to receive their medicines safely. Staff continued to be supported in their roles and received ongoing training and development.

The providers were an integral part of the day-to-day running of the home, which enabled them to continually monitor the quality of care provided and also to know everyone living at the home very well as individuals.

Further information is in the detailed findings below.

The service provides long-term, short-term (respite) and end-of-life nursing and residential care for up to 34 older people who have a mixture of physical and / or sensory needs. Some people also live with dementia and / or mental health needs. The Georgian manor house and adjoining buildings provide a choice of single room and apartment style accommodation. Some rooms have en-suite facilities and there are bathrooms on each of the three residential floors, including a jacuzzi bath. People living at The Manor have access to two lounges, a dining room and large landscaped patio garden. The home is set in three acres of grounds with woodland and a stream. At the time of our inspection there were 28 people living at the home. The home is required to have a registered manager 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 2008 and associated Regulations about how the service is run. The provider’s two directors had jointly owned and run the service for eight years. One was the registered manager for the service and the other was the responsible individual, or main point of contact, for CQC.

Risks to people’s personal health were managed effectively as risks to them and their changing needs were recognised. Staff worked closely with community health professionals and therapists to maximise people’s well-being. People felt safe at The Manor and had excellent caring relationships with the staff who supported them. They enjoyed a range of activities that were meaningful and purposeful and had a positive impact on their daily lives. People spent their day as they wished and enjoyed regular visits from their relatives. They had plenty to eat and drink and any special dietary needs or requests were met. People had confidence in the staff and their skills and never had to wait long for assistance. They benefitted from living in a well organised, forward thinking home where their needs were always put first.

Staff enjoyed working at The Manor and felt well supported in their roles. Staff were clear about their responsibilities to people and felt well-prepared to meet their various needs. There were enough staff; they were not rushed, they had time to talk with people and to meet all of their needs. Staff benefitted from working alongside their trainer and supervisor and the registered manager who was an approved mentor for nursing students on placement at the home. They were able to request training and support when they needed it and felt comfortable to go to the registered manager with any concerns or to suggest improvements. Staff benefitted from effective communication within the home; they knew people’s personalities, likes and dislikes and understood their changing needs. Staff cared about the people they supported and were proud of the service they provided. They supported their colleagues and worked well as a team.

The culture at The Manor was open and transparent and put people at the heart of the service. All staff upheld the provider’s values and nothing was too much trouble. The registered persons provided clear leadership to staff, they were committed and passionate about the quality of the care they provided to people. Their work at the home had received a national award and the home was visited as an example of good practice by external professionals. Quality assurance processes were robust and action plans to improve the service were prioritised and completed quickly. Learning was shared from within and outside the organisation and community contacts were well established. National best practice guidance, legislation and local policies were referenced to set and measure standards of care.

We looked at the care plans for four people and saw that these detailed how people communicated their wishes and if they had the capacity to make daily decisions. We observed staff talking to people about how they wanted to spend their time and what they might want to eat and drink. All care files had care plans and relevant risk assessments. Care plans were person-centred and reflected people's current needs and wishes.

Staff we spoke with told us they received good training and felt supported by the managers and owners. Staff told us, 'This is the best home I have worked in' and 'you can always talk to managers and they will listen to you'.

The compliance action issued on 9 January 2013 was met as everyone living in the home had had their care plan reviewed and updated to fully record their needs and wishes. Systems had been set up to regularly review and audit care records.

We observed that people were able to choose where they spent their time, either in their rooms or a choice of different communal areas. One person told us 'I like spending time in my room, staff pop in to speak to me and I go downstairs when I want to'.

People had an assessment of need in place from which care plans were developed and care plans were personalised to each individual's needs. Care was provided in an environment that was safe, well maintained and met people's needs.

We found some shortfalls in record keeping because the review of care plans and associated documents was inconsistent.