• Care Home
  • Care home

Manor Court

Overall: Outstanding

257 Blandford Road, Efford, Plymouth, Devon, PL3 6ND (01752) 768425

Provided and run by:
Anchor Hanover Group

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Background to this inspection

Updated 5 December 2017

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, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This was a comprehensive inspection completed by two inspectors from the adult social care directorate and an expert-by-experience on the 25 September 2017 and one inspector on 29 September 2017. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Before the inspection, we reviewed information we held about the service. This included previous inspection reports and notifications we had received. A notification is information about important events which the service is required to send us by law.

Prior to the inspection, we asked the provider to complete a Provider Information Return. 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 reviewed this information as part of the inspection.

During the inspection we spoke with the registered manager and 10 care staff. We spoke with 14 people at the service and six visiting relatives. We also spoke with the district manager for Anchor Trust who supported staff during both days of the inspection.

We observed the care people received in the lounge and over lunch. We looked at four records related to people’s individual care needs. These included support plans and risk assessments. We also looked at records which were related to the administration of medicine, training records and four staff recruitment files. We reviewed the quality assurance processes in place at the service and feedback people, relatives and professionals had provided. We examined the dementia evidence the service had gathered to achieve the dementia quality mark (a sign of good practice in dementia care). We also reviewed the internet comments the public had left on a care home review website. We looked at thank you cards and compliments received by the service and received 10 CQC comment cards and 4 emails from relatives during the inspection.

Overall inspection

Outstanding

Updated 5 December 2017

The inspection took place on 25 and 29 September 2017 and was unannounced on the first day.

Manor Court is a residential service providing care without nursing. Nursing services are provided by the community nursing teams. Residential care is provided for up to 37 older people, some living with dementia. On the day we inspected, 36 people were living at the service. High quality accommodation and facilities were provided. Each person had their own room with a kitchenette and ensuite bathroom facilities.

At the last inspection in June 2015, the service was rated Good. At this inspection we found under the leadership of a new registered manager the service had continued to develop and improve and we have rated the well-led and caring section as Outstanding.

The service had a new 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.

The service was exceptionally well-led. The registered manager led a visible, committed, caring team to provide excellent, holistic care. There was a focus on continuous improvement to enhance people’s lives. New research initiatives in dementia care were being continually implemented for the benefit of people for example programmes such as Anchor Inspires, Oomph! and the Archie Project. These supported people to remain mentally and physically active.

People, relatives and professionals described the provider and management team in a particularly positive way. During the inspection, people and staff were relaxed, and there was a calm, quiet atmosphere. We observed staff chatting with people and making them feel special. Everybody had a clear role within the service.

People’s voices were listened to and ideas implemented for example a special black tie evening had been held with old style card games for the gentlemen. Staff were confident to speak out and ask for anything they needed to deliver high quality care for example additional training or new equipment. We were told the registered manager, deputy and staff were a role model to others. This had led to a change in culture at the service over the past 12 months. Everyone we spoke with told us the leadership team were supportive and approachable. This had resulted in high staff morale and high satisfaction amongst people and families. Staff talked positively about their jobs and their love of the people living in the home. All staff we spoke with were proud of the excellent care people received. Staff told us it met the “Mum Test.” The provider’s district manager supported the service and registered managers.

Feedback we received about end of life care was exceptional. Countless letters from families described how compassionate staff supported people and their families throughout the whole process. Families were able to stay at the service during someone’s last days and staff did all they could to meet people’s final wishes.

Staff exhibited an exceptionally kind and compassionate attitude towards people. Staff were mindful of equality and diversity and respected people. Positive, caring relationships had been developed and practice was person focused and not task led. Staff had appreciation of how to respect people’s individual needs around their privacy and dignity and individual behaviours. Feedback we received from people, relatives and professionals was excellent.

People’s risks were managed well and monitored. Positive risk taking was encouraged to support people’s independence. The environment supported people living with dementia with spacious lounges, visual stimulation and dementia friendly lifts. People were promoted and encouraged to live full and active lives and we observed many enjoy an exercise session. An old style sweet shop was being made in the garden during the inspection for people to enjoy.

There were comprehensive quality assurance systems in place. These were analysed and used to improve practice. Incidents such as falls were appropriately recorded and analysed for trends for example times of day a fall occurred and where within the service. Learning from incidents, concerns and feedback raised was used to help drive improvements. The staff team were reflective and listened to advice from professionals for example local safeguarding training had been suggested (in addition to the providers training) and this had been actioned. Inspection feedback was also listened to and reflected upon which further enhanced the quality of care. For example some staff felt they would benefit from face to face Mental Capacity Act training and this has been arranged. During the inspection information we requested was supplied promptly, records were organised, clear, easy to follow and comprehensive.

People were comfortable with staff supporting them and we observed very positive, attentive and caring interactions throughout the two days. Care records were personalised and gave people control over aspects of their lives. Staff responded quickly when they noted changes to people’s mental or physical well-being by contacting the appropriate health professionals, for example people’s doctor. People or where appropriate those who mattered to them, were involved in discussing people’s care needs and how they would like to be supported. People’s preferences for care and treatment were identified and respected.

People had their medicines managed safely. People received their medicines as prescribed, received them on time and understood what they were for. People were supported to maintain good health through regular access to health and social care professionals, such as GPs, mental health nurses, social workers, occupational therapists and physiotherapists.

People told us they felt safe and secure at Manor Court. Security at the service was good, equipment was maintained and regular fire checks were undertaken. An ongoing maintenance schedule was in place with planned work being undertaken. Anchor Trust is a non-profit provider which enabled continual investment in the service for the benefit of people, for example ensuite facilities were being replaced.

Areas were uncluttered and clear for people to move freely around the home. All staff had undertaken training on safeguarding vulnerable adults from abuse, they displayed good knowledge about how to report any concerns and described what action they would take to protect people against harm. Staff all knew the whistleblowing policy and would have no hesitation to raise concerns.

People were supported by staff that confidently made use of their knowledge of the Mental Capacity Act (2005). This ensured people were involved in decisions about their care and their human and legal rights were respected. The service followed the processes which were in place which protected people’s human rights and liberty.

People were supported by a staff team that had received a comprehensive induction programme, training, which included supporting people with dementia, and ongoing support from the registered manager. Staff feedback was listened to and additional training provided where required.

People were protected by the service’s safe recruitment practices. Staff underwent the necessary checks which determined they were suitable to work with vulnerable adults, before they started their employment. People were involved in choosing who worked at the home. Recruitment was value based to ensure the staff employed were kind, caring and compassionate.

The service had a policy and procedure in place for dealing with any concerns or complaints; we reviewed one complaint and discussed this with the registered manager. An open door policy supported people to raise any small concerns early.