Archived: Manor View

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

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

Some people who lived at the home were able to communicate verbally but for people who were unable to speak with us we observed staff support them with a range of communication aids. These included sign language and interpreting people’s body language with regards to meeting their needs and wishes.

People showed they were happy living at Manor View, and that they felt safe and comfortable with the staff team. One person said, “I love it here and want to stay here forever.”

Staff were kind and caring and knew each person well. Staff felt they received good support and enjoyed working at the service. There were enough staff to support people in the way they wanted. Staff received training, supervision, guidance and support so that they could do their job well. Staff respected people’s privacy and dignity and encouraged people’s independence.

Systems were in place to manage risks and keep people safe from avoidable harm. Medication was well managed. Staff followed good practice guidelines to prevent the spread of infection. The staff looked for ways to continually make improvements, worked well with external professionals and ensured that people were part of their local community. People were supported to be as active as possible.

Staff supported people 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.

Audits were carried out to monitor the service and address any improvements required. The registered manager notified the CQC of incidents that they were legally obliged to.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection: Good (Report published 24 November 2016)

Why we inspected: This was a planned inspection based on the rating at the last inspection.

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.

There was a manager in post who had registered with the Care Quality Commission (CQC). A registered manager is a person who has registered with the 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 and associated Regulations about how the service is run. The registered manager is also the provider for this location.

People were not always supported to pursue social interests and take part in meaningful activities relevant to their needs, both at the home and in the wider community.

Relatives and staff were complimentary about the registered manager and how the home was run and operated.

People were unable to communicate with us as too whether they felt safe, happy and well looked after at the home. However relative’s and our observations confirmed that people were safe.

Staff had received training in how to safeguard people from abuse and knew how to report concerns, both internally and externally.

Safe and effective recruitment practices were followed to ensure that all staff were suitably qualified and experienced. Arrangements were in place to ensure there were sufficient numbers of suitable staff available at all times to meet people’s individual needs.

Plans and guidance had been drawn up to help staff deal with unforeseen events and emergencies. The environment and equipment used were regularly checked and well maintained to keep people safe.

Relatives were positive about the skills, experience and abilities of staff who worked at the home. They received training and refresher updates relevant to their roles and had regular supervision meetings to discuss and review their development and performance.

People were supported to maintain good health and had access to health and social care professionals when necessary. They were provided with a healthy balanced diet that met their individual needs.

Staff made considerable efforts to ascertain people’s wishes and obtain their consent before providing personal care and support, which they did in a kind and compassionate way.

Staff had developed positive and caring relationships with the people they cared for and clearly knew them very well. People were involved in the planning, delivery and reviews of the care and support provided. The confidentiality of information held about their medical and personal histories was securely maintained throughout the home.

Care was provided in a way that promoted people’s dignity and respected their privacy. People received personalised care and support that met their needs and took account of their preferences. Staff were knowledgeable about people’s background histories, preferences, routines and personal circumstances.

Complaints were recorded and investigated thoroughly and responded to in line with their service policy.

The inspection team was made up of one inspector. As part of this inspection we spoke with the manager and three members of staff. We checked the environment to confirm that improvements had been made and also reviewed records that related to infection control. We found that shortfalls identified during our last inspection had been addressed or that work to resolve these was in progress and close to completion. The provider may wish to note that not all staff were up to date with their food hygiene training. This meant that some staff may not be aware of their role with regard to food safety and infection control.

Below is a summary of what we found based on the evidence gathered during our inspection carried out on 09 May 2014. This included observations of care and support being delivered, speaking with members of staff and by looking at records.

The detailed evidence that supports our findings can be read in the full report.

Is the service safe?

Care and support was delivered in a way that promoted people's dignity and independence.

We looked at care records which showed that people's needs and preferences had been assessed, documented and reviewed. They were personalised and gave staff clear guidance about the care and support people needed.

We found that appropriate standards of cleanliness and hygiene had not been maintained in all areas of the home. For example, we saw that floor coverings in some areas had been poorly maintained and therefore could not be cleaned properly. This meant that people had not been adequately protected against the risks of health care associated infection.

Is the service effective?

We looked at care records which showed that people's choices and preferences had been taken into account in the planning and delivery of the care they received. These provided staff with clear guidance about how to support people to express choices and make decisions about what they wanted to do and how they spent their time.

We saw that risk assessments had been completed and regularly reviewed in relation to a range of issues relevant to people's care needs and personal circumstances. These included moving and handling requirements, skin and pressure area care and the management of people's medicines.

The provider had suitable arrangements in place to ensure that staff were trained and supported to perform their roles and deliver care safely. For example, we saw that an induction programme, based on nationally recognised standards, had been used to help train, support and develop new members of staff.

Is the service caring?

We saw that staff treated people with respect and kindness while delivering appropriate levels of care that met their individual needs and welfare requirements.

Staff treated people in a patient and caring way. They demonstrated a good understanding of people's health, welfare and communication requirements. This meant that care and support was delivered in a way that best suited and met people's individual needs.

Is the service responsive?

We saw that staff used a wide range of communication methods, both verbal and non-verbal, to explain what was happening and ascertain people's choices in a way that promoted their independence.

The provider had a complaints and compliments policy and procedure in place. We saw that people who lived at the home had been provided with guidance about how to make a complaint. The information provided was in an 'easy read' format with words, symbols and pictures appropriate to their communication needs.

Is the service well led?

Staff told us they were clear about their roles and responsibilities. They were knowledgeable about the care and support needs of people who lived at the home.

We saw that people had been supported to access relevant health care professionals where necessary and appropriate. These included GP's, dentists and speech and language therapists. This meant that care and support had been planned and delivered in a way that took account of people's individual needs and personal circumstances.

The provider had systems in place to assess and monitor the quality of services provided and to identify, assess and manage risks posed to the health, welfare and safety of people who lived at the home.

However, suitable arrangements in line with published guidance relating to the Mental Capacity Act (MCA) 2005, were not in place where necessary to properly assess people's ability to make decisions.

Care plans we looked at showed that people's needs and preferences were thoroughly assessed, documented and reviewed. When asked if they were happy living at the home, one person smiled and said, 'Yes I am.' A relative told us, 'I simply cannot fault the care; it is absolutely wonderful in every respect.'

The premises were safe, suitable and fit for purpose. Adequate emergency procedures were in place and the safety equipment we saw had been regularly checked and well maintained.

Records showed the provider had effective recruitment procedures in place to ensure that staff were fit, able and properly trained to meet the needs of people who used the service. The procedures included carrying out appropriate checks before staff began work.

The provider had an effective policy and procedures in place for recording and dealing with complaints. An 'easy read' guide using pictures had been produced to help people understand how to make a complaint and the methods used to resolve it.