Dryclough Manor

We found the following examples of good practice.

Processes were in place to prevent visitors from catching and spreading infections. This included the provision of personal protective equipment (PPE), such as masks, gloves, aprons, face visors, hand washing facilities and hand sanitizer. Temperature tests were done in a secure entrance area, and a COVID-19 questionnaire was completed in addition to lateral flow rapid COVID-19 testing. Robust visiting protocols had been drawn up and we observed visits taking place during the inspection in line with current Government guidance.

The home worked in close partnership with the Supporting Treatment in Care Homes team. This brought together community nurses, allied health professionals and social workers to work directly with care homes that had residents and staff showing possible COVID-19 symptoms. The aim was to assist with recognizing potential COVID-19 patients at an early stage, to help with initial treatment and to avoid unnecessary hospital admissions.

There was adequate access and take up of testing for staff and people using services.

Shielding and social distancing rules were complied with. The layout of the premises promoted safety and reduced the potential for the transmission of infections. There was clear signage throughout the home on COVID-19, and robust cleaning arrangements, including frequent deep cleaning, were in place. Staff wore a full range of PPE appropriately and consistently.

Staff training, practices and deployment showed the service could prevent transmission of infection and manage any outbreaks.

People’s experience of using this service: Staff undertook medicines training to ensure they had the necessary skills and knowledge. However, there were gaps within some people's medicine administration records and best practice in relation to the recording of medicines administration was not consistently followed.

The front door to the building was not always kept securely locked. Staff were not always aware of who was entering or leaving the building and could not guarantee that people were safe.

People were positive about the registered manager and the way the home was organised and managed. Staff told us they enjoyed working at the home and felt supported.

Recruitment procedures were in place which ensured staff were safely recruited. Staff received the training, support and supervision they needed to carry out their roles effectively.

People's independence was promoted, they had choices and were treated with dignity and respect by staff.

People were supported by caring staff who knew them and their care needs well. We observed genuine affection and kind and caring interactions between people and staff.

People had their nutritional needs met and had access to a range of health care professionals.

The requirements of the Mental Capacity Act 2005 were being met. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible.

Health and safety checks were carried out and equipment was maintained and serviced appropriately.

Activities were available for people to access within the home and individual interests were encouraged. People were supported to engage in these activities.

The home was clean and there was a relaxed and homely atmosphere.

The service had a complaints procedure and a variety of ways for people, visitors, and health care professionals to share their views and provide feedback on the service. The manager used this information to drive improvements within the service, such as increasing the number of activities for people to engage with.

The service met the characteristics of good in four areas and was rated good overall.

More information is in the full report

Rating at last inspection: The service was last rated as good (10 October 2016).

Why we inspected: This was a planned inspection based on the rating at the last inspection. At this inspection we identified some areas which required improvement.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit in accordance with our re-inspection programme. If any concerning information is received we may inspect sooner.

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

Dryclough Manor is a purpose built two-storey care home. Set in its own well-maintained grounds the home can provide accommodation for up to 42 people who require nursing and personal care. At the time of our inspection there were 38 people living at Dryclough Manor. All bedrooms had ensuite facilities.

The home had a manager registered with the Care Quality Commission (CQC) who was present on the day of the inspection. A registered manager is a person who has registered with 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.

We saw that Dryclough Manor was clean and well maintained, Access to the building was secure and staff understood how to protect people living at the home from different forms of abuse. The service had whistleblowing and safeguarding policies that staff could access and staff were aware of their responsibilities to report any untoward behaviour they might witness.

People were supported by a stable staff team who had worked together for a number of years and knew the people who used the service well. We saw that there were enough staff and people told us that the staffing ratio reflected the needs of the residents.

Care records gave a good indication of people’s abilities and provided a good description of their individual likes and dislikes. Where risk had been identified, risk plans were in place to minimise the risk of harm occurring. Senior staff were trained to administer medicines and we saw procedures were in place to ensure the safe management of medicines. We were told that no medicine errors had been reported in the last twelve months.

The people who used the service and their visitors told us they believed the staff were competent and knowledgeable. We saw from looking at the training records that staff received appropriate training to meet the identified needs of people who lived at Dryclough Manor, such as dementia training, capacity and consent, dignity and respect and end of life care.

Staff communicated well with each other and we saw that information was exchanged between staff informally throughout the working day, and a detailed handover meeting took place at the start and finish of every shift. This ensured that care staff were aware of any change in people’s care needs and of any tasks which might need to be completed.

The registered manager and the care staff we spoke with demonstrated a good understanding of capacity and consent. When people were being deprived of their liberty the correct processes had been followed to ensure that this was done within the current legislation.

Attention was paid to people’s diet and people were supported to eat and drink in a way that met their needs. We saw that the food was good and that people had enough to eat and drink.

Care staff at Dryclough Manor monitored people’s general health, and where specific healthcare needs were identified the service was proactive in seeking the right level of support; liaising with health care professionals, such as general practitioners (GPs), District Nurses and physiotherapists to provide an appropriate level of support.

We saw people were comfortable and looked well cared for. Staff were vigilant to people’s needs and were able to respond in a timely way to people’s requests for assistance. They respected people’s need for privacy, but understood the risk of social isolation and did not leave people unattended. Staff spent time talking with people on a one to one basis or in small groups so that people felt like they were included. A person who used the service said to us, “The staff always look after us and check we are OK, or they will leave us alone if we need peace and quiet, they respect that”.

Relatives informed us that they were listened to, and felt comfortable speaking to any of the staff if they had any concerns.

The home had a registered manager who was respected by staff, residents and their relatives, and had a visible presence throughout the home.

To help ensure that people received safe and effective care, systems were in place to monitor the quality of the service provided and there were systems in place for receiving, handling and responding appropriately to complaints.

A new manager and deputy have been in post since November 2013. Since our inspection in January 2014 the new manager, Charlotte Goodwin, has become the Registered Manager for Dryclough Manor on our register.

When we inspected Dryclough Manor on 24 September 2013 we found it was not compliant. Following that inspection the provider wrote to us to tell us what action they would take to address the matters we had brought to their attention. During this inspection we saw evidence to confirm that the provider had done so.

All care plans had been reviewed to ensure they continued to meet peoples care and support needs. During this inspection the staff did not appear to be rushed and the atmosphere was calm.

A programme of refurbishment, repair and improvement was underway and a considerable amount of work had been completed since the last inspection.

The provider had undertaken a complete review of staffing to ensure that levels were correct and that there were suitable and skilled staff on each shift to attend to people using the service. Staff were supported by training, supervision and appraisal.

Systems were in place to regularly assess and monitor the quality of service provided.

The provider did not have arrangements in place to deal with foreseeable emergencies.

One person living at the home said "At the moment there are staffing problems. Something has been going on but I'm not sure what. All I know is they don't have time for us". A relative of a person living at the home said "I have no complaints about the willingness of staff when anything is brought to their attention. I am really concerned that there are not enough staff to deal with the number of residents with their various disabilities".

The home appeared to have a good team of willing staff but the provider did not appear to have acted to support them. This impacted upon the level and support given to people living at the home.

The provider did not have effective systems in place to enable them to come to an informed view about the standard of care and treatment being provided to those living at the home.

Accurate care records were not being maintained in respect of each person living at the home.

People could influence the way in which their personal care needs were met and were regularly involved in informal discussions about their care. The care needs of each person using the service were individually assessed and regularly reviewed.

The procedure for receiving, storing, administering and disposing of unused medication appeared to be strictly followed.

The staff at Dryclough Manor were subject to thorough vetting before they started employment.

The home had a complaints procedure and people told us that complaints were listened to.