Archived: The Manor

The Manor is a residential care service that provides accommodation and personal support for up to 14 older people with learning disabilities. Some people were also living with dementia. At the time of our inspection there were 11 people using the service.

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.

The service was a large home, bigger than most domestic style properties. It was larger than current best practice guidance. However, the size of the service having a negative impact on people was mitigated by the building design fitting into the residential area and the other large domestic homes of a similar size. There were deliberately no identifying signs, intercom, cameras, industrial bins or anything else outside to indicate it was a care home. Staff did not wear anything that suggested they were care staff when coming and going with people.

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

Risk assessments in place were detailed. However, some people’s risk had not been recorded. This meant there was a risk that some staff may not know how to support people safely. Some medicines were not counted or recorded properly, so we could not be sure if people had received the right amount of medicine. Some information about how people liked or needed to take their medicines was missing.

The provider did not always properly assess risks relating to the environment. Work was in progress to improve the environment for people to live in and to make the service was safe for people but there was still a lot of work that needed to be done.

The provider had systems in place to monitor, assess and improve the service. Care records focused on individuals and their needs but we found gaps in some people’s records and this meant some important information may be missing about their care and support.

Staff knew how to keep people safe and used lots of different way to communicate with people to find out how they were feeling and what choices they wanted to make. Care records helped staff know what was important to people and how they wanted to be supported.

There were enough staff to keep people safe, staff received training to keep them up to date with their skills and knowledge and recruitment checks made sure staff were safe to support people.

Staff supported people to follow their interests in the community and at the service. They helped people keep in contact with their family and friends. During our inspection people were very active getting ready with staff to go out or making plans for their day.

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.

The service applied the principles and values of Registering the Right Support. This meant people who used the service were able to live as full a life as possible and achieve good outcomes that include control, choice and independence.

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 04 July 2017).

Why we inspected

This was a planned inspection based on the previous rating.

We have found evidence that the provider needs to make improvements. Please see the safe and well led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

At this inspection we found the service continued to meet the regulations and fundamental standards and remained good.

The service had 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.

People told us they were happy living at The Manor and that they liked the staff. Staff knew how to protect people from the risk of harm and abuse. People’s individual risk was assessed both in the service and in the community and staff worked hard to minimise risk while still encouraging people’s independence.

There were enough qualified and skilled staff at the service. Staffing was managed flexibly to suit people's needs so that people received their care and support when they needed it. Staff had access to the information, support and training they needed to do their jobs well.

The registered manager and staff understood the relevant requirements of the Mental Capacity Act 2005 and how it applied to people in their care. People were involved in decisions about their care, were encouraged to make choices in their everyday life and supported to be as independent as they could be. Staff understood people’s individual needs and supported people with dignity and respect.

Care records focused on the person and were updated according to any changes in people’s health and wellbeing. People were supported to have their health needs met. We saw that people’s prescribed medicines were being stored securely and managed safely.

The provider had a number of audits and quality assurance systems to help them understand the quality of the care and support people received and look at ways to continually improve the service.

Further information is in the detailed findings below.

We found evidence that showed us staff were suitably trained to support the people who used the service and that they treated everyone who lived at the Manor with the utmost respect and compassion. We saw people were supported by staff to be as independent as they could and encouraged to make informed choices about care and support they received.

We found the provider had appropriate arrangements in place to manage medicines and routinely assess and monitor the quality of the care and support people who lived at the Manor received.

However, although people who use the service and relatives said they were happy with the overall standard of care provided at the Manor; a visiting relative and most staff also told us they felt vulnerable people were at risk of being harmed because of one persons behaviour, which continued to challenge the service and staff. A relative who had participated in a recent satisfaction survey conducted by the provider wrote 'before the disruptive resident arrived I was very satisfied with the home'.

In this report the name of a registered manager appears who was not in post and not managing the regulatory activities at this location at the time of the inspection. Their name appears because they were still a Registered Manager on our register at the time.