Manson House

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. This is the first assessment for this re-registered service. This key question has been rated Good. This meant people were safe and protected from avoidable harm.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider had a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

There were effective systems and processes in place to ensure that when things went wrong, incidents were recorded, investigated, and used as opportunities for learning and improvement. Accident and incident records were completed in a timely manner and included sufficient detail to enable managers to identify any contributing factors, trends, or recurring themes. The registered manager reviewed incidents to determine whether any immediate action was required and to identify opportunities to reduce the risk of similar events occurring in the future.

Staff demonstrated a good understanding of their responsibilities for identifying, recording, and reporting accidents, incidents, and concerns. This included recognising and reporting ‘near misses’, where an event had the potential to cause harm but was avoided.

Lessons learned from accidents, incidents, and near misses were shared with staff where appropriate through team meetings, supervisions, and day-to-day discussions. This helped to promote a positive learning culture and ensured staff remained aware of best practice and any changes required to improve safety.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services.

The registered manager or senior staff carried out pre-admission assessments to establish whether the service was able to meet people’s individual needs and preferences before they moved in. These assessments considered a range of factors, including people’s physical health, mental wellbeing, mobility, communication needs, nutritional requirements, personal routines, social interests, and any identified risks. Information was gathered from a variety of sources, including the person themselves, their relatives, healthcare professionals, and previous care providers where appropriate.

Assessments were completed in partnership with people and, where appropriate, their relatives, ensuring they were involved in decisions about their care and support. This collaborative approach supported a smooth transition into the service and helped people feel welcomed, understood, and reassured that their needs would be met by staff who had a good understanding of how they wished to be supported.

The provider worked collaboratively with people and relevant healthcare professionals to understand what safety meant to them and how best to achieve it. Staff focused on enhancing people’s quality of life while ensuring they were protected from bullying, harassment, abuse, discrimination, avoidable harm, and neglect. Any concerns were shared promptly and appropriately to help maintain people’s safety and wellbeing.

People consistently told us they felt safe living at the service. When asked, 1 person said, “I feel very safe here, they make sure the outside doors are locked because there are some bedrooms on the ground floor. It has got a nice family feeling.” Another person told us, “I am very comfortable here, staff are great. The care is fine, nobody gets cross with you, staff behave in a nice way.”

Staff demonstrated a good understanding of safeguarding responsibilities, including how to recognise concerns and the processes for reporting and escalating them. One staff member explained, “If I ever had a safeguarding concern, I would make sure the person was safe first, document and report the concern, and escalate it appropriately. I have complete confidence that if I raised something it would be taken seriously and acted on.”

We also reviewed how the service operated within the principles of the Mental Capacity Act 2005 (MCA) and managed the Deprivation of Liberty Safeguards (DoLS). We found the registered manager had appropriate oversight of DoLS processes and was complying with relevant legislation. People were not subject to unlawful restrictions, and any restrictions in place were appropriately authorised and implemented in the least restrictive way possible.

The provider worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

The provider adopted a positive approach to risk-taking, recognising that enabling people to maintain control over their lives and make their own decisions was an important part of person-centred care. Staff understood the importance of balancing safety with independence and were supported to promote positive risk-taking where this aligned with people's wishes and best interests.

Support measures were tailored to individual needs and put in place to help people remain as independent as possible whilst managing identified risks. For example, equipment, environmental adaptations, monitoring arrangements or additional staff support were introduced where appropriate to reduce risks without unnecessarily restricting people's freedom or choice. This approach enabled people to continue undertaking activities that were important to them, maintain their daily routines and retain control over their lives whilst remaining safe.

Risk assessments and associated support plans were reviewed regularly and updated when people's circumstances changed. This helped to ensure staff had access to current information and were able to provide consistent support that balanced risk management with the promotion of independence, wellbeing and quality of life.

A range of risk assessment tools were in place, including assessments relating to skin integrity and choking risks. People were supported to reposition in line with their individual needs, and regular monitoring of people’s weights showed no evidence of significant unexplained weight loss among those reviewed. Where people had specific healthcare needs, care plans contained detailed guidance for staff. For example, 1 person who had a catheter had a care plan which clearly outlined the required care and when the catheter should be changed. This helped to ensure people received safe, consistent, and person-centred support.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

The provider had effective systems and processes in place to ensure the environment, equipment, and facilities were safe and conducive to delivering high-quality care. The premises were well maintained, free from environmental risks, and provided people with a safe and comfortable place to live. Equipment used to support people’s care was routinely serviced and maintained to ensure it remained safe and fit for purpose.

The service had a warm, homely atmosphere, with people’s bedrooms individually personalised to reflect their preferences, interests, and personalities. One person toldus, “I have got no complaints at all, I am very pleased with my room.” A relative of another person commented, “They are doing a brilliant job, the carers are friendly. The maintenance staff member put up [family member’s] pictures to make it more homely. I do rate them highly.” This demonstrated the provider’s commitment to creating a comfortable and personalised living environment for people using the service.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs.

Most people spent their time in their rooms through choice but those we spoke to told us staff were responsive and if they rang the bell staff answered promptly. People told us they were checked discreetly at night. We observed call bells were answered quickly and did not ring for excessive periods of time. The registered manager told us they checked call bell timings regularly and reported the results to people as part of ‘resident’s meetings.’

The atmosphere within the home was calm, relaxed, and welcoming. We observed positive interactions between staff and people using the service, with staff speaking to people in a kind, caring, and respectful manner. Staff were visible and took time to engage with people, responded patiently to requests for support, and demonstrated a good understanding of people's individual needs and preferences. These interactions contributed to a supportive environment where people appeared comfortable and at ease.

Feedback from staff about staffing levels was mixed. While staff generally worked well together to meet people's needs, some staff members raised concerns about staffing levels at certain times of the day. One staff member questioned whether minimum staffing arrangements were always sufficient to meet people’s needs effectively. Another member of staff felt that staffing levels during the morning could be challenging and said, “It was hard to give people the care they needed.” They explained that a number of people required support from 2 staff members, which could result in people having to wait until a second staff member became available to provide assistance. This highlighted the importance of ongoing provider monitoring of staffing arrangements to ensure people's needs can be met in a timely way, particularly during busier periods of the day. Evidence showed the registered manager had systems in place to oversee and review staffing arrangements. This included completing a monthly safe staffing audit, which considered people's assessed dependency levels and care needs to determine whether staffing remained appropriate. In addition, the registered manager maintained a weekly staffing oversight spreadsheet that monitored staffing hours, vacancies, agency usage, annual leave and sickness levels. These processes supported ongoing review of staffing capacity and helped identify potential pressures or gaps in workforce provision. However, staff feedback indicated there were occasions, particularly during peak periods in the morning, when staffing arrangements could impact on the timeliness of support for some people, reinforcing the need for continued monitoring and evaluation of staffing deployment.

The provider had systems and processes in place to assess, monitor and manage the risk of infection. Measures were in place to identify and control the spread of infection and concerns were shared promptly with relevant external agencies when required.

During our inspection, we observed housekeeping staff working throughout the service. The service was generally clean, tidy and fresh smelling. Structured cleaning schedules were in place for bedrooms and communal areas, and staff told us two rooms were deep cleaned each day as part of the home's infection prevention and control (IPC) programme.

We identified a small number of environmental areas that would benefit from further attention. One housekeeping trolley appeared visibly grubby and would benefit from a thorough deep clean. We also observed a stand aid that required cleaning. In addition, some carpets in first-floor bedrooms were stained. Staff explained there had been ongoing issues with the carpet cleaning machine and said arrangements were being made to resolve these issues. Kitchen doors were heavily marked; however, the manager informed us this was due to the need for repainting and confirmed the work was planned once the garden room project had been completed.

Staff were observed using IPC equipment appropriately. Personal protective equipment, including gloves and aprons, was readily available at stations located throughout the service, enabling staff to access and use it when required. This supported good infection control practices and helped reduce the risk of cross-contamination within the service. The kitchen had recently been inspected by the Environmental Health Officer (EHO) and achieved a 5-star food hygiene rating, demonstrating appropriate standards of food safety and hygiene.

The provider had systems and processes in place to ensure medicines were managed safely and in a way that met people’s needs, preferences and capacities. People were involved in planning their care and treatment, including discussions about changes to their medicines where appropriate.

Robust arrangements were in place for the receipt, checking, storage, administration and return of medicines. People spoke positively about the support they received with their medicines. One person told us, “I have 3 tablets each day, they bring them to me and whilst I take them, they stay. None are missed.”

Medicines were stored securely within medication trolleys, with additional stock held in a locked cupboard. We observed staff administering medicines and found they took a person-centred approach, giving people sufficient time to take their medicines and ensuring drinks were available to support this process. The service used an electronic Medication Administration Record (MAR) system to document the administration of medicines. We checked medicines against MAR system and found stock levels corresponded with the records maintained. Fridge and room temperatures were monitored to ensure medicines were stored within recommended temperature ranges.