Berrycroft Manor

About the service

Berrycroft Manor is a residential care home providing personal care and accommodation to up to 78 people. The service provides support to older people and people living with dementia. At the time of our inspection there were 75 people using the service. The home is purpose built and accommodates people within six units across three floors.

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

People’s medicines were not always managed and administered safely. We were not assured people received their medicines safely and appropriately. People's care plans and associated risk assessments were not always current, accurate and did not always provide staff with the correct information they required to safely meet people's needs. Where people had specific, assessed care needs such as regular repositioning of people, staff did not always keep a clear record of the support they had provided. All environmental safety checks were in order.

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. Care files were person centred and reflected people’s preferences for their care and support.

We have made a recommendation around activity staff provision and meaningful activities for people who are cared for in their room.

Systems and processes to ensure oversight of the service were not always effective. Audits completed had not always identified the concerns we found on inspection. The management team were helpful and quick to investigate when we fed back our findings during the inspection. Feedback from people, relatives and staff was that the management team were supportive and approachable.

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 12 January 2019). At this inspection we found the service requires improvement.

Why we inspected

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

The inspection was prompted in part due to concerns received about medicine safety, people's needs not being met such as food, fluids and repositioning, staff behaviour and low staffing levels. A decision was made for us to inspect and examine those risks. We have found evidence that the provider needs to make improvements in some of the areas reviewed. Please see the safe and well-led sections of this full report.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.

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

During the inspection the management team were transparent, responsive and took steps to mitigate the risks.

Enforcement and Recommendations

We have identified breaches in relation to medicines administration, the management of people’s individual risks and management oversight.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from 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 continue to monitor information we receive about the service, which will help inform when we next inspect.

• Berrycroft Manor is care home located in the Romiley area of Stockport. The home provides accommodation and personal care to older adults and people living with dementia. The home can accommodate 78 people over three floors and was full at the time of our inspection.

People’s experience of using this service:

• The home provided safe care which met people’s needs and wishes. Staff had been trained in how to identify and report safeguarding concerns.

• The home was well run with a clear management structure in place. The register manager told us the provider was responsive to requests for resources and equipment to ensure people received the best care possible.

• The home was clean throughout with effective infection control processes in place.

• Medicines were managed safely, by staff who had received training and been assessed as competent.

• Care files contained detailed risk assessments, which had been regularly reviewed to reflect people’s changing needs. This ensured staff had the necessary information to help minimise risks to people living at the home.

• People were supported 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.

• Staff spoke positively about the support and training provided. Staff completed an induction training programme upon commencing employment and on-going training was provided. Supervision was completed to provide staff with an opportunity to discuss their roles, any areas for improvement and future goals.

• People told us staff were kind, caring and treated them with dignity and respect. Staff had taken time to get to know people, which was evident in the interactions we observed.

• Care files contained personalised information about the people who lived at the home and how they wished to be supported and cared for. People and their relatives told us they were involved in care planning and reviews.

• Peoples’ social and recreational needs were met through an activities programme, facilitated by activity co-ordinators and staff members. A mix of activities were organised throughout the week which catered for all interests and abilities.

• The home had a range of systems and procedures in place to monitor the quality and effectiveness of the service. Action plans had been completed to promote continuous improvement.

• The service met the characteristics for a rating of ‘good’ in all key questions.

• More information is in the full report.

Rating at last inspection:

• At our last inspection the home was rated as ‘good’. The last report was published on 03 February 2016.

Why we inspected:

• This inspection was part of our scheduled plan of visiting services to check the safety and quality of care people received. Inspection timescales are based on the rating awarded at the last inspection and any information and intelligence received since we inspected.

Follow up:

• We will continue to monitor information and intelligence we receive about the home to ensure care remains safe and of good quality. We will return to re-inspect in line with our inspection timescales for good services, however if any information of concern is received, we may inspect sooner.

Is the service safe?

We saw that people were treated with respect and dignity. The people using the service and visiting relatives who we spoke with told us staff respected privacy and dignity and supported people in a way that suited their individual needs and personal preferences.

We saw the home was furnished and decorated to a high standard, was clean, tidy and hygienically clean.

We saw that staff had received appropriate training to ensure they had the knowledge, skills and experience to meet the assessed needs of people living at the home. This meant that people living in the home could be confident that their needs were being met by fully trained staff.

Systems were in place to make sure that managers and staff learned from events such as adverse incidents, complaints, and safeguarding events.

We saw that policies and procedures were in place to support staff in delivering safe and effective care.

Management systems were in place to monitor and audit aspects of practice such as checks on care plans, the cleanliness of the home and medication administration.

Is the service effective?

People living at Berrycroft Manor had an individual care file that included assessments of needs and risk. A corresponding care plan had been implemented to meet people's individual needs. The assessments and care plans were regularly reviewed and updated accordingly.

Prior to people being admitted into the home a member of staff visited the person to carry out an assessment of their needs. This meant that people could feel confident that the service could meet their individual and personal care needs when they moved into the home. If possible people were encouraged to spend some time at the home having lunch and meeting staff and other people living at the home before a decision was made about moving in. We were told that relatives were encouraged to call in and look around the home at any time without having to make an appointment.

Is the service caring?

The atmosphere in the home felt relaxed, pleasant and friendly. From our observations we saw that care staff had a good understanding of people's individual needs and preferences. People were seen to be freely moving around the home and staff were kind and sensitive in their approach to people. We saw that staff were attentive and responded promptly to peoples requests or need for assistance.

We observed that people looked well cared for and were appropriately dressed.

Some of the comments we received from people living at the home were: 'I am happy here' and 'I would rather be here than anywhere else.'

When we spoke with some visiting relatives we were told that the staff delivered care in a kind and caring way. One visiting relative said 'They are very kind, very pleasant, the girls are wonderful, just lovely.' Another relative told us they were 'Absolutely happy with all the care, I have no concerns all.'

Is the service responsive?

We saw that where appropriate the service had accessed advice and care from other health care professionals. For example we saw evidence of visits from the GP's, district nurses, the chiropodist, the optician and the speech and language therapist. This meant that people using the service received co-ordinated care and support.

When we spoke with visiting family members we were told that they were happy with the standard of care and they had not seen or heard anything of concern.

The service had systems in place to ensure that people were regularly consulted about their views and ideas on how the home should be run and the quality of the service delivered. This was done by means of regular informal chats with people and satisfaction surveys. We saw evidence of these surveys being carried out on a regular basis, following which an analysis of the findings were conducted and action plans implemented if required.

Is the service well led?

The service worked well with other services to make sure people living in the home received appropriate care and assessment from the right professionals in a timely way.

When we looked at documentation we saw that there were systems in place to audit and monitor care practices in the home.

When we spoke with staff they spoke highly of the support they received from the manager and the senior staff.

The manager was very visible in the home and operated an open door policy where people were actively encouraged to raise any issues or concerns they had. We saw the manager had good relationships with people living at the home and their visitors. One visiting relative said 'Val the manager runs a great place.'

The manager, senior staff and care staff had developed a good team approach where they worked well together. Staff made many comments about how they felt they worked well as a team. During this visit there was evidence of an enthusiastic approach and a willingness to continually develop the service.

The expert by experience spoke with eight people using the service and two visiting relatives. People spoken with were all positive about the service they received.

All staff spoken with were positive about the standard of care provided at the home and the support given them by the management team.

We found that each person had individual care records that identified their care needs. However some improvements were needed to ensure consistent and accurate recordings in peoples care records.

We looked around the home and saw that the layout of the premises was safe and suitable for carrying out the regulated activity. The premises were maintained to high standard as was the d'cor and furnishings of the home.

We found that staff had been recruited appropriately to carry out their role and to meet the needs of people who used the service.

We saw that the home had an effective complaint procedure that was on display for people to access.