Antron Manor

Antron Manor provides accommodation with personal care for up to 16 people. There were 13 people using the service at the time of our inspection. The service is in one adapted building over two floors.

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

There were enough staff to meet people's needs and ensure their safety. Appropriate recruitment procedures ensured prospective staff were suitable to work in the home.

The environment was suitable to meet the needs of people living at Antron Manor. Health and safety checks of the environment and equipment were in place.

There were processes in place to prevent and control infection at the service, through access to COVID-19 testing where necessary, cleaning schedules and safe visiting precautions.

Systems to assess and monitor the quality and safety of the care provided were in place. They were effective in assessing quality and identifying and driving improvement.

Peoples medicines were managed safely. Staff responsible had the necessary skills to administer medicines. Oversight was in place to ensure medicines were managed safely.

Staff told us that they had received the training they needed to meet people’s needs safely and effectively. The provider maintained oversight of training to ensure staff had the necessary training, knowledge and skills to provide consistent care.

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.

People were supported to eat balanced diet and drink enough to keep hydrated.

The provider maintained oversight of complaints, accidents and incidents and safeguarding concerns. The provider engaged well with health and social care professionals. The service had clear and effective governance systems in place.

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

Rating at last inspection and update

The last rating for this service was good (report published 14 January 2020).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

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.

We found the following examples of good practice.

Staff were following up to date infection prevention and control guidance to help people to stay safe. The provider had arranged for all staff to receive training supplied by the local General Practice on the appropriate use of personal protective equipment (PPE). Additional on-line infection control training had been made available to the staff team.

The service has good stocks of PPE and had purchased additional equipment including higher specification masks, visors, scrubs, and arm and hair coverings for use in the event there was an outbreak within the service. The registered manager and senior carers routinely worked alongside care staff and ensured best infection control practices were followed.

Additional housekeeping staff had been recruited and cleaning staff were now on duty every day. High contact areas were cleaned regularly throughout each shift and cleaning procedures had been reviewed and updated.

The provider had installed a temporary visiting room in the service garden with separate entrances for people and their visitors. A permanently installed clear wall minimised risks of infection and heating was provided to enable visits to be completed safely and comfortably. Visits were by appointment only and the visiting room was cleaned thoroughly between uses. In addition, WIFI internet was available throughout the service and staff regularly supported people to make video calls to friends and relatives.

People and staff were being regularly tested in accordance with current guidelines. Appropriate admission procedures had been developed and everyone who moved into or returned to the service from hospital was initially cared for in isolation.

People were able to access the service’s communal areas if they wished but most people were currently choosing to spend most of their time in their rooms. New more easily cleaned furniture had been installed in one of the lounge areas. People were complimentary of the service and the staff team, their comments included, “They are looking after me very well indeed” and “I am all right thank you. They are looking after me”.

The registered manager communicated regularly with people, staff and relatives to make sure everyone understood the precautions being taken, and how to keep people safe.

Antron Manor provides accommodation with personal care for up to 16 people. There were 15 predominantly older people using the service at the time of our inspection.

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

When we arrived at the service the atmosphere was calm and unrushed.

Staff were busy supporting people to get up and ready for the day.

Staff understood risks to people and how to help reduce them.

Staff recorded each time they moved a person in the daily records. We judged people were receiving appropriate care and support. However, risk assessments did not always guide staff on how often a person required re-positioning, and it was not easy to gather a quick overview of how often a person was re-positioned. This was addressed immediately.

People’s relatives said they felt their loved ones were safe with the staff supporting them.

Systems were in place to safeguard people. People told us they felt safe being supported by staff.

People received their medicines on time from staff who had received training in medicines administration

Infection control measures were in place to prevent cross infection.

Staff were recruited and deployed safely in sufficient numbers to ensure people’s needs were met.

The provider had improved the safety of the premises since the last inspection. Upstairs windows were restricted in their opening. All hot water taps had temperature regulators fitted. Doors were fitted with door guards which closed automatically when the fire alarm was activated.

People told us, "I am very happy here," "I like the food, they know what I can eat and what does not agree with me" and "Staff are very kind and do anything you ask of them."

Relatives told us, “"Very happy indeed, they can’t do enough for Mum. They love her like she was their own" and "We have no concerns at all, they are in and out all the time."

People were supported by staff who had the skills and knowledge to meet their needs. Staff had received appropriate training and support to enable them to carry out their role safely.

Staff meetings were used to remind staff of best practice and to discuss any concerns about people’s needs. Staff told us they felt well-supported by the provider, who was managing the service at the time of this inspection. The providers were actively recruiting for a registered manager but experiencing challenges finding a suitable applicant.

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. Any restrictive practices were regularly reviewed to ensure they remained the least restrictive option and were proportionate and necessary.

There were systems and processes in place to monitor the Mental Capacity Act, and associated Deprivation of Liberty Safeguards assessments and records. People were able to make choices about their life and how their care and support were provided. This information was reflected in people’s care plans. Staff understood the importance of respecting people’s wishes and choices.

People and relatives agreed the staff were kind and caring. Staff respected people’s diverse characteristics and were clear that each person’s individual needs were their priority. People told us they felt listened to and their privacy and dignity were respected.

A new care plan format had been implemented since the last inspection. Everyone had a care plan which was regularly reviewed and updated. These provided staff with guidance and direction to enable them to meet people’s needs.

Where people were not able to be fully involved with their care plan reviews, family members supported staff to complete and review care plans. People’s preferences were sought and respected.

People were provided with the equipment they had been assessed as needing to meet their needs. For example, pressure relieving mattresses. These were correctly set for the person using them.

There were activities provided for people. Activities were advertised in the monthly newsletter issued to every person living at the service.

Audits were carried out regularly to monitor the service provided. Actions from these audits were being acted upon to further improve the service.

Records were stored appropriately. Effective quality assurance systems were now in place. This was an improvement since the last inspection.

People were supported to access healthcare services, staff recognised changes in people's health, and sought professional advice appropriately.

Visiting healthcare professionals told us, “We have no concerns about Antron, I think it is really nice here. We come every day and there is always staff around. People are well cared for here”

Systems were in place to deal with concerns and complaints. This enabled people to raise concerns about their care if they needed to. The manager told us there were no on-going complaints at the time of this inspection.

People, staff and external healthcare professionals told us the service was well led. People were given various opportunities to provide feedback about the service.

Staff told us they enjoyed working at the service and that the team worked well together.

Rating at last inspection and update:

At the last inspection the service was rated as requires improvement (report published 10 January 2019. Following this inspection, the rating has changed to good.

The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of the regulations.

Why we inspected: This was a scheduled inspection to review the action taken by the provider following our previous inspection.

Follow up: We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

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

Antron Manor is a 'care home'. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Antron Manor can accommodate up to 16 people in a detached period property in the town of Penryn. The home consists of three floors with a stair lift providing level access to the first floor. The top floor was used for offices. There were numerous areas for people to sit and spend their time as they chose. At the time of this inspection there were 16 people using the service.

There was a registered manager that registered with CQC in April 2018. A registered manager is a person who has registered with CQC to manage the service. Like registered persons, 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. The registered manager was supported by senior care staff and the directors. One of the directors worked at the service most days and supported the registered manager.

The registered manager was very visible at the service and undertook an active role. Since being at the service they had been working with staff to implement new ways of working. This had been a difficult time for staff as there were a lot of changes. The directors had worked with the registered manager and the staff team to meet agreements regarding the timings of changes and what was necessary.

At the inspection we found people were not protected from unsafe and unsuitable premises. In particular, we highlighted scald risks from the hot water supply and windows on the first floor which were not restricted to prevent vulnerable people from the risk of falling out. After the inspection the provider took immediate steps to mitigate the risks of falling from first floor windows. Window restrictors were put in place within three days on all first-floor windows and two ground floor windows which looked over the basement and had a small drop.

The director said they had identified that the hot water was too hot and had a quote to have thermostatic mixing valves (TMVs) fitted. In the meantime, the registered manager took action and put up hot water warning signs above every hot tap used by people at the service. Since the inspection the registered manager has confirmed TMVs have been fitted.

Ten people’s bedroom doors had wooden door wedges holding them open. These were fire doors and would not be effective in the event of a fire as they would not be able to close. Following the inspection, the provider fitted door guards on these doors so they would close in the event of a fire.

The home was clean and felt homely. Throughout the home there were numerous floor level changes which posed a risk to people of slip, trip or fall hazards. There were no warning signs to advise people of these level changes. Following the inspection, the registered manager wrote to us to inform us that they had put in place signage in areas of uneven flooring and slopes. There were emergency plans in place to protect people in the event of a fire or emergency.

Staff were able to anticipate people’s needs and were respectful, discreet and appropriate in how they managed those needs. There were positive and caring relationships between staff and people who lived in the home and this extended to relatives and other visitors. Staff were compassionate, treated people as individuals and with dignity and respect. Staff knew the people they supported, through their personal histories and daily preferences. Staff showed concern for people’s wellbeing in a caring and meaningful way. Where possible, people were involved in making decisions and planning their own care on a day to day basis. People said staff were caring and compassionate and treated everyone with dignity and respect at all times.

People were supported by sufficient staff to meet their needs promptly. Staff had the required recruitment checks in place. They were trained and had the skills and knowledge to meet their needs. We discussed with the registered manager that one staff member’s employment file had a short unexplained employment gap. Improvements were made ensuring staff employment gaps were explored. Staff had received an induction and were knowledgeable about the signs of abuse and how to report concerns.

People were supported to eat and drink enough and maintain a balanced diet. People said they enjoyed the food they received.

Medicines were safely managed and procedures were in place to ensure people received their medicines as prescribed.

The registered manager had put in place new care plans at the home. One of these care plans had been completed for one person. This care plan reflected the person’s needs and gave staff clear guidance about how to support them safely. We discussed with the registered manager that people’s care plans in the old format needed to be updated to reflect their needs during the transition to ensure they received safe care. Where possible, people where able, and their families had been involved in the development of care plans. Risk assessments were undertaken for people to ensure their health needs were identified.

Accidents and incidents were reported and action was taken to reduce the risks of recurrence. People were referred promptly to health care services when required and received on-going healthcare support. Healthcare professionals were positive about the quality of care provided at the home and the commitment of the whole team to provide a good service.

The registered manager had a quality monitoring system at the service and were looking at ways they could improve further improve. Following the inspection, the registered manager sent us an environmental risk assessment they had completed which identified risks using a traffic light system. Red for a high risk and green for a low risk. Where they had identified a risk, they had put in place actions and signed off the actions. For example, security of the home, to have day and night security records.

The registered manager actively sought the views of people, their relatives and staff. There was a complaints procedure in place and people were confident any concerns they raised would be looked into.

Further information is in the detailed findings below.