Manor House Residential Home

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• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

The service had improved. The rating for this key question has changed from requires improvement to good. People's needs were assessed before they moved into the service and the provider delivered care that was evidence based and on good, industry recognised practice. People's consent to care was sought and where people lacked the capacity to make decisions, care was delivered in line with the principles of the Mental Capacity Act 2005. The provider worked in partnership with external healthcare professionals to ensure people lived healthier lives and monitored their outcomes.

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.

People and their relatives told us they were involved in the assessment of their needs when they first began to use the service. They told us that staff supported them in line with their needs, including when their needs changed.

Staff were involved in developing care plans and reviewing and updating them as necessary.

There was a system in place to assess people's needs in relation to a number of areas including personal care, nutrition/hydration, Independence, communication and mobility amongst others. Care plans were developed and written in line with people's assessed needs, for example if a need was identified, care plans included ways in which staff could support people to achieve their outcomes.

People received care, treatment and support that was evidence-based and in line with good practice standards.

Staff that we spoke with had received the relevant training and were confident in carrying out assessment of people's needs using evidence based standards, which was in line with good practice.

The provider’s systems ensured that staff were up-to-date with national legislation, evidence-based good practice and required standards. Standard, industry recognised assessments were used to assess people's support needs. These included Waterlow to assess the risk in relation to pressure sores, Barthel Index (BI) to measure the extent to which somebody can function independently and has mobility in their activities of daily living (ADL), Edmonton frail scale, Cornell depression scale and the Malnutrition Universal Screening Tool (MUST).

People using the service and their relatives told us they had access to health professionals for their ongoing healthcare support needs. they were able to get information and advice about their health, care and support. They received care and support that was co-ordinated, and services worked well together.

We received overwhelmingly positive feedback from healthcare professionals in relation to the working relationship with the provider. A sample of comments included, "The service have worked well with my team and I. They have been responsive and involved in managing issues / concerns as needed" and "Recently we have worked together with one particular resident who finally seems to be settling after a very challenging start – a real testimony to their patience and skill."

All relevant staff, teams and services are involved in assessing, planning and delivering people's care and treatment and staff work collaboratively to understand and meet people's needs.

Information was shared between teams and services to ensure continuity of care, for example when tasks were delegated or when people are referred between services.

Staff, including the registered manager, told us they had a good relationship with health and care professionals which meant that people got the support they required, quickly. This was reflected in the feedback that was received from professionals. Comments included, "[The registered manager] and the Manor House staff work very well with the GP surgery and are excellent at raising any concerns they have within a timely manner" and "[The registered manager] will ensure to make contact with any concerns/deterioration of residents/patients on my caseload and requests additional reviews if she feels they are necessary."

People were involved in regularly reviewing their health and wellbeing needs where appropriate and necessary, including health assessments and checks with health and care professionals. People using the service, and their relatives, told us they had regular access to their GP and other professionals. One relative said, "They do immediately take action if I have any worries or concerns. Like if [resident] is showing signs of a UTI they immediately arrange for a GP."

There were appropriate, well established processes in place to ensure people's health care needs were met. For example, there were a number of posters and information boards around support from community healthcare teams such as the guidance on identifying UTI’s, Sepsis screening tool and other information. There was evidence of regular reviews from the GP, Optician, Dentist and and Chiropodist. Care records contained evidence of input from healthcare professionals and In the event of a Hospital admission, a Hospital pack could be downloaded from the electronic care planning system.

People using the service experienced positive outcomes in line with their level of need and the provider carried out assessments and reviews to ensure they were regular monitored for changes in their level of need.

There were measures in place to monitor people’s care and treatment and their outcomes. Audits were used to identify issues and themes and to learn lessons to provide positive outcomes for people.

The quality and of the service people that received was routinely monitored by managers and staff through a range of different methods. This included care plan reviews, audits and obtaining feedback.

People, and their relatives, understood their rights around consent to the care and treatment they were offered. People's capacity and ability to consent was taken into account through mental capacity assessments, and they, or a person lawfully acting on their behalf, were involved in planning, managing and reviewing their care and treatment. One relative said, "They regularly update me. I feel reassured they would be quick to respond too. Staff have never done anything without obtaining consent first." Another said, "They get in touch with me straight away if anything happens."

There were systems and practices to ensure that people understood the care and treatment being offered or recommended, this helped them make informed decisions. Mental capacity assessments were carried out and the appropriate referrals for a DoLS authorisation were made where restrictions were needed to keep people safe.

Staff understood the importance of obtaining consent before they delivered care or treatment. They were aware of the need to ask people, and offering them a choice when it came to decisions around personal care, dressing and meals. We observed staff offering choices to people when supporting them, including when administering medicines to them. Staff understood their responsibilities under the Mental Capacity Act 2005, for example, the need to have Best Interests Decisions where it had been assessed that people did not have the capacity to consent to aspects of their care plan.