Manor House Residential Home

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• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

The service had improved. The rating for this key question has changed from requires improvement to good as the provider is no longer in breach of regulations. The provider had followed the action plan they had sent us after their last inspection and improved how they managed their governance systems. The providers oversight and scrutiny systems were now more effective. People's concerns and complaints were well-managed. The provider recognised the importance of learning lessons when things went wrong. They were continuously improving the service to ensure they maintained high-quality, person-centred and safe care for people who lived in the care home. The managers had a clear vision for the care home and routinely used individual supervision and group team meetings to remind staff about the provider’s underlying core values and principles.

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 service aimed to give people consistently good care and staff worked together to try and achieve this. Individual staff supervision and group team meetings were used by the provider to remind staff about their organisations underlying core values and principles.

Managers and staff told us they aimed to give people they supported the best quality person centred care they could. The managers and staff worked well together as a team. The managers had a clear vision for the service and told us they routinely used individual supervision and group team meetings to remind staff about the provider’s underlying core values and principles.

The managers had the relevant skills, knowledge, and experience to effectively lead the service, which they did so with integrity, openness and honesty.

Staff told us that both the registered manager and the provider were a visible presence in the home and led by example. Leaders were knowledgeable about their regulatory responsibilities and also about the priorities for the development of the service. Comments from healthcare professionals reflected this, "Manor House is extremely well managed! [The Registered Manager] knows her patients very well, is very open and collaborative with us and very responsive. It is a pleasure to work with her and her team."

The provider valued and listened to the views of staff. Staff told us they were encouraged to contribute their ideas about what the service did well and what they could do better during regular individual and group meetings with their line managers and fellow co-workers. This showed the provider was willing to listen and take prompt action in response to feedback received from staff. A member of staff told us, “This home is professionally managed. They [managers] listen to what we have to say and act on it. We have lots of meetings where we can express our views and share them with the managers.” Managers and staff told us the provider had a complaints policy which detailed how people could raise concerns if they were dissatisfied with the service they received and the process for dealing with their concerns.

The provider promoted an open and inclusive culture which sought the views of people living in the care home, their relatives, and staff. A relative told us, “I do feel able to speak to staff. They do immediately take action if I have any worries or concerns.” They used a range of methods to gather people’s views about what the care home did well or might do better. For example, people living in the care home and their relatives were routinely invited to attend group meetings with staff and participate in the providers own customer satisfaction surveys. The provider also had a complaints policy which detailed how people could raise concerns if they were dissatisfied with the service they received and the process for dealing with their concerns.

Leaders took action to continually review and improve the culture of the organisation, this included in response to the previous CQC report and feedback received. Leaders ensured there are effective and proactive ways to engage with and involve staff, with a focus on hearing the voices of staff. This included staff surveys, regular staff meetings and having an open door policy where staff felt empowered and were confident that their concerns and ideas would be heard.

Staff told us managers treated them well and they felt they got all the support and guidance they needed from them.

The providers governance framework had been improved to ensure they continuously learnt and improved the quality and safety of the service they provided to people, and that risks were assessed and managed. The provider had developed an improvement plan and followed the actions it set out to take to address all of the issues we identified at their last inspection. This included improving how the service managed risk, checked the suitability and fitness of potential new staff, how staff cared for and treated people they supported, and how they operated their governance systems. The provider routinely conducted audits and spot checks on staffs working practices, and gathered feedback from people living in the care home, their relatives and staff. The outcomes which were regularly assessed and analysed to identify issues, learn lessons and develop action plans to improve the service they provided people.

Managers and staff told us they routinely met to discuss any changes in people’s care and support needs conducted daily tours of the premises to observe staffs working practices. This was also used as a spot audit and visual inspection of the premises. The managers were aware they needed to continue improving how they operated their oversight and scrutiny systems.

The feedback from external healthcare professionals was overwhelmingly positive in relation to the partnership working with the provider. For example, "Manor House is among the most resilient and compassionate care homes I work with. They will accept residents that many other care homes have rejected, and stick with residents with complex/challenging needs, taking a great deal of care and time to try and meet those needs as best they can. Recently we have worked together with one resident who finally seems to be settling after a very challenging start – a real testimony to their patience and skill."

Staff and leaders were open and transparent, and they collaborated with all relevant external stakeholders and agencies to meet people's needs. This meant that people received joined-up care.

The provider worked closely with various external agencies including, GPs, various community teams, social workers and Local Authorities. This was underpinned by a policy of relevant information being shared with appropriate services within the community or elsewhere.

People told us they received ongoing support from various external health and social care professionals who represented them.

It was clear from the feedback we received from managers and staff they recognised the importance of learning lessons and continuous improvement to ensure they maintained high-quality, person-centred and safe care for people.

Safeguarding concerns, complaints, accidents, incidents and near misses were reviewed, analysed, and responded to with emerging themes identified, necessary action taken and ways of avoiding them from happening again looked at. Audits and checks, and the gathering of stakeholder feedback was routinely carried out by managers and senior staff to monitor and learn how to improve the quality and safety of the service they provided. An external health care professional told us, “The registered manager is open to honest discussion and learning, very responsive, and we have an excellent partnership.”