We carried out an unannounced inspection of Huyton Hey Manor on the 31st October 2017 and the 2 November 2017. The first visit was unannounced with the registered provider being aware of our second visit.We last visited the service in December 2014. At that time the service was rated as good with no breaches of regulations identified. During that visit, we identified that the service was not always safe. This related to improvements that were needed to the environment. This visit found that these improvements had been done. People who used the service told us that the improvements made were better.
Huyton Hey Manor is a privately owned care home which provides accommodation for older people some of whom were living with dementia. The service accommodates up to 27 adults. The service is located in the Huyton area of Knowsley and is close to local public transport routes. Accommodation is provided over three floors. The majority of bedrooms are located on the first and second floor and these floors can be accessed via a passenger lift. At the time of our visit, 26 people were living there.
A registered manager was employed at the service. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, 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.
People felt safe living at Huyton Hey Manor. This view was echoed by relatives we spoke with. Staff had had received training in how to protect vulnerable adults and were clear about how they could report any allegations of abuse. They were also clear about the agencies they could speak to if they had concerns about poor practice within the service.
The premises were well maintained, clean and hygienic. Equipment such as hoists, portable electrical appliances and fire extinguishers were regularly serviced to ensure that they were safe. Risk assessments were in place identifying any potential hazards within the environment that could pose a risk to people and how this risk could be prevented. Personal evacuation plans were also in place to ensure the safe evacuation of people in the event of a crisis.
Risk assessments were in place highlighting the risks people faced from pressure ulcers, weight loss and malnutrition. These were closely monitored and reviewed regularly.
Sufficient staff were on duty at all times of the day. Staff rotas, discussions with people who used the service, relatives and staff confirmed this. Staff recruitment was robust with checks in place to ensure that new members of staff were suitable people to support vulnerable adults.
Medication management was good and promoted the well-being and safety of people who used the service. Checks were in place to ensure that medication was given when needed and systems in place to ensure that supplies never ran out. People told us that they always received their medication when they needed it. Staff who administered medication received appropriate training and had their competency to do this task checked.
People and their families considered that staff knew what their role was and knew all aspects of people’s preferences and their daily needs.
Staff received training appropriate to their role. Staff received supervision to ensure that they were aware of their progress and to discuss any needs they had. Group supervision in the form of staff meetings also took place. Staff of longer standing received an annual appraisal of their work.
The registered provider had taken the requirements of the Mental Capacity Act into account. This included assessments on the degree of capacity people had, how limited capacity would impact on their daily lives and how decisions could be made in their best interest. Staff had received training in the Mental Capacity Act and understood the principles associated with it.
The nutritional needs of people were met. Meals were prepared in a clean and hygienic kitchen. Food stocks were sufficient and kitchen staff were aware of the nutritional needs of people. Meals were provided in a pleasant environment with attention paid by staff to ensure that people would be offered meals they wanted. Alternatives were also in place and this was included in menus as well as information provided to people.
People who used the service and their families felt as though staff adopted a caring, patient and respectful level of care. Relatives told us that they considered that since coming to live at Huyton Hey Manor; the quality of life of their relations had improved.
Staff provided a caring and patient approach in the way they delivered care for people. They took the privacy and dignity of people into account through practical arrangements such as knocking on doors and in the manner they interacted with people.
The service had arrangements in place for dealing with situations where people were reaching the end of their lives.
People were complimentary of the activities provided at the service. People had not needed to make a complaint but knew how to do this and were confident they would be listened to.
Care plans were person centred and reviewed regularly in the face of changing need or otherwise. Assessments were in place and completed prior to people coming to live at the service. These included all aspects of people’s health and social needs.
Activities were provided marking key dates in the year as well as other general events such as world themed food nights. People were encouraged to take part to reduce social isolation yet others preferred not to join in and this was respected. People who had expressed an interest in a specific activity had approached the registered provider and had been provided with facilities to pursue this.
The registered manager adopted an open and transparent approach to running the service. People who used the service, relatives and staff considered the manager to be approachable and was running a well led service. The registered manager sought to include staff members in being champions for specific areas such as end of life care, activities or medication. The registered manager had a number of audits in place to ensure that a commentary on the quality of care could be made and fed back comments from questionnaires to people.
The registered manager maintained a presence within the service and demonstrated a detailed knowledge of the needs of each person who lived there.
Notifications required by law of any adverse events within service were always sent to us and the rating from our last visit was put on prominent display.