Archived: Manorfield House

Manorfield House is purpose built and accommodation is on two floors to provide care for up to 27 older people. All of the bedrooms are single occupancy and have en-suite toilet facilities. Communal lounges, conservatory, a dining room and bathing facilities are provided. There is easy access to all the local facilities including shops.

The service has a registered manager. 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.

The registered manager informed us the service is earmarked for de-commissioning in the future by the Local Authority. The registered manager reported although no date had been confirmed for this. People told us they were happy with the care provided and in discussion their relatives confirmed this. People who used the service told us the staff were caring and they liked the registered manager. During the inspection we observed staff spending time with people and it was clear they knew the people they were supporting. Staff were able to tell us about people’s history, likes and preferences.

People who used the service and their family were involved in the care planning process and helped identify how their care should be delivered. Care plans described what staff needed to do to make sure people’s needs were met and covered areas that were important to the person. A range of other professionals were involved to help ensure people stayed healthy.

Care plans and risk assessments were reviewed on a monthly basis and were user friendly so that staff were able to understand the required needs of the people who used the service. This ensured that accurate and up to date information was provided.

People told us there were enough staff to give them the support they needed and this was confirmed in our observations. Staff told us they had received training, the records we looked at reflected this. This meant people could be confident staff had the skills to meet their needs.

Staff received training in the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) and they were able to demonstrate a good understanding of how it was used in practice.

The provider’s staff recruitment and selection procedures were robust which helped to ensure people were cared for by staff suitable to work in the caring profession. All the staff we spoke with were aware of signs and symptoms which may indicate people were possibly being abused and the action they needed to take.

People told us the care they received was effective and they received appropriate healthcare support. We saw people were referred to relevant healthcare professionals in a timely manner.

People told us they had a good choice of food and they were encouraged to participate in a range of appropriate social and leisure activities.

There was an effective quality assurance monitoring system in place which quickly identified any shortfalls in the service and there were systems in place for staff to learn from any accident, incidents or complaints received.

We used this information to answer the five questions we always ask;

' Is the service safe?

' Is the service effective?

' Is the service caring?

' Is the service responsive?

' Is the service well led?

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, their relatives, the staff supporting them and from looking at records.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

Medication care plans had clear instruction for administering and supporting people to take their medication. This included medicines prescribed to be taken 'when required'. Medicines were stored safely, securely and were only accessible to staff who were authorised to handle them.

Staff we spoke with had a clear understanding of their roles and responsibilities within the team, and were knowledgeable about the service.

In the main, care and support was planned and delivered in a way that ensured people's safety and welfare. Care files identified risks and how these were managed.

Is the service effective?

People's files contained pre-admission assessments, which showed that people's health, personal and social care needs were assessed before they moved into the home.

When people were identified as being at risk, their plans showed the actions required to manage these risks. These included the provision of specialist equipment such as pressure relieving mattresses, hoists and walking aids.

Relatives told us they were well informed about their relative's care and treatment and were involved in their regular care plan reviews. They told us the staff were helpful and kind. They said the staff were quick to inform them of any significant changes in their relative's general health.

Visitors confirmed they were able to see people in private and visiting times were flexible.

Is the service caring?

Visitors we spoke with told us they were very happy with the care provided and in their opinion people were well looked after. They described staff as friendly, patient and caring.

We observed staff supporting people who live in the home. Staff were friendly, patient, polite and treated people in a respectful way. During lunch staff encouraged people to be independent and make choices but at the same time assisted people when they required support

We found the care staff we spoke with demonstrated a good knowledge of people's needs and were able to explain how individuals preferred their care and support to be delivered. We saw staff approached individual people in a way which showed they knew the person well and knew how best to assist them.

Is the service responsive?

People's needs were assessed and care and support was planned and delivered in line with their care plan. Care records contained good information about how care and support should be delivered

People and their families were involved in discussions about their care and the risk factors associated with this. Individual choices and decisions were documented in the care plans and reviewed on a regular basis.

People knew how to make a complaint if they were unhappy. We saw the complaints log and saw that any complaints made had been acted upon appropriately and any actions taken had been fed back to the person making the complaint. People can therefore be assured complaints will be investigated and action taken as necessary.

Is the service well-led?

Staff spoken with had a good understanding of the whistleblowing policy. All of the staff said if they witnessed poor practice they would report their concerns.

The provider had an effective system to regularly assess and monitor the quality of the service that people received. We looked at a selection of reports which showed the provider had assessed and monitored the quality of service provision.

People were complimentary about the food and said they had more than enough to eat. If they didn't like what was on the menu they were able to ask for something else to be prepared.

People told us they felt safe in the home and were aware of the complaints system. They also said they would be happy to raise any concerns they had with the staff and would be confident these would be listened to and acted upon.

During the visit we spoke with a visiting healthcare professional. They told us they had no concerns about the standard of care provided at the home and that staff had a good understanding of people's needs.

The visitors we spoke with told us they had no concerns at all about the standard of care provided at the home and always found the staff to be professional in their approach to providing care and support.

While it was apparent that staff had a very good understanding of people's needs and provided person centred care this was not reflected in the care records we looked at. The manager told us this would be taken up as a training issue and all issues around care planning would be address by August 2013.