This was an unannounced inspection carried out on 19 January 2017.Manor Gate Care Home can provide accommodation and personal care for 18 older people and people who live with dementia. There were 17 people living in the service at the time of our inspection.
The service was operated by a partnership that was the registered provider. There was a registered manager in post. 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. In this report when we speak about both the partnership and the registered manager we refer to them as being, ‘the registered persons’.
At our inspection on 23 December 2015 there was one breach of legal requirements. We found that the registered persons had not fully protected people who lived in the service against the risks of inappropriate or unsafe care by regularly assessing and monitoring the quality of the care and facilities provided. This was because quality checks had not been consistently effective in quickly resolving problems in the running of the service. These problems included there not always being enough staff on duty, shortfalls in the way new staff were recruited and oversights in the support people received to eat enough in order to stay well. In addition, the registered persons had not always ensured that care was provided in a way that fully respected people’s legal rights.
After the inspection the registered persons wrote to us to say what actions they intended to take to address the problems in question. We completed a further inspection of the service on 20 May 2016 when we found that the necessary improvements had been made to address the breach and to meet legal requirements.
At this inspection we found that staff knew how to respond to any concerns that might arise so that people were kept safe from abuse, including financial mistreatment. People had been protected from the risk of avoidable accidents and there were enough staff on duty. Background checks had been completed before new staff were appointed.
Parts of the accommodation were not adapted, designed and decorated to meet people’s needs and expectations. Staff had been provided with support and guidance and they knew how to support people in the right way. People had been helped to eat and drink enough to stay well and they enjoyed their meals. Staff had supported them to obtain all of the healthcare assistance they needed.
Staff had ensured that people’s rights were respected by helping them to make decisions for themselves. The Care Quality Commission is required by law to monitor how registered persons apply the Deprivation of Liberty Safeguards under the Mental Capacity Act 2005 and to report on what we find. These safeguards protect people when they are not able to make decisions for themselves and it is necessary to deprive them of their liberty in order to keep them safe. In relation to this, the registered manager had taken the necessary steps to ensure that people only received lawful care that respected their rights.
People were treated with kindness and compassion. Staff recognised people's right to privacy, and promoted their dignity. Confidential information was kept private.
People had been consulted about the care they wanted to receive and had been given all of the practical assistance they needed. Staff promoted positive outcomes for people who lived with dementia. People’s choices were respected and they were offered the opportunity to pursue their hobbies and interests. There was a system for resolving complaints.
People had been invited to suggest improvements to their home and quality checks had been completed. The service was run in an open and inclusive way and good team work was promoted. Staff were supported to speak out if they had any concerns and people who used the service had benefited from staff acting upon good practice guidance.