We carried out a review of the data available to us about The Manor House Thurloxton on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about The Manor House Thurloxton, you can give feedback on this service.
The Manor House Thurloxton provides personal care and accommodation for up to five people. The service specialises in providing care for older people in a family home. The home is a large house situated in its own grounds at the edge of a rural village. The staffing and equipment available in the home mean the service is best suited to people with minimal care needs. At the time of the inspection there were five people in the home. Two people received assistance with personal care. The other people lived their lives as independently as possible supported by staff.
People’s experience of using this service and what we found
Prior to the inspection concerns had been raised that the provider was not following the Government guidance in relation to the management of risks during the pandemic. The provider had not been following Pubic Health England guidance on the use of personal protective equipment (PPE) for care workers working in care homes during the current period of sustained COVID-19 transmission. The provider had also not been following guidance in relation to the regular testing for COVID 19 for staff and residents.
Infection prevention and control policies and procedures did not reflect up to date and current infection control guidance, to take account of the pandemic. Staff had not completed infection prevention and control training in relation to Coronavirus.
During the inspection staff wore the necessary PPE to ensure the risk of transmission of coronavirus was reduced. Following the inspection, regular staff and resident testing for COVID 19 had been implemented and the results shared with us. In addition, the provider wrote to us to confirm staff had completed the essential training to keep themselves and people using the service safe.
The provider was working with the local infection prevention and control nurse specialist to make further improvements to their policies and procedures.
The premises looked clean and hygienic, however, cleaning schedules did not reflect best practice to assure the transmission of infection was reduced. Following the inspection, an infection prevention and control nurse specialist from the Clinical Commissioning Group (CCG), was assisting the provider to develop records and checks of cleaning, to minimise the transmission of infections.
The provider did not have a written contingency plan in place to address a possible coronavirus outbreak. They were being supported by the an infection prevention and control nurse specialist from the CCG to develop this.
We have recommended the provider continue to work with other professionals to keep up to date with current infection prevention and control guidance from the government and take prompt action to update their practice accordingly.
There had been no reported cases of COVID 19 within the service and people said they felt safe and were well cared for. Comments included, “I am very comfortable here. I am aware of what is happening. I wear a mask when I go out” and “Life here is good. I feel safe. (The provider) is very careful with us all.”
The provider had established appropriate visiting arrangements to help prevent the spread of infection. We were assured that the provider was admitting people safely to the service and they were aware of the actions to take should someone become symptomatic or if a positive test occurred for staff or people using the service. We were assured that staff movement and transmission in and between care homes was minimised.
We found the provider was working towards full compliance with the current guidance. Following the inspection, health and social professionals from the local authority and Clinical Commissioning Group were working with the provider to ensure practice, policies and procedures were reflective of current guidance.
Rating at last inspection
The last rating for this service was Good (published October 2017)
Why we inspected
This was a targeted inspection looking at the infection control and prevention measures the provider has in place, following concerns shared with us. As part of CQC’s response to the coronavirus pandemic we are conducting a thematic review of infection control and prevention measures in care homes.
CQC have introduced targeted inspections to follow up on Warning Notices or to check specific concerns. They do not look at an entire key question, only the part of the key question we are specifically concerned about. Targeted inspections do not change the rating from the previous inspection. This is because they do not assess all areas of a key question.
We found no evidence during this inspection that people had been harmed due to the concerns raised. Following the inspection, the provider had taken action to mitigate most of the risks identified and was taking action to address the other concerns, with the support of external health and social care professionals. The overall rating for the service has not changed following this targeted inspection and remains Good.
Follow up
We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for The Manor House Thurloxton on our website at www.cqc.org.uk.
This inspection comprised of two visits to the home. The visit on 23 August was unannounced. The visit on 29 August was announced and provided a further opportunity to speak with the provider and review documentation.
At the last inspection on 25 August 2015 the service was rated as Good. At this inspection the service remained Good.
People told us they felt safe in the home. A relative told us “I come every day. It is totally safe. They know how to look after people.” Staff said they knew how to report any concerns and were confident the manager would take appropriate action. People were supported by sufficient staff to meet their needs. Additional support for staff was available so they were able to prioritise people’s care needs.
People were supported by a small team of staff who knew them well and had the skills and experience to meet their needs. There was a system in place to recruit new staff safely. A programme of training had been planned to ensure staff knowledge was up-to-date.
People received care and support that was personalised and respected their wishes and preferences. People were able to make choices about all aspects of daily living and were encouraged to maintain their independence.
People told us how much they enjoyed their meals in the home. There was one main choice at lunch time cooked freshly using good quality ingredients. People were asked to choose their supper each day from a range of food and were offered lighter meals and snacks when they were unwell. One person told us “Food is very good. A bit too good. Lovely puddings!” Another commented “We have marvellous food.”
People confirmed their health care needs were met in the home. They told us if they were unwell they received prompt attention from their GP and good care from staff in the home. People were supported to attend hospital or clinic appointments.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the values in the service supported this practice.
The registered provider was experienced and committed to providing good care within this family home environment. They wanted to provide a service that met the required regulations in a manner that was appropriate to the size of the home and the needs of people living there.
Further information is in the detailed findings below
This inspection was unannounced and took place on 25 August 2015.
The Manor House-Thurloxton provides personal care and accommodation for up to four people. The home specialises in providing care for older people in a family home. At the time of the inspection there were four people at the home.
The last inspection of the home was carried out in August 2013. No concerns were identified with the care being provided to people at that inspection.
The registered provider took an active role in the running of the home. Registered persons have a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
People living at The Manor House told us they were happy with the care and support they received. They said the manager and staff were open and approachable and cared about their personal likes and dislikes. One person said, “I looked for a place that was small and not institutional, that is exactly what it is like here. It is a family home and we all feel part of the family.” Another person said, “I am so happy living here I never thought I would still be a valued member of a family when I went into care.”
People living in the home required minimal levels of personal care. They were supported by sufficient numbers of staff who had a clear knowledge and understanding of their personal needs, likes and dislikes. We observed the manager and staff took the time to talk with people both individually and when in a group.
There was a happy relaxed atmosphere in the home and during lunch people were relaxed and unhurried. One person said they enjoyed lunch as it was taken in the kitchen with the staff and the manager’s family. They said they were often joined by one of the younger children. Another person said they preferred to take their meals in their room but were always made welcome when they chose to join the family and other people in the home.
Everybody spoken with said the food in the home was “excellent”. One person said, “Everything is home-made and is very well presented.” We joined people for lunch and the meal was nutritional well balanced and made from fresh ingredients. The staff member said I never have to worry about budgeting there are always more than enough fresh ingredients in the home.
The manager had a clear vision for the home. Their statement of purpose said, they aimed to, “provide, loving non institutionalised care, which as far as possible provides an atmosphere akin to that of a family home.” People told us they were happy with the family centred approach to the care provided. Throughout the inspection we saw this vision was at the very centre of the care and support provided by both the staff and the manager.
People were protected from abuse because the provider had systems in place to ensure checks of new staffs characters and suitability to work with vulnerable adults were carried out. Staff had also received training in protecting vulnerable people from abuse.
Although people’s personal care needs were minimal their health care needs were fully assessed and care and support was provided on an individual basis. People saw healthcare professionals such as the GP, district nurse, chiropodist and dentist. Staff supported people to attend appointments with specialist healthcare professionals in hospitals and clinics. Staff made sure when there were changes to people’s physical wellbeing, such as changes in weight or mobility, effective measures were put in place to address any issues.
Although there was not a planned programme of activities people said they found plenty to do. They said they preferred not to take part in organised group activities. They confirmed there was plenty of opportunity to go out or into town shopping as well as joining in with the local community. They also confirmed their family and friends were free to visit at any time.
There were systems in place to monitor the care provided and people’s views and opinions were sought on a daily basis. Suggestions for change were listened to and actions taken to improve the service provided. All incidents and accidents were monitored, trends identified and learning shared with staff to put into practice.
The people who lived in the home were complimentary about the service. People said "I'm being looked after very well. They couldn't be kinder', 'I don't have a single complaint' and 'I recently had a fall and received very quick attention. I feel quite safe here'.
The home was in good decorative order throughout with good quality furnishings and fittings. All bedrooms were a good size and had en suite bath or shower facilities. People told us 'It's just like being at home' and 'It's homely and clean, not at all institutional'.
The design, layout and security of the premises were fit for purpose. The provider carried out environmental risk assessments and employed specialist contractors to undertake remedial work or improvements.
People said there were enough members of staff to meet their needs. One person said 'There is always someone there when you need them'. A member of staff said 'It's a lovely home. It's not pressurised and I get time to spend with the residents'.
Staff told us they worked well together and were a supportive team. They said they could always speak to the manager or colleagues if they had any problems or queries.
We found accurate and appropriate records were maintained by the provider. This helped ensure people received safe and appropriate care.
The home was located in a rural setting. One person said 'It's a little bit isolated'. The owner told us that they regularly offered to take people out to social events at a local church, local caf's, garden centres and other trips.
People who lived in the home were relatively independent but sometimes needed assistance with bathing or dressing. One person said 'I'm treated very well. The girls look after me and get me ready for bed in the evening'. Another person said 'I have no complaints it's a very good home'.
Staff recorded any significant care issues or appointments in a daily diary. This ensured that people received their planned care and treatment. When we spoke with the owner and the staff on duty they were knowledgeable about each individual's care needs and preferences.
People told us that the owner was approachable and did their best to respond to any issues. One person said 'I can ask them anything I like. I've got no complaints but if I had a problem I'm sure they would sort it out for me'.
All of the interactions we observed between people in the home and the staff were friendly, respectful and caring. We were told, 'Everyone is very kind and they make it very homely'. One person said, 'I don't think anything could be improved, it is absolutely perfect for me'. People did not recall seeing their care plans but said if they needed anything they just asked and it was provided.
All of the people that lived in the home commented on how good the meals were. We were told, 'The food is excellent and if we ask for something we get it'.
People told us, 'I'm very well looked after' and 'I'm very happy here. I feel fine and my health has improved'. We were told that the owner took them to their appointments at the doctors, dentists and opticians. One person said 'they will take me to my appointments free of charge without any hesitation'.
Throughout the day of our inspection we observed that the interactions between the staff and the people that lived in the home were appropriate, friendly and caring. People were observed to be at ease and comfortable in the presence of staff and with each other. People told us they felt safe and were confident that any concerns would be acted upon. We were told, 'If I did have any concerns I would tell the person in charge and I am confident they would act on it' and 'Everyone is very pleasant and friendly. There are no restrictions we are free to come and go as we please'.
People told us that they were happy with the standard of personal care and support provided in the home. They said the owner and the staff listened to their needs and always did their best to respond to any requests.