Perry Manor

Updated 16 October 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 26 August 2018 and was unannounced. The team consisted of an inspector, a specialist advisor who is a nurse with knowledge and experience of dementia and an expert by experience. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service. The inspector returned to conclude the inspection on 1 August 2018 and this was announced.

Before the inspection, the provider completed a Provider Information Return (PIR). This is a form the provider completes to give some key information about the service, what the service does well and improvements they plan to make. The provider returned the PIR and we took this into account when we made the judgements in this report.

We checked the information we held about the service and the provider including statutory notifications. Statutory notifications include information about important events which the provider is required to send us. We sought information about the quality of service from the local authority and the Clinical Commissioning Group (CCG) who purchase care and support from the provider on behalf of some people who lived at the home. We also asked Healthwatch for their views. Heathwatch is an independent consumer champion who promotes the views and experiences of people who use health and social care.

We spoke with 19 people and five relatives about what it was like to live at the home. We spent time with people and saw the care and support being provided in communal areas which included how people were assisted at lunchtime.

We talked with the registered manager, deputy manager, two-unit managers and head of housekeeping. Additionally, we spoke with a variety of staff including six care staff, two nurses, one team leader, chef, lifestyle lead, maintenance, business administrator and met a regional director for the provider. A visiting healthcare professional talked about their involvement in supporting people with their health needs.

We looked at 10 people’s medicine records, sampled five people's care and daily monitoring records to see how their care and treatment was planned and delivered. We checked whether staff were recruited safely, and trained to provide care and support appropriate to each person's needs. We looked at the results of the provider and registered manager’s quality monitoring systems to see what actions were taken and planned to continually improve the quality of care and people's experiences.

Updated 16 October 2018

Perry Manor provides accommodation, nursing and personal care for up to 82 older people. There were 80 people living at the home on the day of our inspection. This inspection took place on 26 July 2018 and was unannounced and on 1 August 2018 we returned to the home announced.

Perry Manor is a 'care home'. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Perry Manor accommodates people across three floors, each of which has individual adapted facilities. The needs of people vary from residential, nursing or people living with dementia.

At our last inspection on 3 February 2016 we rated the service 'Good'. At this inspection we found significant developments which had led to improvements. People continued to receive a very good level of care and further developments had been made under' responsive' and 'well-led'. We have rated the service 'Outstanding' in 'responsive' and 'well-led' and therefore overall.

There was a registered manager in post at the time of our inspection. 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 was an excellent role model and together with their staff team they had a passion to learn about and aim for best practice with people very much at the heart of their care. People who lived at the home and all staff were actively encouraged to contribute to the evaluation of the care provided and recommendations of where they could aim higher to drive through improvements. Regular quality audits and checks were completed so that improvements were continually recognised and there was effective follow up action which made sure people received a high-quality service.

The philosophy of the service was created and shared by people who lived at the home, all staff and the management team. These were based around people being supported to live the lives they chose. Staff had developed a ‘can do’ attitude which had brought alive creative initiatives which enhanced people’s quality of life and provided therapeutic benefit when responding to people’s diverse needs.

People were supported to retain an active presence in the local community and to maintain their personal interests and hobbies. There was a rich programme of things for people to do for fun and interest for people to choose to take part in. Peoples own talents were celebrated and people were supported to have lead roles in sharing their talents and interests with other people.

The management and staff team had a passion to undertake outreach work in the local community to promote greater awareness and understanding of the needs of people living with dementia. A dementia café supported people to come and share their experiences in a caring environment where staff were solution focused. Staff also shared their knowledge in different subject areas with people and their families as a way of empowering people to

People were protected from the risks of abuse because staff were trained in recognising and reporting any concerns of potential abuse. The provider had effective recruitment arrangements to ensure staff were suitable for their role before they commenced working at the home. The registered manager made sure there were enough suitably skilled, qualified and experienced staff to support people safely.

Risks to people's individual health and wellbeing were assessed and their care was planned to reduce the risks. Medicines were stored, administered and disposed of safely. Staff followed the providers policies in reducing the risk of cross infections and regularly checks were undertaken to make sure people lived in a clean environment.

People's needs were assessed so these could be met effectively. Staff were trained in subjects aligned to the individual needs of people they provided care and support to. People were supported to eat and drink enough to maintain a balanced diet which met their needs and preferences.

People were supported to maintain their health and prompt action was taken to refer people to healthcare professionals when they became unwell or their health needs changed. People continued to have maximum choice and control of their lives and staff supported them in the least restrictive way possible

People’s needs were supported by staff who were compassionate and caring. Staff understood people's diverse needs and interests and supported them to maintain their independence. Staff respected people's right to privacy and supported people to maintain their dignity.

Further information is in the detailed findings below.