This inspection took place on 22 October 2018 and was unannounced. Manor Field is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection. Manor Field is registered to accommodate six people with learning disabilities and autism. At the time of our inspection there were two people living in the home.
The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.
At the last inspection in October 2017 this service was rated requires improvement. At this inspection, the service remains rated as requires improvement. Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the key questions of safe, effective, responsive, and well led to at least good. They submitted this action plan with information about the improvements to be made, however, at this inspection on 22 October 2018, although some areas had improved there continued to be aspects of the service that required improving.
There was not sufficient oversight or record keeping for staff training. The systems in place did not accurately monitor and record what training staff had completed, when they had completed it, and when it was due for renewal. This resulted in several staff not being trained appropriately to meet people’s needs. When the management had recognised that one staff member had not completed a particular training course, prompt action was not taken to ensure they completed the required training.
People were not always supported by staff who were trained to meet their needs. We saw that staff were supporting individuals who may display challenging behaviour, and who required support from staff that were adequately trained to manage these risks. Staff members were not always trained in this area.
There was not a registered manager in post, but a manager was in place that would be going through the registration process with CQC. 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.
Staff had an understanding of abuse and the safeguarding procedures that should be followed to report abuse. People had risk assessments in place to cover any risks that were present within their lives, and actions were taken to reduce risk where possible. All the staff we spoke with were confident that any concerns they raised would be followed up appropriately by the manager.
Staffing levels were adequate to meet people's current needs, and rotas showed that staffing was consistent.
The staff recruitment procedures ensured that appropriate pre-employment checks were carried out to ensure only suitable staff worked at the service. References and security checks were carried out as required.
Staff supported people with the administration of medicines, and were trained to do so.
People were protected by the prevention and control of infection. The service was clean and tidy, and had a maintenance staff member regularly carry out any works required.
People's consent was gained before any care was provided and the requirements of the Mental Capacity Act 2005 were met. Consent forms were signed and within people’s files.
People were able to choose the food and drink they wanted and staff supported people with this, and people could be supported to access health professionals when required. All aspects of people’s health was documented within their files and updated regularly.
Care planning and risk assessments were personalised and mentioned the specific care each person required, including their likes and dislikes. Staff were aware of people’s preferences, and supported people in a person-centred manner.
People were involved in their own care planning as much as they could be, and were able to contribute to the way in which they were supported. People were listened to by staff.
Staff treated people with kindness, dignity and respect and spent time getting to know them and their specific needs and wishes. People told us they were happy with the way that staff spoke to them, and provided their care in a respectful and dignified manner.
The service had a complaints procedure in place to ensure that people and their families were able to provide feedback about their care and to help the service make improvements where required.
The service worked in partnership with other agencies to ensure quality of care across all levels. Communication was open and honest, and improvements were highlighted and worked upon
At this inspection, we found the service to be in continued breach of regulation of the Health and Social Care Act 2008 (Regulated activities) Regulations 2014. The action we have taken are detailed at the end of this report.