Salisbury Manor

Updated 26 January 2021

The inspection

This was a targeted inspection to check on a specific concern we had about food hygiene and management approach.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

This inspection was carried out by one inspector.

Service and service type

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

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection, this included two whistleblowing concerns. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.

We used all of this information to plan our inspection.

During the inspection

We spoke with two people who used the service about their experience of the care provided. We spoke with seven members of staff and we toured the home and observed infection prevention and control practice. We spoke with the registered manager by video call following the site visit.

After the inspection

We looked at quality assurance, infection prevention and control policy and staff training records. We spoke with the public health specialist nurse from the local authority.

Updated 26 January 2021

This unannounced inspection took place on 7 and 8 August 2018.

This service has a dual registration which means there are two registered providers jointly managing the regulated activities at this one location. The service is subject to one inspection visit however, the report is published on our website twice, under each provider.

Gracewell of Salisbury 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.

The care home accommodates 63 people in one adapted building. At the time of our inspection 58 people were residing at the home. The service is in the city of Salisbury. Accommodation is arranged over three floors which are accessed via a lift. All rooms are en-suite and there are landscaped gardens.

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.

At our last unannounced focused inspection in August 2016 we found the service was not meeting legal requirements. We found concerns relating to medicines management and records relating to incidents and accidents. At this inspection we found the necessary improvements had been made and we rated the service ‘Good’ overall.

Medicines were managed safely. Where appropriate people were supported to manage their own medicines. We observed staff administering medicines and found their practice to be safe. Staff had received training on medicines administration and had their practice observed to check for competence.

Accidents and incidents had been recorded in detail and action taken to minimise the risk of re-occurrence. There were opportunities for staff to discuss incidents and use reflection to learn any lessons. Risks had been identified and safety measures put in place to keep people safe from avoidable harm. All risk assessments were reviewed regularly. Care and support plans contained sufficient detail to support the staff to deliver personalised care.

The service had improved systems in place following falls. If people sustained a fall they were assessed by a nurse. If further medical advice or treatment was needed, this was sought. There were clear records of actions taken, and people were re-assessed as a precaution. Handover information was clear and up to date.

There were daily head of department meetings, regular team and ‘resident meetings’, where people and staff could share ideas. Minutes were kept and reflected on to make sure actions raised were closed. The service sought the views of people and their relatives, to try to improve the care and support.

Staff were recruited safely, and the required pre-employment checks had been completed. There were sufficient staff deployed to meet people’s needs consistently. Gracewell of Salisbury had a consistent and experienced staff team who knew people’s needs well.

Staff understood the different types of abuse and how to report any concerns. Training had been provided in a variety of topics and staff told us they felt well supported. Supervision was available, where staff could discuss any concerns, training needs or development opportunities.

The service was clean and free from unpleasant odours. We observed the staff used appropriate infection prevention and control good practice. The premises and equipment was maintained and serviced when required.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People’s needs were assessed and where needed, referrals were made to healthcare professionals. Records demonstrated that people had access to services such as GP’s, physiotherapists, speech and language therapists, district nurses and dentists.

The dining experience was person centred and inclusive. A ‘whole home approach’ was used, which meant there were ample staff available to offer people the support they needed. People had choice at the table which meant they could choose what they wanted when they saw the options. Snacks and drinks were available in different areas and people were encouraged to help themselves.

People told us they were supported by a kind and caring staff team. Privacy and dignity were maintained and people were supported to maintain their independence. There were no restrictions on visiting so people could have visitors when they wished.

Complaints were managed well and records demonstrated the action taken. People, relatives and staff thought the service was well managed with an open and transparent management approach.

People had the opportunity to record their wishes for end of life care, this information was in people’s care plans. Where the service had provided end of life care the staff had worked with healthcare professionals to make sure people were as comfortable as possible.

There were comprehensive and robust quality monitoring systems in place. Audits were completed at service and provider level. Action plans were produced and the registered manager made sure the necessary action was taken where needed.