Manorfield Residential Home

Updated 16 February 2019

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked 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.

The inspection was undertaken by one adult social care inspector and an expert-by-experience on the 29 January 2019 and was unannounced. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Prior to the inspection we looked at other information we held about the service such as notifications and previous reports. The provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. At our last inspection of the service in August 2016 we did not identify any concerns with the care provided to people.

During the inspection we met and spoke to most of the people who lived at the service. We spoke with eight people in detail about their care. Some people living at the service were living with dementia which meant they had limited ability to communicate and tell us about their experience of being supported by the staff team. Staff used other methods of communication to support people, for example by providing visual prompts by showing people pictures of meals available at lunchtime. Others were able to tell us about the care and support they received. As some people were not able to comment specifically about their care experiences, we used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people living in the service.

We also looked around the premises. We spoke to the registered manager, eight staff and four relatives. We looked at records relating to individual’s care and the running of the home. These included four care and support plans and records relating to medicine administration. We also looked at records of how the registered manager and provider ensured the quality monitoring of the service.

Updated 16 February 2019

We carried out an unannounced comprehensive inspection on 29 January 2019.

Manorfield Residential Home is a care home without nursing for up to 28 people. On the day of our inspection there were 27 people living at the service. It specialises in care for older people some who are living a physical disability, sensory impairment and living with dementia.

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.

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 the last inspection on 2 August 2016, the service was rated Good. At this inspection we found the evidence continued to support the rating of Good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

Why the service remains Good:

We met and spoke with most of the people living in Manorfield Residential Home during our visit, however, not all people were able to fully verbalise their views. We therefore spent time observing people with the staff supporting them. Others could tell us about the care and support they received. Staff told how they used other methods of communication with people who could not verbally express their views, for example the use of pictures.

People remained safe at Manorfield. People who were able to told us they felt safe living there. Comments received about the service included; “You don't ever feel left on your own, so I feel safe.” Relatives said; “We know our relative is safe and happy and we can visit or call any time and staff are always friendly and helpful” and “My relative is safe.”

People continued to receive their medicines safely from staff who had received regular training. People were protected by safe recruitment procedures. This helped to ensure staff employed were suitable to work with vulnerable people. People, relatives and the staff team confirmed there were sufficient numbers of staff to keep people safe. Staff confirmed they could meet people’s needs and support them when needed.

People’s risks were assessed, monitored and managed by staff to ensure they remained safe. Risk assessments were completed to enable people to retain as much independence as possible.

People continued to receive care from a staff team that had the skills and knowledge required to effectively support them. Staff had completed safeguarding training. Staff without formal care qualifications completed the Care Certificate (a nationally recognised training course for staff new to care). The Care Certificate training looked at and discussed the Equality and Diversity and Human Rights policy of the company.

People continued to receive a caring service. People were observed to be treated with kindness and compassion by the staff who valued them. The staff, many of whom had worked at the service for several years, had built strong relationships with people. All staff demonstrated kindness for people through their conversations and interactions. Staff respected people’s privacy. People or their representatives, were involved in decisions about the care and support people received.

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 wishes for their end of life were clearly documented. People's healthcare needs were monitored by the staff and people had access to healthcare professionals as required.

People’s care and support was based on legislation and best practice guidelines, ensuring the best outcomes for people. People’s legal rights were upheld and consent to care was sought. People who required assistance with their communication needs had these individually assessed and met. This meant people were able to communicate their choices about their day to day lives. The provider had a complaints policy in place and records showed all complaints had been fully investigated and responded to.

The service responded to people's individual needs and provided personalised care and support. People’s equality and diversity was respected and people were supported in the way they wanted to be. Care plans were person centred and held full details on how people’s needs were to be met, taking into account people’s preferences and wishes. Information held included people’s previous history including medical and family history. People’s cultural, religious and spiritual needs were also documented.

The service continued to be well led. Clear leadership and governance was provided with the provider’s governance framework, monitoring the management and leadership of the service. The provider’s values and vision were embedded into the service, staff and culture. The provider had monitoring systems which enabled them to identify good practices and areas of improvement. People, relatives and staff said the registered manager was approachable and made themselves available to speak to people. The provider and the management team listened to feedback and reflected on how the service could be further improved.

People lived in a service which had been designed and adapted to meet their needs. The provider monitored the service to help ensure its ongoing quality and safety.