About the service:

• Berrycroft Manor is care home located in the Romiley area of Stockport. The home provides accommodation and personal care to older adults and people living with dementia. The home can accommodate 78 people over three floors and was full at the time of our inspection.

People’s experience of using this service:

• The home provided safe care which met people’s needs and wishes. Staff had been trained in how to identify and report safeguarding concerns.

• The home was well run with a clear management structure in place. The register manager told us the provider was responsive to requests for resources and equipment to ensure people received the best care possible.

• The home was clean throughout with effective infection control processes in place.

• Medicines were managed safely, by staff who had received training and been assessed as competent.

• Care files contained detailed risk assessments, which had been regularly reviewed to reflect people’s changing needs. This ensured staff had the necessary information to help minimise risks to people living at the home.

• 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.

• Staff spoke positively about the support and training provided. Staff completed an induction training programme upon commencing employment and on-going training was provided. Supervision was completed to provide staff with an opportunity to discuss their roles, any areas for improvement and future goals.

• People told us staff were kind, caring and treated them with dignity and respect. Staff had taken time to get to know people, which was evident in the interactions we observed.

• Care files contained personalised information about the people who lived at the home and how they wished to be supported and cared for. People and their relatives told us they were involved in care planning and reviews.

• Peoples’ social and recreational needs were met through an activities programme, facilitated by activity co-ordinators and staff members. A mix of activities were organised throughout the week which catered for all interests and abilities.

• The home had a range of systems and procedures in place to monitor the quality and effectiveness of the service. Action plans had been completed to promote continuous improvement.

• The service met the characteristics for a rating of ‘good’ in all key questions.

• More information is in the full report.

Rating at last inspection:

• At our last inspection the home was rated as ‘good’. The last report was published on 03 February 2016.

Why we inspected:

• This inspection was part of our scheduled plan of visiting services to check the safety and quality of care people received. Inspection timescales are based on the rating awarded at the last inspection and any information and intelligence received since we inspected.

Follow up:

• We will continue to monitor information and intelligence we receive about the home to ensure care remains safe and of good quality. We will return to re-inspect in line with our inspection timescales for good services, however if any information of concern is received, we may inspect sooner.

An inspector visited this service on 22nd April 2014 to carry out an unannounced inspection. Prior to our visit we looked at all the information we hold on this service to help us to plan and focus on our five questions; Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led? Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, their relatives, the staff supporting them and from looking at records.

Is the service safe?

We saw that people were treated with respect and dignity. The people using the service and visiting relatives who we spoke with told us staff respected privacy and dignity and supported people in a way that suited their individual needs and personal preferences.

We saw the home was furnished and decorated to a high standard, was clean, tidy and hygienically clean.

We saw that staff had received appropriate training to ensure they had the knowledge, skills and experience to meet the assessed needs of people living at the home. This meant that people living in the home could be confident that their needs were being met by fully trained staff.

Systems were in place to make sure that managers and staff learned from events such as adverse incidents, complaints, and safeguarding events.

We saw that policies and procedures were in place to support staff in delivering safe and effective care.

Management systems were in place to monitor and audit aspects of practice such as checks on care plans, the cleanliness of the home and medication administration.

Is the service effective?

People living at Berrycroft Manor had an individual care file that included assessments of needs and risk. A corresponding care plan had been implemented to meet people’s individual needs. The assessments and care plans were regularly reviewed and updated accordingly.

Prior to people being admitted into the home a member of staff visited the person to carry out an assessment of their needs. This meant that people could feel confident that the service could meet their individual and personal care needs when they moved into the home. If possible people were encouraged to spend some time at the home having lunch and meeting staff and other people living at the home before a decision was made about moving in. We were told that relatives were encouraged to call in and look around the home at any time without having to make an appointment.

Is the service caring?

The atmosphere in the home felt relaxed, pleasant and friendly. From our observations we saw that care staff had a good understanding of people’s individual needs and preferences. People were seen to be freely moving around the home and staff were kind and sensitive in their approach to people. We saw that staff were attentive and responded promptly to peoples requests or need for assistance.

We observed that people looked well cared for and were appropriately dressed.

Some of the comments we received from people living at the home were: “I am happy here” and “I would rather be here than anywhere else.”

When we spoke with some visiting relatives we were told that the staff delivered care in a kind and caring way. One visiting relative said “They are very kind, very pleasant, the girls are wonderful, just lovely.” Another relative told us they were “Absolutely happy with all the care, I have no concerns all.”

Is the service responsive?

We saw that where appropriate the service had accessed advice and care from other health care professionals. For example we saw evidence of visits from the GP’s, district nurses, the chiropodist, the optician and the speech and language therapist. This meant that people using the service received co-ordinated care and support.

When we spoke with visiting family members we were told that they were happy with the standard of care and they had not seen or heard anything of concern.

The service had systems in place to ensure that people were regularly consulted about their views and ideas on how the home should be run and the quality of the service delivered. This was done by means of regular informal chats with people and satisfaction surveys. We saw evidence of these surveys being carried out on a regular basis, following which an analysis of the findings were conducted and action plans implemented if required.

Is the service well led?

The service worked well with other services to make sure people living in the home received appropriate care and assessment from the right professionals in a timely way.

When we looked at documentation we saw that there were systems in place to audit and monitor care practices in the home.

When we spoke with staff they spoke highly of the support they received from the manager and the senior staff.

The manager was very visible in the home and operated an open door policy where people were actively encouraged to raise any issues or concerns they had. We saw the manager had good relationships with people living at the home and their visitors. One visiting relative said “Val the manager runs a great place.”

The manager, senior staff and care staff had developed a good team approach where they worked well together. Staff made many comments about how they felt they worked well as a team. During this visit there was evidence of an enthusiastic approach and a willingness to continually develop the service.

This review took place to check the provider had made improvements in relation to some concerns we identified at the last inspection in May 2012. At our last visit to the service we spoke to some people using the service. Everyone we spoke with gave us positive feedback about the care they were receiving. Therefore, we did not seek further feedback from people using the service during this review.

We spoke with some of the people living at Berrycroft Manor, some relatives and some of the staff who worked there. We were told that people were happy to be living or working at the home.

Some of the comments from people living at Berrycroft Manor included:

“I am very fussy and I like things done properly and the staff do it as I like.”

“I get on very well with the staff. “

“I can do what I want.”

The staff ask what I want to do.”

“I am very well looked after, the staff are very kind to me.”

“I am quite happy here, I have everything I need.”

“There is always something to do.”

“The food is very good.”

“I like the food and there is always a cup of tea if you want one.”

Some of the comments made by staff included:

"The residents living here are always respected."

“People here are treated with the utmost respect.”

"Of course people get choices."

"People’s needs are met to the highest degree.”

“Staff know the residents as individuals and nothing is too much trouble.”

“We have loads of things for people to do like trips out as well as activities in the home.”

Some of the comments made by relatives included:

“The staff know our relative “Very well and respond to her personal preferences.”

“We were involved in the care plan and we discussed her personal likes and dislikes.”

“We are very happy with the care ‘X’ gets.”

“’X’ is very well looked after.”

“It puts our minds at rest knowing she is safe here.”

“’X’ always looks nice, clean, smart and she has her nails and hair done.”

As part of this review process we saw a draft report following a visit to the service from Stockport Local Involvement Networks (LINks). LINKs are groups of individual members of the public and local voluntary/community groups who work together to ensure that health and social care services are planned and delivered to meet the needs of the people that use them. No concerns were raised in the report.

People told us

“The home is absolutely fine”,

“The care is wonderful”,

“There is always something happening”,

“Staff are very good”

People felt that staff had the skills to care for them properly. “They are never too busy to stop and talk”.

People felt encouraged to maintain their independence and one person told us their mobility had improved whilst living at the home.

People said they liked the home and were content.

This inspection was carried out over two days on 7 and 8 September 2015. Our visit on the 7 September 2015 was unannounced.

Berrycroft Manor was last inspected in April 2014. At that inspection we found that the service was meeting all the regulations we assessed.

The inspection of this service was brought forward following concerns raised at a Coroner’s Inquest in June 2015. Prior to this inspection we received a copy of the

coroner’s Regulation 28 report and the homes action plan in response to that. As part of this inspection we wanted to check the homes action plan had been implemented. We saw that the action plan had been fully implemented. This meant the provider had actioned the concerns raised in the coroner’s report to minimise risk to people living at Berrycroft Manor.

Berrycroft Manor is a purpose built care home and does not provide nursing care.

The home is registered to provide accommodation for a maximum 78 people. The home is set out over three floors and has six suites. The ground floor comprises of Logan Suite, which provides support for people who are living with dementia and Rose Suite for people who require personal care. On the first floor there is Bramble Suite supporting people living with dementia and the intermediate care unit which provides rehabilitation for people requiring a period of recuperation, usually following a hospital admission. On the second floor there is Mulberry Suite supporting people living with dementia and Tayberry Suite for people who require support with personal care. All rooms are single and have en-suite facilities.

A Registered Manager was 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.

Concerns about the home which were identified at a Coroner’s Inquest in June 2015 had been addressed and actioned

We saw medication administration was managed safely and tablet checks for boxed medication was accurate.

Staff we spoke with had a clear understanding of whistle-blowing and safeguarding vulnerable people procedures and knew they could contact people outside of the service if they felt their concerns would not be listened to or taken seriously.

We saw the home was clean, tidy and furnished to a high standard.

The garden areas were well maintained. They were safe and accessible to people living at Berrycroft Manor.

We saw staff treated people with kindness, and respected people’s privacy and dignity.

Information seen in the four care records we looked at indicated that referrals had been made to the appropriate health care services and health and social care professionals when changes became apparent in a person’s health needs.

Those care records we saw contained enough information to guide staff to deliver the care and support required by people who used the service.

The atmosphere in the home felt calm, relaxed and friendly.