Lathbury Manor Care Home 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. The home is registered to accommodate 23 older people; at the time of our inspection, there were 23 people living in there.

At our last inspection in April 2017, this service was rated overall as requires improvement. At this inspection, improvements had been made and sustained and the service is rated overall good. The inspection took place on the 23 April 2018 and was unannounced.

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.

People received care from staff that knew them and were kind, compassionate and respectful. The staff were friendly, caring and passionate about the care they delivered. People had formed positive therapeutic relationships with staff and felt they were treated as individuals.

Detailed care plans were in place, which enabled staff to provide consistent care and support in line with people’s personal preferences and choices. End of life wishes were discussed and plans put in place.

People were cared for by staff who were respectful of their dignity and who demonstrated an understanding of each person’s needs. This was evident in the way staff spoke to people and the activities they engaged in with individuals. Relatives spoke positively about the care their relative received and felt that they could approach management and staff to discuss any issues or concerns they had.

Staff were appropriately recruited and there were sufficient staff to meet people’s needs; staffing levels were kept under review. People were protected from the risk of harm and received their prescribed medicines safely. Staff understood their responsibilities to keep people safe from any risk or harm and knew how to respond if they had any concerns.

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 home supported this practice. There was a variety of activities available for people to participate in if they wished to and family and friends were welcomed to take part in events at the home.

Staff understood the need to undertake specific assessments where people lacked capacity to consent to their care and / or their day-to-day routines. People’s health care and nutritional needs were carefully considered and relevant health care professionals were appropriately involved in people’s care.

Staff had access to the support, supervision and training that they required to work effectively in their roles. Development of staff knowledge and skills was encouraged.

The service had a positive ethos and an open culture. The provider was committed to develop the service and actively looked at ways to continuously improve the service. There were effective quality assurance systems and audits in place; action was taken to address any shortfalls.

People knew how to raise a concern or make a complaint and the provider had implemented effective systems to manage any complaints that they may receive.

This inspection took place on 17 February 2017 and was unannounced.

This was the second comprehensive inspection carried out at Lathbury Manor Care Home.

Lathbury Manor Care Home provides care and support for up to 23 older people with a wide range of needs for personal care and support. This includes people who may be living with dementia. There were 22 people using the service when we visited.

The service had a registered manager. However they were on sick leave on the day 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.

Recruitment practices were not robust and had not been consistently followed to ensure staff employed were suitable for their role. We observed that essential employment checks for some staff had not been obtained.

Records management was disorganised and records were not always fully completed. Some relatives felt that communication at the service did not keep them fully informed.

Staff had been provided with safeguarding training to enable them to recognise signs and symptoms of abuse and how to report them. There were risk management plans in place to protect and promote people’s safety. There were adequate numbers of staff available to meet people's fundamental care needs. People’s medicines were managed safely by staff that were trained to do so.

Staff received regular training that provided them with the knowledge and skills to meet people’s needs. They felt they were well supported by the management team and had regular one to one supervision and annual appraisals. Staff sought people’s consent before providing any care and support. They were knowledgeable about the requirements of the Mental Capacity Act (MCA) 2005 legislation. People were supported by staff to eat and drink enough to meet their dietary needs and to promote healthy eating. Staff supported people to access healthcare services.

People were treated with kindness and compassion by staff; and had established positive and caring relationships with them. People were able to express their views about their day to day routines. Staff ensured people’s privacy and dignity was promoted.

People’s needs were assessed prior to them receiving a service. Some people’s care plans did not contain information about their likes, dislikes and preferences. We were informed that this was being added as each person’s care was reviewed and 50% had been completed the time of our inspection. The service had a complaints procedure to enable people to raise a complaint if the need arose. Quality assurance systems in place to monitor the quality of the care provided.

During this inspection we identified areas where the provider was not meeting expectations and where they had breached a Regulation of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.

This inspection took place on 31July 2015 and was unannounced.

At our previous inspection on 11 March 2015, we found that personal records were on display which meant people could not be confident that information about them was treated confidentially and respected by staff.

After the comprehensive inspection, we undertook this focused inspection to check that the provider had made improvements.

This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection, by selecting 'all reports' link for ‘Lathbury Manor Care Home’ on our website at www.cqc.org.uk’

Lathbury Manor Care Home provides care and support for up to 23 older people with a wide range of needs for personal care and support. This includes people who may have dementia. There were 22 people using the service when we visited.

The service had a registered manager. 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.

During this inspection, we found that there were suitable arrangements in place for the safe and secure storage of people’s personal records.

Information about people was treated confidentially and respected by staff.

This inspection took place on 10 March 2015 and was unannounced.

Lathbury Manor Care Home provides care and support for up to 23 older people with a wide range of needs for personal care and support. This includes people who may have dementia. There were 22 people using the service when we visited.

The service had a registered manager. 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.

People were protected from abuse and felt safe. Staff were knowledgeable about the risks of abuse and reporting procedures. There were appropriate numbers of staff employed to meet people’s needs and safe and effective recruitment practices were followed.

There were suitable arrangements in place for the safe management of medicines.

Staff received appropriate support and training and were knowledgeable about their roles and responsibilities. They were provided with ongoing training to update their skills and knowledge to support people with their care and support needs.

People’s consent to care and treatment was sought in line with current legislation. Where people’s liberty was deprived, Deprivation of Liberty Safeguards [DoLS] applications had been approved by the statutory body.

People were supported to eat and drink sufficient amounts to ensure their dietary needs were met. Staff supported people to attend healthcare appointments and liaised with their GP and other healthcare professionals as required.

People were looked after by staff that were caring, compassionate and promoted their privacy and dignity. People’s needs were assessed and regularly reviewed. The service responded to complaints within the agreed timescale. People were supported to take part in meaningful activities and pursue hobbies and interests.

Personal records were on display which meant people could not be confident that information about them was treated confidentially and respected by staff.

We saw that people were encouraged to have their say about how the quality of services could be improved and were positive about the leadership provided by the registered manager. Effective quality assurance systems were in place to obtain feedback, monitor performance and manage risks.

We spoke with four people using the service and asked them about their experience of using the service. All of the people we spoke with confirmed they were pleased with the care they received; they told us the staff were friendly helpful and polite. They also told us they were treated with dignity and their privacy was respected.

During our visit we observed that staff spoke to people politely and asked for their consent before providing care and assistance. For example, we observed people being offered their medicines; the staff asked whether they needed any prescribed medicines for pain relief.

We looked at the care records for two people using the service. We found the care plans detailed the specific elements of people's care and treatment needs and staff had amended the care plans as and when changes were required.

We found that the provider operated effective recruitment procedures in order to ensure that staff employed at the service were of good character, had the qualifications, skills and experience necessary to their roles and responsibilities.

We found that the provider carried out annual quality assurance surveys to give people using the service, their relatives and other people involved in their care the opportunity to provide feedback about the service provision.

On the day of our visit there were 21 people using the service. We spoke with four people who all confirmed they were pleased with the care and the support they received at Lathbury Manor Care Home. We also spoke with three visitors who all confirmed they were very pleased with the care their relatives received.

People said the staff were friendly, helpful and polite, and their choices were respected. We saw the staff treated people with dignity and helped them to make their own choices.