About the service:

Manor Lodge provides personal care and accommodation for up to 15 people with mental health support needs and physical disabilities. At the time of our visit nine people were using the service.

People’s experience of using this service:

People who used the service were protected from the risk of abuse because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening. Risks associated with people's care and support had been assessed.

There was a policy and procedure about safe administration of medicines. People were supported to take their medicines in the way they wanted. Systems were in place for the monitoring and prevention of infection.

The provider had effective recruitment and selection processes in place. There were enough staff to meet people’s needs. Staff received appropriate professional development and were knowledgeable about their roles and responsibilities.

People’s needs were assessed and care and support were planned and delivered in line with their individual care needs. People were supported to maintain good health and to access health care services and professionals when they needed them. They had a programme of activities in accordance with their needs and preferences.

Staff understood their responsibilities in relation to consent and supporting people to make decisions. People were able to make choices about their care and their views were taken into account. Staff knew people well and interacted with them in a professional manner. They treated people with kindness and encouraged them to do as much for themselves as possible.

People and their relatives were comfortable raising any concerns with the management team or with a member of staff if something was wrong. The management team had good links with a number of health and social care professionals and this helped to ensure people’s needs were fully met.

The provider had systems in place to check and monitor the quality of the service provided. The registered manager demonstrated a good understanding of their role and responsibilities. Appropriate notifications were always made to us when required. People, relatives and staff spoke positively about the management of the service.

Rating at last inspection:

Requires Improvement (report published 17 March 2018).

Why we inspected:

This was a planned inspection based on the rating at the last inspection. At the last inspection 12 February 2018, the service was rated as requires improvement. We asked the provider to take action to make improvements regarding the administration of medicines to people. Staff were not following the prescribed administration time or reading the instructions on the medicine charts before they administered medicines to people and this could put people at risk. We also asked them to improve the system for monitoring how people received their medicines. During this inspection we found the actions have been completed.

Follow up:

We will monitor all intelligence received about the service to inform the assessment of the risk profile of the service and to ensure the next planned inspection is scheduled accordingly.

For more details, please see the full report which is on CQC website at www.cqc.org.uk.

This inspection took place on 12 February 2018 and was announced. At our last inspection in July 2015, we found the provider was meeting the regulations we inspected and the service was rated “Good”. At this inspection, we found improvement was needed regarding the management of medicines and how this was monitored. We made a recommendation about following best practice guidelines for administering medicines.

Manor Lodge 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 service provides personal care and accommodation for 15 people with mental health support needs and physical disabilities. At the time of our visit 11 people were using the service.

There was a registered manager in place. 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 were trained in the administration of medicines. However, they were not following the prescribed administration time or reading the instructions on the medicine charts before they administered medicines to people. This could have a negative impact on people’s health.

There were systems in place to manage, monitor and improve the quality of the service provided. However, the system for monitoring how people received their medicines was not effective and this put people at risk.

Survey results from people and their representatives were positive and any issues identified were acted upon. People and their representatives were able to raise concerns or complaints if they needed to.

People and their relatives felt the service was safe. The provider had systems in place to protect people from the risk of harm. Staff knew how to identify abuse and had appropriate information to report any concerns. The risks associated with people’s support were assessed, and measures put in place to ensure staff supported people safely.

There was a recruitment system in place that helped the provider make safer recruitment decisions when employing new staff. People were cared for by sufficient numbers of suitably qualified, skilled and experienced staff. Staff received a structured induction at the beginning of their employment and received on-going training whilst working for the provider.

People’s needs were assessed and care and support was planned and delivered in line with their individual care needs. People or their representatives had been involved in writing their care plans.

People were encouraged to do as much for themselves as possible. Staff were knowledgeable about the people they cared for. They were treated with kindness and respect.

The requirements of the Mental Capacity Act 2005 (MCA) were in place to protect people who may not have the capacity to make decisions for themselves. Staff had a good understanding of how to support people who lacked capacity to make decisions.

People were supported to have meals that met their needs and choices. The registered manager worked closely with other health professionals to ensure the needs of people were fully met.

The registered manager was clear about their responsibilities and accountabilities. There was an open culture that put people at the centre of their care and support. Staff had a clear understanding of what was expected of them.

This inspection took place on 22 July 2015 and was unannounced. This was our first inspection since the service was registered with us in August 2014.

Manor Lodge is registered to provide care to up to 15 people with mental health support needs and physical disabilities. At the time of our visit six people were using the service.

There was a registered manager in place. 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.

We found staff understood their responsibility to safeguard people and the action to take if they were concerned about the person's safety.

Care plan contained detailed risk assessments. Measures to reduce the risks were detailed and easy for staff to read and follow. Staff followed procedures to reduce the risk and spread of infection.

People's rights were protected because the requirements of the Mental Capacity Act 2005 (MCA) code of practice and Deprivation of Liberty Safeguards (DoLS) were followed when decisions were made about the support provided to people who were not able to make important decisions themselves. People and their representatives were supported to make informed decisions about their care and support, and information was presented in ways they could understand to facilitate this.

People’s care was planned and delivered in ways that met their needs, and support changed when people’s needs or preferences changed. People were offered of a choice of food and drinks and their dietary needs were catered for.

People were supported to stay healthy and were referred to the appropriate health and social professionals as required. People's medicines were managed safely.

People were encouraged to do as much for themselves as possible. Staff were knowledgeable about the people they cared for. Relatives gave positive feedback about the caring and friendly manner of all the staff. People’s privacy and dignity were respected. We saw people were relaxed with staff who were supporting them.

The service had effective recruitment procedures. Staff told us they felt trained to carry out their role.

Systems were in place to monitor the quality of the service. The registered manager and staff carried out regular checks and audits on all aspects of the service. Staff and people who used the service felt free to raise concerns and report any issues, and feedback resulted in learning for the service. People’s feedback was valued.

People and their relatives spoke positively about the service and the way it was managed and run.