Manorfields Residential Care Home is a residential care home that was providing personal care to 34 people at the time of the inspection.

People’s experience of using this service:

People told us they felt safe living at Manorfields Residential Care Home. The risks to people had been assessed and where appropriate some relatives had been involved in compiling and reviewing care plans. Staff had an intimate knowledge about the range of people’s needs. People were supported with their medicines in a safe way. People accessed healthcare services when they needed them, and they were supported to eat and drink enough to remain healthy.

People were involved in making decisions about their care and support and their consent about the care and services offered was obtained. People were supported by a staff team who were kind and caring and treated them in a considerate and respectful manner.

Recruitment checks had been carried out to ensure staff were suitable to work at the service. Training relevant to people’s support needs had been undertaken by staff. The staff team felt involved in the running of the home and were supported by the registered manager and management team.

There were systems in place to monitor the quality and safety of the service being provided. People’s views of the service were sought through meetings, surveys and informal chats. A complaints procedure was in place and people knew what to do if they had a concern of any kind.

The registered manager understood their roles and responsibilities as a registered person. They worked in partnership with other agencies to ensure people received care and support that was consistent with their assessed needs.

More information can be found in the detailed findings below.

Rating at last inspection: The home was rated Good at the last inspection in December 2017.

The service met the characteristics for a rating of “good” in all the five key questions we inspected. Therefore, our overall rating for the service after this inspection was “good”.

Follow up: We will continue to provide ongoing monitoring of this service.

This inspection took place on 16 and 17 October 2017 and was unannounced.

We last inspected this service in September 2015 and found the service to be meeting the regulations, although there was no registered manager in post at the time of our inspection.

Manorfields Residential Care Home provides accommodation and care for up to 40 older adults, many of whom are living with dementia. At the time of our inspection there were 28 people using the service.

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 told us they felt safe with staff and relatives felt their family members were safe. There were enough staff on duty during our inspection visits to meet people's needs. However, staff and some relatives told us there were times when the service was short-staffed and staff were rushed. We asked the registered manager to review how staff were deployed and their response to short-notice staff absence to ensure there were always sufficient staff to meet people's needs.

The risks people were exposed to had been assessed and staff demonstrated they knew how to keep people safe. Some improvements were needed to risk assessments as records did not always reflect people's current needs or changes in risks. Some risk assessments were not personalised to the individual.

Staff were safety recruited to help ensure they were suitable to work in a care setting. They were trained in safeguarding and knew what to do if they had concerns about the well-being of any of the people using the service.

The provider had made improvements to the way in which people's medicines were managed to ensure people were supported to take their medicines safely. People received their medicines when they needed them.

Staff were well-trained and skilled in meeting the needs of people. They were knowledgeable about the people they supported. Staff felt they received good support, and guidance from managers to enable them to provide effective care.

Staff recognised their responsibilities to support people with decision making in line with Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS). Staff sought consent from people to their care and respected people's right to decline care. Records did not always support that staff were complying with conditions with DoLS.

The provider was in the process of undertaking an upgrade of the premises to improve the facilities and décor for people.

People were supported to have sufficient to eat and drink in line with their preferences and needs. Staff encouraged people to eat healthily whilst respecting people's right to choose what they ate.

People had their health needs assessed and care plans put in place to meet their needs. People were supported to access a range of health professionals to help them to maintain their wellbeing.

The staff were caring and kind and genuinely enjoyed their work. The atmosphere within the service was welcoming and calm, with staff spending time chatting with people, providing reassurance when needed and being attentive to people's needs.

Staff got to know people by being introduced to them, spending time with them, reading care plans and speaking with relatives. Staff knew people well and used the information they had about people's preferences to tailor their care and support. Some care records were not up to date and did not reflect changes in people's needs. The registered manager was in the process of reviewing and updating care plans and records.

People were supported to take part in one-to-one or group activities. People could choose how they wanted to spend their time and this was reflected in their care plans.

The

The inspection took place on 30 September and was unannounced.

Manorfields is registered to provide care for up to 40 older adults. They specialise in dementia care. At the time of our inspection there were 36 people living at the service.

Accommodation is provided over two floors. There is a lift and a stair lift available to the first floor.

There was no registered manager in post. An acting manager was covering this position. 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 told us that they felt safe at the service, and were happy living there. Staff had a good understanding of how to safeguard people and protect them from abuse.

There were sufficient numbers of suitably trained staff to meet peoples needs. We saw risk assessments in place in people’s plans of care to promote their safety. Staff were aware of how to respond to emergencies.

We saw that people received their medication in a timely and safe manner, administered by staff who were trained in the administration of medication.

People were offered choices with food and drinks and appropriate support was given when needed.

The manager and care staff understood the principles of the Mental Capacity Act 2005 (MCA), and supported people in line with these principles. This included staff seeking consent from people before delivering care.

Referrals were made to other healthcare professionals in a timely manner to meet their health needs.

We saw staff positively engaging with people living at the service and staff encouraged people to participate in activities.

Our observations showed that people were treated in a caring manner, and with dignity and respect.

Care plans were individualised, and reflected people’s care and support needs. The care plans included information about people’s life histories, interests and likes and dislikes which provided staff with sufficient information to enable them to provide care effectively.

People knew how to make complaints, and these were responded to in a timely manner.

There were systems in place to check the quality of the service provided. The manager sought regular feedback from people living at, and visiting the service.

This inspection took place on 19 November 2014 and was unannounced.

Manorfields provides care for up to 40 older people. Accommodation is provided over two floors and people’s bedrooms and communal bathroom facilities are available on each floor. People can access the garden. There are two stair lifts available to the first floor. At the time of our inspection there were 37 people living at the service and three people were in hospital. Some of these people were living with dementia.

For the past year a registered manager from another service in the provider’s group was providing manager cover at Manorfields as there was no 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. The manager told us that they were intending to apply for registration with us at this service, however we are yet to receive an application.

At the last inspection on 22 January 2014 we found a breach in regulations relating to meeting people’s nutritional needs. The provider sent us an action plan outlining the improvements they would make.

At this inspection we found that some improvements had been made. However some people who had been assessed as requiring support during meal times were left unsupervised.

People told us that they were happy with the service they received and that they felt safe there. Staff had a good understanding of how to safeguard people.

There were sufficient numbers of suitably recruited staff and most people received their medicines as prescribed.

People were provided with a living environment that was, overall, clean. However, there was on occasions unpleasant odours that needed to be addressed.

Staff were well supported and had put into practice the training they received that was essential to their role. Referrals were made to other healthcare professionals when people’s healthcare needs changed.

People told us that staff were kind and helpful towards them and that their privacy and dignity was respected. Staff had a good understanding of people’s care needs and preferences about the way in which they preferred their care to be delivered. However, we noted that one person did not always receive support that met their needs. Communication between the staff team and people who lived at the service was good.

The manager and care staff understood the principles of the Mental Capacity Act 2005 (MCA), and supported people in line with these principles. This included staff seeking consent from people before delivering care.

People had opportunities to put forward their suggestions about the service they received and how the service was run. This included ideas for social activities and we saw that people’s suggestions were acted on. People knew how to raise complaints and these were responded to in a timely manner.

The provider had systems in place to check the quality of the service provided.

We spoke with seven people who used the service. People living at the home told us about their care provided. One person explained, “I like it here. The care workers are very good. They help me when I need them”.

Most relatives felt listened to and told us they were generally happy with the care and service. The provider had a system in place for relatives to use if they had any concerns.

We saw food charts were not always completed accurately and inconsistencies in the way people’s weight had been recorded, from stones to kilograms. This meant that people could lose further weight before staff realised and acted on this.

We saw equipment was available to support people’s mobility so that they could remain independent.

We saw the recruitment procedure for staff members had been followed and appropriate checks were undertaken before staff began work. This meant that people could be assured that they were cared for by suitable staff.

There were systems in place to review the quality of the service provided.

We visited Manorfields Residential Care Home to follow up two areas of non compliance from our previous visit. We did not speak with people who used the service during this visit, although we spoke with manager, a number of care workers and reviewed records.

We found care records had been updated and rewritten, taking into account people's preferences and input from families, wherever possible. We saw efforts had been made to write care plans in a person centred way (this means written from the point of view of the person, stating support and assistance they need from care workers).

We saw people and their representatives had been asked for their views about the service in July 2012. The information from the completed surveys had been reviewed and an action plan developed to address any issues developed. We were told other systems to check the quality of the service, such as medication audits and care plan audits had been or were due to be introduced.

We spoke with six people who used the service. Not everyone we spoke with was able to share their views about the service. We also used the Short Observational Framework for Inspection (SOFI). The SOFI tool allows us to spend time watching what is going on in a service and helps us to record how people spend their time and whether they have positive experiences. This includes looking at the support that is given to them by the staff.

We spoke with one person who preferred to spend their time in their bedroom. The only issue this person raised about living at Manorfields Residential Care Home was about the meals, which they described as bland. They told us they were not offered condiments with their meals. They also told us the care workers ‘pop in’ to speak with them during the day.

One person spoken with told us care workers were good and polite and respectful when they provided care and support.