About the service: Stanton Manor is a residential care home that was providing personal care to people aged 65, people living with dementia or people with mental health needs. They were registered to provide care for 29 people and there were 28 living at the home when we visited. The accommodation consists of a large house with communal areas and a smaller home in the grounds where 8 people live.

People’s experience of using this service:

The service met the characteristics of good with outstanding in caring.

People received extremely caring and kind support from staff who kept their dignity at the centre of all interaction. They were partners in their care and encouraged to make decisions about this. When they were less able to verbalise, the staff used their extensive knowledge of people’s personal histories to support them how they would have chosen. They embraced family and advocate support and input into the care provided. Their priority was ensuring that people were happy and respected in their home.

People continued to receive safe care. There were enough staff to support them and they were recruited to ensure that they were safe to work with people. People were protected from the risk of harm and received their prescribed medicines safely. Lessons were learnt from when mistakes happened.

The care that people received continued to be effective. They 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 received training and support to be able to care for people well. They ensured that people were supported to maintain good health and nutrition; including partnerships with other organisations when needed. The environment was adapted to meet people’s needs.

People were able to get involved in activities and pursue their interests. Staff knew them well and understood how to care for them in a personalised way. There were plans in place which detailed people’s likes and dislikes and these were regularly reviewed. People knew how to raise a concern or make a complaint and the registered manager responded to any complaints in line with the provider’s procedure.

The registered manager was approachable and there were systems in place which encouraged people to give their feedback. There were quality structures in place which were effective in continually developing the quality of the care that was provided to them.

More information is in the full report.

Rating at last inspection: The service was last inspected on 14 June 2016 and was rated good.

Why we inspected: This was a scheduled inspection based on the date the service was registered.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.

We inspected Stanton Manor on 14 June 2016 and it was unannounced. Stanton Manor provides accommodation and personal care for up to 29 people, some of whom are living with dementia. The accommodation is provided in a main building and eight people live in a separate mews. There were 29 people living at 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.

Stanton Manor was last inspected on 24 October and 1 November 2013 and they were not meeting standards around management of medicines and consent to care and treatment at that time. At this inspection, we saw that there were improvements made in medicines management and there were now systems in place to reduce the risks associated with them. They were administered to meet individual needs and were stored securely. The provider was ensuring that people consented to their care and that if they were unable to do this, then appropriate capacity assessments were made and decisions were made in their best interest.

Staff received training and support to enable them to fulfil their role effectively and were encouraged to develop their skills. They understood their responsibilities to detect and report abuse. People told us that there were always enough staff to meet their needs promptly and that they felt safe. They were supported to maintain good health and had regular access to healthcare professionals. Their care plans were regularly reviewed to correspond with changing support needs and they were personalised and accessible.

The provider had systems in place to assess risk, actions were put in place to reduce it and their effectiveness was monitored and regularly reviewed. There were systems in place to drive quality improvement which included regular audits, developing the staff team and working closely with relatives.

Staff developed caring relationships with the people they supported which were respectful and patient. They knew people well and provided care that met their preferences and they had developed communication systems to help them to make choices. People’s privacy and dignity were maintained at all times.

Mealtimes were not rushed and people were given a choice of meal. We saw that food and drink was regularly provided and records were maintained for people who were nutritionally at risk.

People were encouraged to pursue interests and hobbies and regular activities were planned. Visitors were welcomed at any time. People knew the manager and felt confident that any concerns they raised would be resolved promptly. The provider completed quality audits to continually drive improvements.

We were supported on this inspection by an Expert by Experience. This is a person who has personal experience of using or caring for someone who uses this type of care

service.

People told us they were happy with the care and support provided. One person said “They help me to wash and dress, the staff are very nice.” Another person told us “They are always very good to me here.” Care workers were attentive to people’s needs. We observed care workers offer reassurance a number of people who were anxious.

People told us care workers supported them to remain as independent as possible, but provided support where required. One person told us when asked about personal care “I more or less do it myself but they help if not well.” Another person who needed more support told us “It’s very nice here, I just sit here and watch films and don’t bother. I get up when staff come in and they wash and dress me and I go back when they fetch me at night, I just go with the flow.”

Other people told us the routine was relaxed and they had a choice about what they got up and went to bed. One person told us “I get up at 7 am and I do to bed when I want, depending on what is on the television.”

People told us the food was very good and they enjoyed the meals. One person told us “The food is always good here, lunch was lovely and they can always come up with something I like.” Another person said “Breakfast is really nice, I usually have cornflakes and cooked breakfast, only bacon and eggs mind, and not every day, but I could if I wanted.”

We asked people if there were any activities they could join in with. One person told us they liked to join in with some activities, and we then observed this person enjoying painting with the activity co-ordinator. Another person told us “Activities – we don’t do much – mainly eat and sleep. I would like to play dominoes and exercise.” However, when we looked into this further, we saw that this person had been offered both options and had chosen not to join in, preferring to spend time their room watching television. Another person told us about going out to the local town shopping, doing puzzles and the Easter bonnet competition.

People we spoke with confirmed that they were happy with the care they received. One person told us the staff were kind, and another said staff treated them well, and ‘would do anything for you.’ Relatives we spoke with told us that they were very happy with the care their family member received.

We saw that people made decisions about their daily lives. However, there was no reference to whether people had capacity and mental capacity assessments had not been completed for those people who did not.

People did not receive their medication as prescribed and medication was not always kept safe.

People told us there were sufficient staff on duty to meet their needs. We saw that staff had received appropriate training to meet the needs of the people at the service.

We saw that a complaint procedure was in place and complaints had been managed appropriately.