Sutton Manor is a care home. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Sutton Manor provides accommodation with personal and nursing care for up to 38 older people. At the time of our inspection 26 people were living in the home.

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.

At the last inspection, in June 2016, the service was rated overall as good, in the key questions: is the service effective, caring, responsive and well-led. The key question: is the service safe, was rated as requires improvement.

We carried out a comprehensive inspection on 9 January 2019. At this inspection, we found improvements had been made following the last inspection. We rated the key questions: is the service effective as outstanding. We rated the key questions: is the service safe, caring, responsive and well-led as good.

The service overall, remains good.

Sufficient numbers of staff were deployed throughout the home. Staff performance was monitored. Staff received supervision, training and support in a variety of ways to ensure they could meet people’s needs.

Medicines were safely managed and robust checks were in place to identify and take actions when shortfalls were identified.

Staff demonstrated a good understanding of safeguarding and whistle-blowing and knew how to report concerns.

People were helped to exercise support and control over their lives. People were supported to consent to care and make decisions. The principles of the Mental Capacity Act (MCA) 2005 had been followed.

Risk assessments and risk management plans were in place. Personal care was delivered in line with assessed needs and accurate monitoring records were maintained. Incidents and accidents were recorded and showed that actions were taken to minimise the risk of recurrence.

The management team worked collaboratively with external professionals to make sure care and treatment, was highly effective. They followed recognised national best practice guidance and initiatives that supported people to live healthier lives.

People received exceptional levels of support to meet their fluid and dietary requirements. Preferences, needs, likes and dislikes were recorded and actions were promptly taken to support those identified at risk of malnutrition or dehydration.

Staff were kind and caring. People were being treated with dignity and respect and people’s privacy was maintained.

Care was personalised, highly responsive and sensitive to individual needs.

A range of leisure activities were offered and provided people with entertainment and engagement, in and out of the home.

Systems were in place for monitoring quality and safety. Where shortfalls or areas for further improvements were identified these were acted upon.

Everyone we spoke with or had feedback from was positive about the way the service was run and said the registered manager was readily available. Communication was good. Staff were motivated in their work and proud of the service.

This inspection took place on the 17, 20 and 21 June 2016 and was unannounced. Sutton Manor Care Home provides nursing and personal care for up to 38 older people including those who have a sensory impairment or physical disability. At the time of our inspection there were 30 people living in the home.

The home is located is Sutton Scotney on the outskirts of Winchester and is situated within private parklands and gardens. People were accommodated in single rooms or suites with en suite facilities. Communal areas included; a drawing room, library and dining room.

The home has a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 the staff we spoke with demonstrated their understanding of how to safeguard people and report their concerns. People were protected from the risk of abuse.

People had risk assessments in place that detailed their individual areas of risk and how these should be managed to keep people safe. Risk management plans were not always evident for people who were assessed as at risk of falls. Falls were not routinely monitored to identify any developing trends so that remedial actions could be identified. Accident and incident reports did not always identify the actions to be taken to prevent a reoccurrence. This meant the system in use to review, manage and monitor the risks to people from falls was not consistently applied and could leave people at risk from recurring falls.

There were processes in place for the safe ordering, storage and disposal of medicines and medicines were administered to people by trained staff. It was not evident that reviews had taken place to evaluate the safe regular use of medicines that were prescribed to be taken ‘as required’. We found some unexplained gaps in the recording of people’s medicines. The registered manager took action to address these issues following our inspection.

There were sufficient levels of suitably skilled staff available to meet people’s needs. Agency staff were checked for their suitability to work with people and as far as possible the same agency staff were used to provide a continuity of care for people.

Staff completed an induction into their role to ensure they were competent to carry out their responsibilities. Staff were supported by the registered manager, group trainer and senior staff through a range of training courses, regular supervision and annual appraisal to develop the skills and knowledge they needed to meet people’s needs. Records showed staff had completed most of the provider’s mandatory training and were supported with their continuing and professional development.

The registered manager had identified a number of people who they believed were being deprived of their liberty and had made applications to the supervisory body for authorisation. Staff understood the principles of the Mental Capacity Act 2005 (MCA 2005) and people’s consent was sought prior to care and treatment being provided. People rights under the MCA were upheld.

People were offered choice by staff regarding the support they required and where people had made decisions, these were respected by staff. Staff were knowledgeable about people’s preferences and acted to ensure these were met.

People were supported with their nutrition and hydration needs and where people required assistance with eating and drinking this was provided. People told us and we observed the food was good quality and people were offered choice to meet their dietary needs and preferences.

People’s healthcare needs were attended to promptly and people were seen by a range of healthcare professionals as required.

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