This inspection took place on the 7 March 2017 and was unannounced. This means the provider did not know we were coming.

The Manor House, Gosforth is a 46 bed purpose built care home that provides personal care to older people, including people with dementia. Nursing care is not provided.

At the last inspection, the service was rated good. At this inspection we found the service remained good.

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 a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Systems were in place to protect people from avoidable harm or risk. Staff received safeguarding training and were knowledgeable about their role in ensuring people’s safety. Risks to people, staff and visitors were assessed and regularly reviewed. The service took action to minimise risks where appropriate in order to keep people safe from avoidable harm.

Robust recruitment processes were in place to ensure staff members were suitable to work with vulnerable people. Staffing levels were based on the dependency levels of people living at the home and were reviewed on a regular basis. Our observations during the inspection and from feedback we received were that staffing levels continued to be appropriate to safely meet people’s needs throughout the day and night.

Appropriate systems were in place for the management of people’s medicines. People were encouraged to maintain their independence, for example through retaining responsibility for managing their own medicines or self-care if possible. Medicines were stored and managed correctly by staff who were trained and monitored to manage this safely.

Staff were supported through the provision of role specific training, formal supervision and annual appraisals. Staff confirmed they felt well supported in their roles and spoke positively about the registered manager and their leadership and management of the home.

The service worked within the principles of the Mental Capacity Act 2005. People’s capacity to make decisions about their care and treatment was assessed and where appropriate, “best interest” decisions were made on people’s behalf. These involved relevant healthcare professionals as well as people’s friends and family members as appropriate.

People were very complimentary about the kind and caring nature of the staff team. Staff had developed strong, caring relationships with the people they supported and were very knowledgeable about their individual needs, likes and dislikes.

People’s needs were assessed prior to them joining the service. Detailed, person-centred care plans were produced which guided staff on how to care for people. These included details of any preferences people may have. People and their representatives were actively involved in their care planning and were also encouraged to voice their opinions about the service in general.

The services activities co-coordinator was noted for their pro-active approach. They had sought out a diverse range of alternative activities, for groups and for individuals. We noted they were passionate and original in their work and had made a number of improvements in a short time.

People’s needs were reviewed on an on-going basis and action taken to obtain the input of external professionals where appropriate. Systems were in place to ensure people had sufficient to eat and drink and to access other healthcare professionals in order to maintain good health.

A range of systems were in place to monitor and review the quality and effectiveness of the service. Action was taken to address what areas for improvement were identified. Complaints were taken seriously and records maintained of the action taken by the service in response to any form of diss

We found people were asked for their consent before care was delivered. People we spoke with told us they were able to choose how they spent their time. The provider had systems in place to support people who lacked capacity to make decisions.

People had their needs assessed and this information was used to develop personalised care plans. People told us they were happy with their care. People commented, “Marvellous, staff are very good”, and, “Staff are so friendly and accommodating.”

We found the provider, following a previous inspection, had taken action to reduce the risk of cross infection by improving staff practices with regard to hygiene and hand washing.

The provider had arrangements in place to ensure people received their medication when they needed it. Medication was only administered by trained and competent staff.

We found the provider had an effective recruitment process that made sure suitable staff were employed to care for people. One person commented, “Staff are careful and positive and respond if you need something.” One relative commented, “Staff are very good and respond quickly when called.”

People, and their relatives, told us they knew how to complain. None of the people we spoke with raised any complaints about the service. One person commented, “There is no need to complain the home is first class.”

We found the provider undertook a range of assessments to ensure people were protected from potential risks to their welfare. Where people were assessed to be at risk, appropriate action was taken to manage these risks.

The provider had made progress to improve the completion rates of a number of key areas of mandatory training. The provider had also made progress to implement a new induction process for new staff.

The provider had improved the accident and incident reporting procedures to provide relevant information for staff to learn from incidents.

We found that the quality of record keeping had improved and all records viewed during this inspection were completed to an appropriate standard.

During the day we spoke to a number of people living in the home. Comments included:

‘I am well looked after, staff are good to you.’

‘Never question what is for meals, never had a bad one`

‘More than happy here, lovely gardens.’

‘Pressed the buzzer and staff were there, even though I only wanted my television turned off`.

‘You will find nothing wrong here’.

This unannounced inspection took place on 31 December 2014. A second, announced day of inspection took place on 2 January 2015. The previous inspection, undertaken on 9 July 2013, found there were no breaches of legal requirements.

The Manor House Gosforth is a care home without nursing and provides accommodation and personal care for up to 46 people. At the time of the inspection there were 46 people using the service, some of whom were living with dementia.

The home had a registered manager in place, and our records showed she had been formally registered with the Care Quality Commission (CQC) since March 2013. A registered manager is a person who has registered with the 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 said they felt safe living at the home. Staff understood safeguarding issues and described to us what potential abuse might look like and how they would deal with it if they saw anything which concerned them.. Accidents and incidents were monitored and reviewed to identify and issues or concerns.

The registered manager told us each person who used the service had been assessed for their level of dependency and this information was used to determine the minimum staff number needed to run the home. In addition to this system they monitored people’s needs and staff feedback on the number of staff needed, and was able to show us when they increased the number of staff when necessary. Suitable recruitment procedures and checks were in place, to ensure staff had the right skills to support people at the home. Medicines were handled safely and effectively and stored securely.

People told us they were happy with the standard and range of food and drink provided at the home. People were given a choice about what they wanted to eat at each meal. Kitchen staff kept records regarding people’s individual dietary requirements and preferences.

People told us they felt the staff had the right skills and experience to look after them. Staff confirmed they had access to a range of training and updating. Staff told us, and records confirmed that regular supervision took place and that they received annual appraisals.

Mental Capacity Assessments had been completed in line with the requirements of the Mental Capacity Act 2005 (MCA). We also found the provider acted in accordance with the requirements of the Deprivation of Liberty Safeguards (DoLS). These safeguards aim to make sure people are looked after in a way that does not inappropriately restrict their freedom.

People told us they were happy with the care provided. We observed staff treated people kindly and were patient. Staff knew people well, and used their knowledge of people’s families and life histories to engage with them. Staff were able to tell us about people’s particular needs and how best to support them. People’s health and wellbeing was monitored, and staff regularly referred people to GPs and district nurses.

People were assessed against a range of potential risks, such as poor nutrition, falls, skin damage and mobility. Where other risks had been identified assessments had been carried out to ensure people received appropriate care.

Care plans reflected people’s individual needs and were reviewed to reflect changes in people’s care, as necessary. A range of activities were offered for people to participate in, both inside and out of the home. People and relatives told us if they had any concerns they would feel happy to discuss these with senior staff or the registered manager. People told us any issues they had raised had been dealt with quickly and to their satisfaction. Records had been kept of formal complaints, including information on investigations carried out and action taken in response to complaints.

Robust quality monitoring systems were in place which covered areas such as meetings, feedback and audits. All areas of the service were reviewed regularly.

The management and leadership arrangements in the service were good. People who used the service, their relatives and staff spoke highly of the registered manager and the organisation.