Philiphaugh Manor

Risks were identified and mitigated, and staff supported people to safely mobilise. Pressure relieving mattresses were set correctly, and bath hoists had been repaired.

Staff had not consistently documented incidents that had occurred, and accident audits were not comprehensive. We have made a recommendation in relation to these issues.

There were now systems in place to provide staff with guidance on how and when to use 'as required' medicines and people had been appropriately supported with medicines in tablet and liquid forms. However, further improvements were required in relation to medicines systems and records. One person had run out of a prescribed cream and this issue had not been promptly resolved. In addition, notes had not been maintained on the effectiveness of PRN medicines and there was no system in place to record where patch-based medicines had been applied to people's bodies.

Recruitment practices were safe and there were enough staff to meet people's needs. The service had experienced some recruitment challenges and as a result was operating at reduced capacity to ensure people's needs could be met by the available staff.

Staff training had not been regularly updated to ensure all staff had the skills necessary to meet people's needs. In addition, staff new to the care sector had not been supported to complete the care certificate. Staff understood how to report safety concerns within the service and records showed the manager had appropriately raised safeguarding issues with the local authority.

Water pressure issues had been resolved and the decor in bathrooms upgraded. However, both bathrooms were noticeably cold on the day of the inspection and there was no heating available in one bathroom. Records showed people had not been regularly offered opportunities to bathe or shower contrary to people's identified needs and preferences.

People were supported to have maximum choice and control of their lives and staff supported them in the

least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. Systems to record people's consent for photographs had been introduced and there were systems in place to assess people's capacity to make specific decisions.

Issues in relation to damaged carpets and malodourous furniture had been resolved and clutter in the manager's office had been cleared. A new maintenance person had been employed and prompt action was taken to address a maintenance issue identified during the inspection.

People were well supported at mealtimes and told us they enjoyed the food provided. The oven was working correctly, and kitchen staff understood people's needs and preferences.

People's care plans had been updated since the last inspection. However, these documents lacked clear guidance on how to meet people's specific and individual support needs. In addition, care plans for people who had moved in recently contained only limited life history and background information.

People were comfortable in the service and told us they were safe. Staff offered support promptly when required and people requested assistance without hesitation. Relatives and visiting professionals were also complimentary of the services performance.

People's care plans were now stored securely in a locked room when not in use. However, some staff did not know how to access these records.

The service does not have a registered manager. The service's manager was supported by 2 duty managers and the roles and responsibilities of each manager were now well defined.

The provider's quality assurance systems were not effective as they had failed to ensure compliance with the regulations and identify that some management tools were being used incorrectly.

For more information, please read the detailed findings section of this report. If you are reading this as a separate summary, the full report can be found on the Care Quality Commission (CQC) website at www.cqc.org.uk