Manorfield Residential Home

Improvements were required to ensure medicines were managed safely specifically the processes for ordering, storage and disposing of medicines. However, there was no evidence of impact on people. People received their medicines safely, on time and in line with their preferences and prescribers’ instructions. People received safe care from staff who understood safeguarding responsibilities and knew how to protect people from harm and abuse. People, relatives and professionals consistently told us people felt safe living at the service. One person said, “There’s nothing to worry about. The staff are very kind.” There were enough safely recruited staff with the skills, knowledge and training to meet people’s needs safely and effectively. One person told us, “They seem to be able to answer all the questions I may have. Their training is good.” Risks were assessed with people and managed in a way that promoted people’s safety and independence. The provider learned from accidents, incidents and safety events to improve practice and drive service improvements. Relevant safety alerts were communicated promptly and appropriate action was taken. For example, government guidance issued during the recent extreme heat red alert was implemented to help keep people hydrated, safe and well. The environment was clean, accessible, well maintained and free from hazards. People consistently praised the cleanliness of the service, commenting, “It’s spotless,” and “It’s always clean.”

People can only be deprived of their liberty to receive care and treatment with appropriate legal authority. In care homes, this can be done through a procedure called the Deprivation of Liberty Safeguards (DoLS), which is part of the Mental Capacity Act 2005 (MCA). We checked whether the service was working within the principles of the MCA and how they managed DoLS within the service. We found that staff and management worked within the MCA. DoLS authorisations were appropriately applied for and overseen. People were not subject to unlawful or excessive restrictions they had choice, control and freedom over their lives. For example, keypads on the front door and gate prevented those who were not safe to leave independently from doing so. This enabled people to enjoy the care home and gardens safely. Processes were in place to ensure people who were not subject to legal restrictions could access exits independently.

People's needs were comprehensively assessed before and during their stay at the service, with assessments informing person-centred care plans that reflected people’s needs and personal preferences. One person told us, “They asked a lot of questions about what you need and like,” while another said, “It was a smooth transition, there were no issues.” Care was delivered in line with people's assessed needs and current good practice guidance, supporting people to maintain their health, independence and wellbeing. For example, a person described how staff encouraged them to maintain their mobility, saying, “I’m a bit lazy with it, but they make me walk with the walker. They come behind me with the wheelchair in case I need to sit down.” Staff worked effectively with health and social care professionals to monitor people's health and improve outcomes, including ensuring people had regular access to the local GP surgery, which provided daily telephone support to the service and weekly onsite visits. People were supported to make their own decisions and their rights around consent were respected. Where people lacked capacity to make specific decisions, staff followed the principles of the MCA, completed well-documented best interest decisions and involved families and relevant professionals to ensure people's wishes and preferences remained central to the care they received. Staff demonstrated a good understanding of supporting people with fluctuating capacity and more complex decision-making needs.

People were treated with kindness, dignity and respect by staff who had developed caring and compassionate relationships with them. We observed staff interacting with people in a warm, respectful and considerate manner, maintaining people's privacy and dignity while providing support. Staff encouraged people to remain as independent as possible and supported them to make choices about their care and daily lives. The environment had signage supporting people, including those living with dementia, to navigate the home independently. One person told us, “They encourage you to wash your own face and whatever. You don’t have to, but they encourage you to,” Another person said, “They ask if I want any help and if I do, they help me,” reflecting how people remained in control of the support they received. Relatives and professionals consistently described the service as warm and welcoming and spoke positively about the caring relationships staff had developed with people, recognising the personalised and respectful approach taken to support people's wellbeing.

People received person-centred care that reflected their individual needs, preferences and wishes, and they were actively involved in decisions about how their care was planned and delivered. A person said they were consulted when, “Things crop up when you need things changed.” Staff worked in partnership with people and, where appropriate, their families to review care and respond to changing needs, ensuring people remained at the centre of decision-making. The provider encouraged people and their relatives to share feedback, raise concerns and contribute ideas about the service, and people were kept informed about changes made because of their views. Staff worked proactively with healthcare professionals to promote people's physical health and wellbeing, helping to identify concerns early, reduce risks and improve outcomes. Care records demonstrated that people's progress and outcomes were regularly monitored, reviewed and communicated effectively across the staff team, ensuring people experienced consistent, equitable care that met their individual needs.

The service was well led by a visible and supportive leadership team who promoted a positive, open and inclusive culture where people, staff and visitors felt valued, listened to and welcomed. We received consistently positive feedback about the registered manager, with 1 person saying, “She’s a very pleasant person. Very caring and sincere,” and another commenting, “She’s very good. She’s nice. She comes here and has a chat with you. “Governance systems supported oversight of the service, while feedback, shared learning and reflective practice were used to drive continuous improvement and maintain high standards of care. Learning and good practice guidance were shared through meetings, and day-to-day discussions, and staff described an open culture where they felt supported, valued. Staff said they were proud to work at the service and were committed to providing people with good care and positive experiences.