Carisbrooke Manor

People’s experience of using this service: People, relatives and staff told us Carisbrooke Manor had a very warm and homely atmosphere. People looked relaxed and comfortable. Staff cared about the well-being of people they supported and we received positive feedback about the kindness of staff. Relatives were warmly greeted and made to feel welcome. People were treated with dignity and their independence was promoted.

People told us they felt safe. Recruitment processes were robust and there were sufficient numbers of staff to make sure people’s care needs were met. Medicines were well managed. Equipment was checked regularly to make sure it worked properly. The home was clean and fresh. There was a renewal programme in place and plans to upgrade the laundry room had been prioritised.

Risks to people receiving care were assessed and kept under review. Staff had detailed information about how to care for people. We found the standard of person-centred information in people’s care plans had improved.

Staff were well trained and knowledgeable about their roles and the care people needed. People were supported with good nutrition and could access appropriate healthcare services.

People's rights were upheld. They were given choice and their decisions were respected. Where people did not have capacity to make decisions, they were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible.

The service was consistently well-led. People felt able to raise any concerns and were confident they would be addressed. Staff felt well supported by the registered manager and we observed the staff team worked well together. The registered manager and provider completed a range of quality checks and audits of the service to make sure the care and support provided was of high quality. This supported the continuous improvement of the service.

Rating at last inspection: Good (Report published August 2016).

Why we inspected: This was a planned inspection based on the rating at the last inspection.

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.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk.

Carisbrooke Manor is registered to provide care and support for up to 43 people, some of whom are living with dementia, there were 35 people receiving a service at the time of our inspection. The service is located on the outskirts of Scunthorpe. Accommodation is provided on two floors. There is a car park at the service for visitors to use.

The service had a registered manager. 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.

Staff knew how to protect people from abuse and knew they must report concerns or potential abuse immediately to the management team, local authority or to the CQC. This helped to protect people.

Staffing levels provided were adequate to meet people’s needs. Staff understood people’s needs and the potential risks to their wellbeing. Staff were provided with training in a variety of subjects to help develop and maintain their skills. Supervision and appraisal were undertaken for staff to help support them and identify any further development needs.

People's care records were all being re-written. This work had just commenced because people's care records did not contain enough personalised detail to make sure people's needs were known and could be met. This included reviewing people's information in regard to their mental capacity, deprivation of liberty (DoLS) and best interest. Staff followed the principles of the Mental Capacity Act 2005 when there were concerns people lacked capacity and important decisions needed to be made. We recommend that this guidance related to best practice is followed and that this work is undertaken as soon as possible.

People’s nutritional needs were assessed and monitored. Special diet for diabetics and soft diets for people who may have swallowing difficulties were provided. Staff encouraged and assisted people to eat and drink. Advice was sought from relevant health care professionals to ensure people’s nutritional needs were met.

People were supported by staff to make decisions for themselves. Staff communicated with people in a way that could be understood. People who used the service were supported to make their own choices about aspects of their daily lives.

A programmed of activities was provided, which included in-house entertainment, events and outings. Activities were provided to help stimulate people and they were encouraged to maintain their interests.

General maintenance was carried out of the building and service contracts were in place to maintain and service equipment so it remained safe to use.

There was a complaints policy and procedure in place. This was explained to people living with dementia and their relations so they were informed about their rights. People’s views were asked for by the staff. Feedback received was acted upon.

A variety of audits were undertaken to monitor the quality of the service. Issues found during our inspection were addressed by the registered manager and operations director. The registered manager had an ‘open door’ policy and an ‘on call' system was operated out of office hours to support people, relatives, visitors and staff.

There was a homely and welcoming atmosphere within the service.

' Is the service caring?

' Is the service responsive?

' Is the service safe?

' Is the service effective?

' Is the service well led?

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people who used the service, speaking to staff supporting people who used the service and from looking at records.

If you want to see the evidence supporting our summary please read the full report.

Is the service caring?

People's preferences, interests, aspirations and diverse needs had been recorded and care and support had been provided in accordance with people's wishes. Staff demonstrated a good understanding of the needs of the people who used the service and could describe how to maintain people's dignity and how to ensure people's choices were respected.

Risk assessments were completed which ensured staff knew how to keep people safe. People had been involved with the formulation of their care plans and where needed people had been supported to make informed decisions. Health care professionals, for example doctors, speech therapists, occupational therapists and psychologists, had been consulted and their advice sought when people needed more specialist care and attention.

Is the service responsive?

The service had a complaints procedure which people could access. People were therefore assured that complaints were investigated and action would be taken as necessary. The provider consulted with people about how the service should be run and any issues were addressed. People were consulted about their care needs.

Staff followed instructions from visiting health care professionals for example doctors and district nurses. This ensured people received the care and attention they required to meet their needs.

Is the service safe?

The service was safe, clean and hygienic. Equipment was well maintained and serviced regularly, therefore not putting people at unnecessary risk.

The manager set the staff rotas, they took people's care needs into account when making decisions about the numbers, qualifications, skills and experience required. This helped to ensure people's needs were met. Before staff were recruited the provider undertook employment checks. This ensured people who used the service were not exposed to staff who were barred from caring for vulnerable people.

The provider had policies and procedures in place for staff to follow to report any abuse they may witness or become aware of. Staff also received training about how to keep people safe.

Is the service effective?

People's health and care needs were assessed with them and they were involved in writing their plans of care. Specialist dietary needs had been identified in care plans where required. People were provided with a wholesome and nutritious diet and their dietary needs were monitored. Health care professionals were consulted if required.

People's care plans detailed the person's preferences and their method of communication. This enabled the staff to identify when the person was not happy or felt uncomfortable with any given situation.

Is the service well led?

The provider consulted with people about how the service was run and took account of their views. Relevant persons who had an interest in the care and attention people received had also been consulted and their opinions taken into account about how the service was run. Staff received training which equipped them to meet the needs of the people who used the service. The provider also gave staff the opportunity to gain further qualifications.

What people who used the service and those that matter to them said about the care and support they received.

People who used the service told us they were satisfied with standard of care and attention they received. Comments included, 'The staff are brilliant, they are so caring' and 'Nothing is any bother, I'm really happy living here.' People told us they trusted the staff and felt safe.

Staff told us they felt well supported by the manager and could approach them with any concerns they had. They also told us they could ask the manager for guidance. The staff told us they felt the training they received equipped them to meet the needs of the people who used the service.

People were supported to be able to eat and drink sufficient amounts to meet their needs and they were provided with a choice of suitable and nutritious food and drink. People told us they liked the food provided.

The provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening via staff training and provison of policies and procedures. However people who used the service were at risk of abuse because staff did not always follow the policies and procedures. Care and supervision arrangements were not sufficiently robust to ensure that people would be protected from abuse. People we spoke with told us they were happy living in the home and felt safe.

There were effective systems in place to reduce the risk and spread of infection. We conducted a tour of the building and found the home to clean, tidy, well maintained and free from offensive odours.

We found that staff received appropriate training and support. People we spoke with told us they liked the staff that cared for them and felt they were well looked after.