This inspection was carried out on 6 and 8 February and the first day was unannounced. We last inspected Davenport Manor on 23 and 24 November 2016. At that time we rated the service requires improvement overall and identified breaches of three regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We asked the provider to make improvements to the homes environment to ensure it was safe, documentation relating to decision making surrounding the administration of medicines without people’s knowledge and improvements to the quality monitoring systems.

Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the key questions of is the service safe, is the service effective and is the service well led to at least good. At this inspection we found improvements had been made to these areas.

Davenport Manor is a residential care home registered to provide care and support to up to 34 people. The home is situated in the Davenport area of Stockport close to local shops and churches. There is a regular bus service and Davenport railway station is approximately a quarter of a mile away. At the time of our inspection there were 31 people living at 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.

People told us they felt safe and protected from abuse. Staff working in the home had received safeguarding adults training and demonstrated a good understanding of what to do if they suspected a person was being abused or was at risk of abuse.

Medicines were managed safely in line with national guidelines. People were given ‘as required’ (PRN) medicines only when needed. We saw an example where a resident had been displaying difficult behaviour and the resident’s GP commented how the staff at the home managed the person’s behaviour well without relying on excessive medication.

People were encouraged to be independent. During the inspection we observed care staff helping people to do things for themselves where possible. One resident we spoke with told us; “I can do what I want here.” Care records we looked at were written in a way to enable care workers to encourage people to maintain their independence.

People were very happy with the food served in the home. One resident we spoke with told us; “I had pork yesterday and it was beautiful, lasagne today and I ate it all and I’m a fussy eater.” People were involved in creating the menus and were able to request meals that weren’t on the menu if they chose to. Snacks and drinks were available at all times.

People were able to access other healthcare services. A GP visited the home fortnightly and district nurses visited on a daily basis. The GP and district nurse team told us they thought the home provided a good level of care. An optician and a dentist visited the home annually but appointments could be made sooner than this if needed. When people needed to attend hospital appointments and no family members or friends were available to accompany them, the manager told us a member of staff would go with them to the appointment.

People and their relatives were encouraged to personalise and decorate their rooms. We saw rooms where stencils had been put on the wall and resident’s own furniture had been brought in to make the room feel like their lounge as well as their bedroom.

People told us they felt well cared for. A person we spoke with told us; “I have nothing bad to say about it, every one of the staff are superb, I can have a joke and a laugh with them. I was nervous about coming here but quite honestly they were so warm and welcoming.”

Regular

This inspection took place on 23 and 24 November 2016 and was unannounced on the first day.

We last inspected Davenport Manor on 13 and 14 April 2015. At that time, we rated the service requires improvement overall and identified breaches of five regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and one regulation of the Health and Social Care Act 2008 (Registration) Regulations 2014. We asked the provider to make improvements in relation to the supervision of staff, provision of person-centred care based on an assessment of needs and preferences, management of medicines, the safety of the environment and governance and monitoring of the service. The provider sent us an action plan to tell us how they would ensure they would meet the requirements of the regulations.

At this inspection we found the provider had implemented their action plan and had made improvements in a number of areas. However, we identified three breaches of the regulations. These were in relation to the safety of the environment, working within the requirements of the Mental Capacity Act and Deprivation of Liberty Safeguards, good governance and keeping accurate records of care. You can see what action we told the provider to take at the back of this report.

We made five recommendations. These were in relation to reviewing guidance and procedures in relation to the administration of medicines, the use of surveillance in care homes, recruitment procedures, assessing staffing levels and the provision of activities.

Davenport Manor is a residential care home registered to provide care and support to up to 34 people. The home is situated in the Davenport area of Stockport close to local shops and churches. There is a regular bus service and Davenport railway station is approximately a quarter of a mile away. At the time of our inspection there were 31 people living at 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.

The provider had not taken adequate steps to ensure the environment was safe for people living at the home. We found window restrictors in place to prevent potential falls from height were not sufficiently robust. The provider had not ensured timely action had been taken to address concerns raised following an electrical safety inspection. We received evidence shortly after our inspection that these shortfalls had been addressed.

Staff told us they had sufficient time to complete all their duties. Staff told us there were sufficient numbers of staff to meet peoples’ needs, and people living at the home confirmed they did not have to wait long if they required any support. Staff told us night shifts could sometimes be hard work but that the on-call manager would provide support if required.

Medicines were managed safely, and staff we spoke with demonstrated a good knowledge of requirements in relation to peoples’ medicines. There were no clear instructions for staff to follow in relation to the administration of ‘when required’ medicines. However, our discussions with staff showed they were aware when to give these medicines and what they were for.

There were no vacancies for care staff at the time of our inspection, which meant care was provided by a consistent staff team. People told us they liked and got on with the staff. Care staff knew people well and were able to talk with us in depth about peoples’ needs and preferences.

Care plans were reflective of peoples’ current needs and had been reviewed regularly. Staff were aware of the guidance contained in care plans.

We received positive feedback from GPs who regularly visited the service, who told us staf

We carried out this inspection on the 23 December 2013. The inspection was conducted due to some concerns raised regarding the standard of cleanliness at the home and because of some issues that we had identified during our inspection in June 2013 relating to record keeping.

We checked the cleanliness of a number of rooms and bathrooms at the home and found them to be all clean, tidy and well presented.

The cleaner we spoke to told us that they had recently completed a 12 week course on cleanliness and infection control, which they said they had found very useful.

We looked at 17 sets of daily records. We saw that they were completed to a higher standard than when we last checked them. We could not find any significant gaps in them.

During our unannounced inspection on 18 June 2013, we spoke to the registered manager, the deputy manager, six members of staff, eight people using the service, three of their relatives, one of their friends and a healthcare professional who was also present that day.

People we spoke to told us that they had some input into the care and welfare of their relatives. One person told us; "My father is well looked after as far as I can tell on my visits. He appears to get on well with staff. Staff ring us if there is a problem with his health.”

We spoke to a healthcare professional who was visiting the home. They were complimentary about the staff and the care they provided. They told us; “I have no concerns about the home, apart from the lack of activities.”

All the residents we spoke to were complimentary about the food. We were told; “I don’t really want to talk today, but this is very good for me. Carers are good and so is the food. In fact couldn’t be better.”

The staff we spoke to told us that there was effective team work in place. They told us that the registered manager was approachable and helped keep morale high.

We saw that records kept within the home were poor in many areas. The care plans that we looked at showed many instances where dates had not been recorded on a variety of assessments that had been completed.

We completed an unannounced inspection at Davenport Manor on 29 August 2012. During this visit we spoke with four people who used the service, three visiting relatives and three members of staff for their views on the service.

People living at Davenport Manor appeared relaxed and content in their surroundings. When asked people said they had everything they needed and they were happy.

The visiting relatives we spoke with were all positive with regards to the care their family member received. Some of their comments were: “They (the staff) do a good job here,” “The GP is always called in a timely manner if the staff notice something is not quite right” and “The staff are kind, helpful, they are very good to ‘X’.”

Staff told us that people’s privacy and dignity were respected and personal choice was encouraged. They told us that activities took place most days and “The care here is really good.” “One person said “This is a home with very high standards.”

This was an unannounced inspection to this location.

When we visited there was a registered manager in place.

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.

Davenport Manor is registered to provide care and accommodation for up to 34 people. The home is situated in the Davenport area of Stockport Greater Manchester. Accommodation was on two floors which could be accessed via a staircase or a passenger lift. All bedrooms except two were single occupancy and seventeen rooms had an en suite toilet. There were three communal areas that supported people spending time together. There was a garden to the rear of the property and an off road car park at the front. There were 28 people living at the home at the time of our visit.

Relatives spoke positively about staff and we saw good relationships between individual staff and people who used the service. People spoken with told us they were happy with the care being provided and with the staff working at the home.

Staff spoken with understood the needs of the people who lived at the home and we saw that care was provided with kindness and promoted people’s dignity. We saw that people who used the service looked relaxed and comfortable in the home.

Staff employed at the home had been trained to help make sure they had the skills and knowledge to provide care and support in line with best practice. Staff had also undertaken training to help make sure that the care provided to people was safe and effective to meet people’s needs. We saw there were sufficient staff on duty to meet people’s needs.

We looked at a sample of staff records which showed they had all received a thorough induction when they started work at the service to help them understand their roles and responsibilities, as well as the values and philosophy of the home.

Not all of the care plans seen showed that people had received a care needs assessment before they moved into the home to help make sure that care would be delivered in response to the their individual needs. We also found that significant information about people’s health status and their well-being was not included in their care plan.

We found written care instructions were not up to date and had not been written to help make sure that care would be delivered consistently and safely by staff. People’s risk assessments did not state how potential risks should be managed.

During the inspection we saw that the home was being cleaned however, we were aware of offensive odours in the home.

Medicines were stored, administered and returned safely and records were kept for medicines received and disposed of, this included controlled drugs (CD’s). However we found gaps where some medication administration records (MAR) had not been signed to show that medicines had been given.

There was a notice displaying group activities available for people who used the service. However no activities took place during our visit to the service.

We saw that the correct safeguarding procedures were in place. Staff knew about the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS). Where appropriate a DoLS authorisation was in place for people who lacked capacity to make a decision.

People and their relatives knew how to make a complaint and felt confident to approach any member of the staff team if they required.

Feedback from people and their relatives was given in the form of complaints, comments and compliments. The most recent annual service user satisfaction survey was last conducted in November 2013, therefore up to date feedback from people and their relatives was not available.

We found a number of breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.You can see what action we told the provider to take at the back of the full version of the report.