About the service

Handsworth is a residential care home located in the borough of Trafford, Greater Manchester. The home is registered with the Care Quality Commission (CQC) to provide care and accommodation to a maximum of 43 people, aged over 65 years. At the time of this inspection the home had two vacancies.

People’s experience of using this service:

¿ People living Handsworth received outstanding care which was responsive to their needs.

¿ We received excellent feedback from people and their relatives regarding the quality of care provided to people living at the home.

¿ Staff consistently demonstrated the values of the home and put people at the heart of everything they did.

¿ Staff were clear they worked as a team and for the benefit of people living at Handsworth.

¿ Equality, diversity and protecting human rights was a golden thread that ran through every aspect of the home. People were valued as individuals and diversity was celebrated.

¿ Activities were meaningful and reflected people’s interests and personal preferences

¿ People's support plans were tailored to them and had been developed with involvement of their families.

¿ Food was home cooked with a varied menu and people were given lots of choice

¿ The management team was highly effective and led by example. There was a strong culture of continuous learning, openness and transparency.

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

Rating at last inspection

‘Requires Improvement’ (report published on 14 February 2018).

Why we inspected

This was a planned follow-up inspection based on the rating at the last inspection. At this inspection, the key questions of safe, effective and well-led have improved to good. The key question of caring has improved from good to outstanding. The overall rating is now 'Good.'

Follow up

We will continue to monitor this service and plan to inspect in line with our inspection schedule for those services rated ‘Good.’

The inspection took place on 12 and 13 December 2017 and the first day was unannounced. At the previous inspection in September 2016, we asked the provider to take action to make improvements in seeking people’s consent to receive care and staff training in mental capacity. These actions had been partially been completed.

Handsworth is a care home. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The care home is registered for up to 43 people and is located in a residential area of Bowdon in Greater Manchester. Accommodation is across three floors. There is an accessible garden to the rear of the premises and parking for several cars is available at the front of the home. All rooms have their own toilet and some rooms have ensuite shower rooms. At the time of our inspection there were 39 people living at the service.

There was a manager in post who had been registered with CQC since October 2010. 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.

We found two breaches of the Health and Social Care Act regulations in relation to adequate recording and communication of risks. You can see what action we told the provider to take at the back of the full version of the report.

We made two recommendations about enhancing the current emergency evacuation system and strengthening how the Mental Capacity Act was applied with the service.

The service was not consistently safe as risk assessments did not contain sufficient details to ensure staff supported people safely. Recruitment processes helped to ensure suitable staff including volunteers were employed and staffing levels were sufficient to support people appropriately. There were systems in place to protect people from risk of abuse, accidents and incidents.

Appropriate maintenance and checks took place to ensure equipment and the environment were safe for people living at the care home and staff supporting them. The building was in need of refurbishment. However the registered manager could not tell us when this work would start.

Staff’s knowledge and awareness of mental capacity and deprivation of liberty safeguards was satisfactory. People’s care records contained capacity assessments and appropriate applications for deprivation of liberty had been made. However, requirements of the mental capacity act were not always applied effectively. For example, consent to care was not always consistently recorded in people’s care records.

People told us the food was of acceptable quality and meals took into consideration people’s preferences. This helped to maintain people’s good health and wellbeing. We identified concerns regarding how information about special dietary needs such as fork-mashable foods was communicated to staff. We asked the registered manager to address these concerns.

The provider ensured new staff completed an induction and received mandatory and on-going training. Staff had regular supervision and yearly appraisals. This helped to ensure staff were equipped and supported to carry out their role.

The provider had proactive systems in place to ensure people’s healthcare needs were met as and when required. The local GP operated a weekly surgery from the care home and people were supported by staff to attend hospital appointments.

The service was caring and compassionate. People’s dignity and privacy were treated respectfully. We saw that there was good rapport and friendly interactions between people and staff. Staff demonstrated that they knew people well and were able to describe people’s perso

Our inspection took place on 14 September 2016 and was unannounced. At our last inspection in January 2014 we found the provider was meeting all the standards we looked at.

Handsworth is a well presented home in a residential area of Bowden close to Manchester. It is registered for up to 43 people. The provider is Methodist Homes (MH). It benefits from an accessible garden to the rear with raised planters. Parking for several cars is available to the front of the home. All rooms have their own toilet and some rooms benefit from ensuite shower rooms.

There was a registered manager in post at the time of our inspection. 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.

People had assessments and care plans that identified areas of risk associated with their care and support, however there was limited guidance in place to show staff how to minimise risk and some actions identified were not always followed effectively. For example we saw in one care plan the person’s weight was to be measured weekly, however records showed this was done at irregular intervals.

The provider ensured staff were knowledgeable about the risks of abuse and had policies, practices and training in place to ensure staff understood their responsibilities under safeguarding.

Appropriate background checks were carried out before new staff began working in the service.

The registered manager and staff did not fully understand the principles and responsibilities in accordance with the Mental Capacity Act (MCA) 2005. We found staff did not fully understand capacity, which meant people may not receive appropriate support to make decisions.

Appropriate arrangements were in place to manage the medicines of the people who used the service.

Staff received a thorough induction which included checks on their competencies. We saw there was a programme of training in place which included mandatory training and regular refresher courses. A programme of regular supervision meetings and annual appraisals was in place.

We observed the lunchtime service and saw it was relaxed, with people assisted to make choices

in a patient and caring way. People were supported to eat their meal and we saw the staff

members provided this support when needed.

We saw the provider had robust systems in place to ensure any complaints or concerns were recorded and investigated. We saw accidents and incidents were reported. We were able to see what actions had been taken in response to these reports.

We received consistently positive feedback about the registered manager. The audits were detailed and we saw evidence which showed any actions resulting from the audits were acted upon in a timely manner.

We have identified breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 during this inspection. You can see what action we told the provider to take at the back of the full version of the report.

We visited Handsworth on 14th January 2014. On the day of the visit there were 42 people using the service. There was a manager in place who was appropriately registered with CQC.

The home was warm, clean and welcoming. Appropriate policies and procedures were in place and up to date and staff members were aware of how to access them and the of correct procedures to follow.

We looked at five care records which contained up to date health and medical information, monitoring charts, risk assessments and personal profiles. Wishes and preferences were recorded and people who used the service and their relatives were included in discussions about their care.

We spoke with a visitor and several people who used the service. The visitor said, “I have seen a great improvement in my X’s mobility and general well-being which I feel is down to good care and good food. I wish I had brought X here sooner”. One person who used the service told us, “I am very well looked after and the staff go out of their way to help”. Another said, “I don’t think you could find anywhere better”.

We spoke with two members of staff who demonstrated an awareness of safeguarding and mental capacity issues. Staff felt they were well supported. Staff meetings were held regularly, and training was comprehensive and on-going.

Complaints were taken seriously and followed up appropriately. Regular audits were undertaken and the results analysed. Improvements were made to the service as appropriate.

Handsworth was a warm and inviting home. Bedrooms covered 4 floors and people who used the service had access to their own toilet facilities in their rooms, some rooms had ensuite shower facilities. We saw that bedrooms had locks on them and staff confirmed that people who used the service were able to lock their rooms if they wanted to.

We were told that they had a volunteer that attended twice a month to play the piano. They had a prayer meeting each Friday and a church service on Thursday.

We spoke with one relative who told us that their relative “did things here and got stimulation” and that they had a “quality of life when they came here”.

We spoke with 2 people who used the service who told us that they were “happy here”.

Staff told us that people who used the service had access to a hairdresser who visited twice a week and there was a hairdresser’s room available.

We were told that there was an activity co-ordinator on daily. Activities were on display in the hall and there was evidence of different activities throughout the day. The registered manager told us that they used memory boxes for some activities.

We saw that people who used the service and their relatives had access to a library and leaflets. We saw a file for information leaflets on medications on display.

Arrangements were in place to ensure that medicines, including controlled drugs, were securely stored. A safe system was in place for the ordering and returning of medicines.

We spoke with some of the people living at Handsworth, some visitors, relatives and some of the staff who worked there. We were told that people were happy to be living or working at the home.

People using this service, who liked to be called residents, told us that they got on well with staff and that their care and support was provided in a respectful and dignified manner. People confirmed that they received the right amount of support to make decisions and choices about things that were important to them.

Some comments we received from residents living at Handsworth were:

“Our privacy and dignity is respected all the time.”

“Staff always knock before coming into my room.”

“They (the staff) are always kind and respectful.”

“Of course you get choices, you can stay up until midnight if you want.”

“All our care needs are met and the girls always encourage us to be independent”.

“We have activities every day, I especially like the church service on a Thursday.”

“I absolutely feel safe here.”

“I can’t fault the staff in any way.”

"I am very happy living here."

We spoke to some of the visitors and relatives who all told us they were very happy with the service provided and had no complaints. Some of the comments were:

“I think privacy and dignity is most definitely respected, I can’t speak highly enough of this place.”

“I got my mum back and that’s all due to the staff here.”

“’X’ is very well looked after and all her care needs are met.”

“The staff here are all lovely.”

“We are always kept informed by the staff of anything that happens to ‘X’.”

“This is a very friendly, happy home with a lovely environment.”

“Everybody is treated as an individual.”

“It never crosses my mind to worry about ‘X’s’ safety.”

“This is home from home.”

As part of this review process we contacted Trafford Commissioners and Trafford Local Involvement Networks (LINks). LINKs are groups of individual members of the public and local voluntary/community groups who work together to improve health and social care services. They gather the views of local people and use them to influence how health and social care is commissioned and delivered. No concerns were raised.