Manor Rest Home is a residential care home for 19 people Some of whom may be living with dementia. The service has spacious living areas and is set over two floors with a stair lift in place should this be needed. The service is set in a residential area with easy access to the local community and has a large garden. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. The Care Quality Commission regulates both the premises and the care provided, and both were looked at during this inspection.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

Care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare. There were systems in place to minimise the risk of infection. People were cared for safely by staff who had been recruited and employed after appropriate checks had been completed. People’s needs were met by sufficient numbers of staff. Medication was dispensed by staff who had received training to do so.

People were safeguarded from the potential of harm and their freedoms protected. Staff were provided with training in Safeguarding Adults from abuse, Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS). People were supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice.

People had sufficient amounts to eat and drink to ensure that their dietary and nutritional needs were met. The service worked well with other professionals to ensure that people's health needs were met. The environment was appropriately designed and adapted to meet people’s needs.

Staff were well trained and attentive to people's needs. Staff could demonstrate that they knew people well. Staff treated people with dignity and respect.

Records we reviewed showed people and their relatives were involved in the planning and review of their care. Care plans were reviewed on a regular basis and when there was a change in care needs. People were provided with the opportunity to participate in activities which interested them at the service. These activities were diverse to meet people’s social needs. People knew how to make a complaint should they need to. People were provided with the appropriate care and support at the end of their life.

The provider had a number of ways of gathering people’s views, they held regular meetings with people and their relatives and used questionnaires to gain feedback. The provider carried out quality monitoring to help ensure the service was running effectively and to make continual improvements.

The Inspection took place on the 29 March 2016.

Manor Rest Home provides accommodation and personal care without nursing for up to 19 persons some may be living with dementia. At the time of our inspection 18 people were living at the service.

The service had a registered manager. 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.

Care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare. People were cared for safely by staff who had been recruited and employed after appropriate checks had been completed. People’s needs were met by sufficient numbers of staff. Medication was dispensed by staff who had received training to do so.

People were safeguarded from the potential of harm and their freedoms protected. Staff were provided with training in Safeguarding Adults from abuse, Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS). The manager knew how to make a referral if required.

People had sufficient amounts to eat and drink to ensure that their dietary and nutritional needs were met. The service worked well with other professionals to ensure that people's health needs were met. People's care records showed that, where appropriate, support and guidance was sought from health care professionals, including a GPs and district nurses.

Staff were attentive to people's needs and treated people with dignity and respect. Staff were able to demonstrate that they knew people well.

People were provided with the opportunity to participate in activities which interested them. People knew how to make a complaint; complaints had been resolved efficiently and quickly.

The service had a number of ways of gathering people’s views including talking with people, staff, and relatives. The manager carried out a number of quality monitoring audits to help ensure the service was running effectively and to make improvements.

We spoke with eight of the seventeen people who used the service. We spoke with one person's relative, three staff members and the providers. We looked at three people's care records and medication administration charts. Other records viewed included staff training records, personnel records, health and safety checks, and satisfaction questionnaires completed by stakeholders of the service. We considered our inspection findings to answer questions we always ask; Is the service safe? Is the service effective? Is the service caring? Is the service responsive? Is the service well-led?

This is a summary of what we found;

Is the service safe?

When we arrived at the service the staff asked to see our identification and asked us to sign in the visitor's book. This meant that the appropriate actions were taken to ensure that the people who used the service were protected from others who did not have the right to access their home.

People told us they felt safe living in the service and that they would speak with the staff if they had concerns. We saw records which showed that the health and safety in the service was regularly checked. This included regular checks on such areas as fire safety equipment, gas and electric appliances as well as checks on the environment. This told us people were looked after safely.

People were provided with their medication in a safe manner and at the prescribed times. We saw that medication was stored safely.

We saw that the staff were provided with training in safeguarding vulnerable adults from abuse, Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS). This meant that staff were provided with the information that they needed to ensure that people were safeguarded.

We saw that staff were recruited appropriately and employed after appropriate checks were completed. This meant people were cared for safely by people of suitable character and skills.

Is the service effective?

People's care records showed that care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare. The records were regularly reviewed and updated which meant that staff were provided with up to date information about how people's needs were to be met. People told us they were; “Well looked after;” and that they were; “Happy here.” One person told us; “Staff are good they look after me.”

Is the service caring?

We saw that people were relaxed in the company of each other and staff. We saw that staff were attentive to people's needs. Staff we spoke with were able to demonstrate they knew people well. We saw staff treating people with dignity and respect. One person we spoke with said; “Staff are very good, very helpful, cheerful, all nice girls.” Another person told us the service was:”Homely and friendly.”

Is the service responsive?

People using the service were provided with the opportunity to participate in activities which interested them. People's choices were taken in to account and listened to. People's care records showed that where appropriate, support and guidance was sought from health care professionals, including a doctor, optician, chiropodist and district nurse. The service had recently taken part in a pilot study with their local general practitioner on avoiding unnecessary admissions to hospital. This told us that the service worked well with other professionals and that people's needs were met.

The service had its own minibus to help people access activities in the community.

Is the service well-led?

The service had a quality assurance system and records seen by us showed that identified shortfalls were addressed. As a result the quality of the service was maintained.

We spoke with five people using the service. Comments included, ”We have a whale of a time.” “The food is very good.” “It couldn’t be nicer.” We spoke with two relatives comments included, “It’s absolutely excellent.”

People and relatives told us that staff were caring and responsive to people’s needs. We also spoke with a visiting professional who advised from their experience that, “Everyone is very helpful”.

We found that the provider had reviewed their systems to make them more effective for gaining people’s consent to their care.

We found that the provider had systems in place to ensure people’s nutrition and hydration needs were met.

We reviewed three staff personnel files and found that systems still needed improvement. We spoke with seven staff and we were told that there was enough staff available.

We found that some improvements were needed regarding the management of medicines and the monitoring and assessing the quality of service provision.

We spoke with four people using the service who told us that they liked living at Manor Rest Home and staff gave them enough support. Comments included, “The best care home there’s ever been.” “The best of the bunch.” “They look after you here.”

We reviewed three people’s care plan files and found that it was not clear that arrangements had been made to obtain people’s consent for their care, or from others involved in their care.

We found that staff supported people to obtain appropriate health and social care support.

The provider had systems in place for people and others to raise any concerns or compliments and for the assessment and monitoring of the service.

We found systems in place for infection control however we had concerns regarding the safety and suitability of premises.

We found that whilst the provider had systems in place for recruitment they were not being consistently followed.

We spoke with five staff who told us they had support to undertake their work.

People living in Manor Rest Home told us that they experience good care and are very happy with the service they receive. They said, “I feel lucky to live here and would not want to live anywhere else” and, “They look after me very well here and the staff are all marvellous.”

People said that they liked the food at the home and were offered choices about what they ate. People felt that the accommodation was comfortable although one person told us that they would much prefer to have their own room rather than sharing with someone else. People told us that they felt safe and secure at Manor Rest Home and that the staff were always nice to them.