People’s experience of using this service:

People and their relatives were complimentary about the care provided at Mistley Manor. The environment was clean, comfortable and safe.

People were supported safely by sufficient and competent staff who knew people well and supported them according to their needs and preferences.

People were involved in how the service was run and encouraged to be as independent as possible. They had the choice to participate in a range of activities which promoted a good quality of life.

Staff were kind, caring and passionate about the service provided. They supported people with dignity and respect.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. The policies and systems in the service supported this practice.

People knew how to raise a complaint and their views were listened to and investigated.

People's health was well managed and staff had positive links with professionals which promoted wellbeing for them. The service was designed in a way that allowed people to remain at the service as their needs changed.

The owners of the service were actively involved the day-to-day operation of the care home and provided good support to the registered managers. There was a positive culture within the service and the management team worked well together.

The registered managers had not kept the commission up to date with some events that had happened within the service and we made a recommendation to ensure this improved.

Rating at last inspection: Good (report published 14 July 2016)

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

Follow up: We will continue to monitor all intelligence received about the service to ensure the next planned inspection is scheduled accordingly.

This inspection took place on 23 March 2016 and was unannounced.

Mistley Manor is registered to provide accommodation and personal care for up to 66 people. On the day of our inspection there were 48 people living in the service. The accommodation was located over three floors. The third floor had four suites which could accommodate two people in each to be used for couples wishing to receive care and support while living together. The service had an onsite licensed bar and a cinema.

The service had two registered managers. 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.

During our previous inspection on 20 October 2015 we found that this service had breached our regulations in some areas and we carried out this inspection to check that they had carried out the work required to improve the quality of the service as set out in their action plan to bring the service within regulation.

During that previous inspection there were concerns in several areas, including concerns that arrangements for gaining people’s consent under the requirements of the Deprivation of Liberty Safeguards were not being met effectively. That there were not enough staff on duty to keep people safe and concerns that some people did not get medicines at their preferred time of day or when they were required.

During this inspection we found that the service had taken the necessary action and was offering a good service overall.

Staff had received the training they needed to understand how to meet people’s needs. They understood the importance of gaining consent from people before delivering their care or treatment. Where people were not able to give informed consent, staff and the manager ensured their rights were protected.

There were enough staff to support people safely and they were clear about their roles. Recruitment practices were robust in contributing to protecting people from staff who were unsuitable to work within the care profession.

Staff knew what to do if they suspected someone may be being abused or harmed. Recruitment practices were robust and contributed to protecting people from staff who were unsuitable to work in care. There were enough staff to support people safely and they were clear about their roles.

Records showed that staff had received training to perform their role.

Medicines were managed and stored properly and safely so that people received them as the prescriber intended.

People had enough to eat and drink to meet their needs and were able to eat in comfortable and attractive surroundings. The service had a restaurant on the ground floor and people were served the meal of their choice by waiters. Non-alcoholic drinks were available or people were able have a drink from the licenced bar with their meal if they wanted. Staff assisted or prompted people with meals and fluids if they needed support.

Staff treated people with warmth and compassion. They were respectful of people’s privacy and dignity and offered comfort and reassurance when people were distressed or unsettled. Staff also made sure that people who were becoming unwell were referred promptly to healthcare professionals for treatment and advice about their health and welfare.

Staff showed commitment to understanding and responding to each person’s needs and preferences so that they could engage meaningfully with people. Outings and outside entertainment was offered to people and staff offered activities on a daily basis.

Staff understood the importance of responding to and resolving concerns quickly if they were able to do so. Staff also ensured that more serious complaints were passed on to the management team for investigation. People and their representatives t

This inspection took place on 20 October 2015 and was unannounced.

Mistley Manor is registered to provide accommodation and personal care for up to 66 people. On the day of our inspection there were 39 people living in the service. The accommodation is located over three floors. The third floor had four suites which could accommodate two people in each. The service had an onsite licensed bar and cinema.

The service had two registered managers. 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 requirements of the Deprivation of Liberty Safeguards were not being met. Mental capacity assessments were generic with the same wording used in several assessments. They were not specific to the person and the decision and did not reflect that a person’s capacity to make a decision may fluctuate. The use of restraint was not recorded and monitored according to the services’ own policy.

The service did not have a system to monitor staffing levels and people’s views varied as to whether staffing numbers were sufficient with most feeling that these were not enough staff at particular times of the day.

Medicines were stored and administered safely. However, some people did not get them at their preferred time of day or when they were required.

A choice of food and drink was available that reflected people’s nutritional needs and took into account their personal preferences or health care needs.

People and staff had developed positive, caring relationships. People felt they were looked after by kind, friendly staff who knew them well.

Records showed that staff had received training in to perform their role. However, we found that the training records was not accurate. Staff participated in an induction programme and shadowed senior staff before providing care.

People did not feel that they had been involved with their care planning. Care plans covered people’s care needs. Risks to people had been identified and assessed. However, some risk assessments were generic and did not reflect the individual circumstances of the person.

People were not provided with support to continue with activities they may have enjoyed before moving into the service. Facilities available to people within the service such as a library and cinema were not always fully exploited.

Records kept by the service in relation to the running of the service were not always accurate. The management team did not carry out regular quality assurance and audits of the service to check the quality of care people received and drive improvement.

You can see what action we told the provider to take at the back of the full version of the report.