This inspection took place on 24 and 25 July 2018 and was unannounced. This was the first inspection of the service since it was registered on 21 July 2017.Astbury Manor Care Home is a care home without nursing that provides a service for up to 64 older people, some of whom may be living with dementia. People receive accommodation and personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The accommodation is arranged over three floors. The ground floor has 21 rooms, the first floor has 20 rooms and the second floor has 23 rooms. All bedrooms have en-suite showers. People who are living with dementia are accommodated on the first floor. There are communal areas on each floor offering different places where people can sit or be with visitors outside their bedrooms. People living on all floors have access to outside areas via a mostly paved garden on the ground floor and terraces on the first and second floors. At the time of our inspection there were 39 people living at the service.
The service had a registered manager as required. 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. The registered manager was moving to manage a different care home and a new manager had been employed and was in the process of registering as manager with CQC. The registered manager, new manager and regional manager were all present and assisted us during the two days of the inspection.
One of the stated values of the service was quoted as, "We treat each and every resident as an individual, based upon their unique needs and preferences." All staff demonstrated a strong commitment to this value in all interactions with people living at the service. The staff team were extremely caring and respectful and provided support in the way people preferred. Staff knew people very well and there was an atmosphere of people and staff working together in partnership as they went through the day. There was much laughter and relatives commented on how caring the staff were with one comment seen that said the service was, "Absolutely outstanding… Staff are so friendly and helpful."
Staff were very happy in their jobs and there was an excellent team spirit. They felt supported by the management team and told us they had never felt so valued and encouraged to progress within their roles. Staff displayed enthusiasm and a strong determination to provide the best service they could. This applied to all staff in all areas of the service including managers, care staff, catering staff and housekeeping staff.
People were relaxed and there was an open and inclusive atmosphere at the service. People received care and support that was very personalised to meet their individual needs. People were supported to maintain relationships with those important to them. The service provided access to local events in order to enhance social activities for people. They took into account their individual interests and links with different communities. There were sufficient numbers of staff to meet people's care needs and medicines were stored and handled correctly.
The premises were newly built to a high specification and had furniture, furnishings and fixtures of good quality. However, improvements were needed to ensure areas where people with dementia lived were more 'dementia friendly'. The first floor, where 17 people were living with dementia, had few adaptations to help people compensate for sensory loss and cognitive impairment. In addition, the premises did not have adaptations that could help people living with dementia maintain their independence for as long as possible. A start had been made on identifying the improvements needed. We have recommended that the provider implement best practice guidelines for accommodating people living with dementia.
Staff had a good understanding of how to keep people safe and protect them from abuse. Personal and environmental risks to the safety of people, staff and visitors had been assessed and actions had been taken to minimise those risks. Recruitment processes were in place to make sure, as far as possible, that people were protected from staff being employed who were not suitable. People’s right to confidentiality was protected and their dignity and privacy were respected.
People received care and support from staff who received appropriate training and support. Staff training was up to date and they felt they received the training they needed to carry out their work safely and effectively.
People were supported to eat and drink enough and their health and social care needs were met. Their needs were monitored and care plans were reviewed monthly or as changes occurred. They 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. Quality assurance systems were in place to monitor the quality of service being delivered and the running of the service.