Archived: The Manor Care Homes

Updated 5 March 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

The inspection was prompted to follow up the enforcement action which resulted from the last inspection in September 2017.

Inspection site visit activity started on 23 January 2018 and ended on the same day. It included direct observations of the staff group and how they offered care to people, speaking with the people and their relatives, the management staff and a visiting health professional. We visited the office location on 23 January 2018 to see the acting manager and office staff; and to review care records and policies and procedures.

This unannounced inspection was carried out by two inspectors and an Inspection Manager. Before the inspection visit we looked at the information we held about The Manor including any concerns or compliments. We looked at the statutory notifications we had received from the provider. A statutory notification is information about important events which the provider is required to send us by law. We considered this information when planning our inspection to the home.

Some of the people living at the home were not able to tell us, in detail, about how they were cared for and supported because of their complex needs. Therefore, we used the short observational framework tool (SOFI) to help assess whether people’s needs were appropriately met and identify if they experienced good standards of care. SOFI is a specific way of observing care to help us understand the experiences of people who could not talk with us.

We spoke with two people and five visiting relatives and a visiting health professional to gain their experiences of The Manor. The group quality assurance manager, support compliance manager, acting manager, deputy manager and lead nurse assisted us on the inspection. We asked them to supply us with information that showed how they managed the service, and the improvements regarding management checks about the safety and governance of the home following our last visit. We also received some information following this inspection visit. We also spoke with a senior carer, three care staff, and the cook.

We looked at five people’s care plan records to see how they were cared for and supported. We looked at other records related to people’s care such as medicine records, daily records and risk assessments. We also looked at staff recruitment and training records, quality audits, records of complaints, incidents and accidents and safety records.

Updated 5 March 2018

The inspection took place on 23 January 2018, and the visit was unannounced.

The Manor provides residential and nursing care for older people. The Manor is registered to provide care for up to 67 people, over three units in the home. At the time of our inspection there were 15 people living at the home in Windsor unit, and Sovereign and Tudor units are currently closed. The Manor Care Homes 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.

At the last inspection of the service on 16 and 19 September 2017 we found there was an absence of the provider managing risks. This was a breach of Regulation 12 and 17 of the Health and Social Care Act 2008, and a breach of Regulation 18 (Registration) Regulations 2009, Notification of incidents.

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 Safe and Well Led to at least good. We did not receive an action plan from the provider which should have outlined the action they were going to take. At this inspection we found that the provider had made improvements in all three areas where there was a breach. This followed the involvement of a consultant who brought their own staff team into the home to support the provider.

There was no registered manager in post. The provider confirmed the acting manager had begun the application process. 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 Manor Care Homes 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 provider has formulated an action plan and has commenced improvements in the home. There is an extensive plan of refurbishment where improvements to the fire safety have been highlighted. Decoration of areas has commenced and these are being planned with people’s dementia and failing sight in mind so areas will be highlighted in vivid colours.

At the last inspection of the service we found there was a lack of oversight by the provider to check quality monitoring had been carried out effectively. At this inspection, we found that the provider had commenced a wide range of quality monitoring checks. We will return to ensure these are embedded and protect people in the home.

The provider carried out quality monitoring checks in the home supported by the acting manager and home’s staff. The provider had a clear management structure within the home, which meant that the staff were aware who to contact out of hours if an emergency arose, or an equipment repair was necessary. The provider had developed opportunities for people to express their views about the service. These included the views and suggestions from people using the service, their relatives and health and social care professionals. Staff were aware of the reporting procedure for faults and repairs and had access to the maintenance diary to manage any emergency repairs.

We found that applications had been made to the local authority to legally deprive people of their liberty. The acting manager and care staff had been trained in the Mental Capacity Act (MCA) 2005. They were also aware of best interests meetings to ensure peoples treatment was in line with the MCA and Deprivation of Liberty Safeguards. People were asked for their written consent to care following their admission to the home. This was in addition to staff agreeing their actions prior to each caring intervention.

Staff had received training for their specific job role, and staff had begun to be enrolled on more formalised training which would increase their overall knowledge and provide them with a nationally recognised qualification in care. Staff were able to explain how they kept people safe from abuse, and were aware of whistleblowing and what external assistance there was to follow up and report suspected abuse. Staff were subject to a thorough recruitment procedure that ensured staff were qualified and suitable to work at the home.

People were provided with a choice of meals that met their dietary and cultural needs. The catering staff were aware of people’s dietary needs, and sought people’s opinions about the menu choices to meet their individual dietary needs and preferences. A range of activities tailored to people’s interests were provided by staff on a regular basis. Staff had had access to information and a good understanding of people’s care needs. People were able to maintain contact with family and friends and visitors were welcome without undue restrictions.

Relatives we spoke with were complimentary about the acting manager and staff, and the care offered to their relations. People were involved in the review of their care plan, and when appropriate their relative’s views were included. Staff had access to people’s care plans and received regular updates about people’s care needs. Care plans were being re-written to ensure they were easy to read and described the care and assistance people required. Care plans included changes to peoples care and treatment and people were offered and attended routine health checks, with health professionals both in the home and externally.

We observed staff positively interacted with people throughout the inspection, where people were offered choices and their decisions were respected.

We received positive feedback from the local authority with regard to the improved care and services offered to people at The Manor Care Homes.