We carried out a review of the data available to us about The Manor - Care Home Physical Disabilities on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about The Manor - Care Home Physical Disabilities, you can give feedback on this service.
The Manor - Care Home Physical Disabilities is a purpose built two storey residential care home with three adjacent bungalows. It is able to provide support for up to 22 people. At the time of the inspection there were 20 people using the service. Each person’s accommodation included ensuite facilities. There is a communal lounge/dining area and an area where people can undertake hobbies, interests and pastimes in an accessible way.
People's experience of using this service and what we found
Although staff received up to date training on infection prevention and control practices, there were poor practices in place which put people at risk of infections and cross contamination. The provider told us they would urgently address these matters. However, until we identified these issues people were at risk of harm
Staff understood how to protect people from poor care and abuse. The service worked with other agencies to do so. Staff had training on how to recognise and report abuse and they knew how to apply it.
People’s care plans were an accurate reflection of the support they needed to mitigate risks and stay safe. The service had enough appropriately skilled staff to meet people's needs and keep them safe.
Staff supported people with their medicines in a way that respected their independence and achieved positive health outcomes.
Lessons were learned when things went wrong and actions were taken to prevent recurrence.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
People and those important to them, including advocates, were involved in planning their care. This enabled people to be able work with staff to develop the service. Staff evaluated the quality of support provided to people, involving the person, their families and other professionals as appropriate. Audits, monitoring systems and oversight of the service were mostly effective.
For more information, please read the detailed findings section of this report. If you are reading this as a separate summary, the full report can be found on the Care Quality Commission (CQC) website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was good (published 20 February 2018).
Why we inspected
We undertook this inspection as part of a random selection of services which have had a recent Direct Monitoring Approach (DMA) assessment where no further action was needed to seek assurance about this decision and to identify learning about the DMA process.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
Follow up:
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
The Manor - Care Home Physical Disabilities is a two storey building with three adjacent bungalows and is registered to accommodate up to 22 people. At the time of this inspection there were 21 people living at the service.
The inspection took place on 5 January 2017 and was unannounced. At our previous inspection on 15 December 2015 the service was rated as 'Good'. At this inspection it remained 'Good'.
A registered manager was in post. 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.
Staff had received training about keeping people safe and they were knowledgeable about describing the signs and symptoms of any potential harm. Staff empowered people to be safe and staff knew the reporting process should this ever be needed if a person was harmed. People were given as much information as they needed about staying safe.
Risk assessments were in place and these were accurate and up-to-date. Where people needed external support, this was sought from for example, a speech and language therapists. This was to help ensure people’s care was as safe as it could be.
People's needs were met by staff who were recruited safely, deployed to ensure people’s needs were met and trained appropriate to their role.
People were administered their prescribed medicines safely. Staff administered people's medicines who had been trained and deemed competent to do this by the registered manager. Medicines were managed safely in line with current guidance.
Staff were supported in their role and they knew what standard of care was expected. Incidents were used as an opportunity for learning and to help drive improvements.
People were enabled to access healthcare services. People's nutritional needs were met by staff who knew each person's needs well. Staff knew when people needed support and also when to respect people's independence.
The premises and equipment were safely maintained and helped people to improve their independence.
A positive and good working relationship existed between the registered manager, staff and relevant stakeholders. People were supported in partnership with other organisations including the local authority and care commissioners to provide joined up care.
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 were involved in their care and relatives or friends helped provide information which contributed to people's independent living skills. People were treated equally regardless of their needs. Staff helped people to take part in and enjoy pastimes and social stimulation that were important to them.
People's care plans were as detailed and staff used people's personal life histories to help get to know what was important to each person. Staff understood what mattered to people when providing personal care by involving them and encouraging independence.
People were provided with information and or enabled to access advocacy services when required.
Complaints were investigated in line with the provider's policies and procedures. Support was available if people needed to raise concerns or make a complaint.
Support arrangements and procedures were in place to understand and meet the needs of people requiring end of life care when this was required.
The registered manager motivated the staff team with regular meetings, formal supervision, mentoring and being shadowed by themselves or experienced staff members.
The registered manager understood their responsibilities and worked with people, staff and the provider to improve the quality and safety of care that was provided. Quality assurance procedures, a programme of audits and leadership helped drive improvements in the quality of service that was provided.
Further information is in the detailed findings below.
The Manor - Care Home Physical Disabilities is registered to provide accommodation for up to 21 people who require nursing or personal care. This was for people with acquired brain injuries or other complex physical and learning disabilities. At the time of our inspection there were 21 people living at the service. The service is located in the village of Brampton and offers ample parking and accessible premises for people, staff and visitors.
Accommodation is provided in a combination of bungalows and a two storey building. All bedrooms are single rooms with en suite facilities. Separate facilities are provided if people preferred a bath.
This unannounced inspection took place on 9 December 2015.
The service had a registered manager in post. 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.
A robust recruitment process was in place which helped ensure that the quality and suitability of staff met legal requirements. Only staff that were deemed suitable by people using the service and the registered manager were offered employment. People’s needs were met by staff who had the right skills and experience to meet these in a timely manner. An effective induction process was in place to help support and develop new staff.
Staff were trained in medicines administration and had their competency regularly assessed to ensure they adhered to safe practice. Staff had been trained in protecting people from harm and were confident in their understanding of what safe care meant. Staff were knowledgeable about who they could escalate any concerns about people’s safety to if they ever had a need.
The CQC is required by law to monitor the operation of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) and to report on what we find. The registered manager and staff were knowledgeable about the situations where an assessment of people’s mental capacity could be required. All staff were working within the principles of the MCA. However, not all staff had an embedded understanding of the MCA. This meant that there was a risk of people being provided with aspects of their care that was not always in their best interests. No person using the service lacked capacity to make decisions about their care.
People’s care was provided with compassion by dedicated staff who knew and understood people’s preferences and how to respect these very well. People’s privacy and dignity was maintained by staff using appropriate means. People were supported to make decisions about the aspects of their lives that were important to them.
People were involved in planning their care provision. This included involvement from their relatives, healthcare professionals, social workers and staff. Advocacy arrangements were in place to support those people who required someone to speak up on their behalf. Regular reviews of people’s care were completed to help ensure that people were provided with care and support based upon their latest information.
People were supported to access a range of health care professionals including their physiotherapist, GP, dentist or speech and language therapist (SALT). Health care advice and guidance was adhered to. Prompt action was taken in response to the people’s changing health care needs. People’s health risks were regularly assessed and managed according to each person’s needs.
People were supported to have sufficient quantities of the food and drinks that they preferred and staff encouraged people to eat healthily. People were supported with their nutritional and hydration needs with diets which were appropriate for their needs to help ensure they achieved or maintained a healthy weight. People had the choice to eat when and where they wanted.
People were supported to raise concerns or suggestions in a way which respected their communication skills. Staff responded quickly to any changes in a person’s well-being which indicated if the person was not happy. Information and guidance about how to raise compliments or concerns was made available to people, their relative’s and representatives.
Audits and quality assurance procedures in place helped identify areas for improvement and what worked well. Good practice was shared through a range of forums including visits by the operations’ director, team leader and staff meetings. Staff were supported to develop their skills, increase their knowledge and obtain additional care related qualifications.
We found that care records were current and reflected the needs of people who lived in the home. Staff demonstrated a good understanding and knowledge of the care and support people required.
During our inspection on 18 January 2012 we found that an area of The Manor required refurbishment as it was not safe and suitable for people to live in. During our inspection on 8 May 2013 we found that improvements had been made to this area.The premises were well maintained and records showed that appropriate safety checks had taken place on systems and equipment which meant the home was safe for people to live in.
There were regular ongoing training sessions in place to ensure that staff safely delivered care and support to people.
The provider had a system in place to check that people were satisfied with the service and they had various monitoring checks on a number of aspects of the service.
People told us that they were able to get up and go to bed when they liked. One person did say that 'sometimes' they had to wait for assistance as staff were busy elsewhere. People also told us that how they spent their time during the day was of their own choosing.
The three people who we spoke with said that they felt that their health and physical care needs were met at the home. They said that the staff were 'lovely' and 'kind'. We spoke with them, and a relative, about how people spent their time. They all said that there were activities provided by the activities co-ordinator and that there was a good stock of games and puzzles for people. One person told us about the garden project which had been entered for the local 'village in bloom' event. However, three people also told us that there was lots of time when they felt that there was nothing to do. One person said, "Its very boring here when the staff are busy".
People told us their needs were met by staff although two people raised concerns that they had to wait longer at times due to lower staffing levels and they felt care could be a little rushed. Residents meetings were held regularly and well attended although one person said they did not always feel comfortable raising issues at a meeting but could approach the manager or their deputy who always listened to them. Another person told us they acted as a residents representative taking issues to the manager as well as to wider meetings run by the provider.