The Manor

Updated 21 December 2022

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by two inspectors, a medicines inspector and an Expert By Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

The Manor is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. The Manor is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority safeguarding team and quality assurance and contracts team. We used all this information to plan our inspection.

During the inspection

We met people who lived at the service and spoke with 30 of them about their experience of the care provided. We also spoke with nine relatives visiting the service during the inspection. We spoke with 13 staff, including the registered manager; regional director, nursing and care staff; maintenance and ancillary staff including cleaning staff and kitchen staff.

We reviewed a range of records. This included four people's care records and 13 medication records. We looked at two staff files in relation to recruitment. A variety of records relating to the management of the service, including fire safety, maintenance records and a wide range of monthly audits were also viewed.

Following our inspection visits, we continued to seek clarification from the provider to validate evidence found. We looked at the information sent by the provider. This included quality assurance audits, minutes of staff meetings, staff training records, and the medicines management policy. We also received feedback from seven professionals who worked with the service and one relative.

Updated 21 December 2022

About the service

The Manor provides nursing care and accommodation for up to 86 people. It is arranged over two floors and divided into three units. Hestercombe on the ground floor provides care to older people and the two units on the first floor, Victoria and Vivary provide care and to older people and working age people who have nursing care needs.

At the time of the inspection there were 49 people living at the service; this included six people who were staying for short term respite stays.

People’s experience of using this service and what we found

People were mostly positive about the care and support they received, however, we received mixed feedback about staffing levels, especially from people living on the Hestercombe unit. The registered manager accepted the feedback and staffing was increased by one member of care staff on Hestercombe by the second day of the inspection. We have recommended the provider continues to monitor the deployment of staff across the service to ensure people received safe, effective and prompt care.

People told us they felt safe. Comments included, “I feel safe most of the time. They have got some excellent carers” and “I wouldn’t change it for anything. The staff are excellent” Risks to people had been assessed and mitigated to help keep people safe. People received their medicines safely. Infection control processes protected people from the risk of infection.

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 were supported by staff who were suitably trained and had their competencies assessed. People were supported in a respectful and dignified way and their privacy was respected, and their independence was promoted. The service employed a physiotherapist assistant. Several people spoke highly of the physiotherapist assistant’s help and support.

People's care plans were individualised and reflected their needs and personal preferences. The service worked together with healthcare professionals to ensure people's health, care and wellbeing needs were met.

People were supported and encouraged to pursue activities and interests. An activities programmes was in place and people said they enjoyed a range of activities. The building design met people's needs and the building was fully accessible. The premises were bright and spacious with wide corridors and opportunities to connect with the outdoors.

Quality assurance processes were in place to monitor and improve the quality and safety of the care provided. The provider sought feedback to help drive service improvement. We received positive feedback about the registered manager and how the service was managed since their appointment. Comments included, “The manager will listen” and “You can talk to (the registered manager). I find her very nice”. Professionals told us, “Until (the registered manager’s) appointment the ship was somewhat rudderless… With the registered manager’s appointment, we have found a responsive and effective manager who is clearly getting to grips with any issues and concerns and we have already made great progress”.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was requires improvement (published 21 January 2021).

The provider completed an action plan after the last inspection to show what they would do and by when to improve.

At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

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.

The overall rating for the service has changed to good based on the findings of this inspection.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for The Manor on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.