Manor Hall Nursing Home

The proposed designated care setting is a unit for up to five people with its own communal space. There was a separate entrance to be used solely for the designated care setting and a separate outdoor space as well.

We found the following examples of good practice.

The home was clean and well maintained. There was regular cleaning throughout the day, and this included high-touch areas. Robust cleaning schedules were in place. The deputy manager and the head housekeeper were the infection control leads for the home and undertook spot checks on staff practice. The deputy manager also did daily walk rounds to observe practice and support staff and people.

Staff were provided with adequate supplies of PPE and staff were seen to be wearing this appropriately. Staff had received specific COVID-19 training from the provider, and this included guidance for staff about how to put on and take off personal protective equipment (PPE) safely. Updates and refresher training took place to ensure all staff followed the latest good practice guidance. Staff were seen to be following correct infection prevention and control practices (IPC). Hand sanitiser was readily available throughout the home. infection control leads undertook spot checks on staff competency and practice on the use of PPE.

There were systems in place to enable people to remain in contact with their families by phone calls and video calls during the pandemic. Each bedroom had a telephone to facilitate this. Communication aids were available to help people with hearing difficulties to understand what staff wearing face masks were saying to them.

The provider had regular testing for COVID-19 in place. All staff have a weekly PCR and daily lateral flow device test (LFD).

The registered manager had plans in place to ensure that staff working in the designated care setting would not need to access the rest of the service. This included separate entrances and bathrooms for staff.

We were assured that this service met good infection prevention and control guidelines as a designated care setting.

Further information is in the detailed findings below.

The proposed designated care setting is a unit for up to five people. There was a separate entrance to be used solely for the designated care setting and a separate outdoor space as well.

We found the following examples of good practice.

• Staff had completed training about COVID-19 and how to prevent the spread of the virus.

• Bedrooms had their own phones installed. This was to make it easier for residents to have contact with friends and family.

• Communication aids were available to help people with hearing difficulties to understand what staff wearing face masks were saying to them.

• The provider already had regular testing for COVID-19 in place to ensure all staff were tested every week.

• The registered manager had plans in place to ensure that staff working in the designated care setting would not need to access the rest of the service.

We were assured that this service met good infection prevention and control guidelines as a designated care setting.

Further information is in the detailed findings below.

Manor Hall Nursing Home provides personal care and accommodation for a maximum of 44 older people who live with frailty and long- term health needs such as diabetes and Parkinson’s disease. Some people also lived with dementia. There were 36 people living there at the time of our inspection.

The service is in its first year under a new provider which has had it challenges. There have been staff changes, especially at management level, which had impacted on their implementation of change and taking the service forward. Since November 2019 a new management team was created which has strengthened the team. This has been reflected in the report.

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

Systems and processes to assess, monitor and improve the quality and safety of the service provided were in place. However, there were areas of people’s documentation that needed to be improved to ensure people received consistent, safe care. There was a new management team who commenced employment in November 2019. They have introduced comprehensive audits however time was still needed for a cycle of all audits to be completed. Action plans generated from audits still needed to be completed for us to be able to assess if auditing systems were always effective to sustain improvements.

People received safe care and support by staff who had been appropriately recruited, trained to recognise signs of abuse or risk and understood what to do to safely support people. One person said, “I like living here, it’s comfortable and I’m safe.” A visitor said, “I visit all the time, they look after her very well, she is safe here.” Medicines were given safely to people by trained and knowledgeable staff, who had been assessed as competent. There were enough staff to meet people's needs. Staff were deployed in a planned way, with the correct training, skills and experience to meet people’s needs. Infection control was well managed and the home was well-maintained and free from hazards.

Staff received the training they needed to meet people’s needs safely and effectively. The training matrix tracked staff training ensuring all staff received the training and updates needed to provide safe consistent care. The staff rotas confirmed that staff deployment was consistent and that staff skills were considered when planning the rotas. A plan of supervision to support staff was available. One staff member said, “We get supervision every two months I think, we have a new manager, who is approachable.” People’s nutritional and health needs were consistently met with involvement from a variety of health and social care professionals. Peoples’ weight was monitored and fortified food provided when necessary. People enjoyed the food and comments included, “Pretty good,” and “Tasty, sometimes too much.” Visitors felt the food was “Good” and their relatives were eating well.

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.

Everyone we spoke to was consistent in their views that staff were very kind, caring and supportive. People were relaxed, comfortable and happy in the company of staff and we saw positive staff interactions during the inspection. Visitors told us, “Amazing staff,” and “Kind and caring, second to none.” People’s independence was considered important by all staff and their privacy and dignity was also promoted.

Staff delivered care in a person-centred way based on people's preferences and wishes, which were clearly documented.

People were involved in their care planning as much as they could be and families told us that they were involved in the well-being of their loved ones. One visitor said, “I discuss my relatives care with staff, I feel involved.”

Complaints made by people or their relatives were taken seriously and thoroughly investigated. The management team were committed to continuously improve their service. They had developed structures and plans to develop and consistently drive improvement within the service and maintain their care delivery to a good standard.

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

Rating at last inspection

This service was registered with us on 09/04/2019 and this is the first inspection.

Why we inspected:

The inspection was prompted in part due to concerns received about care documentation and care delivery. A decision was made for us to inspect and examine those risks.

Follow up:

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.