Royal Manor Nursing Home

Updated 22 July 2023

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 2 inspectors. An Expert by Experience spoke via telephone to people’s relatives the day after our visit to the home. 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

Royal Manor nursing home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and we looked at both during this inspection.

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided. At the time of our inspection there was not a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. 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 used all this information to plan our inspection.

During the inspection

Inspection activity started on 21 June and ended on 22 June. We visited Royal Manor nursing home on 21 June 2023.

We observed the support the people received to help us understand their experience of receiving care. We spoke with 4 people that were using the service and 10 people’s relatives, 5 members of staff including the operations manager, deputy manager, care staff, cook and activities coordinator. We reviewed a range of records. This included care records and medicines records. We looked at 3 staff files in relation to recruitment and training.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We reviewed a variety of records that were sent to us by email, relating to the management of the service. This included audits and feedback from staff, people using the service and relatives.

Updated 22 July 2023

About the service

Royal Manor Nursing Home is a care home service with nursing providing personal care to people aged 65 and over. The service can support up to 30 people. At the time of the inspection 25 people were using the service.

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

There was no registered manager in post. It is a legal requirement to have a registered manager in post and at the time of the inspection there had been no registered manager since July 2022. The provider had recruited a manager to the post twice since the registered manager left but neither person have remained in post.

Individual assessments were in place to enable staff to support people safely. However, we identified some potential environmental risks. These were addressed during and following the inspection.

A policy regarding safeguarding the people using the service, included information about restraint. We asked the provider to clarify the services position on restraint. This has now been done and confirms the home has a no restraint policy. This ensures that staff have clear guidance. Staff understood the safeguarding procedure to follow to report any concerns and we saw that training had been provided.

People’s needs were assessed prior to moving to the service and they were supported in line with current evidence-based guidance and in accordance with their preferences. People were supported to take their prescribed medicines safely by trained staff. Audits were undertaken to monitor medicines management.

People confirmed there were enough staff and we saw sufficient staff were available to meet their needs. People were supported by staff whose suitability was checked before they commenced employment.

People were supported to follow their dietary requirements and preferences. Where people were at risk of malnutrition and dehydration this was monitored, and referrals made to the relevant healthcare professionals. People were supported to access health care services.

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.

The home was cleaned to a good standard and well maintained. We saw staff used disposable aprons and gloves when required.

People and their relatives confirmed the staff were caring and considerate. People were supported to maintain their privacy and dignity and their wishes were respected. Care plans included people’s needs and preferences and life histories, to enable staff to understand people better. People’s religious/ faith needs were met.

People, relatives, and staff were encouraged to feedback into the running of the service. Complaints were addressed and a procedure was in place.

Audits were in place to monitor the quality of the service and make improvements where needed. The management team worked alongside partner agencies to enhance the support provided to people.

Rating at last inspection (and update)

The last rating for this service was requires improvement (published 25 June 2022)). Since we awarded this rating, the registered provider of the service has changed. We have used the previous rating to inform our planning and decisions about the rating at this inspection. This is the first inspection for this provider.

Why we inspected

We were prompted to carry out this inspection due to concerns we received about the management oversight of the service. A decision was made for us to inspect and examine those risks.

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.