Archived: The Manor Nursing Home

Updated 11 September 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 in part by concerns raised about the care provided in another location owned by the provider. For this reason, we looked at issues around safe care and how well led the service was.

This inspection took place on 15 June 2018 and was unannounced.

The inspection was carried out by an inspector and a specialist advisor. The specialist advisor was a nurse.

Before the inspection we examined information, we held about the service. This included notifications of incidents that the registered persons had sent us since our last inspection. These are events that happened in the service that the registered persons are required to tell us about.

During the inspection we visited both units. We spoke with three people who lived at the service, two members of care staff, one nurse, the provider, the administrator and the registered manager. We also looked at three care records and records that related to how the service was managed including staffing, training and quality assurance.

Updated 11 September 2018

The Manor Nursing Home is a ‘care home with nursing’. 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. It provides accommodation for older people, people living with a learning disability and those with mental health conditions or dementia. The home can accommodate up to 26 people. At the time of our inspection there were 22 people living in the home. Care is provided in two units which are based on a single site.

At the last inspection in August 2017 the service was rated, ‘Requires Improvement’. We found a breach in Regulation 17. The provider had failed to put in place processes and systems to address issues previously identified by CQC. 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 question to at least good. We undertook an unannounced focused inspection of The Manor Nursing Home on 15 June 2018. The team inspected the service against two of the five questions we ask about services: is the service safe, is the service well led? This is because these were areas where concerns had been raised. At this inspection we found the overall rating remained requires improvement. Issues identified at the previous inspection had failed to be fully addressed. This is the third time the service has been rated ‘Requires improvement’. We found their remained a continuous breach of Regulation 17.

No risks, concerns or significant improvement were identified in the remaining Key Questions through our ongoing monitoring or during our inspection activity so we did not inspect them. The ratings from the previous comprehensive inspection for these Key Questions were included in calculating the overall rating in this inspection.

There was 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. In this report when we speak about both the company and the registered manager we refer to them as being, ‘the registered persons’.

Quality checks were being completed but these had not identified some of the issues we found at inspection. Issues identified at previous inspections had not been addressed fully.

Medicines were not managed consistently safely. Where people received their medicines without their knowledge (covertly) the provider had not followed best practice guidelines.

There were arrangements to prevent and control infections.

The provider had ensured that there was enough staff on duty. In addition, people told us that they received person-centred care.

There were systems, processes and practices to safeguard people from situations in which they may experience abuse including financial mistreatment. Risks to people’s safety had been assessed, monitored and managed so they were supported to stay safe while their freedom was respected. Background checks had been consistently completed before new staff had been appointed.

There was a registered manager who promoted a positive culture in the service that was focused upon achieving good outcomes for people. Staff had been helped to understand their responsibilities to develop good team work and to speak out if they had any concerns. People, their relatives and members of staff had not been consistently involved in the running of the service. The registered manager had put in place arrangements that were designed to enable the service to learn and ensure its sustainability. There were arrangements for working in partnership with other agencies to support the development of joined-up care.

The provider had informed us about accidents and incidents.

Further information is in the detailed findings below.