• Care Home
  • Care home

Manor House Residential Home

Overall: Requires improvement read more about inspection ratings

58-60 Main Street, Middleton, Market Harborough, Leicestershire, LE16 8YU (01536) 771722

Provided and run by:
RKL Living Ltd

All Inspections

1 February 2023

During an inspection looking at part of the service

About the service

Manor House Residential Home is a residential care home providing accommodation for up to 22 people who require personal care , some of whom are living with dementia. The service is a converted period property. At the time of our inspection there were 17 people using the service.

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

The provider’s systems and processes to assess and monitor the safety and quality of people’s care continued to require further improvement and development.

We found the provider had not fully implemented the actions they told us they would take following their previous inspection.

We found improvements were needed in areas not identified by the provider.

The provider’s policies and procedures were not consistently implemented by staff or understood.

Audits and practices to monitor the service had failed to monitor and keep under review staff knowledge, training and competence in key areas, which included medicine management and safeguarding people from abuse. Some staff had not undertaken training in topics related to the promotion of people’s health and well-being.

People’s safety was not assured as staff were not confident in identifying all types of potential abuse. Staff did not always follow the procedure for the administration of medication or the monitoring of safe medicine management. However, we found no evidence that people had not received their medicine as prescribed.

People and their family members told us they felt safe at Manor House Residential Home, as staff were available to help them when required. People were supported by sufficient staff who had undergone a safe recruitment process. People lived in an environment with safe infection and prevention measures.

People’s health and wellbeing needs were assessed, and their health and welfare monitored by staff. Staff liaised with health care professionals about people’s care. People’s dietary needs were met and people were assisted by staff where required to eat and drink. Snacks and drinks were served throughout the day. A plan for ongoing environmental improvements to décor and furnishings was in place.

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 family members were complimentary about the service and spoke of good communication with the management team. The provider sought feedback from family members about the quality of the service and undertook an analysis of the findings.

The provider had identified areas for improvement, which included the planned introduction of an electronic system for the recording and monitoring of people’s care, including medication and medicine systems.

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 5 February 2020) and there were breaches of regulation. The service remains rated Requires Improvement. This service has been rated Requires Improvement for two consecutive inspections.

Why we inspected

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

We carried out an unannounced comprehensive inspection of this service on 7 January 2020. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve Safe care and treatment, Safeguarding service users from abuse and improper treatment and Good governance.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe, Effective and Well-led which contain those requirements.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service remains the same. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Manor House Residential Home on our website at www.cqc.org.uk.

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.

Enforcement and Recommendations

We have identified continued breaches in relation to safeguarding people from abuse and good governance, which included staff training and competency, and the implementation of some policies and procedures. We also found concerns related to medicine administration and medicine systems.

Please see the action we have told the provider to take at the end of this report.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

7 January 2020

During a routine inspection

About the service

Manor House Residential Home is a residential care home for up to 22 older people living with dementia. At the time of inspection there were 21 people living at the home.

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

There was a registered manager who had been the manager of the service since it registered with CQC in October 2010.

The provider did not have adequate systems in place to assess and monitor the safety and quality of people’s care. Their policies were outdated and did not reflect current practice. The provider had not carried out regular audits to maintain the safety of the environment, fire safety procedures, decoration or repairs. Immediately following the inspection, the provider implemented systems to monitor and improve the safety of the home; these systems needed to be shared with staff and embedded into practice.

Staff did not always understand how to safeguard people from the risk of harm. Following the inspection, the provider updated their policy and put in systems to identify when incidents occurred and when to report to safeguarding. These systems require embedding to be effective.

Staff were recruited using safe recruitment practices, however, the provider did not have systems in place to ensure staff remained safe to work.

There were enough staff deployed to meet people’s needs. People’s medicines were managed in a safe way. People’s risks were assessed at regular intervals or as their needs changed. Care plans informed staff how to provide care that mitigated these known risks. People were supported to access relevant health and social care professionals.

People received care from staff they knew. Staff had a good understanding of people's needs, choices and preferences. People and their representatives were encouraged to be involved in planning how their care was provided. Staff gained people's consent before providing personal care and ensured their privacy and dignity were maintained.

Staff received training to enable them to meet people’s needs and were supported to carry out their roles.

There was a complaints system in place and people were confident that any complaints would be responded to appropriately.

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.

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

Rating at last inspection

The last rating for this service was Good (published 22 July 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

We identified three breaches of regulation in relation to safety of the environment; safeguarding and management oversight. Please see the action we have told the provider to take at the end of this report.

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.

4 July 2017

During a routine inspection

Manor House Residential Home provides care for up to 22 people living with dementia some of who experience behaviours that may challenge others. The home consists of two floors, communal areas and gardens in the village of Middleton in Northamptonshire.

At the last inspection, the service was rated Good; at this inspection we found the service remained Good.

The service continued to provide safe care to people living with dementia. Staff understood their responsibilities for safeguarding people from harm and followed the provider’s policies to provide people’s prescribed medicines safely. There were enough suitably skilled staff to meet people’s needs. Staff had been recruited using safe recruitment practices.

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 received care from staff that had received training to meet people’s specific needs around their dementia. Staff were compassionate and helped to develop positive relationships with people which helped to manage behaviours which may challenge others.

People received a balanced diet from staff that understood their dietary needs. People were helped to maintain their independence and dignity by the use of suitable crockery and support from staff.

People were treated with respect and helped to maintain their dignity.

People were supported to access healthcare professionals and staff were prompt in referring people to health services when required.

People’s risks were assessed and staff had person-centred care plans they followed to mitigate these risks. Care plans were updated regularly and people and their relatives were involved in their care planning where possible.

Staff sought people’s consent before providing care and people’s mental capacity was assessed in line with the Mental Capacity Act 2005. The registered manager understood their responsibilities and referred people appropriately for assessment under the Deprivation of Liberty Safeguarding.

The provider and registered manager continually assessed, monitored and evaluated the quality of the service to identify areas for improvement, and implement change where required.

25 June 2015

During a routine inspection

This unannounced inspection took place on 25 June 2015. The home provides support for up to 22 people living with dementia. At the time of the inspection there were 19 people living at the home. The home has an Enhanced Dementia Classification (EDC) which enables people to be supported with advanced dementia through to end of life care.

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.

People told us that they felt safe in the home. Staff understood the need to protect people from harm and abuse and knew what action they should take if they had any concerns. Staffing levels ensured that people received the support they required at the times they needed. We observed that on the day of our inspection there were sufficient staff on duty. The recruitment practice protected people from being cared for by staff that were unsuitable to work at the home.

Care records contained risk assessments to protect people from identified risks and help to keep them safe. They gave information for staff on the identified risk and informed staff on the measures to take to minimise any risks.

People were supported to take their medicines as prescribed. Records showed that medicines were obtained, stored, administered and disposed of safely. People were supported to maintain good health and had access to healthcare services when needed.

People were actively involved in decision about their care and support needs. There were formal systems in place to assess people’s capacity for decision making under the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS). People felt safe and there were clear lines of reporting safeguarding concerns to appropriate agencies and staff were knowledgeable about safeguarding adults.

Care plans were in place detailing how people wished to be supported and people were involved in making decisions about their care. People participated in a range of activities both in the home and in the community and received the support they needed to help them do this. People were able to choose where they spent their time and what they did. Pictorial formats of upcoming events and signage around the home to support with daily living was in place.

Staff had good relationships with the people who lived at the home. Complaints were appropriately investigated and action was taken to make improvements to the service when this was found to be necessary. The registered manager was visible and accessible. Staff and people living in the home were confident that issues would be addressed and that any concerns they had would be listened to.

27 November 2013

During an inspection looking at part of the service

Our inspection of 6 June 2013 found that risk assessments for the building and premises had not been completed for some time. During this inspection we saw that risk assessments were being carried out on at least a weekly basis. The action taken when risk was identified was also recorded.

We were unable to speak with people who used the service about the safety and suitability of the premises. We spoke with a relative of a person who had recently moved in. They told us they were satisfied with the care and support their relative received. They said "the staff are very caring and spend a lot of time with people".

6 June 2013

During a routine inspection

We spoke with two people who used the service. Both said they liked the staff who supported them. We observed staff interacting with people who used the service. Staff were respectful, kind and helpful. We saw that people who used the service were occupied and engaged in activities that were meaningful to them.

We looked at the safety and accessibility of the premises. The provider had carried out some refurbishment since our last visit in January 2013. We saw that risk assessments of the premises had not been carried out for some time.

11, 15 January 2013

During a routine inspection

We used a number of different methods to help us understand the experiences of people using the service because the people using the service had complex needs which meant they were not able to tell us their experiences. We observed that people who used the service were treated with respect and dignity. People had their privacy respected and were able to maintain as much independence as possible.

5 April 2011

During a routine inspection

We spoke with several people using the service who told us they were happy with the quality of care and support provided. They found staff were confident and trained to provide the care that they needed, respectfully and in the manner that suited them.

People said they had opportunities to take part in activities organised by the home and receive visitors at any time. People are supported to continue their interests and hobbies, such as gardening, reading the newspaper and singing.

Staff were observed interacting with people well and providing encouragement, support and the care that they needed. Some of the comments we received from people using the service included:

'I find the staff do respect me'

'I choose what I want to do and when'

'I don't need much help but I know staff do have to help others'

'Nothing's too much for the staff'

'Am quite happy and safe here'

'I've got nothing to complain about'

'It's very good here, as you can see, there's always something happening here'

'We do get on with life, everyday is different and we do different things. I have to say we do enjoy a good sing-song'

'Have nothing to complain about, quite happy and if there was a problem you just tell them'

The local authority who commission services and carry out contract monitoring visits at the home. They gave us positive feedback about the quality of care provided at the home, especially in relation to maintaining the wellbeing of people with dementia, thus preventing them having to move into a nursing home.

The Local Involvement Networks (LINks) members were consulted on this issue. We received one response, commenting positively about the provision of care, health and medication support, choice of meals, respecting people's privacy and dignity, trained staff supporting people and cleanliness of the home.