Manor Farm Care Home

Updated 2 November 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 team consisted of three inspectors, a pharmacy inspector, a specialist nurse advisor 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

Manor Farm Care Home 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. Manor Farm Care Home 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 inspection, there was not a registered manager in post because the registered manager had recently left employment. There was an interim manager in place and the provider had started the process of recruiting a new permanent manager.

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. 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

We spoke with seven people who used the service and nine relatives. We spoke with 16 staff including the manager, regional director, maintenance person, chef, activities coordinator, two domestic staff, two nurses, one assistant nurse and six healthcare assistants. We looked at a range of management records including, medicines, quality audits and building safety certificates. We reviewed ten people’s care records including risk assessments and seven staff recruitment records. After the site visit, we continued to liaise with the service. The registered manager sent us documentation we asked for and clarified any queries we had.

Updated 2 November 2022

About the service

Manor Farm Care Home is a care home which provides nursing and residential care for up to 81 older people who may be living with dementia. At the time of this inspection there were 68 people using the service. Manor Farm Care Home provides care in one building spread over three floors, each floor is accessible by a lift.

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

We found a number of issues with how medicines were managed. Quality audits did not pick up on the areas we identified with medicines.

People were safeguarded from the risk of harm or abuse. Staff were recruited safely and there were enough staff on duty to meet people’s needs. People had risk assessments to reduce the risk of harm they may face. People were protected from the risks associated from the spread of infection. The provider had a system in place to learn lessons from accidents, incidents and complaints.

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. Staff asked for consent before delivering care. People had their care needs assessed prior to admission.

Staff were supported with regular supervision and training opportunities. People were supported to access healthcare and to meet their nutritional and hydration needs. The building was adapted to meet people’s mobility needs. The service was undergoing a redecoration and refurbishment programme.

Staff were observed to interact with people in a caring manner. People’s cultural and religious needs were met. People and relatives were involved in decision making about the care. Staff promoted people’s privacy, dignity and independence.

Care records were detailed and personalised. There were a variety of activities offered to people and plans in place to enhance what was offered. People’s communication needs were met. The provider had a complaints procedure and complaints were dealt with appropriately. People’s end of life care wishes were documented.

People, relatives and staff spoke positively about the leadership in the service. The provider had regular meetings with people and staff where they could be updated on the service development. The provider worked jointly with healthcare professionals to improve outcomes for people.

We have made a recommendation about environmental safety.

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 14 November 2017).

Why we inspected

This inspection was prompted by concerns raised with us by the local authority about the general safety and care people received. A decision was made for us 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.

We have found evidence that the provider needs to make improvements. Please see the safe and well-led key question sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified breaches in relation to medicines management and quality audits at this inspection.

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

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.