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Royal Manor Nursing Home Good

The provider of this service changed - see old profile

Inspection Summary

Overall summary & rating


Updated 20 February 2018

This inspection visit took place on 12 December 2017. At the last inspection in October 2016 the service was rated as Requires Improvement. At this inspection, we found the provider had made some improvements to the service and others were planned or in progress.

Royal Manor Nursing Home is a care home which provides residential and nursing care to older people including people recovering from physical and mental health issues and some who are living with dementia. 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. Royal Manor Nursing Home is registered to provide care for up to 31 people. At the time of our inspection there were 24 people using the service.

The service had a registered manager. 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.

Potential risks people were exposed to had been identified and assessed. Risk assessments provided information and guidance to support staff to carry out their role. However, information in some records was contradictory and could be confusing for staff. Staff were knowledgeable about the needs of people whose behaviours could challenge. Records required further development to ensure staff were provided with clear guidance on interventions and responses to keep people safe.

Staff were able to describe the signs and symptoms of abuse and felt confident to report them. The provider's safeguarding policy required reviewing to provide people and staff with contact details for external agencies to support them to raise concerns outside of the service.

Effective recruitment processes were followed and there were enough staff to meet people's needs. People received their medicines safely and as prescribed.

Systems were in place to ensure the premises were kept clean and hygienic so that people were protected by the prevention and control of infection. We found two items of furniture that presented a risk to the control of infection.

There were arrangements in place for staff to monitor and take action when people experienced accidents or incidents. Further work was required to collect this information and use it to identify trends and patterns in accidents and incidents within the service to improve safety.

People's needs and choices were assessed and their provided in line with their wishes, preference and desired outcomes. People were supported to be involved and make decisions and choices about their care. We made a recommendation about care plans.

Staff were provided with regular opportunities to keep their knowledge and skills up to date. This included essential training and on-going development training. This supported staff to provide effective care based on current best practice.

People were supported to have sufficient to eat and drink in line with their dietary needs. People were supported by staff to use and access a wide variety of other services and health care professionals to maintain their health and well-being. Staff supported people to access health appointments when required to make sure they received continuing healthcare to meet their needs.

Staff demonstrated their understanding of the Mental Capacity Act 2005 (MCA). They gained people's consent before providing care and respected people's right to decline their care.

The provider was in the process of upgrading the décor of the premises to support people using the service.

People had developed positive relationships with staff, who were kind and caring and treated people with respect. Staff understood people's individual needs and preferred means

Inspection areas


Requires improvement

Updated 20 February 2018

The service was not consistently safe.

There were systems in place to protect people from the risk of abuse and staff were aware of their responsibilities. Risks were assessed, records required further detail to provide the information all staff needed to keep people safe from harm or injury. People were supported to take their medicines safely.

The provider analysed and reviewed each accident and incident. Systems required further development to ensure processes were effective in identifying trends and patterns to reduce the risk of accidents/incident or near misses re-occurring.



Updated 20 February 2018

The service was effective.

People's needs were assessed and met by staff who had completed the training they needed to provide effective care. Staff received supervision to support their professional development. People were supported to maintain their health and well-being.

Staff understood the principles of the Mental Capacity Act 2005, including gaining consent to care and people's right to decline their care.



Updated 20 February 2018

The service was caring.

People and their relatives felt staff were kind and caring. People were involved in developing their care plans and provided with support to make choices and decisions about their care.

Staff treated people with respect and could explain how they protected people's right to privacy and dignity. We saw all but one staff member applied this in practice.



Updated 20 February 2018

The service was responsive.

People and those important to them were involved in the development and review of their care. Care plans and assessments were personalised to meet individual needs, wishes and preference.

People were supported to pursue hobbies and interests of their choice. A complaints policy was in place and people knew how to complain if they needed to.



Updated 20 February 2018

The service was well-led.

The management and leadership of the service were supportive of people's needs and provided staff with the guidance and support they needed to provide good care.

People and staff were supported to share their views about the service. Audits and checks were used to drive improvements and develop the service.