Archived: Manor Cottage R/H

1-3 Manor Crescent, Paignton, Devon, TQ3 2NT (01803) 550363

Provided and run by:
Mr Kenneth Peek

All Inspections

10 December 2012

During an inspection looking at part of the service

We (the Care Quality Commission) spoke with the acting manager and looked at the care records for three people.

During this inspection we followed up on improvements required following an inspection in October 2012 when a warning notice was served relating the maintenance of records. We found that some improvements had been made and the specific areas of concern in the warning notices had been addressed. However the home was not fully compliant with the outcome as a whole.

We saw that the format for care plans had changed. We also saw that records relating to food and fluid charts, risk assessments, and instructions to staff had improved.

18, 22 October 2012

During a routine inspection

We visited this service because we needed to follow up issues of non compliance that we identified at our visit in May 2012. We had also received some concerns relating to the heating and hot water at the home.

One person told us that they liked living at the home and said "They are so kind here, I'm well looked after".

Staff that we spoke with knew the needs of the people living at the home. Care records did not reflect this knowledge and in many cases records were inaccurate and out of date.

We found that although people liked living at the home, some of their needs were not being met adequately.

We found that staff were now receiving regular supervision sessions to support them in their jobs, but that they had received no further training since our last visit.

16 May 2012

During an inspection looking at part of the service

Manor Cottage was last visited by the Care Quality Commission in April 2011. At that visit, we (the Care Quality Commission) found that Manor Cottage was not meeting one or more essential standards and that improvements were needed. During this inspection we looked to see if these improvements had been made.

The owner, Mr Peek is currently at the home daily, overseeing the management of the home. He told us that he is advertising for a new manager.

This inspection took place over two days and three inspectors were involved.

People we spoke with said they felt well treated and their privacy and dignity were respected. We saw examples of where people were being treated with respect by staff. We saw a privacy screen in place in one double occupancy room.

We looked at some care records to see how people's care was planned and delivered. One person told us that he was "happy here. The staff are all friendly". He also told us that his care needs were being met and the staff allowed him to be independent, which he liked.

At our last visit we found that care and treatment was not being planned and delivered in a way that ensured people's safety and welfare. We found that improvements had been made, but this was not reflected in the recordings we saw.

We looked at the care records for four of the people who lived in the home to find out how the home had assessed their health and personal care needs, and how they planned to meet those needs. Each person had a care file that contained a range of documents relating to their care and support needs.

Staff told us they were made aware of any changes to people's needs at handovers but they also told us they rarely looked at the care plans. We saw some evidence that care plans were reviewed and updated. We looked at the daily recordings for people. We saw that these 'evaluation sheets' were completed during the morning, afternoon, evening and night time. However, we looked at these around 11am and saw that some recordings stated the person had 'drinks given throughout morning and checked on' another stated 'sat in lounge listening to music till lunch', but lunch was not till 12.30pm. This gave the impression that staff were writing records for events before they happened.

Following our visit we spoke on the telephone with a visiting social care professional who was also monitoring the care at the home. They told us that they felt things had improved at the home and that people's needs were being met.

Staff were able to tell us about different types of abuse and what they would do if they suspected abuse was occurring. However, the provider may wish to note that one staff member told us that they had not received any training in this area and another told us they were unaware of the home's safeguarding or Whistleblowing policies.

We toured the communal areas of the home and looked in some of the bedrooms. The home was generally clean and tidy throughout. However, the provider may wish to note that some areas of the kitchen were very dirty.

We found that there had been improvements to the way medicines were handled since our previous visit. We saw that medicines were kept safely, and that there were new systems for storing controlled drugs correctly, and suitable arrangements for medicines needing cold storage in a refrigerator.

People that we spoke with praised all the staff who work at the home. We also spoke with the staff and observed them while they provided care and support to people who use the service. We heard staff speaking with people in a kind and respectful manner and they responded promptly, discreetly and sensitively to people when they asked questions or needed help.

On our second visit there were 17 people living at the home with three care staff on duty and a cook and cleaner. The owner of the home was also present.

People's care records were not always accurate and up to date. We saw that in some cases risk assessments relating to people's health care needs had not been fully completed and therefore people were at risk of receiving inappropriate care or treatment.

17 April 2012

During an inspection in response to concerns

We carried out an unannounced inspection to Manor Cottage on Tuesday 17th April 2012, two inspectors were present

We met or saw all but one of the people living at the home at the time of our visit. We spoke with four people living at the home; one person told us 'It's very good, I am happy enough'. Another person said 'The staff are good to me I have no complaints'.

A number of people living at Manor Cottage have dementia type illnesses and did not have the ability to express their views on whether their privacy and dignity was respected, whether their needs were met or if they had a choice.

We did saw staff knocking on bedroom doors before entering and they offered choices as to what drinks people could have and where they would like to sit.

We observed the care delivered to people living at the home, looked at what support people got and whether they had positive experiences.

Overall we saw people were treated respectfully by staff. People's privacy was generally maintained with basic choices, for example where they sat or what they ate. However, people's preferences in relation to their individual needs were not being met or recorded consistently.

We found that care plans did not always contain up to date information about people's changing needs.

1 November 2011

During an inspection looking at part of the service

We visited the home on two days: 24 October and 1 November 2011. The people we spoke with appreciated staff encouraging them to do things for themselves. One person said, 'Although I need assistance to get into and out of the bath the staff leave the bathroom and let me get on with it which is how I like it'. She added that a call bell is to hand should she require help.

At our last visit to the home we noted some call bells were out of reach and would not be reached by people when they were in bed. We saw one call bell lodged behind a wardrobe. During this visit, the same call bell was wedged behind the same wardrobe. This means that if a person was on the floor they would not be able to summon help. We were told that staff do daily checks on peoples bedrooms but noted that checks to ensure call bells are accessible were not included on this list. There were varied views on the speed with which the staff responded to the call bells with some saying, 'Right-away' and others saying, 'Can be up to 20 minutes if they are busy somewhere else'.

The people we spoke with stressed how good and helpful the staff were with phrases such as, 'The girls are lovely', 'Kind and gentle', 'They look after me very well', 'Girls alright', 'Staff ' no problem at all', 'They look after us very well, very kind', and 'I get on alright with the staff'.

The people we saw appeared well cared for. People who had decided to stay in bed looked warm and comfortable. People were wearing appropriate footwear and had access to drinks.

We spoke with one visitor who was also pleased with the care his family member received.

Care records had also improved since the last inspection, but continue to need further improvement to make sure people get the care they need.

We noted that there had been many improvements in the cleanliness and hygiene of the home. However, we also noted that the systems to detect and control cleanliness and hygiene were not as effective as they could be.

People in the home told us that they are happy with the way that medicines are given, and reported no problems. We watched people being given their medicines at lunchtime. We saw that they are given in a safe way. People were encouraged to take their medicines and they were asked if they needed any medicines that were prescribed to be given 'when required'.

6 September 2011

During an inspection in response to concerns

People at the home are able to choose where they spend their day. One person told us 'I'm alright', 'my room is small but the garden is nice'.

We found that, during the morning, much of the communication and interaction we saw was either task based or based around staff giving information such as telling people it was time for a meal. We observed that some staff members were hurried and off-hand in their attitude and manner with people. Three people were able to talk to us when we spoke with them individually. Two of these people were anxious about different matters and sought reassurance from us. Throughout our visit we observed that people were left for long periods without any interactions by staff.

People told us they thought they were well cared for. Despite this we were told by two people that they were wearing some one else's clothes. Staff told us they often got mixed up when they were not labelled. We saw two bedrooms that were each being shared by two people. Neither of these rooms had a screen available for privacy should the occupants of these rooms want to undress or need personal care.

People appreciated the activities on offer. One person said they particularly enjoyed the quizzes organised by staff. On the afternoon of our visit a visiting activities provider spent a couple of hours engaging people in an armchair exercise class. The people participating appeared to enjoy this.

People we talked to about the food at Manor Cottage were positive. One person described the food as 'great' and another person said it was 'always good'. People said that a three course lunch was served daily with vegetable soup offered as a first course. People told us there was always plenty to eat. Staff explained that the kitchen was never closed so making snacks at all times of the day and night was easy to do.

People did not comment on the poor cleanliness in the home and thought staff were 'very nice'.