The Manor Care Home

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.This is the first assessment for this service registered under different legal entity/provider. This key question has been rated good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 71 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider made sure people’s care and treatment were effective by assessing and reviewing their health, care, wellbeing and communication needs with them. People had care plans that covered areas such as health and well-being to meet people’s individual needs. Professionals were positive about the service and their support for people. People and their families were involved in the reviews and assessment of their needs, and support was provided where needed to maximise their involvement. People and relatives told us they were happy with the staff’s support.

Staff had access to people’s care plans and risk assessments. They were aware of the different needs of people and related risks. Staff were able to navigate the system and provide us with information for our assessment. Staff said any changes in people’s needs were reported and discussed in meetings on how best to support them. People’s care and support were also reviewed as part of the scheme in the service, called ‘Resident of the day’.

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. Relatives were kept up-to-date with people’s care and support and informed about any changes. The manager worked with and sought support from different stakeholders to ensure people’s care was in line with legislation and current evidence-based good practice and standards. The manager and the staff team were motivated to plan and deliver people’s care and treatment, including what was important and mattered to them.People’s nutrition and hydration needs were met in line with current guidance. People and relatives were mostly positive about meal times and choices. People said, “The food is lovely. I do enjoy my glass of wine. They’re pretty good on the food, they’ll make something else if I don’t like it” and “It’s good, I love food. You get plenty of food. If I don’t like it, I tell them and they take it away and ask me what I want.”Kitchen staff communicated with the staff team on a regular basis to ensure they had the right information on people’s diets, preferences and any specific requirements. People could have a drink or snack at any time. We observed that people had drinks available to them and were encouraged to maintain their hydration.

The provider worked well across the teams and services to support people. The information was shared between teams and services to ensure continuity of care and when people were referred between services. Staff shared information and communicated with each other about planning tasks throughout the day. The provider worked in collaboration across teams and services to support people as they moved between services so that people had positive outcomes. When people came to live in the service, staff observed and reviewed their care to ensure any adjustments were made to their care plans. Relevant teams and services were involved in assessing, planning and delivering people's care and treatment.

The provider and staff supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live a healthier life and, where possible, reduce their future needs for care and support. Staff sought medical support from healthcare professionals when required. People had wellbeing meetings to review their health and wellbeing needs. These were held with staff, people and families to discuss various matters to ensure people’s care was appropriate. The service liaised with different external professionals such as occupational therapists, physiotherapists, speech and language therapists, community nurses and GP surgeries. The managers and the staff were knowledgeable and informed about people’s health and wellbeing.

The provider routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves. The manager and staff worked together to ensure that outcomes for people were positive and consistent. People had care and support that was co-ordinated, and everyone worked well together. The manager added, “We use clinical risk meetings, for example, [there was a person with a gap near their bed] and it was discussed in the meeting and staff were able to contribute to the process. With people and changing needs, we know that we need to review and update as and when needed. I go out and speak to the staff to let them know about any changes.”The manager and the staffing team worked together to use effective approaches to monitor people’s care and treatment and their outcomes. We observed staff were calm, respectful and attentive to people’s emotions and support needs.

The provider did not tell people about their rights regarding consent or respect these when delivering care and treatment. People’s rights were not fully protected when they needed covert medicines. One person at the service was receiving their medicines covertly; this involves giving medicines to a person without their knowledge or consent. The provider’s policy noted this process should only be considered in exceptional circumstances and used as a last resort. However, the provider did not ensure an appropriate care plan was in place, including how to attempt medicine administration first before progressing to covert administration if needed. This would ensure covert administration was used as a last resort and for the shortest period. There was no evidence to show the person was continuously refusing medicines to justify the use of covert administration or that regular reviews were taking place to ensure the covert administration was still needed and used for the shortest time. This meant people’s rights were not respected or upheld, making the process unjustified. Some people had monitoring devices installed in their bedrooms to manage risks associated with their mobility. This included the use of sensor mats and motion sensors. However, the provider did not ensure that people’s consent was sought prior to installing the devices. For example, 2 people had motion sensors in their bedrooms, but there was no decision specific mental capacity assessment for this decision, nor a best interest decision to ensure it was the least restrictive option. One assessment for another person was completed after our assessment. This meant people’s rights were not always protected and respected in line with the Mental Capacity Act 2005 (MCA) to ensure that less restrictive options had been considered.

During our visit, we also observed people's rights to make their own decisions about their daily life were respected. Staff understood how to support people with different daily decisions. Staff sought people's consent before providing care or support. We observed staff were polite, kind and respectful towards people and respected their decisions. If people did not want to take part in an activity, the staff responded appropriately. The manager told us how they communicated and encouraged staff to assume capacity, support people with their choices, wishes and right to refuse care. People agreed staff checked with them and respected their decisions about their daily life.