Manor Care Home - Middlewich

On this page

• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

Caring – this means we looked for evidence the provider involved people and treated them with compassion, kindness, dignity and respect.

At our last assessment we rated this key question good. At this assessment the rating has changed to requires improvement. This meant people did not always feel well-supported, cared for or treated with dignity and respect.

The service was in breach of legal regulation in relation to dignity and respect.

This service scored 65 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We observed instances where inappropriate language was used by staff when referring to people and their equipment, which did not uphold a person-centred approach. One person was propped up in bed using an unsuitable item, their room contained continence products no longer in use, and prescribed medical aids belonging to others, compromising their privacy and personal space.

Another person was taken for a shower through communal areas, including the dining room and corridor, wearing only nightwear, which exposed their legs and compromised their dignity. At mealtimes, we observed staff standing over people while assisting them to eat which did not promote respectful engagement. On one occasion, a staff member assisting someone with their meal left without offering an explanation.

Inappropriate documentation practices were noted. Sensitive information, including details about people’s care and equipment needs, was displayed on the walls in their bedrooms rather than stored securely in their care records. Additionally, signage in communal areas that identified people as having dementia could be distressing, especially as people may not be aware of their diagnosis.

However, we observed many examples of kind and compassionate interactions. Staff knocked on doors before entering and explained the care they were providing.

People told us they felt well cared for. One person said, “All the staff are nice and very helpful.” Another person commented, “They look after a lot of us and they do a good job.” Relatives spoke positively about the care provided. One relative said, “I do feel they are a caring team here.” Staff treated visiting professionals with kindness and respect.

The provider treated people as individuals and made sure people’s care, support and treatment met people’s needs and preferences. They took account of people’s strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics.

We observed staff tailored their approach based on individual needs. Staff had access to people’s care records and gave examples how people required different approaches. One staff member explained, “If it states in a care plan that somebody should be attempting to walk, we try and find the time and we do this with everybody where possible also with prompting to brush their teeth and to wash themselves.”

People’s individuality was reflected in their living environment. Bedrooms were personalised and decorated to reflect people’s tastes. Special occasions, such as birthdays, were celebrated, and a fortnightly church service was held in the home. Staff were observed engaging warmly with visitors and supporting them to feel welcome. Relatives told us staff understood their loved one’s preferences well and delivered personalised care, including arranging activities that reflected people’s preferences.

The provider promoted people’s independence, so people knew their rights and had choice and control over their own care, treatment and wellbeing.

Staff respected people’s choices and promoted autonomy wherever possible. For example, one person independently managed most of their own care needs and made informed decisions about the level of support they wished to receive, which promoted both their independence and emotional wellbeing.

The provider offered a variety of individual and group activities based on people’s interests. An activity timetable was in place, and a new record of participation to note outings into the community ensured everyone had equal access to excursions and events. People were encouraged to influence the activity programme. Some people had requested more film screenings and the addition of a greenhouse, both of which were implemented. A new outdoor tearoom was created in memory of a previous person who lived at the home.

People were offered choices throughout the day, including when and where to eat. For example, one person asked to eat outdoors, and this was accommodated. Another person changed their mind about their meal choice and was promptly offered an alternative, which they accepted.

The provider did not always listen to and understand people’s needs, views and wishes. Staff did not always respond to people’s needs in the moment or act to minimise any discomfort, concern or distress.

In some cases, care plans did not provide adequate, person-specific guidance for staff to manage emergency situations effectively. One person was diagnosed with epilepsy had no documented information about the type of epilepsy they experienced, known triggers or early warnings signs, or the specific interventions staff should use in the event of a seizure. This lack of personalised risk assessment and emergency planning increased the likelihood of delayed or inappropriate responses during a crisis.

However, we observed a positive example of responsive care; one staff member quickly and calmly intervened when a person started showing signs of agitation. Their timely and skilled response de-escalated the situation effectively, helping the person return to a calm state within moments. People had access to call bells, which were placed within reach for those cared for in bed, aiding them to quickly call for assistance when needed.

The provider cared about and promoted the well-being of their staff, supported and enabled staff to always deliver person-centred care.

Systems were in place to support the well-being of staff. For example, applications forms included questions relating to staff health and well-being, as well as whether any reasonable adjustments were needed. Staff received regular supervision with their line manager, providing opportunities to discuss workload, well-being, and professional development. Staff reported feeling supported by the management team. Comments from staff included, “I do feel our management team is fantastic. The registered manager has such a calm approach, I feel like I’m listened to,” “The managers and colleagues are absolutely brilliant” and “My well-being is supported.”

The provider promoted a positive workplace culture by recognising and valuing staff contributions through initiatives such as Employee of the Month scheme. One staff member was encouraged to develop and roll out a well-being survey for colleagues, further supporting team engagement and contributing to their own development.

However, rotas showed some staff had been working excessive hours, which posed a potential risk to staff well-being and performance. The issue was promptly addressed by the provider.