Manor Care Home - Middlewich

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Responsive – this means we looked for evidence the provider met people’s needs.

At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant people’s needs were met through good organisation and delivery.

This service scored 64 (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 did not always make sure people were at the centre of their care and treatment choices and they did not always work in partnership with people, to decide how to respond to any relevant changes in people’s needs.

Some care plans lacked sufficient detail about people’s backgrounds, life histories, personal preferences, and the management of specific health conditions. Care records did not consistently reflect individual’s physical, mental, emotional, and social needs, nor were they routinely updated to reflect changes in people’s circumstances or preferences.

However, staff and the management team demonstrated a good understanding of the people they supported. People spoke positively about the care they received, with one person saying, “They (staff) do look after us.” A relative said, “They (staff) look after all the main things very well.”

There were some shortfalls in how the provider understood the diverse health and care needs of people, so care was not always joined-up or responsive as it should have been.

For example, care plans were not consistently updated when people’s needs changed, which meant staff did not always have the most accurate or current information to provide appropriate support.

There was evidence of multidisciplinary working. External professionals were involved in care planning and decision-making and confirmed staff appropriately escalated concerns to seek additional support when required. Continuity of care was promoted through consistent staffing arrangements, such as set weekend teams. Staff had access to additional training to enhance their knowledge, including specialist training in dementia, helping to improve their ability to meet complex and individual needs.

Providing information

Score:

3

The provider supplied appropriate, accurate and up-to-date information in formats tailored to individual needs.

Information was available in a variety of formats, including large print and visual formats, such as an activity timetable with pictures, to aid understanding. Noticeboards throughout the home displayed relevant information, and event books and newsletters were clearly presented in the reception area for easy access. Where needed, staff provided information verbally and adapted their communication approach to suit the individual. One staff member told us, “When people have difficulty communicating, we learn how to communicate with them by spending time with them.”

The service user guide provided clear, transparent details about the home’s terms and conditions, helping people and their families understand what to expect from the service.

The provider supplied appropriate, accurate and up-to-date information in formats tailored to individual needs.

Information was available in a variety of formats, including large print and visual formats, such as an activity timetable with pictures, to aid understanding. Noticeboards throughout the home displayed relevant information, and event books and newsletters were clearly presented in the reception area for easy access. Where needed, staff provided information verbally and adapted their communication approach to suit the individual. One staff member told us, “When people have difficulty communicating, we learn how to communicate with them by spending time with them.”

The service user guide provided clear, transparent details about the home’s terms and conditions, helping people and their families understand what to expect from the service.

The provider had an open door policy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff involved people in decisions about their care and told them what had changed as a result.

People told us they felt confident to raise concerns and knew who to speak. One relative said, “All staff are approachable.”

A complaints policy was in place, and records showed complaints were investigated thoroughly, with outcomes clearly shared with those involved.

Feedback mechanisms were in place, including annual surveys which showed mainly positive responses. However, regular resident and family meetings had stopped due to low attendance, reducing opportunities for shared feedback. Following this, the registered manager reacted proactively by introducing new ways to gather views. These included a dedicated survey for relatives, regular one-to-one feedback sessions with a selection of people each month, and the launch of weekend coffee mornings.

The provider did not always make sure people could access the care, support and treatment they needed when they needed it.

There were delays in making some referrals, such as to occupational therapy, which placed people at risk of harm. Once this was identified, the registered manager acted quickly by introducing a referral monitoring system to improve oversight and ensure timely access to services.

However, referrals to other specialist services, such as speech and language therapy, were made promptly. Staff routinely contacted healthcare professionals, including GPs and community nurses, for advice and support when required.

The service was regularly visited by a range of health and social care professionals, helping to ensure people received coordinated care. For people without a regular dentist, referrals were made to community dental services to meet their oral health needs. An out-of-hours on-call system ensured support and guidance were always accessible in emergencies or when urgent care was needed.

Staff and leaders actively listened to information about people who were most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this.

Staff could describe examples of reasonable adjustments made to promote accessibility and improve outcomes, for example, the provision of mobility aids, commodes, and hoists tailored to individual needs.

Cultural awareness and inclusion were actively promoted through events that celebrated different backgrounds. For example, during an Indian cultural day, staff engaged in cooking traditional dishes and participating in dance activities.

People were supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life.

Documented plans were in place that reflected people’s wishes, including preferences for where they wanted to be cared for at the end of their life, whether they wanted hospital admission, and details of Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) decisions where applicable.

The registered manager told us, “We aim for people not to be alone and not go to hospital if they can be comfortable here.” Staff had received end-of-life training to ensure a compassionate and respectful approach to supporting people and their families during this time.

One staff member said, “I ask the team leader if it is okay to enter and clean the room, then ask the resident if I can come in.”