We carried out a review of the data available to us about Walkden Manor on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Walkden Manor, you can give feedback on this service.
Walkden Manor is a residential care home located in Salford, Greater Manchester which can accommodate up to 29 people. At the time of the inspection there were 23 people living at the home.
People’s experience of using this service and what we found
Prior to our inspection, we were contacted by Greater Manchester Fire and Rescue Service (GMFRS) due to concerns they had identified regarding fire safety. Some of the concerns were regarding storage of waste which could assist the spread of a fire, blocked fire exits, inappropriate fire doors and a lack of compartmentation in certain areas of the home. A new risk assessment was also required as it had failed to account for the concerns identified by the fire service.
At the time of our inspection, the home were working towards completing the necessary improvements and had been given until 1 November 2022 and 26 January 2023 to complete the work.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
This last rating for the service was Good (Published August 2021).
Why we inspected
We undertook this targeted inspection to check on a specific concern we had about fire safety. The overall rating for the service has not changed following this targeted inspection and remains Good.
Follow up
We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
People’s experience of using this service and what we found
People told us they felt safe living at Walkden Manor. Safeguarding allegations were reported to the local authority for further investigation. People received their medication as prescribed and we observed the home to be clean and tidy throughout. Staff wore appropriate personal protective equipment (PPE) throughout the day. There were enough staff to care for people safely and correct recruitment procedures were followed.
Auditing and governance systems were in place at both provider and managerial level to monitor the quality of service effectively. Staff meetings took place which enable staff to discuss their work to drive improvements. Staff said they enjoyed their work and spoke of a positive culture at the home. People told us the home was well-led.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was good (published March 2019).
Why we inspected
This was a planned inspection based on the previous rating.
Prior to this inspection we reviewed the information we held about the service. No areas of concern were identified in the other key questions (effective, responsive and caring). We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.
We looked at infection prevention and control (IPC) measures under the Safe key question. We look at this at all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to coronavirus and other infection outbreaks effectively.
The overall rating for the service is good. This is based on the findings at this inspection. You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Walkden Manor on our website at www.cqc.org.uk.
Follow up
We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
Walkden Manor is a residential care home situated in Worsley, Greater Manchester and is registered with the Care Quality Commission to provide care for up to 29 people. At the time of the inspection there were 28 people living at the home.
People’s experience of using this service:
• The atmosphere in the home was calm and relaxed and we observed staff and people engaged in conversation and laughter throughout our inspection.
• Staff had been recruited safely and there were sufficient numbers of staff on duty to meet people's needs.
• Care files were organised and easy to navigate. Risks were appropriately managed and the equipment in place to manage people’s risks was maintained and in good working order.
• The registered manager in collaboration with the activities coordinator and care staff had made positive improvements to the environment and outdoor areas of the home. The themed corridors promoted people’s independence and enabled people to navigate themselves around the home freely.
• People spoke positively of the staff and the care they received. The staff knew people’s needs well and demonstrated they were committed to ensuring people’s individual needs were met.
• Staff received an induction, relevant training and supervision to support them in their role.
• The home was well -led. There was strong leadership in the home and an open and honest culture. When things had gone wrong lessons were learnt and training and support provided to prevent re-occurrence.
• Governance and oversight of the service had continued to improve since our previous inspection. There was an operational structure in place and audits had evolved to ensure compliance with the regulations.
Rating at last inspection: Good but well-led was rated as Requires Improvement; last report published on 11 May 2016. For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Why we inspected: This was a planned inspection based on the rating at the last inspection. The service remains Good but well-led had also improved to Good.
Follow up: Going forward we will continue to monitor intelligence about this service and plan to inspect in line with our re-inspection schedule for those services rated Good. If we receive any information of concern, we may inspect sooner.
Walden Manor is a residential care home situated in Worsley, Greater Manchester and is registered with the Care Quality Commission to provide care for up to 29 people. The home is located on a busy main road in the town and is close to local shops and transport routes.
At our previous inspection on 29 June and 09 July 2015, we found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 in relation to person centred care, dignity and respect, safe care and treatment, good governance and staffing. As a result, we issued requirement notices and four warning notices due to the concerns we had identified. The home was also placed into special measures meaning significant improvements were required, or further enforcement action could be taken. Following this inspection, the home sent us an action plan, detailing the improvements they intended to make.
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. At the time of our inspection, the current home manager had recently returned to the home in January 2016 after previously spending a period of time as manager at the sister home close by. As such, they were not registered with the CQC (Care Quality Commission) as the home manager.
At the previous inspection, we had concerns in relation to risk management, medication, staffing levels, infection control, the safety of the environment and moving and handling techniques used by staff. During this inspection, we saw improvements across all areas. We found there were enough staff available meet people’s needs in a timely manner and we saw lounge areas were not left unattended when in use.
We undertook a tour of the building and found it to be clean and tidy, with domestic staff carrying out their duties during the day. Although many of the people who lived at the home were different than from at our last inspection, we saw people were transferred safely into their chairs by staff, with appropriate moving and handling assessments having been undertaken.
People who lived at the home told us they felt safe. The relatives we spoke with also said they felt their family members were safe living at the home as a result of the care provided. Staff had a good understanding of safeguarding procedures and how to report concerns.
We found appropriate recruitment checks were undertaken before staff started working at the home. This included ensuring references from previous employers were sought and either a DBS/CRB (Disclosure Barring Service/Criminal Records Bureau) check was undertaken.
Medication was given to people by staff who completed relevant training. Regular audits of medication were also undertaken to ensure this was being done safely.
At our previous inspection, we had concerns in relation to staff training, meal times and dementia friendly environments. During this inspection we saw staff had now received appropriate training to support them in their roles and told us they felt well supported. We saw people received appropriate support at meal times and saw that although independence with eating was encouraged, staff prompted people as much as possible to ensure good nutritional intake.
We saw improvements had also been made to make the environment more ‘Dementia Friendly’. This included adequate signage around the building and the use of sensory objects people could touch and use as they walked around the building. There was also a picture of a large, makeshift window, which looked out onto a lake located on the corridor of the ground floor. We saw people looking at this during the inspection on several occasions.
We found appropriate DoLS (Deprivations of Liberty Safeguards) applications had been made by the manager, where people had been deemed to lack capacity to make decisions. Staff had also received training in this area and had an understanding of the legislation.
At our previous inspection we found people weren’t always treated with dignity and respect by staff. This included people not being taken to the toilet in a timely manner and were seated in arm chairs that were not clean. We also saw staff walked directly into people’s rooms rather than knocking first. We were also concerned people were gotten up early by staff, rather than it being their choice.
We saw improvements during this inspection and observed pleasant interactions between staff and people who lived at the home. People were able to get up at times they wanted to and ate breakfast at a time that was suitable to them.
The people we spoke with told us they were happy with the care they received and overall, said they liked the staff. The relatives we spoke with told us they had noticed improvements at the home in recent months.
At the last inspection, we had concerns with staff not providing person centred care, not following guidance in care plans or from other health professionals and not involving people in their on-going care and support. There was also a lack of stimulation and activities for people.
During this inspection, we saw care was provided in line with people’s likes, dislikes and person preferences. Where people had been referred to other agencies for advice such as the falls service or to a dietician, their advice was followed by staff. People were also engaged in an arts and crafts activity in the afternoon of the inspection and we observed staff sitting and engaging in conversation with people who lived at the home.
People had care plans in place which provided relevant guidance about how to care for people. These were reviewed at regular intervals and updated where necessary.
We saw complaints were responded to appropriately, with a detailed response given to each complainant.
At our previous inspection we had concerns with the general leadership and management of the home. We found there were poor governance systems in place which consisted of poor record keeping and ineffective quality assurance systems.
Confidential records were also stored inappropriately and the service did not always send us notifications about certain incidents which had occurred. During this inspection we saw regular auditing was now being undertaken, across all areas of the home. Where any shortfalls had been identified, there was a clear record of what action had been taken.
Staff, relatives and people who lived at the home all spoke favourably about the management and leadership of the home and did not raise any concerns.
We saw the ratings from the previous inspection were displayed near the front door of the home, which is now a legal requirement.
This unannounced inspection took place on 30 June and 9 July 2015.
Walkden Manor is located in Salford, Greater Manchester and is owned by Walkden Manor Care Homes Ltd. The home is registered with the Care Quality Commission (CQC) to provide care for up to 29 people. The home provides care to those with residential care needs, many of whom live with dementia. People’s bedrooms are located on both the ground and first floors of the building. In addition, there are two lounges and a dining room, with doors opening onto a patio area at the rear of the building. Car parking is available at the home, as well as in side streets close by.
We last visited the home in November 2014 where the service was rated as ‘Inadequate’ overall. Since that inspection, the provider sent us action plans in relation to each breach of regulation, telling us about what improvements they planned to make. We also met with the provider on 5 June 2015, where were told that things were progressing well at the home. This inspection focussed on what improvements had been made since our last visit.
During this inspection, we identified five breaches of the Health and Social Care Act (Regulated Activities) Regulations 2014 in relation to Person Centred Care, Dignity and Respect, Safe Care and Treatment, Good Governance and Staffing. We raised these concerns with the home owners and manager who following the inspection, sent us an action plan detailing how these concerns would be addressed, along with any necessary timescales they would be completed in.
At our previous inspection we had concerns with how medication was handled and issued a warning notice in relation to this regulation. At this visit, we still identified problems which meant people did not always receive their medication safely. This is a breach of regulation 12 (2) (g) with regards to the proper and safe management of medicines; of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.
During this inspection we had concerns over the safety of the environment which placed people at risk. We observed a lock on the door to the basement to be broken, which meant that people could easily access the staircase unaccompanied and fall. When we returned to the home on the second day of our inspection, a key pad lock had been added to the door to ensure it was secure
We also saw that window in the lounge was also left wide open, with a gap big enough for somebody to climb through, leading to a busy main road. The window was open when we arrived at the home at 5.40am and anybody from outside could also have gained unauthorised access. These concerns demonstrated a breach of regulation 12 (2) (d) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 in relation to Safe Care and Treatment.
During the inspection, we observed one gentleman who smoked, had managed to gain access to a lighter and as a result, set a handkerchief on fire. This person also had cigarette burns in their coat which placed them at further risk of starting a fire within the home. We found there was no risk assessment in place for the use of a lighter within this persons care plan. On the second day of the inspection, the new home manager had implemented a risk assessment for this person so that staff were aware of the risks this presented and what they needed to monitor.
We saw that moving and handling transfers were not always completed safely. On the first day of our inspection, we observed three transfers which were not completed in a safe manner. This still proved a problem when we visited the home during the second day. In this instance, a new care plan had been implemented for one person who required assistance from two members of staff with all transfers. However, this had not been fully communicated to all staff on shift as we observed one member of staff assisting a person to stand on two occasions. These incidents demonstrated a breach of regulation 12 (2) (a) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 in relation to Safe Care and Treatment.
We also had concerns in relation to infection control and the general cleanliness of the building at our previous inspection. At this visit, we still observed areas of poor practice around the home. These related to a large stain on the floor outside the downstairs bath room, paper towel dispensers being empty, two foot operated pedal bins being broken and hand hygiene guidance not always being located near the sink for people to refer to in the upstairs bathroom. We also observed a mattress with faeces on it at approximately 10am. These issues demonstrated a breach of regulation 12 (2) (h) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 in relation to Safe Care and Treatment.
We also had concerns over night time staffing levels and the fact that there were no staff trained to administer medication through the night. We saw improvements in this area during the inspection, with the staff present being appropriately trained to administer medicines such as pain relief as required on both days of the inspection. Prior to our inspection, we received whistleblowing information, stating that night staff were working at the home without receiving appropriate training first. We looked at old staff rotas and saw that one member of staff in particular had worked 19 night shifts at the home without receiving any training. We asked the home owner and manager to show us evidence of any training records for this person, however they were unable to provide these to us. This is a breach of regulation 18 (1) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 in relation to Staffing. This was because we were unable to see that suitably skilled, qualified and competent staff were working at the home on a consistent basis.
We checked to see what improvements had been made to make the home environment more ‘Dementia friendly’. We saw that signage had been introduced around the home directing people to areas such as bedrooms, toilets and the dining room. Although this had been introduced, wall colourings were still very bland in appearance and things such as people’s bedrooms doors did not clearly stand out, making them easier to locate. There was also a lack of consistency as to who had their name or picture on their bedroom door which meant they may be unable to correctly locate it.
We checked to see what training staff had available to them and if they felt suitably supported to undertake their role. We looked at the training matrix which identified any training undertaken by staff. This showed that staff had received training in areas such as moving and handling, health and safety, infection control and medication. Despite this, the matrix demonstrated that only five members of staff had done Safeguarding Adults training, six had done Dementia training, two had done MCA/DoLS training and that nobody had received any training relating to Challenging Behaviour. This was out of 16 members of staff listed on the matrix. Following our inspection, we asked the home owner to provide us with evidence that staff were appropriately training in these areas, however this was not sent to us. We were told a refresher course in relation to Moving and Handling had been scheduled for Friday 3rd of July.
We observed the lunch time period at the home on the first day of the inspection. The lunch time period lacked oversight and there was nobody ensuring that people’s nutritional needs were being met. For instance at our last inspection, we raised concerns that staff were assisting more than one person at the same time and we saw that this still took place during this inspection. This was not a personalised or dignified way for people to received assistance whilst eating their meal. This improved on the second day of our inspection, with more staff presence in the dining room, where people received individualised support.
There was a lack of stimulation for people during the day with people being left unaccompanied in the lounge areas for long periods. We saw a skittles activity taking place in the afternoon but people told us this did not meet their personal preferences. One person said; “The only activities are skittles, which I‘m well past. We need entertainers to come in to entertain us in the lounge as it can get very boring”. Whilst looking at people’s care plans we saw that ‘bucket lists’ had been created for people containing activities they wanted to undertake. However, there was no evidence these had been explored by staff at the home. Some contained basic activities such as getting out of the home more often, gardening and playing the guitar. These were missed opportunities to provide activities that were personal to people. This is a breach of regulation 9 (1) (c) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 in relation to Person Centred.
We observed several instances where people who lived at the home were not treated with dignity and respect. For example we saw that one person who lived at the home was seated in a chair which had faeces on it. We alerted staff to this and this person was then moved to another chair, however they were not offered a change of clothing. Another person who lived at the home said that they wet themselves because staff had not assisted them to the toilet in a timely manner. These concerns meant there had been a breach of regulation 10 (1) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 in relation to Dignity and Respect.
We saw several examples where people’s personal preferences were not adhered to and we saw no evidence that people were involved in the creation and ongoing review of their care plans. Where people’s care plans specifically stated they would like to do certain things, these were not always provided for them by staff. For instance, about whom they sat with at lunch or the types of clothing they wore. This is a breach of regulation 9 (1) (e) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 in relation to Person Centred Care.
At the time of our inspection, there was no registered manager in post, who was appropriately registered with the Care Quality Commission. A new manager had commenced in post on the day prior to our inspection. 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.
There was a lack of leadership on the day of our inspection, with nobody overseeing what was going on within the home. For instance, there was nobody overseeing the lunchtime period where we identified concerns at our last inspection and nobody overseeing that staff were deployed in the correct areas within the home, which we had observed to be unsupervised. The new manager had only commenced employment at the home the day before we visited and was still getting used to how the home needed to be run. The home owners were present, but again, were not overseeing that things were running smoothly at the home throughout the day and were office based.
At our previous inspection we had concerns in relation to records not being maintained at the home such as charts to people being re-positioned and monitoring food and fluid intake. During this inspection we saw that other records were still not being maintained such as checks on people during the night and continence sheets. We saw these had not been completed since 25 June 2015. We raised this concern where we were told they had been transferred to the back of people’s doors but when we checked, they were still not being completed consistently by staff. This is a breach of regulation 17 (2) (c) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 in relation to Good Governance.
We found that records held at the home were not held securely, with confidential information easily accessible to anybody in the building. For example, on the third floor or the home records waiting to be archived were left in boxes on the floor and could be accessed by anybody. On the second day of the inspection, this area was much tidier with the records being stored beyond a locked door. We also found that the drawer containing staff personnel files was not locked and neither was the office door. Additionally, people’s care plans were either in a drawer that was not locked or left on the side in the office for anybody to read. This is a breach of regulation 17 (2) (d) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 in relation to Good Governance.
There were a range of audits in place which had been completed by the previous manager and also the home owners. They covered care plans, meal time experience, cleanliness, medication, water temperatures, monthly fire equipment checks, weekly H&S and maintenance checks including door guard closure, monthly audits of fire alarm, automatic door closure and exit route checks. A head office audit had also been completed on 2 June 2015 and looked at areas including staff files, training and cleanliness. Despite these audits, they did not identify some of our findings during the inspection for instance that people did not have moving and handling assessments in place, or our environmental concerns. This is a breach of regulation 17 (2) (a) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 in relation to Good Governance.
Following an examination of safeguarding records maintained by the service, we found that the service had failed to notify the Care Quality Commission of abuse or allegation of abuse in relation to people who used the service. This is an offence under Regulation 18 of the Health and Social Care Act 2008(Regulated Activities) Regulations 2014, with regards to notification of other incidents.
The overall rating for this provider is ‘Inadequate’. This means that it has been placed into ‘Special measures’ by CQC. The purpose of special measures is to:
Services placed in special measures will be inspected again within six months. If insufficient improvements have been made such that there remains a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating the service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve. The service will be kept under review and if needed could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement we will move to close the service by adopting our proposal to vary the provider’s registration to remove this location or cancel the provider’s registration.
We are considering our enforcement actions in relation to the regulatory breaches identified. We will report further when any enforcement action is concluded.
Walkden Manor is located in the Worsley area of Salford, Greater Manchester. The home is located on a busy main road and in Worsley and has good access to a range of shops and local transport routes. Car parking is available at the rear of the building and in side streets close by. We last visited the home on the 23 May 2013 and found that the service provider was meeting the requirements of the regulations.
We inspected Walkden Manor on 12 and 26 of November 2014. These were both unannounced inspections which meant staff did not know we would be visiting.
Walkden Manor provided personal care and accommodation for a maximum of 29 people, some of whom had dementia. The home has three floors and at the time of our visits there were 25 people living at the home.
There was a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider.
We found six breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010 in relation to the management of medicines, infection control, staffing, respecting and involving people, care and welfare and record keeping.
These breaches related to regulations 9,12, 17 and 18 of the fundamental standards to with regards to person centred care, safe care and treatment, governance and staffing. You can see what action we told the provider to take in the detailed findings of the report.
Medication was not handled safely. We found staff had allowed a controlled drug to run out for one person who lived at the home before it was re-ordered. This meant this person did not receive their medication for three days. This was a breach of regulation 13 of the Health and Social Care Act 2008 with regards to management of medicines. This relates to regulation 12 of the fundamental standards with regards to safe care and treatment.
We found there were not enough staff at night to safely meet the needs of people who lived at the home. We arrived at the home at approximately 6.30am on both days of our inspections and found only two care assistants were on shift to provide care for 25 people with no senior member of care staff available. As a result, this meant there was nobody available to administer medication during the night if they needed it, such as pain relief. This was a breach of regulation 22 of the Health and Social Care Act 2008 with regards to staffing levels. This relates to regulation 18 of the fundamental standards with regards to staffing.
We saw certain areas of the home were unclean which posed the risk of infection to people. The dining room was dirty and was not cleaned in between breakfast and lunch. There was food on the floor, chairs and food stains on the wall. There was also food stuck to ornaments on the window ledge. We observed skirting boards around the home to have dust on them when we checked them. This was a breach of regulation 12 of the Health and Social Care Act 2008 with regards to cleanliness and infection control. This relates to regulation 12 of the fundamental standards with regards to safe care and treatment.
One person who lived at the home required re-positioning every two hours. We looked at the records completed by staff and found gaps in records between the 4 and 6 of November 2014. The manager told us that the turns had been completed, however could not locate the records. This meant we could not ensure this task had been carried out.
Another person who lived at the home was required to be re-positioned every two hours. We looked at the records completed by staff and found gaps in records between the 4th and 6th of November. The manager told us that the turns had been completed, however could not locate the records. This meant we could not ensure this task had been carried out. These were a breaches of regulation 20 of the Health and Social Care Act 2008 with regards to record keeping. These breaches relate to regulation 17 of the fundamental standards with regards to governance.
We were told by staff that at lunch time, four people needed assistance to eat their food. We observed staff sat in-between two people at the same time and provided assistance rather than providing individual support. This was not a dignified way for people to eat their food and although they did complete their meal, the food would have been cold. During breakfast, on the second day of our inspection we saw one person was not supported to eat their food despite it being recorded as a requirement in their care plan. These were breaches of regulation 9 of the Health and Social Care Act 2008 with regards to care and welfare of people who use the service. This relates to regulation 12 of the fundamental standards with regards to safe care and treatment.
We found peoples choices and personal preferences were not always adhered to. This was because people were not able to choose when they got up in the morning and were instead woken by staff. We spoke with staff during the second day of our inspection who informed us that in the past, there had been a culture at the home where it was expected that a certain number of people would be up from bed by the time the day staff arrived on shift. This was a breach of regulation 17 of the Health and Social Care Act 2008 with regards to respecting and involving people who used the service. This relates to regulation 9 of the fundamental standards with regards to person centred care.
Generally, people and their relatives told us they were treated with dignity and respect.
There was a training matrix used to monitor the training requirements of staff which showed they had undertaken training in a variety of areas. Some topics were listed as ‘booked’ and needed updating such as safeguarding and infection control with a Deprivation of Liberty (DoLS) session for all staff confirmed for December 2014. Some people who lived at the home suffered from dementia, however the training matrix identified three members of staff had not completed dementia training at all, one person last completed the training in 2010 and one in 2011.Other staff had done this in 2013. We raised this with manager who told us these staff would be booked on to the course.
We found the location to be meeting the requirements of the Deprivation of Liberty Safeguards (DoLS) with systems in place to protect people’s rights under the Mental Capacity Act 2005. This legislation protects people who lack capacity and ensures decisions taken on their behalf are made in the person’s best interests and with the least restrictive option to the person's rights and freedoms.
We saw evidence the home involved, and worked closely with other health professionals such as GPs, opticians, district nurses, physios and podiatrists. Staff supervision and appraisal was consistent. The manager told us they took place ‘quarterly’ and we saw records to confirm these had taken place.
We looked at the surveys which were sent to residents, professionals and relatives. No overall analysis of these had been completed and there was no evidence of how things raised had been responded to. This meant it was unclear how peoples views and opinions were used to improve the quality of services provided.
At the time of the inspection the registered manager was spending time at Walkden Manor as well as providing management cover at the sister home in the area. This meant the manager was not always available to provide guidance to staff when they needed it and monitor what was going on. A relative commented; “At the minute, the manager is here one day a week at the most”.
There were a range of audits completed at the home, however they did not identify what action had been taken as a result of issues that were identified. In addition, there no trends analysis on the back of accidents and incidents to monitor any re-occurring themes.
We identified three instances where appropriate notifications had not been submitted to the CQC as required by the registered manager. This included a fall where somebody was hospitalised and two safeguarding incidents which occurred at the home.
We asked people who used the service and their relatives what they thought of the service provided at Walkden Manor. Comments from people included;
'There has been a change in the home since the beginning of the year for the better'. The staff are very attentive to our needs'.
'I like to try and walk every day. I bring the newspapers in each morning'.
'The staff are smashing. I couldn't ask for better people'.
'Care is better than fine. It's definitely the friendliest of all the homes in the area although it is not as posh as some homes in the area'.
'The staff check if I am ok. They make sure I have everything I need'.
We found that people's nutrition and hydration needs had been met and that where required, people were assisted and prompted to eat their meals throughout the day.
We reviewed the staffing rotas and found that there were sufficient staffing levels on the day of our inspection. We also noted through observations that staff were able to meet people's needs in a timely manner.
We looked at audits, surveys and meetings minutes and found that there were appropriate systems in place to monitor the quality of service provision.
During our inspection we found that people had been treated with dignity and respect and had now been involved in their care whilst living at Walkden Manor. One person told us 'The staff are lovely. They treat me very well'.
We looked at whether there were enough suitably, qualified staff in order to meet people's needs at the home. The manager told us that she has increased staffing since our last inspection and was currently still recruiting. From the rota provided we saw that the manager had planned sufficient staffing for the home however on the day of inspection one member of staff had failed to attend their shift. Although the manager worked 'on the floor' to cover this shortfall the effect of being one carer short did impact on the delivery of care within the home.
On the day of our inspection we found that generally, people's nutrition and hydration needs had been met. However, we did observe that some people who required assistance to eat, did not receive support from staff on several occasions.
We checked records and found that they were clear, concise and had been signed by carers and also by people who used the service where possible.
The inspection team was led by a Care Quality Commission (CQC) inspector joined by an Expert by Experience who has personal experience of using or caring for someone who uses this type of service and a practising professional
We also used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us.
We spoke with six people living at the home their comments included: "The home is lovely I enjoy living here." "The staff go and get you anything you ask for inside or outside the home." "It's ok and that the staff are nice."
A visitor expressed concerns that people were "expected to fit into the routines of the home." 'They don't have enough time to spend talking to people.' 'They could do with more staff.'
We asked people if they were able to make choices and one person told us: "I was asked about likes and dislikes." 'The staff give help when it is needed.'