You are here

Manor Park Requires improvement

Reports


Inspection carried out on 12 August 2019

During an inspection looking at part of the service

About the service: 24 Manor Park Grove is a residential care home that was providing personal and nursing care to five people with a learning disability. The care home accommodates people in a domestic style house with some adaptations.

People’s experience of using this service:

Although staff knew people’s needs and the risks people may present, people were not always supported effectively and consistently by staff.

Systems to monitor the quality and safety of the service had not been effective at monitoring and improving the quality of the service.

The home was clean, and people’s rooms were personalised. However, some environmental risk were not well managed.

People were supported to receive their medication as prescribed and systems were in place to ensure only suitable staff were recruited.

The service applied some of the principles and values of Registering the Right Support and other best practice guidance. The care setting was domestic in style and layout providing a comfortable and homely environment for people to live in. However, we saw limited opportunities for people in terms of choice, control, and independence.

We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this full report.

The Secretary of State has asked the Care Quality Commission (CQC) to conduct a thematic review and to make recommendations about the use of restrictive interventions in settings that provide care for people with or who might have mental health problems, learning disabilities and/or autism. Thematic reviews look in-depth at specific issues concerning quality of care across the health and social care sectors. They expand our understanding of both good and poor practice and of the potential drivers of improvement.

As part of thematic review, we carried out a survey with the registered manager at this inspection. This considered whether the service used any restrictive intervention practices (restraint, seclusion and segregation) when supporting people. The service used some restrictive intervention practices as a last resort, in a person-centred way, in line with positive behaviour support principles.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection:

The last rating for this service was Good (report published February 2019)

Why we inspected

We received concerns that indicated people were not receiving safe care and treatment. As a result, we undertook a focused inspection to review the Key Questions of Safe and Well-led only.

The overall rating for the service has changed from good to requires improvement. This is based on the findings at this inspection.

Enforcement

We have identified breaches in relation to safe care and treatment and good governance at this inspection.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded

Follow up:

We will continue to monitor the service through the information we receive until we return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.

Inspection carried out on 21 January 2019

During a routine inspection

This inspection took place on the 21 January 2019 and was unannounced. Manor Park is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Manor Park is registered for five people with learning difficulties. On the day of our inspection, five people were living at the service.

At the last inspection on 24 May 2016 the service was rated good. At this inspection the provider and registered manager had maintained this good rating overall. Historically the home has a sustained a history of compliance with legal requirements.

The home has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen. People living at Manor Park could live a life as fully as they were able in a homely environment that had been created to meet their needs.

On the day of our inspection there was a registered manager in post who was available throughout the 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 was run.

There were effective systems in place to monitor the quality and safety of the service provided. However, a lack of attention to the maintenance and repairs by the maintenance staff indicated that the home was not well maintained.

People living at the service were protected from the risk of harm because the provider had processes in place to ensure their safety. Staff all knew and understood their responsibilities in relation to protecting people from abuse and had had received the training they needed to support their understanding of safeguarding adults. The registered manager had fulfilled their legal responsibilities and had reported any issues to the local safeguarding teams and CQC.

People were supported by enough staff who had been adequately trained. Staff competence was regularly assessed to check their understanding. The registered manager followed robust recruitment checks to ensure that staff employed were suitable to support people using the service with all aspects of their care. People received their prescribed medication safely.

People’s needs were assessed and there was person centred guidance available for staff to follow about how to meet people’s needs. This meant that staff knew how people liked their care to be delivered and what was important to them.

Staff sought consent from people before caring for them and they clearly understood and followed the principles of the Mental Capacity Act, 2005 (MCA). Where people were deprived of their liberty, processes had been followed to ensure that this was done lawfully.

The service was well led and staff spoke warmly about the people living there. We saw that people and relatives were treated with kindness. Staff supported people with respect and dignity, and had developed some positive relationships with people.

People received care that met their individual needs, people’s views and preferences were sought and staff provided people with opportunities to have a meaningful and interesting life and be integrated into the local community.

Information about people’s care was provided in formats that were accessible to people so that they could understand. The registered manager provided strong and stable leadership and clear direction to the staff team who said they felt supported.

Inspection carried out on 24 May 2016

During a routine inspection

This inspection took place on 24 May 2016 and was unannounced. The inspection team consisted of one inspector. At our last comprehensive inspection in February 2015 we found that people who used the service were not being supported in line with the requirements of the Mental Capacity Act 2005. Following the inspection the registered provider gave us reassurances and sent us plans about how they would ensure they met the needs of the people they were supporting and their legal requirements. During this inspection we found this had improved.

Manor Park is a care home without nursing for up to five people who have learning disabilities. At the time of the visit three people were using the service. The home had a registered manager although they had been off work for some time. 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 of the Health and Social Care Act 2008 and associated Regulations about how the service is run. The service and staff were being supported by a registered manager from another of the provider’s homes and was present during our inspection.

People’s relatives and staff told us they felt people were safe in the home. Staff were aware of the need to keep people safe and they knew how to report allegations or suspicions of poor practice.

People were protected from possible errors in relation to their medication because the arrangements for the storage, administration and recording of medication were good and there were systems for checking that medication had been administered to people in the correct way.

People’s relatives told us that they were very happy with the care provided. People had opportunities to participate in a range of activities in the home and community, but staff respected people’s wishes when they wanted to be alone in their rooms.

People’s relatives and friends were encouraged to visit and made welcome by staff.

Staff regularly asked people how they wanted to be supported and when necessary people were supported by those important to them to express their views. People were treated with dignity and respect.

Staff understood the needs of the people who used the service and how they liked to be supported. We saw that staff communicated well with each other.

Staff were appropriately trained, skilled and supervised and they received opportunities to further develop their skills.

The manager and staff we spoke with understood the principles of protecting the legal and civil rights of people using the service.

People were supported to have their mental and physical healthcare needs met and were encouraged to maintain a healthy lifestyle. The manager sought and took advice from relevant health professionals when needed.

People were provided with a good choice of food in sufficient quantities and were supported to eat meals which met their nutritional needs and suited their preferences.

The temporary manager had provided effective leadership to ensure staff were well motivated and enthusiastic. The manager and provider assessed and monitored the quality of care consistently through observation and regular audits of events and practice.

Inspection carried out on 24 February 2015

During a routine inspection

This inspection took place on 24 February 2015 and was unannounced.

Manor Park is a residential home which provides care to people who have learning disabilities. The service is registered with the Commission to provide personal care for up to five people however at the time of our inspection three people were using the service. There was a registered manager at this location, although they were not present during our inspection we spoke with them during the day on the telephone. 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 and associated Regulations about how the service is run.

At our last inspection in July 2013 the provider was compliant with all the regulations we looked at.

We observed staff continually ask people how they wanted their care to be delivered and supported them in line with their requests. People were relaxed with staff and confident to approach them for support. Staff said they enjoyed supporting people and spoke affectionately about the people who used the service. People were supported to pursue the interests they said they liked such as listening to music and going to restaurants. During our inspection staff supported people to go out into the community for lunch in line with their wishes. People were also supported to be as independent as they wished such as helping to prepare their meals and wash their laundry.

People were supported to maintain relationships which were important to them such as meeting with relatives and attending their chosen place of worship. People were supported by staff to express their views about the service at monthly meetings and were involved in discussing the care they received. Relatives told us they were involved in the planning and reviewing their relative’s care and were often approached by the provider to comment on the service when they visited or spoke to staff on the telephone.

The provider had conducted assessments to identify if people were at risk of harm and if so had included guidance about how this could be reduced. People’s medicines were managed safely and there were care plans for people who were known to be at risk of malnutrition. Records which monitored people’s nutritional intake and weight were up to date so that people were supported to eat and drink enough to keep them well. We saw that when necessary the provider had involved other healthcare professionals such as dieticians in people’s care.

All the relatives and staff we spoke with told us that they felt there were enough staff to meet people’s care needs. Staff were able to demonstrate they had the skills and knowledge to communicate effectively with the people who used the service and expressed a good knowledge of what people liked to eat. Although the registered manager was away during our visit, a member of staff who was acting up in to the manager’s role was knowledgeable about their additional responsibilities. Staff were supported with their personal development and to deliver what was required of their roles.

People were kept safe and staff could know how to recognise when people might be at risk of harm and the provider’s process for reporting any concerns. Records showed that the provider had worked with other agencies when they had received information of concern in order to keep people safe. This protected people from the risk of abuse.

The provider did not always follow their responsibilities under the Mental Capacity Act 2005 (MCA) They had not conducted assessments when people were thought to lack capacity or held meetings to ensure decisions were made in the best interests of the people who used the service. When people lacked capacity, the provider had not taken action to seek that the care and treatment people received restricted their movement and rights under the MCA. The provider had not ensured that staff were clear about the requirements of the Mental Capacity Act 2005 (MCA). You can see what action we have told the provider to take at the back of the full version of the report.

Relatives told us the provider regularly sought their views when assessing the quality of the service although there were no formal arrangements in place to capture the views of people who did not visit the service. Relatives said they felt the provider acted on their opinions. Staff said the registered manager was approachable and responded to their concerns promptly. There were process in place to enable staff to express their views and records showed that the provider had taken action in response to issues raised at regular meetings.

The provider had a system to assess the quality of the service and identify how it could be improved. The provider had developed an action plan to implement improvements at the service and we saw that most actions had been completed on time.

Inspection carried out on 5 July 2013

During a routine inspection

People could not tell us their experience of the service because of their complex needs and conditions. We spent two hours in the communal areas of the home observing how people were cared for. Staff communicated well with people including people with no verbal communication.

We noted that people were positively engaged with their surroundings and the people around them. Staff encouraged and supported them to be at the centre of all activity including some of the tasks of running the home such as making a dessert for the evening meal.

We found that people's needs were assessed to establish the care that they needed and care was planned and delivered in line with their individual care plan.

We found that people's food and hydration needs were assessed by health care specialists and care plans were updated accordingly. Staff followed the guidance provided by specialists to protect people from risks such as choking. There were systems in place to monitor the food and drink intake of people identified as being at risk of poor nutrition or hydration.

We found that there were sufficient numbers of staff on duty to meet people's needs and staff understood people's needs. Staffing levels had some flexibility and could be decided on the basis of people's needs and level of risk. Staff were trained and properly supported to provide care to people who used the service and were encouraged to acquire qualifications and further skills relevant to the work that they do.

Inspection carried out on 14 May 2012

During a routine inspection

We visited the service on 14 May 2012. People we spoke with were not able to tell us about their experience of living at the home because of their complex needs. We spent three hours in the communal areas of the home observing how people were cared for. We used a number of different methods to help us understand the experiences of people using the service.

We met three of the people who lived in the home on the day of our visit. They each looked well cared for. Each person looked at ease with workers and managers and engaged in what was going on.

We saw and heard workers and managers treat people with respect and dignity.

Inspection carried out on 20 October 2011

During an inspection looking at part of the service

We did not speak with people who are using the service because we did not visit the home.

Inspection carried out on 17 May 2011

During a routine inspection

We did not ask for or receive any direct quotes from people using the service. However, we did receive the following information:

During our visit we spoke to a person in her bedroom. She told us that staff provided good standards of care. She explained that if staff were worried about her health they would ask a professional to get involved. She said that she had been unwell lately and people were trying to find out why and that she had recently had some tests. Throughout our discussions with her she did not express any concerns about they way that staff had responded to or were handling her health issues.

Reports under our old system of regulation (including those from before CQC was created)