Archived: Manor Court

Updated 21 December 2015

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place over four days on 01 June 2015, 04 June 2015, 08 June 2015 and 11 June 2015. An unannounced inspection took place on the first day; this meant the registered provider did not know we would be visiting. The registered provider knew that we would be returning on the following three days. Two inspectors, a specialist advisor and an expert by experience were involved at different points during this inspection. An expert by experience is a person who has had personal experience of using or caring for someone who uses this type of care service.

Before the inspection we reviewed all of the information we held about Manor Court which included notifications which we had received from the service and the local authority who commissioned the service. Notifications are changes, events or incidents that the provider is legally obliged to send us within the required timescale. We also spoke with the local clinical commissioning group (CCG) and the local authority commissioning team about the service.

The provider was not asked to complete a provider information return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make.

During the inspection we spoke with the registered manager, operations manager, administrator, handyman and ten care staff. We also spoke with 12 people who used the service. Throughout our inspection we observed care and support in communal areas of the home and spoke with people in private who lived at the home. We reviewed eight care records, 17 staff files and records relating to the management of the home including policies and procedures. We explored some areas in more detail because we wanted to see what action the registered provider had taken to address the areas of non-compliance from the last inspection.

Updated 21 December 2015

This inspection took place over four days on 01 June 2015, 04 June 2015, 08 June 2015 and 11 June 2015. An unannounced inspection took place on the first day. This meant the registered providers did not know we would be visiting. The registered providers knew that we would be returning on the following three days.

Manor Court is a care home offering accommodation to up to 20 older people. It is situated in the rural village of Moorsholm. The home provides accommodation over two floors. The ground floor houses two communal lounges and a separate dining room with an outdoor courtyard to the rear of the property. There are four bedrooms which offer en-suite facilities.

The home had a registered manager in place. 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. The registered manager was also one of the registered providers and had worked at Manor Court for many years.

We previously inspected Manor Court in September 2014 and October 2014. At that inspection we found the service was not compliant with Regulations 10, 11, 12 and 23 of the Health and Social Care Act 2008, regulated activities 2010. We found there were no systems in place to monitor the quality of the service and records were not up to date or did not contain the information needed to care for people. People were not protected from the risk of infection because equipment and facilities had not been maintained. Cleaning in the home was not up to date and there was a lack of personal protective equipment and hand wash in bathrooms. Safeguarding concerns had not been reported appropriately and staff knowledge about safeguarding and the procedures was limited. Supervision, appraisal and training was not up to date for staff. This meant that staff were not supported to carry out their roles.

Infection control procedures had not improved at this inspection and were inadequate to ensure people were protected from the risks associated with poor cleanliness and infection. We found the home was not clean and hot water temperatures did not meet the required standards. Bathrooms and toilets were not consistently stocked with hand wash, paper towels, hand gel and foot operated bins.

Some staff training had been carried out, but there were gaps in some areas, such as infection control, diabetes, dementia and the Mental capacity Act. Also the registered manager had not undertaken any refresher training and albeit they cooked the food had not undertaken basic food hygiene level two training, which is an essential when catering. We found that supervision and appraisals had not been carried out with staff despite this being highlighted at the last inspection.

Managerial oversight of the home remained inadequate and we found that the systems in place were not effective. Staff shared their concerns about the leadership which was provided at the home. Staff did not feel the management were consistent in their approach and were unsure about the roles of the management team.

Meetings for people who used the service, their relatives and staff had not been carried out. This meant that information was not always disseminated to everyone.

Care documentation was not personalised and did not consistently contain the information required. There were gaps in the recording of information about people’s involvement in decision making.

People were not always involved in decisions which affected them. Appropriate support [advocate or independent mental capacity advisor] had not been sought for people.

There were enough staff in place to provide care and support to people, however staff were responsible for caring, cleaning, laundry and food preparation and cooking. We could see that staff put people first which meant that cleaning and laundry tasks were left.

Everyone we spoke with told us they felt safe living at the home and felt well cared for by staff. A safeguarding record was in place and we could see that a recent safeguarding alert had been appropriately dealt with. All staff had a good understanding about the types of abuse and the procedures which they needed to follow.

Appropriate procedures for dealing with medicines were in place. Medicines were stored safely and staff had received up to date training.

People had the equipment they needed. Checks of equipment and the building were in place.

People had access to enough food and hydration. We found cupboards were well stocked. People spoke positively about the food which was provided.

Health professionals regularly visited the home. Records showed that referrals had been completed when needed and staff carried out the advice given to them. People were supported to attend appointments.

Everyone we spoke with knew how to make a complaint and all staff we spoke with knew what action they needed to take. At the time of our inspection, nobody we spoke with wished to make a complaint.

We found breaches in the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. There were no dedicated staff to conduct laundry, catering and cleaning duties. Training, supervision and appraisals were not up to date. Infection prevention and control procedures were not up to date. Care records were not personalised and did not always contain the information required. Quality assurance methods were not consistently carried out.

You can see what action we told the provider to take at the back of the full version of this report.