Manor Barn Nursing Home

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. At our last assessment we rated this key question requires improvement. At this assessment the rating has changed to Good.

This meant people were safe and protected from avoidable harm.

The service was in breach of legal regulation in relation to people’s safe care and treatment. This breach has been met

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People benefited from a positive learning culture where incidents, accidents and concerns were reported, reviewed and used to improve care. Staff described an open culture where they felt supported to raise concerns and discuss mistakes, and leaders promoted a transparent approach focused on learning rather than blame. Incidents were investigated through review and root cause analysis processes, with learning shared across the home and wider provider group. Improvements made following previous concerns had strengthened oversight, reporting arrangements and quality assurance systems. This supported continuous improvement and helped reduce the risk of similar incidents occurring again.

People experienced coordinated care because systems were in place to support safe admissions, transfers and ongoing care. Before people moved into the service, comprehensive assessments were undertaken involving nursing staff, managers, healthcare professionals, people and those important to them. Assessments considered whether people's health and care needs could be safely met within the home and whether the placement was appropriate for both the person and the existing resident group.

Care plans and risk assessments were developed following admission and were updated as staff gained a better understanding of people's needs. Leaders described how care plans were reviewed following accidents, falls, deterioration in health or hospital admissions to ensure information remained accurate and reflected current risks. Staff received updated information through handovers and daily huddles to help maintain continuity and consistency of care.

People were supported safely when accessing external healthcare services. Hospital transfer documentation included information regarding medical history, medicines, resuscitation decisions and current support needs. This helped ensure healthcare professionals had access to the information required to provide safe and effective treatment.

People were protected from abuse, neglect and avoidable harm. Staff understood safeguarding responsibilities and knew how to raise concerns. Leaders maintained oversight of safeguarding matters and investigated concerns appropriately, using learning to strengthen practice and reduce future risks. The provider also monitored the use of restrictive practices and ensured Deprivation of Liberty Safeguards (DoLS) applications were submitted and reviewed where people were deprived of their liberty in order to receive safe care and treatment. This helped ensure people were protected while their rights and freedoms were respected. People and relatives consistently told us they felt safe living at the home. One person told us, "I feel safe here," while a relative said they "never worry about her safety" because staff knew their family member well and responded appropriately to concerns.

People's risks were identified, assessed and managed in a way which promoted safety whilst supporting choice and wellbeing. Care records provided guidance for staff regarding risks associated with mobility, falls, skin integrity, nutrition, hydration, choking, diabetes and long-term health conditions. Staff understood people's risks and described the measures in place to reduce the likelihood of harm.

Leaders took a proactive approach to monitoring changes in people's wellbeing. Concerns identified during care delivery were escalated promptly and appropriate monitoring, care planning and referrals to healthcare professionals were implemented where required. Risks associated with falls, behaviours of distress and dementia-related needs were regularly reviewed, with additional controls introduced when necessary to keep people safe.

People's nutritional and choking risks were also well managed. Staff understood individual dietary needs and observations showed people received support in line with their care plans. Modified meals were prepared in accordance with recognised guidance and presented in a way that promoted both dignity and safety.

People lived in an environment that was clean, safe and suitable for their needs. Observations found the home to be well maintained and equipped to support people living with nursing needs and dementia. Personalised bedrooms, accessible communal areas and specialist equipment supported people to receive care safely and comfortably.

Environmental risks were identified and managed through audits, routine checks and ongoing maintenance arrangements. Provider oversight included regular visits to the home and environmental checks formed part of audit processes. Leaders spoke positively about improvements made following previous concerns and demonstrated oversight of environmental safety through governance systems.

Leaders had considered environmental risks associated with extreme weather and described measures taken to promote hydration and comfort during periods of high temperature. During the assessment we observed readily available drinks, staff regularly offering refreshments and the use of fans throughout the home to improve people's comfort.

People were supported by sufficient numbers of suitably skilled, competent and experienced staff. Relatives consistently described staff as knowledgeable and told us people received care from staff who understood their needs. Feedback highlighted a cohesive team approach, with relatives commenting positively on communication and staff awareness of residents' health and support requirements.

The provider maintained oversight of staffing, competency and training. Training compliance was monitored centrally, with weekly oversight of mandatory training completion. Staff completed comprehensive induction and training programmes and competence assessments were undertaken in key areas, including medicines management. Provider-level oversight ensured training compliance and competency issues were identified promptly.

There was evidence of continuity in staffing arrangements. The service did not routinely use agency staff and utilised permanent and bank staff to provide consistency for people. Leaders monitored dependency levels and adjusted staffing arrangements when people's needs changed. Staff described effective communication systems including daily huddles, handovers and regular meetings which supported safe care delivery.

People were protected from the risk of infection because infection prevention and control systems were embedded in practice. The home was observed to be clean and staff demonstrated an understanding of infection prevention principles. Leaders monitored standards through audits and oversight processes and acted where improvements were identified.

Kitchen and catering staff demonstrated robust hygiene and food safety practices. Systems were in place to monitor food temperatures, fridge temperatures, cleaning schedules and allergens. Staff described measures used to prevent cross-contamination and records demonstrated oversight of food safety processes.

People received their medicines safely and as prescribed. Medicines management systems supported safe ordering, storage, administration and disposal of medicines. We observed medicines administration and found staff followed safe processes whilst also maintaining a person-centred approach. Staff understood individual preferences and explained how people could choose where they preferred to receive their medication.

The provider had invested in electronic medicines management systems which reduced the risk of administration errors and provided real-time oversight of medicines administration. The system generated alerts where doses were missed and enabled leaders to review medicines management practices promptly. Staff demonstrated knowledge of medicines administration processes and records reviewed showed clear documentation and oversight.

Robust arrangements were in place for controlled drugs, stock reconciliation, ordering, competency assessment and responding to medication errors. Records showed medication incidents were investigated, root cause analysis was completed, and learning was shared to support safer practice. Leaders promoted an open culture where staff were encouraged to report errors and near misses so action could be taken to reduce future risks.