Manor Barn Nursing Home

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence. This is the first assessment for this newly registered service. This key question has been rated requires improvement. This meant the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent. The service was in breach of legal regulation in relation to person-centred care.

This service scored 58 (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 make sure people’s care and treatment was effective because they did not check and discuss people’s health, care, wellbeing and communication needs with them. Assessments and reviews of people’s health, care and wellbeing needs were not completed consistently. Some were detailed in areas but were not always holistic. A person with dementia was spending their days in bed. An assessment noted they were at risk of social isolation but there was no structured plan in place to guide staff in how to reduce this risk. Another person who was diabetic had no risk assessment or care plan to detail how risks associated with diabetes should be managed. The provider had failed to complete a functional assessment for people with learning disabilities. This meant there was not a planned approach to supporting a person’s needs and staff were not providing consistent support. Some assessments and care plans provided clear guidance for staff in meeting people’s communication needs. For example, a care plan included the use of whiteboards, notebooks and an electronic tablet to support one person to communicate their needs. One person’s care plan included that staff should encourage sign language, however, staff had not received training in sign language to be able to support this method of communication.

The provider did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them. They did not always follow legislation and current evidence-based good practice and standards.

People’s care and support was not always planned and delivered in a person-centred way. A person with learning disabilities had not received a comprehensive functional assessment to support evidence-based care planning. This meant staff did not have the guidance they needed to support the person in a structured way to improve skills, increase levels of independence and develop their interests.

Staff were using some evidence-based systems to meet people’s health care needs. This included assessing and monitoring risks of malnutrition, skin integrity and continence as well as using a pain scale for people who were not able to verbally communicate if they were in pain.

The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

Staff described effective systems for sharing information between themselves and with other services. One staff member explained how the electronic care planning system enabled staff to be informed about people’s needs. They said, “Any important information is on the electronic system, and we also receive updates in emails and at staff meetings.” A relative described improvements in how staff worked together and said they were knowledgeable about people’s needs and any changes. They told us, “Senior staff and nurses are always available to discuss any questions I may have.”

A health care professional spoke highly of staff working in partnership with them. They said, “The nurses often make time to join us when we are carrying out a patient review.” They explained how this helped to provide information, context and to discuss any concerns.

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.

People and their relatives told us they were supported to maintain their health. One relative told us, “I am very impressed and reassured with the frequency of thorough medical checks that mum receives.” A person told us how their health care had improved, they said, “It’s been better since they (staff) had some training.” A health care professional described staff as being “Proactive, and good advocates for people regarding their health needs.” Records showed staff were supporting people to access health care services when they needed them.

The provider did not always routinely monitor people’s care and treatment to continuously improve it. They did not always ensure outcomes were positive and consistent, or that they met both clinical expectations and the expectations of people themselves.

Some people with swallowing difficulties required a thickening powder to be added to their drinks. There was no system in place to record that the powder had been added. This meant the provider could not be assured that people were consistently supported with fluids safely. Following this assessment the registered manager provided evidence of a new recording system to ensure staff were administering thickening powder when needed.

Some people were not able to use a call bell to attract attention when they needed support. Alternative systems for monitoring people were not always effective. Following this assessment the registered manager provided evidence of new arrangements to ensure staff were checking people’s wellbeing regularly.

Staff lacked understanding about how to identify and support positive outcomes for people with learning disabilities. For example, there was a failure to consider how to support independence and develop new skills and there was no health action plan in place to monitor health outcomes.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment.

People told us staff checked with them before providing care, one person said, “They always ask me first.” We observed staff were checking with people before providing care or supporting them to move. Staff had received training in the Mental Capacity Act 2005 and gave examples that demonstrated their understanding. One staff member told us how family members and the GP were involved when considering a decision in a person’s best interest. They said, “We make sure people’s views and wishes are considered.” Records showed people’s ability to consent had been assessed. Some people had Deprivation of Liberty Safeguards (DoLS) in place. Where conditions had been imposed the registered manager had ensured appropriate actions were taken to meet the conditions.