Manor Barn Nursing Home

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Responsive – this means we looked for evidence that the provider met people’s needs.

This is the first assessment for this newly registered service. This key question has been rated requires improvement. This meant people’s needs were not always met.

The service was in breach of legal regulation in relation to person centred care.

This service scored 61 (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 always ensure people were at the centre of their care and treatment choices. There was not always a holistic approach to providing person-centred care.

People’s need for social stimulation was not consistently assessed and considered in a personalised way. Some people were spending the majority of their time in their bedroom, but risks of social isolation were not consistently assessed and managed. People told us, and we observed, they were not supported with meaningful activities that were relevant to them. This was having a negative impact on people’s quality of life. The registered manager told us of plans to recruit a member of staff to develop an activities programme but this had not yet been implemented.

A person with learning disabilities was not receiving the social support and stimulation they needed and staff were not trained and experienced in providing care for people with learning disabilities. We observed an activity taking place where a person was receiving a number of verbal prompts. They showed signs of becoming upset because they could not follow the instructions, the inspector intervened to prevent further distress. Staff had not provided the facilitator with any guidance about how to support a person with this activity. Language staff used to describe a person’s needs, including within their care plan, was not always appropriate and did not reflect a respectful and person-centred approach.

Following this assessment the registered manager provided information about how they would address these shortfalls.

The provider understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supportive of choice and continuity.

People and their relatives said staff supported their health and care needs in a flexible way. One person described how staff co-ordinated appointments for them, saying, “They are very helpful and make sure I attend when I need to.” A relative said, “The manager arranged for a member of staff to take us to the hospital in the home's minibus, they couldn’t have been kinder.” A health care professional spoke positively about how staff had worked collaboratively to ensure good continuity of care for a person who had specific health needs. They told us, “They (staff) have actively sort out support and guidance to ensure they are giving care appropriately.”

The provider did not always supply appropriate, accurate and up-to-date information in formats that were tailored to individual needs. Some people had communication needs which required information to be provided in a specific format. Care plans identified people’s communication needs including those due to sensory loss or confusion related to living with dementia. However, there was a lack of guidance for staff in how to meet these needs. Staff were guided to support people to make choices but there was a lack of clarity about how best to provide information to enable meaningful choice. A person living with a learning disability was able to understand some Makaton sign language. Their care plan included that staff should encourage sign language. However, staff did not have access to visual Makaton signs and symbols and had not received training in the use of Makaton. Staff lacked understanding of the requirements of Accessible Information Standards and the registered manager said this was an area of practice that they were aware needed further work and there were plans to make improvements.

The provider made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff involved people in decisions about their care and told them what had changed as a result.

People and their relatives told us they felt able to raise any issues or concerns with staff. One relative described improvement in communication systems. They said, “Regular monthly meetings have been established for all relatives and friends, signposting any changes and upcoming matters which I find helpful.”

People and their relatives told us they were aware of the provider’s complaints procedure and said they would feel confident to raise any concerns. One relative told us there had been concerns raised about shortfalls in arranged activities. They said, “Sometimes programmed activities do not happen on the day, which can be disappointing for residents, however we have been told activities staff have been recruited. I am encouraged that the situation will become more settled.” Another relative told us they had raised concerns previously but felt the service was improving and described being involved in decisions.

The provider made sure that people could access the care, support and treatment they needed when they needed it.

People and their relatives told us they were supported to access services they needed. One person said, “I usually make my own appointments but if I am struggling the staff will step in and help.” A relative spoke positively about the support they had received taking their loved one to a hospital appointment. They told us, “The positive and friendly attitude (of the staff member) helped reduce the stress of the hospital trip for both (person’s name), and myself.”

Staff and leaders did not always actively listen to information about people who are most likely to experience inequality in experience or outcomes. This meant people’s care was not always tailored in response to this. Some people who lived with dementia experienced difficulties with orientation. The provider had not given full consideration to creating a dementia friendly environment to reduce barriers and enhance people’s quality of life and experiences. Hospital passports are intended to support communication when people with learning disabilities go to hospital or access other health services, to reduce risks of them experiencing inequality. The provider had not identified the need for a hospital passport to be in place to provide information regarding the person’s individual needs. Staff were not focussed on how to support outcomes and enable people to live a good, ordinary life as part of their local community.

People were supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life.

Staff described effective communication and joint working with staff from a local hospice. This supported care planning when people had specific needs at the end of life. One staff member told us, “I really like to provide end of life care, I can access training when I need it.”

People and their relatives had been involved, where appropriate, to develop plans that documented people’s wishes and any special arrangements that were required to ensure people were cared for in the way they preferred. One relative told us, “They have already put medicines in place in case they are needed, because things could change quickly.”