Ealing Manor Nursing Home

On this page

• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

Caring – this means we looked for evidence that the provider involved people and treated them with compassion, kindness, dignity and respect.

This is the first assessment for this service since registered as a partnership in 2024. This key question has been rated requires improvement.

This meant people did not always experience consistently compassionate, person-centred care. Although people generally described positive relationships with staff, some people experienced delays in receiving support and limited opportunities for meaningful engagement, independence and choice.

This service scored 55 (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 consistently experienced care and support that was compassionate, respectful and promoted their dignity.

Some people told us staff did not always have enough time to provide care in a way that met their expectations. One person described personal care as, "Not always gently, it's like a scrubbing brush." Another person told us, "Staff are nice but they do not have time to come and speak." Other people said staff were busy and they sometimes had to wait for support. These experiences indicated people did not always receive care in a way that promoted dignity, comfort and meaningful interaction.

Our observations showed variation in people's experiences. During mealtimes, we saw examples of staff providing kind and respectful support. Staff sat at people's level, encouraged them to eat and offered support calmly. However, we also observed occasions when people waited for assistance because staff were supporting others elsewhere in the service. This reduced opportunities for staff to spend time engaging with people beyond task-based care.

However, much of the feedback about staff was positive. People told us staff treated them well and relatives spoke positively about staff attitudes and approaches. One relative described staff as "Very loving towards everyone." Staff generally knew people well and positive caring interactions were seen throughout the assessment. Although many caring relationships were evident, people's experiences were not consistently positive.

The provider treated people as individuals and generally ensured their care, support and treatment reflected their individual needs, preferences, backgrounds and personal circumstances.

Staff knew people well and were able to describe their individual preferences, routines, interests and support needs. People told us they were able to make choices about their day-to-day lives and one person said, "I do like it here because I can do what I want." Staff were able to explain how they adapted care to reflect people's preferences and personal circumstances.

The provider recognised and responded to people's cultural and dietary needs. Relatives described staff accommodating individual preferences and one relative told us, "If asked they would make Indian food." Another relative described staff as "Very amenable" when supporting a family wedding celebration at the service. Staff also supported people to maintain relationships with family members and worked with relatives to understand people's backgrounds, preferences and routines.

We observed examples of staff responding flexibly to people's preferences and supporting people in a way that reflected their individual needs. Staff demonstrated good knowledge of the people they supported and were able to describe what was important to them.

Staff knowledge and day-to-day practice demonstrated that people's individuality, preferences and personal circumstances were generally recognised and respected.

The provider did not always ensure people were supported to maximise their independence, exercise choice and maintain control over their day-to-day lives.

Some people told us they were unable to access activities, go outside or maintain their independence without support from relatives. One person told us, "Don't get out. Only if daughters take me out." Another person said they would like to sit outside but this was "not offered." A further person told us, "I can't do things for myself here." People also questioned whether activities advertised by the service were always available in practice. This limited opportunities for people to pursue interests, maintain social connections and exercise choice and control over their daily lives.

People’s experiences indicated they were not always supported to do the things that mattered to them. Some people described spending long periods in the home without opportunities to access the local community or spend time outdoors. This reduced opportunities to maintain independence and achieve outcomes that were important to them.

However, staff supported people to make choices in some areas of their daily lives. People were offered choices at mealtimes and observations showed staff respected people’s preferences where possible. Some people maintained aspects of their independence. One person told us, "I do my own hair," while another continued exercises independently following physiotherapy.

Although people were supported to make some day-to-day choices, opportunities to promote independence, choice and control were not always maximised.

The provider did not always ensure people could communicate their immediate needs and receive timely and appropriate support when they required assistance.

People could not always summon assistance when they needed support. During the assessment, several people did not have access to their call bells or had call bells positioned out of reach. On one visit, we heard a person calling out for assistance from their bed. They did not have access to a call bell and could not independently summon staff support. Another person told us, "When it comes to toileting I can't get any help." These experiences demonstrated that people were not always able to request support when they needed it.

Our observations showed people did not always receive timely assistance. During one visit, a person asked for help to remove a heavy cardigan because they were too warm, but staff were not immediately available. We also observed people waiting for support at mealtimes because staff were assisting others in bedrooms. These experiences reflected wider concerns about staff availability and people's ability to access support promptly.

People’s feedback was mixed. Some people told us they sometimes waited for assistance and felt staff were busy. However, other people said they did not usually wait long for support. Staff understood when changes in people's health required urgent attention and records showed appropriate escalation to healthcare professionals when concerns were identified. Healthcare professionals also told us staff appropriately recognised deterioration and sought medical advice when required.

Although staff responded appropriately to changes in people's health, people could not always access support promptly or receive assistance in a timely way when immediate needs arose.

The provider did not always ensure workforce pressures were effectively identified and addressed or that staff consistently felt supported and enabled to deliver high-quality, person-centred care.

Staff described pressures associated with staffing levels, particularly at night. Staff told us there was often 1 care worker on each floor overnight and people who required support from 2 staff sometimes had to wait until assistance became available. One staff member told us, "It is hard at night and we may need more staff." Another staff member said additional staffing during part of the day would be beneficial. These pressures affected staff's ability to spend time with people and respond promptly to all requests for support.

Not all staff felt comfortable raising workforce concerns. One staff member told us they had not spoken to managers about staffing because, "I don't want trouble." Staff meeting records also referred to low staff morale. This reduced assurance that staff consistently felt able to speak openly about workforce pressures and their impact on people's care.

Our observations reflected some of these concerns. During mealtimes there were occasions when limited staff were available in communal areas because other staff were supporting people in bedrooms. Some people waited for assistance and opportunities for meaningful engagement were reduced.

However, most staff described managers as approachable and supportive. One staff member told us, "Management is very supportive," and others said managers listened when concerns were raised. The service also benefited from a stable and long-serving workforce, with many staff having worked at the service for several years.

While positive relationships with leaders were evident, workforce pressures were not always effectively addressed.