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Archived: Manor House Inadequate

Inspection Summary

Overall summary & rating


Updated 18 June 2016

We undertook an unannounced inspection of this service on 5, 6, 7 and 8 May 2016. Manor House is registered to provide accommodation and personal care for up to 22 older people who may be living with dementia. The premises are a detached house with a garden, situated in Lydd. The service has 19 bedrooms, three of which are twin rooms. Eight rooms have ensuite facilities. Bedrooms are spread over two floors which can be accessed by the use of a passenger lift. People had access to two bathrooms, separate toilets and a dining room, lounge and quiet lounge. 14 people were living at Manor House at the time of the inspection.

Our previous focused inspection, on 9 February 2016, found breaches of four regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We asked the provider to take action in relation to staffing levels, safeguarding people from abuse, staff recruitment processes and to protect people in the event of an emergency. The provider gave us an action plan, although this did not address the actions required. At this inspection we found that no improvements had been made.

The service had a registered manager. 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 provider and registered manager did not have oversight of the service. The quality of all areas of the service had not been checked to make sure they were of the required standard. The registered provider and registered manager were not aware of the shortfalls in the service that we found at the inspection. The registered manager had not informed us of important events that happened at the service without a delay.

People did not always receive care at the time that they needed or wanted it. Staff did not always respond to people’s needs or calls for assistance.

People were not protected from abuse and avoidable harm as incidents had not been recognised or recorded and responded to appropriately.

The provider had not ensured there were enough staff to meet people’s needs. Staff said, “There are not enough staff and people don’t get the care they need.”

Safe recruitment practices were not followed to help ensure only suitable people worked in the home. Not all staff had received a criminal records check.

Staff did not monitor people’s risks appropriately, although we saw risk assessments in people’s care files we found staff did not always follow relevant guidance. People were left at significant risk of developing skin sores as they slept in old beds or divan beds with mattresses which were not fit for purpose.

The provider had failed to maintain the environment. Furniture was old and falling apart, padding from some armchairs was missing and seat cushions were old and worn. The smell of urine was overpowering, from being greeted at the front door and throughout the service. Carpets were stained and dirty. In people’s bedrooms, mattresses and bedding were covered in urine stains and some curtains had faeces on them, which had been left to build up for months, in some areas the smell was unbearable and eye-watering.

The provider and staff did not understand their responsibility in relation to infection control. The home was dirty. There were stained toilet seats, old dirt and grime around baths and carpets were covered in crumbs and dirt.

Staff did not receive an adequate induction when they started working at the service. Most staff had received training, although some had not received recent updated or refresher training to ensure they followed current best practice guidance. Training was not effective as staff were not providing support to meet the needs of people and ensure their health, welfare and dignity.

The provid

Inspection areas



Updated 18 June 2016

The service was not safe. People�s safety was compromised in a number of areas and people were exposed to harm.

There were not enough staff to provide safe and effective care.

Pre-employment checks and processes were not robust to ensure suitable staff were employed.

People�s medicines were not managed, administered or stored appropriately.

The provider did not notify the safeguarding authority of relevant incidents. Risks to people were not managed to ensure their safety.

Infection control was poor and people lived in an environment which was not clean or safe.



Updated 18 June 2016

The service was not effective. Staff did not receive supervision.

Significant gaps were identified in training staff received. There was no system in place to support staff and identify their training and development needs.

People did not receive appropriate support to eat and drink enough. Food and fluid charts were not completed when people were at risk of malnutrition or dehydration. Action was not taken when people lost weight.

People�s health care needs were not recognised or met. People did not receive appropriate support when their health deteriorated. People were not supported with their assessed healthcare needs.

The requirements of the Mental Capacity Act 2005 were not followed. Mental capacity assessments were not completed and decisions made on behalf of people were not made in accordance with the legislation. People were not offered choices about their care or treatment.



Updated 18 June 2016

The service was not caring. People were not treated with kindness by staff.

People�s privacy was not protected and their dignity was not maintained.

People or their relatives were not involved in decisions about their care

and treatment.



Updated 18 June 2016

The service was not responsive.

Care plans did not contain sufficient and up to date information about people�s needs to allow staff to deliver care

in a responsive and personalised way.

There was a lack of activity provision to meet people�s individual needs.

People received no mental stimulation or interaction from staff.

Complaints were not recorded or responded to. When people or their relatives were unhappy about the service they received, they were not listened to.



Updated 18 June 2016

The service was not well-led.

Action had not been taken to address previous breaches of regulations we had identified.

The leadership of the service was poor and placed people at significant risk of harm. There was no quality monitoring in place, and no plan to improve the quality of service people received.

The management of the service had an impact on the day to day culture. Staff morale was low. People and staff were not actively involved in the service. Staff views were not sought by the provider and there was no evidence people were consulted about the home.