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Archived: Manor House Inadequate

Reports


Inspection carried out on 5 May 2016

During a routine inspection

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 carried out on 9 February 2016

During an inspection to make sure that the improvements required had been made

This was the first inspection of this service since it registered under Astral Care Limited. The inspection was undertaken on 9 February 2016, and was an unannounced inspection. The Commission received concerns in relation to the service. As a result we undertook a focused inspection to look into those concerns. This report only covers our findings in relation to those concerns.

The service 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. There is street parking available nearby. 18 people were living at Manor House at the time of the inspection.

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.

People did not have their needs met by sufficient numbers of staff. Staff rotas were not based on people’s needs or the environment in which people lived. People had limited opportunities for meaningful activities.

People were not protected by safe recruitment procedures. Some application forms did not show a

full employment history and gaps in employment had not been explored when staff were interviewed. Staff felt the provider and their consultant were not approachable and were not confident that they would change things for the better.

Staff had received safeguarding training. They were aware of how to recognise and report safeguarding concerns to the registered manager and to outside agencies like the local council safeguarding team. However, the policy for staff to follow was not written by the current provider and did not contain current information, for example, it referred to out of date regulations.

Staff knew how to blow the whistle and were confident they could raise any concerns outside agencies if needed. The registered manager responded appropriately when concerns were raised.

The new owner visited the service around twice a week and was being advised by a consultant. People lived in a satisfactory environment. Equipment had received regular checks or servicing to ensure it was safe.

Medicines management was safe and people received their medicines when they should. Risks associated with people’s care and support had been assessed.

We found four breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we have asked the provider to take at the end of this report.