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Manor Park Care Home Requires improvement

The provider of this service changed - see old profile

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Inspection report

Date of Inspection: 4 August 2014
Date of Publication: 3 October 2014
Inspection Report published 03 October 2014 PDF


Inspection carried out on 4 August 2014

During a routine inspection

The inspection visit was carried out by two inspectors and an expert by experience. During the inspection, we spoke with the quality manager, the deputy manager, four care assistants, the maintenance person, three kitchen staff, 14 people who lived at the home and 5 relatives of people who lived at the home. Not all of the people we spoke with who lived at the home were able, due to complex care needs, to tell us about their experience of living at the home. We observed care given to people in the communal areas, including lunch, and in their bedrooms. We also also looked around the premises, observed staff interactions with people who lived at the home, and looked at records. There were 72 people living at the home on the day of the inspection, this included 21 people living with dementia.

We considered all the evidence we had gathered under the outcomes we inspected.

We used the information to answer the five key questions we always ask;

� Is the service safe?

� Is the service effective?

� Is the service caring?

� Is the service responsive?

� Is the service well led?

This is a summary of what we found. The summary describes what we observed, the records we looked at and what people using the service, their relatives and the staff told us.

If you want to see the evidence that supports our summary please read the full report.

Is the service safe?

Care was not planned and delivered in a way that ensured people's safety and welfare. There were insufficient numbers of suitably qualified staff to meet people�s needs. We have asked the provider to make improvements.

People were cared for in an environment that was not clean and hygienic. This meant people may not be protected from the risk of infection because appropriate guidance had not been followed.

One person�s relative told us, �There are no staff to watch people in the main lounge of the nursing unit. People are unable to summon help if they need it�.

We observed an incident occur on the unit for people living with dementia. Staff did not take appropriate action to prevent a reoccurrence, did not document the incident in a timely manner, or refer the incident to the local authority safeguarding team in a timely manner.

Peoples� medicines were stored in rooms which were above the required temperature and medicines were not managed safely. This meant vulnerable elderly people were being put at risk.

Is the service effective?

The service was not effective. The home did not promote a good quality of life for the people that lived there.

We looked at six people�s care files. We saw that some important documents within people�s care records had not been completed.

People were not supported with diet and fluids to support their health. This meant people were not protected from the risks of inadequate nutrition and dehydration.

Audits were not effective; they either failed to identify issues or failed to follow up on issues when they were identified. This meant peoples� care needs were not being met.

Is the service caring?

On the unit for people living with dementia, we saw people were supported by staff who did not appear to have the necessary skills to meet their care needs. However we did see some staff to be patient and encouraging when supporting people.

Relatives we spoke with told us they were not happy with the care provided at the home. One person�s relative told us, �The staff here are not good. I�d say about 90% of them do not care. We have raised concerns with the manager and nothing changes. It�s not nice when you come to visit and your relative smells and has dirty finger nails. It�s just not good enough.�

One person who lived at the home when asked what they would do if they were unhappy said �I wouldn�t bother saying anything, I don�t think anyone would care.�

We saw some people displaying signs of distress but staff did not intervene. One care assistant said to us �That one just says �nurse�, �nurse�, �nurse� over and over.�

Some care assistants we spoke with told us they felt frustrated at the restrictive practices in place at the home. For example, on the unit for people living with dementia people�s toiletries had to be stored in a cupboard and not in the person�s bedroom. People also had to have their meals and drinks out of plastic plates, bowls and cups. However, when we looked in people�s care records we saw there were no risk assessments in place to address this.

When we looked around the residential unit of the home we saw people�s bedrooms had been personalised and contained personal items such as family photographs. However, on the unit for people living with dementia we saw people�s rooms were stark with very little in them. We were told by staff on this unit that people�s bedroom doors were locked on they had got up in a morning and people had to ask staff to let them back into their rooms. They told us this was to ensure people did not wander into other people�s bedrooms. However, for people living with dementia this may be difficult and meant they were limited to where they spent their time.

Is the service responsive?

We heard call bells going off for long periods during our visit. We also saw several call bells which were out of reach in bedrooms and bathrooms we looked in. We noted that call bells were not in reach of people in the lounge areas. Two visitors told us they have seen people in wheelchairs have to wheel themselves to the call bells to summon help for people who are not able to mobilise.

All of the people we spoke with, including relatives and visitors, told us that there were not many activities for people to engage with. One person said, �There�s not much to do except watch TV.� One relative said, �I�ve never seen much going on in the way of activities. When we asked people who lived at the home about what they did to pass the time. None were enthusiastic in their responses. One said �Sometimes there�s bingo, I go to that if I feel like it. I don�t know whether it is on today, though.� Another person said �I would love to dance sometimes.� We asked whether anyone ever put music on and encouraged them to do this. They said �No, never. But that would be lovely.�

We asked people in the upstairs lounge about their access to the garden. One said �I�d like to go out there, especially when it�s warm. We don�t get to do it very often though.�

Several people who lived at the home used the word �Boring� to describe their experience of living in the home. One said �I�m bored to tears. I just want to get out of here.�

We found the complaints system at the home was not effective. Comments and complaints people made were not responded to appropriately.

Is the service well-led?

The service was not well-led. People were not protected against the risks of inappropriate or unsafe care. The provider had a system in place to assess and monitor the quality of the service people received however, when issues were identified through audits we were unable to see that actions had taken place. This meant the system of audit within the home was not effective. The leadership on the unit for people living with dementia and the nursing unit at the home did not assure the delivery of high quality, person centred care. When we asked care assistants why some practices were in place they said it was just what they had been told to do.