Manor Park Care Home

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence. At our last assessment we rated this key question Good. At this assessment the rating has changed to Requires Improvement. This meant the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent.

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

This service scored 38 (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 make sure people’s care and treatment was effective because they did not check and discuss people’s health, care, wellbeing and communication needs with them.

People and relatives were often not involved in care planning and reviews of care. People told us they were not sure if they had a care plan and said they had not seen one. We reviewed 15 people’s care plans and found the care plans were either not up to date or inaccurate and did not reflect people’s current needs.

The provider did not always work well across teams and services to support people.

We observed a lack of consistent and effective teamwork which impacted on people’s safety and the care and support they received. We observed examples of staff working well together as a team. However, we also saw occasions when staff failed to communicate effectively with each other which left people exposed to risk. Agency staff were not always supported by permanent staff and did not always have access to information about people’s needs. Care records were not always accurate which meant there was a risk when information was shared it was not accurate or fully complete.

Care records evidenced the involvement of external professionals such as the GP, district nurses and Speech and Language Therapy team (SALT). However, we found professional advice was not always followed. For example, care records showed the district nurse had advised one person who had a pressure wound should not be left in a wet incontinence pad. However, records showed long gaps between pad changes and noted the person’s clothes and pad were wet when they were changed. This not only impacted on the person’s dignity but also placed the person at risk of infection and further skin damage.

The provider did not always work well across teams and services to support people.

We observed a lack of consistent and effective teamwork which impacted on people’s safety and the care and support they received. We observed examples of staff working well together as a team. However, we also saw occasions when staff failed to communicate effectively with each other which left people exposed to risk. Agency staff were not always supported by permanent staff and did not always have access to information about people’s needs. Care records were not always accurate which meant there was a risk when information was shared it was not accurate or fully complete.

Care records evidenced the involvement of external professionals such as the GP, district nurses and Speech and Language Therapy team (SALT). However, we found professional advice was not always followed. For example, care records showed the district nurse had advised one person who had a pressure wound should not be left in a wet incontinence pad. However, records showed long gaps between pad changes and noted the person’s clothes and pad were wet when they were changed. This not only impacted on the person’s dignity but also placed the person at risk of infection and further skin damage.

The provider did not always support people to manage their health and wellbeing, so people could not always maximise their independence, choice and control. Staff did not always support people to live healthier lives, or where possible, reduce their future needs for care and support.

People’s choices regarding this were limited. For example, although some people were supported to access fresh air and outdoor space, many other people were cared for in bed and did not get the opportunity to get up or go outside. One person in bed was continually shouting out, “Help me. I want to get out now, I want to go out.” It was unclear from the person’s care records why they could not get out of bed. A relative of another person told us, “[Family member] doesn't get out at all. I have complained about this. They could try and get [family member] out of bed, they seem to be in their night clothes 24 hours a day.”

The provider did not routinely monitor people’s care and treatment to continuously improve it. They did not ensure that outcomes were positive and consistent, or that they met both clinical expectations and the expectations of people themselves.

Systems and processes were not effective in routinely monitoring people’s care and treatment to continuously improve it. Oversight was lacking with regards to monitoring care and treatment, learning lessons, taking action and improving outcomes for people.

The provider did not always tell people about their rights around consent and did not always respect their rights when delivering care and treatment.

The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The MCA requires that, as far as possible, people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible. People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the MCA. In care homes, and some hospitals, this is usually through MCA application procedures called the Deprivation of Liberty Safeguards (DoLS).

Where DoLS were in place, these were not managed well and systems were not in place to evidence how any requirements of the DoLS, known as conditions, were being met.

Where people lacked capacity, the principles of the MCA were not always followed. Capacity assessments were not always completed and, where people lacked capacity, best interest assessments were not always in place for relevant areas. For example, where sensor equipment was being used to alert staff when people mobilised.

People were not consistently involved in making decisions about their care and a person-centred approach to care was lacking.