Manor View Care Home

People's experience of using this service and what we found

People were supported to have their medicines as prescribed by staff who had been trained and assessed as competent. However, medicine administration was not consistently recorded, the registered manager immediately put strategies in place to mitigate the risk of this occurring again.

People were protected from known risks. However, records were not always completed accurately to evidence this. Risk assessments were completed, and strategies identified to mitigate these risks. Staff understood safeguarding and how to recognise and report any concerns of potential abuse.

Quality assurance tools had not always identified the concerns we found at this inspection. The management team committed to develop an action plan to work towards making improvements to their quality assurance processes.

Staff were safely recruited, inducted and trained to meet people's needs. Adequate staffing levels were observed.

People were supported by staff who knew them well and had the information required to meet their needs. People and relatives were all consistently positive about the staff and the support they received.

Care plans contained person centred, detailed information to support staff in understanding the person's individual holistic needs. People's likes, dislikes, preferences, choices and life histories had been recorded.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People's communication needs were assessed and when required, information had been presented in a different format to meet people's needs. Such as, large print or easy read.

Staff supported people to access healthcare services as required. Any specialist support was recorded, and actions completed.

People were supported to access activities, outings and celebrations. Friends and relatives were welcomed into the service and people were supported to maintain relationships.

People were protected from infections. Staff wore appropriate personal protective equipment, the home was regularly cleaned and the registered manager followed government guidance on COVID-19.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was good (published 27 June 2019).

Why we inspected

This inspection was prompted by a review of the information we held about this service and the previous rating.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Manor View Care Home on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Manor View provides care for up to 49 people. There were 32 people using the service at the time of our visit. The home is comprised of two separate buildings. They are known as Manor View and Church View. The home is registered to provide nursing and residential care for older people living with dementia.

We found the following examples of good practice.

¿ We were assured that this service met good infection prevention and control guidelines as a designated care setting.

¿ The Church View building had been equipped to accommodate up to 14 people under the designated care setting. The staff team would work exclusively this building to reduce the risk of cross infection.

¿ We observed staff wearing appropriate Personal Protective Equipment (PPE) at the time of inspection.

¿ Staff were very sensitive and attentive to people's needs and supported people in relation to their care and wellbeing. For instance, people were supported to contact family and friends by phone or video calls.

¿ The provider had regularly updated policies and procedures to ensure they included changes and best practice guidance in relation to COVID-19. Staff we spoke with were knowledgeable about the updates and were working in line with them.

¿ Tests for COVID-19 were being carried out in line with guidance, where possible.

¿ The premises were clean, there was a cleaning schedule in place and adequate cleaning hours to ensure it was maintained. Additional cleaning of high use areas had been implemented, including door handles, and hand rails.

¿ Staff had completed training in infection control, COVID-19 and how to put on and take of their PPE. Staff were frequently briefed about changes in government advice that impacted on their role. Staff we spoke with confirmed this. The registered manager was also accessing refresher training for all staff in hand washing procedures.

Further information is in the detailed findings below.

Manor View is a 'care home.' People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

People's experience of using this service:

People using the service were safe. Staff had received training to enable them to recognise signs and symptoms of abuse and they felt confident in how to report these types of concerns. People had risk assessments in place to enable them to be as independent as they could be in a safe manner. There were sufficient staff with the correct skill mix on duty to support people with their required needs and keep them safe. Effective and safe recruitment processes were consistently followed by the provider.

People received their medication as prescribed, although, some aspects of the service's medication management was not safe. Effective infection control measures were in place to protect people.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

Staff received an induction process and on-going training. They had attended a variety of training to ensure they were able to provide care based on current best practice when supporting people. They were also supported with regular line manager supervision.

People told us they enjoyed the food served at Manor View. People were supported to eat and drink to maintain a balanced diet. People were supported to maintain good health and have access to health and social care services as required.

People were supported to access a variety of health professionals when required, to make sure they received additional healthcare to meet their needs.

Staff provided care and support in a caring and meaningful way. They knew the people who used the service well. People and relatives, where appropriate, were involved in the planning of their care and support.

People's privacy and dignity was maintained. Care plans were written in a person-centred way and were responsive to people's needs. People were supported to follow their interests and join in activities.

People knew how to complain. There was a complaints procedure in place which was accessible to all.

Quality monitoring systems were in place. A variety of audits were carried out and used to drive improvement to the service. The registered manager committed to increase the frequency of medication audits.

More information is in the full report.

Rating at the last inspection:

At the last comprehensive inspection, (published 27 June 2018) the service was rated requires improvement.

Why we inspected:

This was a planned inspection. At this inspection we rated the service Good.

Follow up:

We will continue to monitor intelligence we receive about the service until we return to visit as per our inspection programme. If any concerning information is received, we may inspect sooner.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Manor View is a ‘care home.’ People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Manor View provides care for up to 49 people. The home is divided in to two separate units. The main unit, Manor View, provides nursing and residential care for older people living with dementia. The smaller unit, Church View, provides residential care for older people living with dementia. The service is in the Doncaster village of Hatfield.

At the time of our 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. However, the registered manager had recently left and a new manager had been in post five days, when we conducted the inspection.

Risks associated with people’s care and treatment had been identified but action taken to minimise risk had not always been documented. Some people had lost weight but it was not clear what action had been taken.

Some parts of the environment required attention and doors to sluice areas and store rooms had been left open. The kitchen area in Church View required attention to ensure people were not at risk of infection.

Accidents and incidents were recorded but documentation did not always reflect what action had been taken.

The registered provider had systems in place to ensure people received their medicines as prescribed. Some people had been prescribed medicines on an as and when required basis known as PRN medicines. We saw PRN protocols were in place but lacked detail about when to administer the medicine.

People were safeguarded against the risk of abuse. Staff we spoke with were knowledgeable about safeguarding and knew what action to take if they suspected it was occurring.

Staff were supported to deliver their role and were knowledgeable about their responsibilities. Staff knew people well.

During our inspection we observed that people who used the service were supported to maintain a balanced diet. However, food and fluid charts gave little information about what people’s daily intake had been and weigh loss was not always monitored.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. The service was compliant with the Mental Capacity Act 2005.

Staff interacted well with people and treated them with kindness and respect. We observed staff maintaining people’s dignity by knocking on doors prior to entering bedrooms. Some personal information was displayed throughout the home and we asked the management team to consider confidentiality issues.

The registered provider employed an activity co-ordinator who was responsible for arranging outings and events and ensuring people engaged in social stimulation if they wanted to.

We observed staff interacting with people and found they supported people to meet their needs. However, care records we looked at lacked detail.

The registered provider had audits in place to monitor the quality of the service. However, these needed developing and embedding into practice to ensure they encompassed all areas and identified issues.

We found a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the registered provider to take at the back of the full version of the report.