Manton Heights Care Centre Also known as Ranc Care Homes Limited

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. At our last assessment we rated this key question requires improvement and there were breaches of regulations in relation to safe care, including medicines and risk management and premises. At this assessment, the rating has remained requires improvement. Although the provider was no longer in breach of regulations, work was needed to ensure care was consistently safe and improvements made were embedded.This meant some aspects of the service were not always safe and there was an increased risk that people could be harmed.

This service scored 59 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Staff and most people said managers took concerns seriously and responded with compassion and understanding. One person told us, “If something goes wrong, they sort it. They are pretty responsive.” However, some relatives said action to resolve known issues was sometimes slow. A relative said, “I’ve raised it over and over and nothing got done.” During the assessment, we raised concerns with the manager, and they took prompt action to address these.

Staff felt confident to raise concerns and said managers would listen and act. Staff recorded, investigated and reviewed most incidents. Managers used this information to identify risks and improve practice. However, we found some incidents had not been recorded or reported correctly. The management team reviewed these and confirmed the gaps. By the second site visit, they provided evidence of action taken to prevent this happening again.

Managers shared learning with staff through meetings and handovers to improve practice.

Systems were in place to monitor themes and trends, and managers acted on findings in a timely way. For example, we identified issues with stock records and missing opening dates on some medicines. The manager addressed these promptly and took steps to strengthen practice and reduce future risks.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed and monitored. People experienced safe and consistent care because staff worked well with partners to support continuity. Staff gathered detailed information before people moved into the service. They used this to plan care that met each person’s needs. They involved people, relatives and professionals to ensure transitions were smooth and well organised. When people moved between services, such as hospital admissions, staff shared clear and up‑to‑date information. This helped ensure care continued safely. Staff communicated changes effectively within the team, which helped maintain consistency. Managers worked with health and social care professionals to make timely referrals and respond to changes in people’s needs. People and their relatives said transitions were well managed and staff understood and supported their needs throughout. A person described the support they had received to ensure a smooth transition back home following a lengthy rehabilitation at the ABI unit. This included a home environment assessment and prescribed equipment. Staff worked with the social work team to ensure a reablement programme was in place to support them safely once they were home.

Although we found improvements since our last assessment, further work was needed. Staff did not always recognise, record or report incidents where there was a risk of harm. The service had systems in place to manage and report safeguarding concerns. However, staff did not always record incidents as safeguarding or report them when appropriate. This increased the risk of actions not being taken to reduce future risks. This was particularly the case where a person experienced distress frequently. During this assessment, the provider took action to address these issues. The manager set clearer expectations for staff, provided additional training and made retrospective safeguarding referrals where needed. They also asked for guidance from external partners about how to manage reporting when there may be multiple incidents during a short period of time.

Most people said they felt safe. Staff respected people’s rights and choices and understood the importance of maintaining dignity. A person said, “It feels very, very safe. The night staff check every hour to see if I am okay. Staff are lovely and worth every penny. Staff are respectful and make me feel comfortable with my personal support.”

Where restrictions were in place, staff considered these carefully and in line with legal requirements, including Deprivation of Liberty Safeguards where needed. Staff understood the need to balance safety with people’s rights and independence.

The provider was working to improve how they supported people to understand and manage risks. In the main, Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them. However, improvements were needed to ensure staff monitored and managed risks consistently.

Not all care plans contained enough detail to guide staff. For example, guidance on how to support 1 person with covert medicines was not clear enough to ensure safe practice. The provider took swift action to address this and confirmed they were reviewing all care plans and risk assessments.

Staff did not always complete records fully. This made it harder to monitor outcomes effectively. For example, when people reacted physically or verbally to feelings of distress, records did not always describe what had happened or how staff responded. This limited staff understanding of triggers and patterns. The provider recognised this issue and had arranged training to help staff improve their recording. Despite these gaps in recording, we observed staff responded well to people. They recognised signs of distress and used calm and kind approaches to reduce escalation and protect dignity.

For the most part, people were supported to manage risks while maintaining their independence. Staff in the ABI unit showed particularly strong practice. They supported people to take positive risks as part of rehabilitation and to regain independence. Staff completed and reviewed person‑centred risk assessments regularly and involved people or their representatives in decisions about how risks were managed.

The provider did not always identify and manage risks in the care environment.Staff generally kept the environment safe and took steps to manage risks. However, we found some areas that needed improvement. For example, cupboards under a sink in one dining room were not locked when we checked. These cupboards contained cleaning products, including dishwasher tablets and fluids, which could cause harm if accessed. The cupboards had combination locks, but staff were not using them. Staff secured these immediately once we raised the issue.

The perimeter gate and fencing were not secure. which meant the outside grounds were not fully safe. This resulted in a person leaving the area unsupervised which put them at risk of harm. The provider had not addressed this promptly, but they completed the required work before our second visit.

The premises and environment were greatly improved since the last assessment. The provider had made good progress with planned refurbishment. The manager shared future plans to better meet the needs of people living with dementia. Equipment was available, in good condition and used correctly to support safe care delivery. Managers carried out regular checks and ensured servicing and safety certificates were in place, including for fire safety.

Staff understood their responsibilities and followed clear procedures to manage environmental risks. Fire safety arrangements were effective, with clear evacuation plans and staff knew what to do in an emergency. Most people said they felt safe in the environment and confident staff maintained it well.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs. The provider followed safe recruitment processes and completed the required checks before staff started work.

There were enough staff on duty with the right skills and experience to meet people’s needs, including where people required 1 to 1 support. When staff raised concerns about staffing levels the manager was responsive and took timely action. For example, staff requested additional staff at night for 1 part of the service. The manager reviewed and agreed this during the course of this assessment. They also adjusted staff deployment across the service to ensure each area had the right mix of skills and experience.

People received consistent care from a regular staff team who knew their preferences and routines. Staff had the skills, knowledge and training needed for their roles. They completed inductions, ongoing training and competency checks to support safe practice. A relative said, "Staff appear to be trained. They know what they are doing. New staff can be seen shadowing, following experienced staff when they start.”

Staff said they felt supported through supervision and guidance when needed. Managers monitored performance and addressed concerns to maintain standards. They recorded lessons learned when issues occurred, so the whole team could improve.

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading. We found improvements had been made since our last assessment. Staff followed clear infection prevention procedures in line with national guidance. We observed the service was clean and well maintained, with good hygiene standards throughout. Staff used Personal Protective Equipment (PPE) correctly and understood when it was required. They prepared and handled food safely and followed good hygiene practices.

Managers ensured staff received training and completed regular audits to maintain standards. Staff recognised signs of infection and reported concerns promptly. People said they felt the service was clean and staff helped them stay safe from infection. A person said, "It is spotlessly clean, the bedding is changed daily.”

Medicines were mostly managed safely, and systems had improved since the last assessment. However, some areas required further strengthening to ensure consistent practice. We found some differences between recorded and actual stock levels. The manager said this had occurred when staff carried forward stock but had not recorded this accurately. They took immediate action to address this with staff and reduce the risk of it happening again.

Staff did not always record opening dates clearly. The manager said staff wrote dates under medicine bottles, but this was not consistent. For example, one bottle of eye gel did not have a clear opening date. This meant staff could not be sure it was still safe to use within the 28‑day safe use period. Guidance for covert and short‑term medicines was also not always clear. Audits had identified some of these issues, and managers had started to improve recording and update guidance.

There were effective systems in place to support safe medicines management. The service used an electronic system, which helped staff record and monitor medicines accurately. Medicines were ordered and supplied on time.Staff worked well with healthcare professionals and escalated concerns when needed. They stored medicines safely, including controlled drugs, and monitored temperatures to keep them within safe limits. Staff completed training and competency checks and followed safe administration practices.

People received person‑centred support with their medicines. Staff explained changes and responded promptly when they needed pain relief. Clear protocols were in place for ‘when required’ medicines. Staff also managed topical and complex medicines safely, with support from healthcare professionals.