We carried out a review of the data available to us about The Old Manor House on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about The Old Manor House, you can give feedback on this service.
The Old Manor House is a residential care home providing personal care to up to 14 people. Some people were living with dementia. At the time of our inspection there were 10 people using the service.
People’s experience of using this service and what we found
The provider had systems in place to protect people from the risk of abuse and people told us they felt safe.
Medicine management systems were generally safe. However, the storage area for medicines was small and cramped with other equipment being stored in the room. The temperature of the room was difficult to manage. We have made a recommendation about this. The recently introduced electronic medicines monitoring system was being reviewed and monitored to ensure records were accurate.
Risk assessments were completed to help identify and minimise risks people faced. Staff had been recruited safely and during the inspection we observed there were enough staff to respond to people's needs and ensure their safety.
Appropriate recruitment procedures ensured prospective staff were suitable to work in the service.
The environment had been refurbished since the previous inspection. It was spacious and there was equipment available to support staff in providing safe care and support. Health and safety checks of the environment and equipment were in place.
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.
Incidents and accidents were managed safely. The registered manager took necessary action to keep people safe and minimise the risk of reoccurrence. Steps were taken to learn lessons if things went wrong.
There were processes in place to prevent and control infection at the service. Additional training and systems had been adopted through the COVID-19 pandemic. There were additional cleaning and safe visiting precautions.
The systems in place to monitor the quality of care within the service were effective. The registered manager promoted a positive person-centred culture and fully understood their responsibilities as a registered manager.
The management team-maintained oversight of complaints and safeguarding concerns. They engaged well with health and social care professionals.
For more information, please read the detailed findings section of this report. If you are reading this as a separate summary, the full report can be found on the Care Quality Commission (CQC) website at www.cqc.org.uk
Rating at last inspection:
The last rating for this service was good published 27 July 2018.
Why we inspected
This inspection was prompted by a review of the information we held about this service.
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.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
This unannounced comprehensive inspection took place on 18 June 2018. The provider for this service has recently become a limited company. This means the service has recently re-registered with CQC under a new legal entity. This was the first inspection of the service since being re-registered.
People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
The service is required to have a registered manager and at the time of the inspection there was a registered manager in post. 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 and associated Regulations about how the service is run.
We spent time in the communal areas of the service. Staff were kind and respectful in their approach. They knew people well and had an understanding of their needs and preferences. People were treated with kindness, compassion and respect. The service was comfortable and appeared clean with no odours. People’s bedrooms were personalised to reflect their individual tastes.
People told us, “Yes, they’ll do anything for you here,” “They are all very nice here,” “Absolutely yes, they are all very good,” “Absolutely fantastic staff, would recommend this home, wonderful with no exception” and “Staff do everything possible and more than one could expect.”
Relatives told us, “I have always been very happy with the care provided, they [staff] are good to her. Recently they have moved her downstairs so that they can keep a closer eye on her, I have no concerns” and “I visit regularly and [Person’s name] is always clean and well cared for. The staff are very kind.”
The premises were well maintained. The service is registered for dementia care. There were people living at the service who were living with dementia and were independently mobile. However, there was no pictorial signage at the service to support some people, who may require additional support with recognising their surroundings.
The premises were regularly checked and maintained by the provider. Equipment and services used at The Old Manor House were regularly checked by competent people to ensure they were safe to use.
Care plans were held on an electronic system. They were well organised and contained accurate and up to date information. Care planning was reviewed regularly and people’s changing needs were recorded. Daily notes were completed by staff. Risks in relation to people’s daily lives were identified, assessed and planned to minimise the risk of harm whilst helping people to be as independent as possible.
The service had identified the minimum numbers of staff required to meet people’s needs and these were being met. The service had no staff vacancies at the time of this inspection.
There were systems in place for the management and administration of medicines. It was clear that people had received their medicine as prescribed. Regular medicines audits were being carried out on specific areas of medicines administration and these were effectively identifying if any error occurred such as gaps in medicine administration records (MAR). The system for monitoring people who self administered their own medicines was effective.
Meals were appetising and people were offered a choice in line with their dietary requirements and preferences. Where necessary staff monitored what people ate to help ensure they stayed healthy.
People had access to activities. An activity co-ordinator was not in post as staff and visiting entertainers provided a planned programme of activities. People were supported to go out by staff, to attend appointments, or visit local attractions.
Technology was used to help improve the delivery of effective care. One person had been provided with a wrist worn call bell to ensure they could call for assistance when needed and the risk of them tripping over the cable of the wired call bell had been reduced.
Staff were supported by a system of induction training, supervision and appraisals. Staff meetings were held regularly.
People were supported by staff who knew how to recognise abuse and how to respond to concerns. The service held appropriate policies to support staff with current guidance. Mandatory training was provided to all staff with regular updates provided. The manager had a record which provided them with an overview of staff training needs.
People's rights were protected because staff acted in accordance with the Mental Capacity Act 2005. The principles of the Deprivation of Liberty Safeguards (DoLS) were understood and applied correctly. However, there was no record of the best interest process having been followed prior to an application for a DoLS authorisation being made. We have made a recommendation about this in the Effective section of this report.
The manager was supported by the management team and the provider. The staff team were motivated and happy working at the service. The staff felt valued and morale was good. Staff told us, “I am happy here, it is a nice place to work” and “We all get along well and help each other.”
There were effective quality assurance systems in place to monitor the standards of the care provided. Audits were carried out regularly by both the registered manager and members of the senior management team.