Manordene

On this page

• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

Caring – this means we looked for evidence that the provider involved people and treated them with compassion, kindness, dignity and respect.

At our last assessment we rated this key question good. At this assessment the rating has changed to inadequate. This meant people were not treated with compassion and there were breaches of dignity; staff caring attitudes had significant shortfalls.

The service was in breach of legal regulation in relation to people not being treated with dignity and respect.

This service scored 25 (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 treat people with kindness, empathy and compassion, or respect their privacy and dignity.

There was a mixed response from people and their families around the caring nature of staff. One relative told us, “Staff are very nice. They have a laugh with (people) and that’s important.” Whilst a person when asked if staff were caring told us it was, “So, so.” They told us some were nice but other carers could be bit a ‘gruff’. Another person told us, “They (staff) pop in to check I am okay. They don’t stop to chat.”

We found people’s nutritional milkshake drinks and yoghurts were being stored in people’s warm bedrooms and given to them without cooling them. The registered manager told us, “That is something that I did, it’s in their room so it’s easier for the carers and I did bring that up regarding the fridges, storage is something I need to look at.” This demonstrated an inconsiderate approach towards people as staff had not considered how the temperature of the drink or yoghurt may affect people’s enjoyment of having them or their willingness to have them.

There were undignified practices by staff at the service. During lunch we observed staff to stand over people to give them mouthfuls of food. One member of staff was standing over 2 people alternating giving each person a mouthful of food. Staff were also not interacting with people in a meaningful way. There was only 1 communal room in the service which meant that visiting professionals either had to ask people if they could be moved to their bedrooms or have a private consultation in front of other people. One visiting professional told us, “I don’t feel comfortable in front of other members of the care home. It’s not appropriate to do it front of others. Just because they have dementia it doesn’t mean they shouldn’t have their privacy.”

The provider did not treat people as individuals or make sure people’s care, support and treatment met people’s needs and preferences. The provider did not take account of people’s strengths, abilities, aspirations, and unique backgrounds.

People did not always have choices around their care delivery. There was a schedule of showers and people were only routinely offered 1 shower per week. This schedule was placed on display at the nurse station. One person told us they would like a shower every day but that they were not offered but would like to be asked. A member of staff told us, “There has always been a schedule for showers.” We also observed that all people had a 2 handed plastic beaker for their drinks. However, there was nothing in people’s care plans to state that everyone needed these adapted cups. The registered manager told us, “To be honest, that’s what they are used to and told us would look into people having other types of cups.

The lounge was poorly set out with all the chairs set around the walls of the room without any space in between not giving people some space from the person sat next to them. There was also no space for people’s relatives to sit next them. We noted from 1 person’s care plan they reverted to their native language and got frustrated when staff did not understand them. However, there was no evidence of any actions taken to address this.

The provider did not promote people’s independence, so people did not know their rights and have choice and control over their own care, treatment and wellbeing.

Although people were encouraged and supported to maintain their relationships with their family and friends, visitors were restricted from visiting during mealtimes in the lounge. The registered manager told us, “I like the privacy in the lounge. We ask them not to come during that time.” However, care homes should aim to be person-centred, treating the care home as the person's home, where family visits are an integral part of maintaining their quality of life and relationships. Family support at mealtimes often provides a valuable benefit to people and staff.

We saw from 1 person’s care plan that only female care staff were to provide personal care. However, their care notes indicated they were frequently being supported by a male member of staff. People were not given choices on whether they wanted to sit at the dinner table to have their meal. One member of staff told us, “People don’t sit at the dining tables as some people don’t have good behaviour, they fight, that’s why we do it like that.” However, rather than manage this individually, there was a blanket approach taken to not offer any people this option. Another member of staff told us, “I cannot eat like that myself and sitting on the armchair all day long. I don't like that.”

The majority of people had a cognitive impairment. However, they were all required to choose their meals the previous day. In addition, those people on a modified diet did not have a choice of meal. A member of staff told us they would just give people the ‘soft’ option.

The provider did not listen to or understand people’s needs, views and wishes. Staff did not respond to people’s needs in the moment or act to minimise any discomfort, concern or distress.

During the morning, the majority of people were sat in the lounge. Whilst staff offered people’s drinks, care was very task focused. When staff sat down next to people, they were not interacting with people in any meaningful way. The volume of the television in the lounge was loud and there were loud televisions coming from people’s bedrooms and the noise was clashing. In addition, there were 4 people that were seated at a right angle to the television which would have made it difficult for them to watch it.

When people were given their meals, they were not told what the meal was. We observed 1 person started to cough which was ignored by staff until we asked them to intervene. When people were not eating, 1 member of staff just stood over them and asked in an uncaring tone, “Why are you not eating. It’s fish.” They did not sit with the person and gently encourage them or ask if they wanted an alternative meal. The same member of staff then said to another person, “I’ll come to feed you, okay? Let it cool down.” The member of staff then walked away and never did return to the person.

The provider did not always care about or always promote the wellbeing of their staff. They did not always support or enable staff to deliver person-centred care.

Staff told us they felt stressed and at times overwhelmed with the workload. One member of staff told us, “You're rushing from A to B all the time, aren't you? You're sort of chasing your tail. I think it does bring a bit of morale down over time because you're getting tired.” Staff told us they had raised concerns that there were not sufficient staff based on the needs of people. However, they did not always feel listened to. Comments from staff included, “There is no discussion (with the leaders) because there is no time” and “We're not listened to as carers. When we go to them with things, I think they poo, poo us quite a bit.”

However, staff were allocated appropriate breaks and were provided with a staff room that they could use.