Manor Hall Nursing 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 remained Good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 75 (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 made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

People's health and social needs were assessed before coming to live at the service; the impact of these had been fully considered and there was clear information about what was important to people and how they would like their care and support to be delivered. This had also ensured the service could meet the identified needs of the person and that staff had the necessary training to keep them safe and well. There was evidence of family involvement within the documents.

People’s communication needs were assessed regularly and different methods of communication tried and reviewed so as to ensure people were offered every opportunity to participate in their care decisions. People’s care records were reviewed regularly to ensure they remained an accurate reflection of people’s needs. The provider's processes for assessing and reviewing people's care and support needs were robust. People's assessments included sufficient detail about their individual care needs and preferences, which had ensured their needs were met consistently and effectively.

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards.

Recognised risk assessment and monitoring tools were used appropriately to track improvements or concerns. These were integrated in to the care plan system. The management team had oversight of these and planned action appropriately with the involvement of family and the staff team. The service had links with other organisations such as tissue viability services, and speech and language therapists (SaLT).

Staff received training in line with current good practice guidance. Staff told us how they worked alongside the GP’s, social workers and other health and social care professionals to ensure referrals were made appropriately and any recommendations were acted upon. For example, people’s ability to eat safely and maintain a healthy weight were assessed and monitored and appropriate action taken. Staff were knowledgeable regarding people’s eating requirements, and this was clearly recorded to ensure all changes were shared. Where needed, advice was sought from healthcare professionals on how people’s diets should be adapted to suit them. Information was available in the kitchen to ensure people received appropriate drinks, meals and snacks to match their needs. Food and fluid charts were completed to monitor people’s intake, which allowed staff to provide support and encouragement to people who were struggling to eat and drink.

We saw evidence of a monthly analysis of infections, weight loss and gain, and falls, which recorded action taken and the referrals to the appropriate health professionals. People’s care plans showed the service worked in conjunction with external health care professionals, to ensure people received the care they required in line with their changing needs.

The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

People's health and social needs were assessed before coming to live at the service; the impact of these had been fully considered and there was clear information about what was important to people and how they would like their care and support to be delivered. Care plans and risk assessments showed evidence of regular reviews that ensured they remained an accurate reflection of people’s needs. Staff ensured that entire care plans with associated risk assessments were sent with people when they moved between services. Staff gave open and honest information during assessments to ensure smooth transitions of care. One staff member said, “I think we work well with most health professionals, I know things have been difficult with the GP but we have been told it is being addressed, it hasn’t affected us really but it could have.”

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.

Some people were able to told us that the staff encouraged them to remain independent and keep mobile. One person said, “Staff help me to do things myself, I am slow but get there eventually, I am steadier now I use a wheel walker,” and “Foods good, the staff do look after my health, I didn’t do well at home, but it was mainly loss of confidence, now I am, I suppose safe, my breathing is not good, but staff support me really well.” Families told us, “They ensure my loved one gets everything they need to stay healthy, balanced food, though they do like treats, keeping hydrated is really important and they do a good job, the doctor is involved, they see optician as well, I’m not sure about dentists, but I know they keep an eye on their teeth.”

There were processes in place to guide staff about how to support people to lead healthier lives. People were encouraged by staff to eat healthy meals and drink regularly to maintain their physical health. They were encouraged to walk and be active, and to take part in activities. Care documents showed there was evidence of regular reviews and input from the GP, Optician, Dentist and Chiropodist.

Equality and diversity were embedded in the principles of the service and the provider had an equality and diversity policy in place to protect people and staff against discrimination.

The provider routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

The staff team worked closely with the GP, dieticians, physiotherapists and speech and language therapists (SaLT). Care plans and assessment tools were in line with guidance from the national institute for health and care excellence (NICE). The provider carried out assessments and reviews to ensure they were regularly monitored for changes in their level of need. There were organisational systems in place to monitor people’s care and treatment and their outcomes. Audits were used to identify issues and themes and to learn lessons to provide positive outcomes for people.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment.

People were asked for their consent and were involved in day-to-day choices and decisions. People told us, “They always ask me first because I want to do as much as I can, if I need help, I ask for the help I need, they don’t just presume or just do it.” Relatives told us, “My relative can give consent for simple everyday things, but not for other things, we have had a best interest meeting with the doctor and I know they have forms for my relative with the social worker.”

Staff we spoke with were able to tell us how they offered people choices in their daily care and demonstrated an understanding of people’s right to make their own decisions. Staff told us, “We treat everybody the same, with dignity, with respect, we always ask them first and then offer to help, we never take anything for granted. It can be difficult sometimes because moods may change.”

Staff had received training in safeguarding and The Mental Capacity Act 2005 (MCA). 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 Mental Capacity Act (MCA). In care homes, and some hospitals, this is usually through MCA application procedures called the Deprivation of Liberty Safeguards (DoLS). The service was working within the principles of the MCA and if needed, appropriate legal authorisations were in place to deprive a person of their liberty. The documentation supported that each DoLS application was decision specific for that person. For example, regarding restrictive practices such as bed rails, covert medicines, sensor mats and locked doors. We saw that the conditions of the DoLS had been met