Background to this inspection
Updated
15 August 2023
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.
As part of this inspection, we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.
Inspection team
The inspection team was made up of 2 inspectors and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service and worked remotely to carry out telephone interviews with relatives.
Service and service type
The manor care home is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. The Manor care home is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
Registered Manager
This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.
At the time of our inspection there was a registered manager in post.
Notice of inspection
This inspection was unannounced.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.
During the inspection
We spoke with 6 people who used the service and 3 relatives of people who use the service about their experience of the care provided. We contacted 5 health and social care professionals for their feedback and spoke with 8 members of staff including the registered manager, members of the management team, care workers, the chef, and the provider.
We reviewed a range of records. This included 4 people’s care records and multiple medication records. We looked at 2 staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service were reviewed.
We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.
Updated
15 August 2023
About the service
The Manor Care Home is a residential care home providing care and accommodation for up to 21 older people who live with a learning disability and autistic people. Some of whom have physical disabilities, and/or are living frailties of old age and dementia. On the day of our inspection, there were 19 people living at the home.
We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.
People’s experience of using this service and what we found
Right Support: People were mostly 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.
Staff did not always support people to have a range of opportunities and experiences to maintain their skills for as long as possible and have greater control over some areas of their own lives. Staff carried out daily tasks such as cooking and cleaning without actively supporting people to take part. The provider was seeking additional training for staff to understand how to be more focused on people’s strengths and promote what they could do, so people had a fulfilling and meaningful everyday life. Each person had their own room, which was personalised to meet their needs and preferences.
People lived in one large house and shared spaces, at busy times such as mealtimes the environment was noisy. Consideration had not been given to creating a dementia friendly setting such as supporting people to recognise their surroundings and move independently around the service.
The provider was aware of and were committed to providing resources to make any necessary improvements as quickly as possible. Staff equality and diversity was respected and promoted at the service and within the provider’s organisation.
Right Care:
People and their relatives told us they received kind and compassionate care. Staff understood how to protect people from poor care and abuse. The service worked with other agencies to do so.
People received good quality health care, support, and treatment because staff and specialists could meet their needs. Most staff knew and understood people well.
People were supported to eat and drink safely.
Right Culture:
People were not supported by managers and staff who fully understood current good practice in relation to learning disability and autism people, some of whom were living with dementia.
Leaders and the culture they created did not always support the delivery of high-quality, person-centred care. Internal quality assurance systems and processes to maintain and develop the safety and quality of care were not always operating effectively.
Staff equality and diversity was respected and promoted at the service and within the provider’s organisation.
People we spoke with and their relatives told us, they liked living at the Manor care home and liked the managers and staff.
The provider had reflected on feedback from the inspection and had started to make changes.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was good (published 3 July 2019)
Why we inspected.
This inspection was prompted by a review of the information we held about this service. This report only covers our findings in relation to the Key Questions Safe, Effective and Well-led. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall 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.
The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.
Enforcement
We have identified 2 breaches of regulation in relation to staff training and governance at this inspection. Please see the action we have told the provider to take at the end of this report.
Follow up
We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for the manor care home on our website at www.cqc.org.uk.