Manor House Residential Home

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

The service had improved. The rating for this key question has changed from requires improvement to good as the provider is no longer in breach of regulations. The provider had followed the action plan they had sent us after their last inspection and improved the way that risks to people were assessed and mitigated against and improved the training provision that was available to staff. People were protected from the risk of harm and abuse. Staff understood their duty to protect people from abuse and knew how and when to report any concerns they had to managers and staff. We made a recommendation to the provider at the last inspection regarding the environment which had been acted upon. The provider had improved the overall design and decoration of the care home. The premises were also kept clean and staff followed current best practice guidelines regarding the prevention and control of infection. There were enough staff employed to meet people's needs and staff recruitment checks were robust. Risks to people and the environment were assessed and steps taken to mitigate these and keep people safe from harm, including those in relation to medicines.

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.

Managers told us all incidents and accidents, safeguarding concerns, and near misses were logged and reviewed to determine potential causes and to identify any actions they needed to take to reduce the likelihood of similar incidents reoccurring. Staff confirmed information about any lessons learnt was always shared and discussed with them during regular individual and group meetings, and daily shift handovers. Managers encouraged an open and transparent culture about safety at the service where people receiving a service, their representatives and staff could raise concerns without fear about what might happen.

People told us the provider learnt lessons when things went wrong and acknowledged when they could and should have do better. A relative told us the provider had apologised and learnt lessons after they had raised a concern about the standard of care their family member received at the care home. The relative confirmed appropriate action had been taken by the provider to reduce the possibility of similarly incidents happening again.

The provider learnt lessons when things went wrong. They had policies and procedures that included how to achieve continuous improvement. Managers continually reviewed all incidents and accidents, safeguarding concerns, complaints and near misses to determine potential causes and identify any actions they needed to take to reduce the likelihood of reoccurrence and learn lessons. This information was shared and discussed with staff during team meetings and handovers.

Healthcare professionals confirmed with us that the provider worked well with them to ensure that people's needs could be met. One healthcare professional said, "The service have worked well with my team and I. They have been responsive and involved in managing issues/concerns as needed." Other comments included, "[The registered manager] and the Manor House staff work very well with us."

People’s needs were assessed before they moved into the service. People were involved in making decisions when they moved into the service.

The registered manager spoke about the process that was followed when people first moved into the service. Staff were aware of the importance of providing continuity of care and supporting people during this process. One staff said, "The first few days and weeks, people are more anxious so we have to help them as much as we can throughout this period."

The provider ensured that care and support was planned and organised with people, together with partners and communities which helped to maintain continuity. The provider worked with partners to ensure there was a joined up approach when people moved into the service and the records we saw reflected this.

The provider's safeguarding policies and processes were in line with relevant legislation. The registered manager worked well with external agencies and acted in a timely way to make sure people were safeguarded and protected from further risk.

We observed how people using the service interacted with staff and they looked at ease and comfortable in staffs presence.

Managers supported staff to safeguard people from abuse. Staff understood how to recognise abuse and neglect, protect people from its different forms and to report any concerns to their line managers. A member of staff told us, “I would let the managers know right away if I saw any abuse at Manor House. I know they would take the appropriate action as we operate a zero tolerance to abuse policy at the care home.” Furthermore, the managers understood their legal responsibility to refer safeguarding incidents to all the relevant external agencies without delay, ensure they were fully investigated and to take appropriate action to minimise the risk of similar incidents reoccurring.

People told us the care home was safe. One person said, "I do feel safe living here. I’ve not encountered any problems.” Another person’s relative added, “My [family member] is well looked after by the staff who work here and is definitely kept safe.” An external health care professional also remarked, “We work closely with Manor House staff to ensure our patients are kept safe. They notify us of any concerns/risk or safeguarding concerns promptly, so these are actioned in order for us to keep residents safe.”

We observed staff supporting people in a way that kept them safe from harm. This included supporting people at risk in relation to nutrition during mealtimes. Where people needed support mobilising, staff were available to help them.

Risks to people had been assessed by the provider through good care planning. This included risk assessments which helped to identify potential areas of risk for staff to be aware of and also associated care plans to manage and minimise the risks to people. These were reviewed regularly and meant staff had up to date information about the action they needed to take to keep people safe. Risk assessments were individual to people and included ways in which people could live independent lives whilst being as safe as reasonably possible. These risks included areas such as mobility, risk in relation to nutrition, risk of developing pressure sores and others.

Staff that we spoke with were aware of the risk to people and the steps they would take to keep people safe from harm. Staff spoke about the people that needed extra support such as those that needed hoists to mobilise and those that needed repositioning to minimise the risk of developing pressure sores. These were in accordance with people's care records which demonstrated that staff had the knowledge to support people appropriately.

Risks to people’s safety was managed well. People told us staff knew how to support them with regards to their mobility and that staff did everything they could to keep them safe from harm. One relative said, "When they take her to the bathroom or move her, they always have two people for safe transfers. They use a sara steady (a hoist) to transfer her."

As recommended at the provider last inspection they had improved the overall interior design and décor of the care home. People told us the care home was a much more comfortable and pleasant place to live since the provider had totally refurbished the homes interior décor. One person said, “I like what the owner has done to the place. It’s amazing what a lick of paint and some new fixtures and furniture can do. The whole place feels so much more homely these days.” A relative added, “The place was originally a bit run down but since having the new manager took over, this has made an enormous difference in the care, the activities and the look of the place. It’s been recently redecorated with all new furniture. The home now looks great.”

Managers and staff told us they overall interior design and decoration of the care home had significantly improved as recommended at their last inspection. A member of staff told us, “The single biggest improvement I’ve seen at the home has been to the homes interior. The new owners have invested quite a bit of money in modernising the place, which the building was crying out for. As you can see the place has been totally transformed and now looks great.” Managers were able to assure us that there were effective governance arrangements to monitor the safety and upkeep of the premises and equipment.

Regular checks were completed by managers and staff to monitor and maintain the safety of the care homes physical environment. This included regular health and safety checks on the homes electrical, gas and water systems. The provider had an up to date fire risk assessments in place for the building and personal emergency evacuation plans [PEEPs] in place for everyone who lived at the care home.

People lived in a care home environment which was homely and people were comfortable in their surroundings. We saw since our last inspection as recommended the provider had significantly improved the homes physical environment. This included a new clinical room and conservatory, and new flooring, lighting, furniture and interior décor which was completed as part of their recent refurbishment of the care home. The premises were kept free of obstacles and hazards and we observed people moving safely and independently without any staff assistance around the care home. We also saw the environment was now much more ‘dementia friendly.’ For example, people's bedroom doors were decorated in individual contrasting colours and styles to mimic a front door and help them to orientate themselves and identify their room. We overheard people describing who lived where in the care home by explaining what colour their bedroom door was. Easy to understand pictorial signs were used throughout the care home to help people identify the various functions of each room, including the dining room, lounge, toilets and bathrooms.

During our visit, we observed that there were enough suitably skilled and experienced staff to support people. Staff were visibly present throughout our inspection supporting people and carrying out their duties. For example, we saw staff supporting people with regards to moving safely, getting ready and during the lunch period.

People told us there were enough staff to support them and to engage in the activities they wanted to. Relatives of people that we spoke with also told us there were enough staff at the service. One relative told us, “[My family member] has 1-1 support, 24 hours a day."

The provider had made improvements to the recruitment processes in place which helped to ensure staff were recruited safely. This included checks on right to work, identity and with the Disclosure and Barring Service (DBS) who provide information including details about convictions and cautions held on the Police National Computer. The information helps employers make safer recruitment decisions. Training and supervision records showed staff had access to appropriate training and supervision opportunities. These records showed that training was current which meant staff stayed up to date with latest practice. Staff received regular supervision through both individual and group meetings which helped to ensure they were given the appropriate support as needed.

The registered manager told us staffing allocations always included a team leader and someone trained to do medications on each shift, this meant there were suitably skilled staff to meet people’s needs. Staff we spoke with confirmed that there were always enough staff available throughout the day and overnight to meet people’s needs. Staff we spoke with were happy with the training and support they received.

People told us staff kept the care home clean and odour free. A person said, “The staff do a good job keeping the place clean.” The provider had cleaning schedules in place to guide staff on maintaining the cleanliness of the care home.

The care home was clean and tidy. We saw staff use personal protective equipment [PPE] effectively and safely.

The provider followed current best practice guidelines regarding the prevention and control of infection including, those associated with COVID-19. The provider’s infection prevention and control policy was up to date. The provider supported visits to the care home in line with the government guidance in place at the time of the inspection. The provider continued to access COVID-19 testing for people living and working in the care home when they showed signs and symptoms of COVID-19.

Managers and staff told us they had received up to date infection control and food hygiene training.

Training records showed that staff received training in administering medicines. Staff confirmed this telling us, "We have had medicines training, we do refresher. [The registered manager] is supportive and pushes us to do the training." Staff demonstrated a good understanding of safe medicines procedures and the individual needs of people with regards to their medicines support needs.

People received their medicines as prescribed. People and relatives told us they were given their medicines on time. Comments included, "I have seen staff administering medication. No issues with this."

People received their medicines as prescribed and the provider's processes supported this. Medicines profiles were in place for people which gave information about people's support needs, including medical conditions, allergies, if they were complaint with medicines and other information. There were protocols in place for medicines which were administered as required and also guidance for staff to follow with regards to covert medicines. Medicines Administration Records (MAR) charts were completed for people and we observed staff administering medicines in a safe way.