Manor Farm Care 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 provider supported people to stay safe. We heard from families and other professionals who told us they felt the home was safe and that people’s needs were met. Environmental risks were managed safely. Health and safety checks were completed and effective infection control measures were evident. This kept people, staff and visitors safe. Staff were recruited safely with the right experience and qualifications and were offered a training package to meet people’s needs. There was a robust system in place for the management of medicines which ensured safe handling and administration.

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.

People and their families felt comfortable talking to the staff, felt listened to and were getting to know the Manager who had started working in the home in recent weeks. People we spoke to knew how to complain if they were unhappy and felt that the home acted upon their concerns.

Managers told us lessons learnt from accidents, incidents and complaints were shared with the staff team. A staff member gave an example of a person using the service who acquired an infection, and the manager completed documentation which they shared with staff to make sure the correct infection control protocol was in place. Staff told us they were encouraged to raise concerns and share ideas and of their view of the home’s openness and transparency to learn when things go wrong.

The provider analysed accident and incident data, looking for patterns and identifying actions that could be taken to improve staff working practice. The provider shared all information regarding incidents and accidents with the families of people living in the home as well as to statutory bodies such as the local authority and the Care Quality Commission [CQC].

Care records showed people’s care needs were assessed before they entered the service, and a more detailed assessment was carried out once they began using the service. Details of each person’s individual needs were captured during the assessment process which took into consideration the views of the person, their family and other involved professionals.

The Manager told us about how they worked closely with hospitals and the local authority to support people to move into the service. We heard how the process is often managed quickly when a person is ready to be discharged from hospital or they are needing to move from their homes owing to serious risks. Managers told us people were only supported to move into the service if they were assured they could meet the person’s needs safely. Staff told us people are assessed either from home or hospital. They told us about the need to work closely with other professionals to ensure equipment and services people require are in place when a person moved in.

Health professionals told us that whilst there is always room for improvement, particularly with communication around visits they felt that the home worked in providing support to people. well with other health agencies to provide the support each person required.

The home assessed needs and gathered information before a person moved in. We saw that these were carried out before a person moved into the home. The assessment highlighted the support needs a person had to ensure that the home could meet their needs. The assessment also included some information about the person’s life history as well as the views of their closest relatives. The Manager told us that when a person is referred to the home, they will make referrals for specialist help required by the person to aid a smooth transition into the home. However, the pre-assessment form did not have a section to prompt the assessor to highlight any referrals that may be required meaning this could potentially be overlooked.

People told us they felt safe living at Manor Farm. One person told us, “I don’t worry because there’s always someone about if I need help.” Another person said, “Everything reassures me, I trust them.” Families told us, “I visit [person] regularly so am confident in my thoughts. The fact is, they are safe and secure, that comes from the quality of care. We trust the carers and they know what they are doing.” Another family member told us how well their relative is cared for particularly with their dementia. One family member said, “[Person] is safe and comfortable here. My confidence comes from the determination of the girls here to do their best. They give good support and reassurance.”

The staff we spoke to were able to tell us about abuse and the actions they would take if they were concerned for the safety of anyone living in the home. They were able to tell us about who they would talk to inside of the organisation as well as other professional bodies including the local authority and the Care Quality Commission if they had concerns. Staff knew about the whistleblowing policy and under what circumstances they would use it.

We observed staff being kind and caring and supporting people in a safe way. People were supported safely using equipment to transfer them from between their beds and wheelchairs. People were being supported to eat when they needed to. Staff did this at a pace the person required and positioned themselves correctly to do this so the person could eat safely. We saw people sitting in chairs in the lounges and activity rooms. We noted that people had drinks nearby, either a hot drink or squash.

The home had systems in place for reporting concerns to the local authority and CQC. People’s care records documented where a person had a deprivation of liberty safeguarding (DoLS) authorisation in place and detailed where there were conditions that needed to be met. Where relevant, records also contained mental capacity assessments and best interest decisions. For example, we saw how professionals had assessed and reported regarding the person lacking capacity to consent to being admitted into Manor Farm and to staff administering their medicines. We also noted a best interest decision made for another person to receive their medication covertly.

The people living in the home told us about the risks they faced and how staff supported them to manage this. One person told us, “I did have a fall in my room, and they came and sorted me out.” Another person told us, “I’m alright here and I don’t worry because I feel they care for me well. They know I don’t like being hoisted, but they are always so careful and give me confidence.” Risk assessments were well written and detailed the specific support people needed to maintain their safety and independence. We noted that in addition to risks around physical safety we saw the provider had given thought to people’s emotional needs. Assessments were written for people who had to spend large amounts of time in their beds and as a result are at risk of becoming isolated.

As part of a daily walk around of the service the Manager carries out their own observations identifying any risks they see. They told us about the importance of risk assessments and making sure staff had the necessary skills to support a person with a particular risk.

We saw some people needed additional support to keep themselves safe owing to their frailty. We saw specialist equipment such as cushioned pillows and adaptive wheelchairs used for the safety and comfort for those who required them. We observed people with nursing needs and people with dementia being supported safely to meet their specific needs and did not identify any concerns during our visits to the home.

Risk assessments were well written and clear for staff to follow. The information highlighted what each risk was with clear steps on how staff should minimise the risk. We saw a comprehensive range of risk assessments tailored to individual needs. We saw that many were specific to a person’s safety such as risk of falls and action to take in the event of a fire. We also noted that the provider had given consideration to people spending a lot of time in their room, identifying isolation as a possible risk to a person’s emotional wellbeing. The risk assessments were reviewed regularly and clearly detailed the actions a staff member needed to take to minimise risk.

People and their families did not raise any concerns with the environment. The provider had undertaken a programme of extensive refurbishment recently.

The Manager told us the home had undertaken a programme of replacing furniture, including chairs and tables to help create a more homely feel as well as to ensure people’s safety. Staff told us cleaning products were stored securely to prevent risks to people’s safety. Products were locked away on each floor and were only accessed by staff when required.

The environment including people’s rooms were safe. We saw no hazards that posed a risk to people. The temperature of the home was even throughout, set to keep people warm but not unnecessarily hot. We noted that people’s wardrobes where fitted were fixed to the wall. This prevented them falling causing serious injury. We saw in people’s rooms that wardrobes were fixed to the wall preventing the risk of injury. We noted a concrete structure in the garden that housed the gas mains supply to the property was not covered. We raised this was the manager and this was immediately addressed to prevent it being accessed by anyone unauthorised to do so. We saw appropriate fire evacuation equipment in the stairwell designed to support people from the building who did not mobilise. Routes out of the building were unimpeded. However, we saw a door leading out from the building into the back of the property. The Manager told us that this door is a secondary means of escape though we noted would need to be opened with a key in the event of a fire.

The provider had a robust system in place for ensuring a safe environment. Necessary checks were carried out on utilities and equipment in the home. Records of checks on all aspects of fire systems were in place to minimise the risk of fire. Visual checks and audits were carried out at regular intervals to monitor safety. During our visit we tested the effectiveness of the home’s call bell system. These bells are there for people who are in their rooms to enable them to call for assistance. We noted that when operated, staff responded immediately to the alarm being raised.

People and their families told us, “I visit [person] regularly so am confident in thinking that she is safe and that comes from the quality of care. I trust the carers and they know what they are doing.” A person living in the home told us, “I’m happy here, the place caters for my needs. I don’t bother with my call bell as there is always enough staff around for me to call.”

The provider carried out all relevant recruitment checks to ensure staff were eligible and safe to support people and possessed the right skills to do so. The Manager told us they were having team meetings at different times of the day to ensure all staff received the same information. They said this helped with consistency and ensured staff such as night workers felt included as part of the team. The Manager told us there is always a person with seniority within the home who can facilitate decision making when required. They also told us about their out of hours service and how staff can always reach management if needed. The staff we spoke to told us about the regular training and supervision they received to be able to perform their duties. They told us about the range of training courses they did to meet the needs of the people living in the home which included training related to older people and people living with dementia. The nurses told us how they can access the training offered to all care staff and about the training they undertook to maintain their professional registrations as qualified nurses.

We saw sufficient numbers of staff during our assessment to meet people’s needs. We noted there was enough staff across all floors, particularly at busy times such as lunch time, when staff were able to serve the food promptly and give people the support they needed without people having to wait.

There was a robust system for staff support and supervision. Staff received support and guidance to fulfil their roles. The provider shared information with us that detailed their learning. As well as their list of courses all staff must attend, we saw how the provider identified where gaps were in their learning and the actions, they would take to address this.

People told us when they are supported staff wear appropriate protective clothing such as gloves and aprons. Rooms were clean and tidy, and we noted the constant presence of cleaning staff throughout our assessment. We saw staff supporting people with wet wipes for their hands after lunch allowing people to feel fresh and clean after eating.

Staff told us about the training they received to understand how to lower the risk of infections spreading. They told us their training included infection control, handwashing and food hygiene. The manager told us they checked the cleanliness of the environment and whether there was sufficient personal protective equipment as part of their daily checks.

The home had a dedicated laundry system preventing the risk of cross contamination and people’s laundry being mixed together. We saw adequate hand washing facilities throughout the home available for both staff and visitors. We noted that the home was well lit and was odour free throughout. Much of the communal spaces in the building had recently been decorated. Staff followed the providers policy noting the equipment used for cleaning and the systems for cleaning different areas of the building such as items used for cleaning bathrooms kept separate to those for cleaning communal areas.

The home had an infection prevention and control policy in place for staff to follow. This provided staff with guidance about what equipment to use and how to follow safe working practices.

People’s medicines were available and in stock. People who needed their medicine at specific times were given them at the correct time. There was clear information for staff to support people who used ‘when required’ medicines, including medicines used for pain relief. When people refused medicine, this was clearly documented. People’s behaviour was not inappropriately controlled by medicines. Care plans had up to date information about how staff could support with their medicines. However, people with diabetes did not always have information on how to manage out of range blood sugar levels. We saw that staff did not always record blood sugar levels in line with the care plan on electronic systems. However, a family member told us, “My only gripe is the pain relief. When we come in, sometimes she says she is in pain, and we tell them she needs paracetamol.”

The service had recently employed a new manager into the service. They told us they were supported by other regional and national staff leaders whilst they were embedding. Staff received regular training and were assessed to ensure they were competent to handle and administer medicines. Leaders told us that additional assessor training was organised for members of staff who administered medicines.

The service completed regular audits to improve medicines management. Actions were logged and followed up by local and national leaders. The service had also recently been externally audited and resulting actions recorded and tracked. The service had a medicines policy in place that was available to staff. Medicines were stored securely, and access limited to authorised staff. The service worked closely with other local services to monitor and provide support to people. We saw evidence of the service proactively seek advice and support from other services, including mental health services and GPs. The service had a process for administering medicines covertly. We saw evidence of advice from relevant healthcare professionals including pharmacists to ensure that medicines were safe to be administered covertly. However, the service could not be assured that medicines were always stored in line with manufacturers guidance. Staff did not always follow the services policy when ensuring medicines requiring refrigeration were stored within the required range.