Archived: Manor Court

This was a responsive inspection due to concerns raised about lack of management and the risk of the safety of people who used the service. Concerns were also raised about the general cleanliness of the home, the availability of personal protective equipment (PPE), pantry was dirty and no programme for deep cleaning. The focus of the inspection was to answer five key questions; is the service safe, effective, caring, responsive and well-led.

As part of this inspection we spoke with 14 people who used the service and two relatives. We also spoke with the registered owner/manager, operations director, administrator and four care staff. We also reviewed records relating to the management of the home which included eight people's care records and audits for assessing and monitoring the quality of service provision, a range of other audits and staff training records.

Is the service safe?

Two members of staff who had been there approximately four months had not seen any care plans or received training on the common mandatory induction standards such as manual handling, they stated they had been shown manual handling by other staff. On the first day of inspection we saw no evidence that the staff who showed the moving and handling techniques had up to date training themselves. On the second day we found that training had started to take place with hoist training being undertaken on the 23rd September 2014.

Fire audits were in place but no fire drills had taken place, although we were told by staff that these had been done 'verbally' by staff we spoke with on the day. On the first day of inspection people who used the service did not have a Personal Emergency Evacuation Plan (PEEP) in place. We were shown a sheet near the fire alarms which described people who needed two to one care with mobility, we were told by the operations director that this needed updating, as it was inaccurate and out of date. This meant that the service had failed to appropriately assess record and plan the safe management of any emergencies that could arise. On the second day of inspection PEEP plans were in place but contained limited information.

Is the service effective?

Not all staff had received training to meet the needs of the people who used the service. On the first day of inspection staff had not received training on the Mental Capacity Act or the Deprivation of Liberty Safeguards, along with the safeguarding of vulnerable adults. On the second day of inspection safeguarding training had taken place but they were waiting for the books to be 'marked'.

The manager did not carry out any reviews to assess and monitor the quality of service provision. There were no records of staff being trained to provide care to people who live with a dementia or who may display behaviour that challenges. This was despite the home offering accommodation and personal care to people with these identified needs.

Is the service caring?

Observations showed the staff knew the people who used the service well for example one staff member stated, 'We had better make sure X gets their hair cut, they hate it when it grows over their ears'.

Is the service responsive?

On the two day inspection we looked at eight sets of care records in total. We found that the care records contained a lot of repetition; they were not person centred and contained very little detail about the likes and dislikes or past history of the people who used the service. Only four care files had photo identification in place. On the first day of inspection care staff we spoke with said they were aware the care plans needed updating from the last Care Quality Commission inspection in October 2013 and said that although they had started they had not had time to complete them. On the second day we saw that two sets of records we looked at had been reviewed and updated in September 2014; however the remaining six sets of records had not been reviewed since June 2014.

On the first day of inspection we did see an activity timetable, but saw no evidence of activities taking place. On the second day of inspection the owner/registered manager told us that they had employed someone that week who they hoped would take over the activities. One staff member told us they get a singer into the home about every four to six weeks and the people who used the service really enjoyed that. On the second day of inspection the vicar had come into the home and 11 people who used the service took part. Some people had received communion and others a blessing.

We looked in the complaints file; there was no record of any complaints this year. The operations director told us if anyone has a complaint they would sit at the kitchen table with the manager and discuss it, no records were kept of these discussions.

Is the service well-led?

We saw that the manager had no effective quality assurances or processes in place. Staff we spoke with said they felt the manager needed more support to run the home.

We had concerns about the volume of work care staff needed to complete. As well as caring for the people who used the service, care staff also had to do the cooking, cleaning and laundry within the home.

Furniture in the home needed updating, bare wood was visible on all vanity units in en-suites making them difficult to clean and prevent infection. Soft furnishings were in need of a deep clean, chairs were ripped and the arms of chairs were stained with what looked to be old, dried food. On the first day of inspection red bags to carry soiled laundry were not always used and there was no clear evidence of a dirty in and clean out workflow in the laundry. On the second day of inspection we observed red bags being used.

People who used the service told us 'It's very nice but I would rather be at home.' 'The food is very good and it's lovely and clean in here.' 'I have made friends with people we sit and watch television together.' 'The staff are very good to me. They have always been kind, I can't say anything else.' 'It's a happy place the staff do a good job for us.' 'I like to go in the kitchen and wash up and clean up. If there's out wants doing I will have a go at it.' 'I don't like bingo or games.' 'I read the paper. I get the woman's weekly magazine and I watch the television. I like to read the Express.' 'You can see the trees from my room. I think mine is one of the best rooms in the house.' 'Some staff are better than others.' 'You can do as you like there are no rules. If you like to sit in your chair all day then you can.' And 'I'm content.'

Relatives we spoke with said 'It's always nice coming in they always have a chat and offer you a cup of tea.' 'They are concerned if anyone is off colour.' 'It's home from home you won't find better.' 'I take dad out. Today we are going out over the moors, he likes a trip out.' 'The food is best home cooking.' And 'The girls are lovely.'

We asked all the people who used the service if there were enough activities during the day to keep them occupied. All said that they were very happy and did not want anything else. People said that they thought there was enough staff on duty during the day and night

During the inspection we spoke with five people who used the service and two relatives. We also spoke with the manager, the operations manager, a senior care assistant and a care assistant. People who used the service told us that they were happy with the care and service received. One person said, 'As far as I am concerned they do very well for us.' Another person said, 'I've lived here for three years, I am very happy and it's handy for the family.'

We were able to observe the experiences of people who used the service. We saw that staff treated people with dignity and respect. We saw that people had their needs assessed and that care plans were in place. One person said, 'You won't find better than this. The staff are very good.'

People were supported to eat and drink sufficient amounts to meet their needs. People told us that they enjoyed the food that was provided. One person said, 'The food is good home cooking and very tasty.'

We saw that the service had appropriate equipment. We saw that checks and servicing of equipment was undertaken to ensure that it was safe.

We saw that there was sufficient staff with the right knowledge and experience to support people.

We found that the care, treatment and support offered to people at Manor Court, was provided by suitably qualified, skilled and experienced staff.

We saw that the home retained and maintained accurate and appropriate records which protected people who used the service from the risks of unsafe or inappropriate care and treatment.

People who used the service told us, 'It is lovely here, I have a beautiful bedroom. I brought some bits in myself from home and it has a lovely view'.

Another person told us, 'I knew her (the owner) before I moved here, it is lovely, one big happy family'.