Archived: The Manor House Residential Home

Updated 11 January 2016

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 8 October 2015 and the inspection was unannounced. The inspection team consisted of two inspectors and an expert by experience with expertise in dementia care. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Before the inspection we reviewed the information we held about the home. This included looking at information we had received about the service and statutory notifications we had received from the home.

We usually send the provider a Provider Information Return (PIR) before the inspection. This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We did not send a PIR to the provider before this inspection.

We used a number of different methods to help us understand the experiences of people who used the service. We spent time observing care and support being delivered. We looked at seven people’s care records, medicines administration records (MAR) and other records which related to the management of the service such as training records, staff recruitment records and policies and procedures.

We spoke with eight people who were living in the home, five relatives, three care staff, the cook and the registered manager.

Representatives from Healthwatch Calderdale visited the home on the 28 August 2015 and made no recommendations in relation to the service. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England.

Updated 11 January 2016

This inspection took place on 8 October 2015 and was unannounced. At the last inspection on 14 May 2015 we found three breaches in regulations which related to staffing, person centred care and good governance. The provider sent us an action plan which told us improvements had been made. At this inspection we found some improvements had been made.

The Manor House Residential Home provides accommodation and personal care for up to 30 older people, some of whom may be living with dementia. There were 18 people living in the home on the day of inspection. Accommodation is provided over two floors and there is a passenger lift available to assist people with mobility problems. There are lounges on both floors and a dining room and kitchen on the ground floor as well as communal toilets and bathroom facilities. A laundry is located on the lower ground floor.

The home had a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

The home had a safeguarding policy in place which made staff aware of their roles and responsibilities. We found staff knew and understood how to protect people from abuse and harm and kept them as safe as possible.

At the last inspection we were concerned that there was not always sufficient staff on duty to meet people’s needs and that staff did not always receive the training and support they required to carry out their roles effectively. On this inspection we found the provider had increased the number of staff on night duty and placed more emphasis on staff training and supervision. However, we have recommended that the registered manager kept staffing levels under review to ensure they are adequate to meet people’s needs.

There were procedures in place and guidance was clear in relation to Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS) that included steps staff should take to comply with legal requirements. The registered manager also told us they were working with the local authority to make sure they were working in line with guidelines. This legislation is used to protect people who might not be able to make informed decisions on their own.

The staff we spoke with had a general understanding of the MCA and DolS and how they impacted on the care and treatment they provided. However, the training matrix showed not all staff had yet completed training on the subject.

We saw arrangements were in place that made sure people's health needs were met. For example, people had access to the full range of NHS services. This included GPs, hospital consultants, community health nurses, opticians, chiropodists and dentists. We also saw since the last inspection the care documentation in place was more person centred and provided staff with accurate and up to date information.

We found that although people received their medicines as prescribed there were no protocols in place for medicines prescribed “as and when required” (PRN). Therefore there was no guidance in place to inform staff on under what circumstances they should administer the medication.

People told us they found the staff caring, and said they liked living at the home. Relatives gave us positive feedback about the care and support their family members received. Throughout the inspection we saw staff were kind, caring and patient in their approach and had a good rapport with people.

Staff were careful to protect people’s privacy and dignity and people told us they were treated with dignity and respect. We saw information relating to people’s care and treatment was treated confidentially and personal records were stored securely.

We saw the complaints policy had been available to everyone who used the service. The policy detailed the arrangements for raising complaints, responding to complaints and the expected timescales within which a response would be received.

Staff told us communication within the home was good and staff were confident senior management would deal with any concerns relating to poor practice or safeguarding issues appropriately.

However, we found that although the quality assurance monitoring systems in place had been improved since the last inspection further work was required to evidence the service was consistently being managed effectively and in people’s best interest.

We have made recommendations about staffing and where to seek guidance on they way the premises could be adapted in a way that helps people living with dementia manage their surroundings, retain their independence, and reduce feelings of confusion and anxiety.