CQC report explained · a residential care home
What the CQC found at Manor Farm Care Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found that risks were assessed and managed, the environment was clean and safe, there were enough staff, and medicines were stored and administered safely. A medicines error had been identified and action had been taken to reduce the risk of it happening again.
- Effective?
- Good
- Staff were up to date with mandatory training and received supervision and appraisals. The home met the requirements of the Mental Capacity Act and Deprivation of Liberty Safeguards, and supported people with food, drink and access to health professionals.
- Caring?
- Good
- People were treated with kindness, dignity and respect. Staff supported people to make choices, remain independent and receive personal care in private.
- Responsive?
- Good
- Care plans reflected people's preferences and people and their representatives were involved in planning care. People had access to activities, trips and other meaningful engagement, and knew how to complain.
- Well-led?
- Good
- Inspectors found that the new management team had made significant improvements and created an open culture. Quality checks identified issues and managers took action to address them.
What inspectors found, April 2018
Manor Farm Care Home is rated Good; inspectors found safe, kind and personalised care after major improvements since the previous Inadequate rating.
This was an unannounced comprehensive inspection on 13 March 2018. Inspectors spoke with people living in the home, relatives, care staff and managers. They observed care and reviewed care records, staff files and management records.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough staff, safe medicines systems, suitable training, kind care, personalised support and meaningful activities.
The report says the home had been rated Inadequate overall in September 2017 and had breached several regulations. At this inspection, inspectors found that the necessary improvements had been made and that the home complied with all the regulations previously breached.
Inspectors found a strong focus on improving quality. They noted that care plans had been rewritten, an electronic care records system was in use, and managers were carrying out regular checks and acting on problems.
Major improvement
The home had improved substantially since the previous inspection. Inspectors found that all regulations previously breached were now being met.
“At this inspection we found that the necessary improvements had been made to comply with all the regulations previously breached.” from the report
Kind and respectful care
People described staff as kind and caring. Inspectors observed respectful interactions, privacy being protected and support for independence.
“A culture of caring was instilled by the management team and we observed that staff were kind, caring and compassionate towards people.” from the report
Personalised support
Care plans included people's preferences and life histories. Staff offered activities and trips linked to people's interests.
“People's preferences and views on their care were reflected in detail in their care records.” from the report
Good activities and choice
People could take part in group or one-to-one activities, with choices about whether to join in and what to do instead.
“People were offered opportunities to access meaningful engagement and activity, both in a group setting and on a one to one basis.” from the report
Active management
Managers were visible, involved staff in improvements and used audits and electronic records to monitor care.
“An effective system had been implemented to assess the quality of the service.” from the report
End of life plans still developing
needs fixingEnd of life care plans were in place, but inspectors said they were still being developed. They needed more information about where people wanted to be cared for at the end of life.
“These were being developed at the time of our inspection to include more information, such as where people would like to be cared for at the end of their life.” from the report
- 01How have the improvements made after the September 2017 Inadequate rating been maintained?
- 02How do you record and review each person's wishes about where they would like to be cared for at the end of life?
- 03What checks are now used to prevent medicines errors, and how are staff supported if an error occurs?
- 04How are people and their relatives involved in reviewing personalised care plans?
- 05How do you make sure activities continue to reflect each person's interests and choices?
This was an unannounced comprehensive inspection covering all five key questions and the overall quality of the home. This explanation was written from the published report of 26 April 2018 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, December 2017
Manor Farm Care Home was rated Inadequate and remained in special measures, with serious safety and management failings despite early improvements by a new team.
This was an unannounced inspection on 5 September 2017. Inspectors spoke with people living at the home, a relative, staff and managers. They checked care records, medicines, recruitment files, meetings and quality checks, and observed care.
The home was still failing to keep people safe. Care plans and risk assessments were incomplete or conflicting. There were serious concerns about malnutrition, equipment checks, fire safety checks, cleanliness and food storage. Staff medicines practice was safe, but some staff training was out of date.
Inspectors found staff were kind and responded promptly to people. However, care was not consistently person centred, people were not always involved in planning their care, and some people were bored or socially isolated. A new management team had started three weeks before the inspection and had made some early changes, but the inspectors found that significant shortfalls remained.
The overall rating was Inadequate. Safe and well-led were rated Inadequate. Effective, caring and responsive were rated Requires Improvement. The home therefore remained in special measures and was subject to further regulatory review.
Kind and respectful staff
Inspectors saw staff treating people with kindness, respect and privacy. Staff responded quickly when people asked for help.
“We observed that staff were kind to people and treated them with respect.” from the report
Safer staffing levels
Staffing levels had improved and people said staff responded promptly to call bells. The new manager had introduced systems to organise staff duties.
“We found that improvements had been made to the staffing level which ensured people received appropriate care at the time they needed it.” from the report
Medicines managed safely
Inspectors found no problems when checking medicine records and stocks. Medicines were stored and given safely.
“We did not identify any issues during this audit and concluded that medicines were stored and administered safely.” from the report
Early action by new management
The new management team had recognised the scale of the problems and was sending the regulator weekly updates on its action plan.
“The new management team had effective oversight of the poor quality of the service and were actively taking steps to improve the care people received.” from the report
People at risk from poor care plans
seriousRecords did not reliably describe people's risks or the support they needed. One person who was significantly underweight lost a further seven kilograms.
“This person continued to lose weight between our inspections and lost a further seven kilograms which accounted for 21% of their body weight.” from the report
Unsafe premises and equipment checks
seriousChecks on walking frames and wheelchairs had not been completed, and worn walking-frame ferrules could have caused falls. Other building safety risks were also found.
“We found that these checks had still not been carried out.” from the report
Cleanliness and food safety
seriousThe laundry area and mobility equipment were not clean. Food was not consistently labelled or dated, creating a risk that people could be given food that was no longer safe.
“This meant that staff would not know when this food required disposal and people were could be placed at risk of being given food which was no longer fit for consumption.” from the report
Training and legal safeguards
seriousSome staff were overdue for important training, and there was no system to check their competence. Capacity assessments and DoLS applications were also not properly completed.
“A system to assess the competency of staff had not been implemented despite this being raised as a concern during our last inspection visit.” from the report
Limited activity and personalisation
needs fixingSome people were left for long periods without meaningful engagement. Care records did not contain enough information about people's interests, communication or life history.
“We observed that people were still left seated in communal areas for extended periods of time with no engagement from staff and with no staff present.” from the report
- 01How have you completed and checked the new care plans for people at risk of malnutrition, pressure ulcers or falls?
- 02What action has been taken to confirm that all staff have completed overdue training and passed competency checks?
- 03How are people's weight, food and fluid intake, incidents and changes in risk now monitored and reviewed?
- 04What has been done to improve cleanliness, food labelling, laundry arrangements and checks on walking frames and other equipment?
- 05What meaningful activities are now available each day, including for people who prefer to stay in their bedrooms?
This was an unannounced inspection covering all five key questions, and the report compared the findings with the previous inspection on 3 and 7 February 2017. This explanation was written from the published report of 20 December 2017 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Manor Farm Care Home
4 rated inspections over 3 years: the service has held its Good rating throughout.
- April 2018Goodcurrent ratingup from InadequateSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- December 2017Inadequatestayed InadequateSafe: InadequateEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- June 2017Inadequatedown from GoodSafe: InadequateEffective: InadequateCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- February 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- November 2013
Registered with the Care Quality Commission on 7 November 2013.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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