CQC report explained · a residential care home
What the CQC found at Manor Farm
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- One person's medicine was not given as prescribed, and not all night staff were trained to give medicines. Some safety checks had also not been completed on time.
- Effective?
- Requires improvement
- The building was damaged and not well maintained, and staff did not always promote healthy eating. Training had improved, but not all staff had received all the training needed.
- Caring?
- Requires improvement
- Staff knew people well and provided kind, compassionate and patient care. However, staff did not always protect dignity, use respectful language or follow through on people's requests.
- Responsive?
- Requires improvement
- Care plans were generally informative, but some information was missing or needed review. People did not always have information in a format they could understand, although communication tools and activities were being reintroduced or increased.
- Well-led?
- Requires improvement
- The registered manager was approachable and had clear improvement plans. However, audits had missed important problems and improvements had not yet become consistent practice.
What inspectors found, July 2022
Manor Farm is rated Requires Improvement; inspectors found kind care and recent progress, but safety, dignity, independence and management systems were not consistently good.
This was an unannounced inspection after concerns about safety, staffing and care quality. Inspectors visited on three occasions, spoke with people, relatives, staff and other professionals, observed daily care, and checked care, medicine, staffing and management records.
All five areas were rated Requires Improvement: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough staff to meet people's needs, kind and patient support, better activities and improved communication with relatives. However, the home was not well maintained, healthy eating and independence were not always promoted, and staff did not always protect dignity.
The home was rated Good at the previous inspection, published in April 2020. The report says improvements had started since the current registered manager returned, but they were not yet fully in place or consistent.
Kind and patient care
Staff knew people well and inspectors saw kind, compassionate and patient support. Relatives also reported recent improvements in care.
“People received kind, compassionate, and patient care.” from the report
Activities and community life
People were supported to take part in activities, follow their interests and spend time in the local community. Opportunities had improved in recent months.
“Staff supported people to take part in activities and pursue their interests in their local area and interact with people who had shared interests.” from the report
Support with anxiety
Staff used distraction and other planned approaches to support people during distress. Restrictions were used only as a last resort and for the shortest time possible.
“People's freedom was restricted only where they were a risk to themselves or others, as a last resort and for the shortest time possible.” from the report
Improved family involvement
Relatives said communication and involvement had increased. The home used meetings, newsletters and care reviews to hear relatives' views.
“Relatives told us their communication and involvement with the service had substantially increased since the registered manager took up post.” from the report
Medicines and night cover
seriousOne person's medicine was not given in line with the prescriber's instructions. People might also have had to wait for medicines at night because not all night staff were trained to administer them.
“We found one person's medicines were not being given in line with the prescriber's instructions.” from the report
Poor condition of the home
seriousWalls, paintwork and an internal window were damaged. A washing machine had been out of use for a year, and some bedrooms were bare and needed redecorating.
“The provider had not adequately maintained the premises.” from the report
Dignity and independence
seriousStaff were not always discreet or respectful, and the language used about people was not always positive. People also missed opportunities to build everyday skills such as cooking and laundry.
“People's home environment and some aspects of their support did not respect their dignity or promote their independence.” from the report
Weak quality checks
seriousManagement audits did not identify all the problems found by inspectors, including issues with medicines, mealtimes and a person's night-time routine. Improvement work was not yet embedded.
“Provider audits had not identified all of the issues found during this inspection.” from the report
- 01What repairs and redecoration have been completed since the inspection, including the bedrooms, communal areas and washing machine?
- 02How will you ensure that a trained member of staff is always available to give medicines at night?
- 03What checks now confirm that medicines, mealtimes and night-time routines are being managed correctly?
- 04How are people being supported to build life skills, make healthy food choices and work towards longer-term goals?
- 05What training and supervision do all permanent and agency staff receive on dignity, communication and independence?
This was an unannounced inspection prompted by concerns about safety, staffing and care quality, and it assessed all five key questions as well as infection prevention and control. This explanation was written from the published report of 14 July 2022 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, March 2021
Inspected but not rated; inspectors were assured about infection prevention and control at Manor Farm.
This was a targeted inspection on 4 March 2021. Inspectors checked how the home was prepared to prevent and control coronavirus infections. They reviewed the home’s policies and audit findings and inspected the service after an announced visit.
Inspectors were assured that visitors, admissions, testing, personal protective equipment and cleaning were managed safely. The home was clean, free from clutter and odours, and had risk assessments for people or staff at increased risk of infection.
This inspection did not give an overall quality rating. The Safe question was inspected but not rated. The inspection focused only on infection prevention and control, so it does not provide a full picture of the home’s care.
Clean environment
Inspectors found good cleaning arrangements. The home was clean, without clutter or unpleasant smells.
“Good cleaning regimes were in place. The service was clean, odour and clutter free.” from the report
Personal protective equipment
There was enough personal protective equipment, and staff were using it effectively.
“Enough personal protective equipment (PPE) was available and staff used this effectively.” from the report
Visitor controls
The home had a process for managing visitors in line with government guidance. Visiting was temporarily suspended except in exceptional circumstances, with a planned restart on 8 March 2021.
“There was an effective process and systems in place for any visitor entering the service which is in line with the government guidance.” from the report
Risk planning
Risk assessments were in place for people and staff who were at increased risk of infection, including arrangements for isolation.
“Individual risk assessments were in place for any person or staff member at an increased risk of infections including being able to isolate.” from the report
Inspectors raised no specific concerns in this report.
- 01How did visiting restart from 8 March 2021, and what visiting arrangements are in place now?
- 02How are people using the home and staff accessing infection testing now?
- 03How are individual infection risk assessments, including plans for isolation, kept up to date?
- 04How does the home support regular contact between residents and their families?
- 05How often are infection prevention policies, cleaning arrangements and audits reviewed?
This was a targeted inspection of infection prevention and control under the Safe question; the service was inspected but not rated and the other areas were not assessed. This explanation was written from the published report of 27 March 2021 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
4 rated inspections over 6 years: the service has held its Requires improvement rating throughout.
- July 2022Requires improvementcurrent ratingSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- March 2021Inspected but not ratedSafe: Inspected but not rated
- April 2020Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- August 2017Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- June 2016Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- September 2014
Report published without a new overall rating.
- July 2014
Report published without a new overall rating.
- May 2013
Report published without a new overall rating.
- November 2011
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 10 December 2010.
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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