CQC report explained · a residential care home
What the CQC found at Manor House Residential Home
Not yet rated: the CQC has not published a rated inspection for this home, which is usual for a new registration.
What inspectors found, March 2023
Rated Requires Improvement; inspectors found kind and effective care, but concerns about safeguarding, medicines and management remain.
This was an unannounced focused inspection on 1 February 2023. Inspectors spoke with people, relatives, staff and managers. They reviewed care records, medicine records, recruitment files and quality checks.
The home was rated Requires Improvement overall. Safe and well-led were also Requires Improvement. Inspectors found staff did not always understand safeguarding procedures, medicine procedures were not always followed, and checks by managers had failed to find important problems.
Effective was rated Good. People's health, food and drink needs were supported, staff worked with health professionals, and mental capacity procedures were followed. The home had made some improvements to fire safety, environmental risks and its furnishings.
This was the second consecutive Requires Improvement rating. The home had not fully completed the improvements promised after the previous inspection. The regulator will ask for an action plan and continue to monitor progress.
Staffing and recruitment
People said there were enough staff and that staff responded promptly. Recruitment records contained the required checks.
“People were supported by sufficient staff who had undergone a safe recruitment process.” from the report
Health and nutrition
People's health, food and drink needs were assessed and supported. Staff helped people eat and drink at their preferred pace and contacted health professionals when needed.
“People's nutritional and hydration needs were met.” from the report
Care environment
Fire safety and environmental risk controls had improved. Refurbishment and redecoration work was also under way.
“Fire safety procedures had improved. Fire exists were clear, and Personal Emergency Evacuation Plans (PEEPs) had been developed” from the report
Warm relationships
People and relatives spoke positively about staff and communication. Inspectors saw staff showing empathy and care.
“Family members spoke positively about the care provided, which included the positive and caring relationships developed between their relative and staff.” from the report
Safeguarding knowledge
seriousSome staff were not confident about recognising all types of abuse or reporting concerns to outside organisations. Six of the 16 care staff had not completed safeguarding training.
“People were at potential risk as staff knowledge of safeguarding and the types of abuse was limited.” from the report
Medicine procedures
seriousOn one occasion, a medicine was given without checking its name and dose against the record, and medicines were not always counted against the records. Staff medicine competency checks had not been done routinely.
“We observed on one occasion a member of staff dispense a person's medicine without checking the medicine name and dosage against the medication administration record [MAR].” from the report
Weak management checks
seriousThe provider's audits did not identify problems with medicines, safeguarding training, staff skills or unsecured wardrobes. The provider had not fully completed its previous action plan.
“The provider's quality monitoring and auditing of medicine systems and processes had failed to identify staff were not consistently following the procedure for medicines administration and management.” from the report
- 01How many care staff have now completed safeguarding training, and how do you check they can recognise and report different types of abuse?
- 02How do you check each medicine against the MAR before it is given, and how often are staff medicine competencies assessed?
- 03What changes have you made since the warning notice about governance and quality checks?
- 04Have all staff completed the outstanding training in pressure area care, oral hygiene and diabetes?
- 05How do you check that environmental risks, such as unsecured wardrobes, are found and fixed promptly?
This was a focused inspection of Safe, Effective and Well-led only; Caring and Responsive were not inspected, and the overall rating used previous ratings for the questions not covered. This explanation was written from the published report of 7 March 2023 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, February 2020
Manor House Residential Home is rated Requires Improvement; inspectors found kind, person-centred care, but serious weaknesses in safety, safeguarding and management oversight.
This was an unannounced inspection on 7 January 2020. One inspector spoke with a resident, relatives and staff, observed care, and checked care plans, medicines records, staff files and management records.
The home provided kind and respectful care. Staff knew people well, supported their choices, served meals suited to their needs and arranged activities. Care was personalised and complaints were responded to.
Inspectors found important safety problems. Fire precautions, environmental risks, repairs, safeguarding reports, staff checks and quality audits were not managed reliably. The provider made changes after the inspection, but CQC said these systems still needed to become established in everyday practice.
The overall rating changed from Good at the previous inspection to Requires Improvement. Safe, Effective and Well-led were rated Requires Improvement. Caring and Responsive remained Good.
Kind and respectful staff
Staff knew people well and supported them in a kind and respectful way. Privacy and dignity were maintained during personal care.
“Staff supported people to maintain their dignity; personal care was provided in private.” from the report
Personalised care
Care plans included people's likes, dislikes, interests and important relationships. Staff adapted care to people's personalities and previous lives.
“People's care was planned and delivered in a person-centred way. Staff treated each person as an individual and considered people's personalities and previous lives.” from the report
Food and healthcare support
Staff knew people's dietary needs and preferences, monitored food and drink intake, and involved health professionals when needed.
“Staff knew people's dietary requirements, including their likes and dislikes; staff ensured people were served their preferred meals.” from the report
Activities and relationships
People were supported to take part in activities and events. Visitors were welcomed and staff helped make important occasions special.
“People enjoyed activities that occupied their hands and minds. For example, one to one time with activities staff doing crafts.” from the report
Fire and environmental safety
seriousFire exits were blocked, fire equipment was not always available and evacuation plans were missing. People were also exposed to risks from hot surfaces, unsafe storage and delayed repairs.
“The provider had not always ensured fire safety procedures had been followed. For example, ensuring fire exits were clear, fire extinguishers readily available and safe storage of combustible materials.” from the report
Safeguarding incidents were not reported
seriousFive incidents of verbal or physical abuse recorded over a short period had not been reported to the manager or local safeguarding team. Staff guidance was also out of date.
“Between 24 December 2019 and 4 January 2020 staff had recorded in the staff handover book and people's daily notes, five incidents of verbal and physical abuse between people living at the home; these had not been reported to the registered manager or reported to the local authority safeguarding team.” from the report
Weak management checks
seriousThe provider did not carry out reliable audits of safety, care records, medicines, infection control or the environment. This meant problems were not consistently identified or acted on.
“The provider did not have a system to regularly monitor the quality and safety of people's care.” from the report
Medicines audits needed improvement
needs fixingPeople received their medicines as prescribed, but regular medicines audits had not been carried out. Some instructions for medicines given when needed were not up to date.
“However. the registered manager had not carried out regular medicine management audits.” from the report
Home needed updating
needs fixingThe home needed refurbishment and redecoration, and some design features were difficult for people living with dementia to use. A refurbishment plan was due for completion by October 2020.
“The home needed updating and redecoration. Following our inspection, the provider and registered manager met to discuss and plan the refurbishment and redecoration of the home.” from the report
- 01What checks now confirm that fire exits are clear, fire equipment is available and every person has an up-to-date personal emergency evacuation plan?
- 02How are incidents of possible abuse identified, recorded and reported to the local safeguarding team?
- 03How often are the environment, repairs, medicines, infection control and care records audited, and can we see the latest results?
- 04What work has been completed on refurbishment, redecoration and dementia-friendly features since the inspection?
- 05How are staff suitability checks, including updated Disclosure and Barring Service checks, kept up to date?
This was a planned, unannounced inspection covering all five key questions; the previous ratings were from the inspection published on 22 July 2017. This explanation was written from the published report of 5 February 2020 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 House Residential Home
4 rated inspections over 8 years: the service has slipped, from Good to Requires improvement.
- March 2023Requires improvementcurrent ratingstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
Read what inspectors found at Manor House Residential Home →
- February 2020Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementWell-led: Requires improvement
Read what inspectors found at Manor House Residential Home →
- July 2017Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- July 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- December 2013
Report published without a new overall rating.
- July 2013
Report published without a new overall rating.
- February 2013
Report published without a new overall rating.
- May 2011
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 24 January 2011.
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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