CQC report explained · a residential care home
What the CQC found at Manor House
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- People generally felt safe and staff understood safeguarding procedures. However, some risk plans were not detailed enough, medicines were not always stored at the right temperature, and fire safety improvements were still being completed.
- Effective?
- Requires improvement
- People usually received suitable food, drinks and healthcare support. However, information about specialist diets was not always clear or up to date, food records were incomplete, and some staff were not confident about specific care needs.
- Caring?
- Good
- This question was not inspected during this visit. The report records that people and relatives spoke positively about staff and the care provided.
- Responsive?
- Good
- This question was not inspected during this visit. The report does not give a new rating for this question.
- Well-led?
- Requires improvement
- The manager was open, supported staff and worked with outside agencies. However, quality checks had not identified some problems with medicine storage and risk management records.
What inspectors found, September 2022
Rated Requires Improvement; inspectors found kind care but ongoing risks with fire safety, medicines, care records and management checks.
This was an unannounced focused inspection on 24 and 25 August 2022. Inspectors spoke with people, relatives, staff and health professionals. They looked at four care plans, recruitment records and how the home was managed.
People generally felt safe and spoke positively about staff. Staffing and recruitment were suitable, people received their medicines as prescribed, and staff supported people to make choices. Food was generally well received, and healthcare referrals were made when needed.
However, some risks were not fully recorded, medicines were not always stored safely, and information about specialist diets was not always accurate. Fire safety work was still being completed. Management checks had improved but had not found all the problems inspectors identified.
The overall rating remains Requires Improvement. Safe, Effective and Well-led were each rated Requires Improvement. Caring and Responsive were not inspected in this visit, so the overall rating also used ratings from the previous inspection.
People felt safe
People said they received safe care. Staff knew how to recognise and report abuse, and recruitment checks were completed.
“People felt safe using the service. Staff understood how to recognise and report abuse.” from the report
Kind and supportive staff
People, relatives and health professionals gave positive feedback about staff. Staff also said they felt supported by the manager.
“People spoke positively about the staff and the care they provided.” from the report
Choice and consent
Staff supported people to make choices and followed the principles of the Mental Capacity Act. People said staff asked for consent before providing support.
“People had been supported to make decisions about their care and support in their best interests” from the report
Healthcare links
Staff referred people to healthcare professionals when needed. Health professionals said concerns were referred to them in a timely way.
“Healthcare professionals were positive about the support staff gave people and told us staff referred any concerns to them in a timely way.” from the report
Fire safety work was unfinished
seriousFire reviews had identified improvements needed to fire doors and the alarm. The provider said the required work should be completed by December 2022.
“The provider was taking action to make required improvements to fire safety within the service, including improvements to the fire alarm and fire doors to make them safe.” from the report
Medicine storage temperatures
seriousMedicines were not always stored at the temperature stated by the manufacturer during hot weather. This created a risk that medicines might not work as intended.
“Medicines were administered and disposed of safely, but were not always stored at a temperature in accordance with the manufacturer's instructions.” from the report
Risk and diet records were unclear
needs fixingSome care plans did not give staff enough detail about risks, including choking. Information about two people's dietary needs was also unclear or out of date, although it was updated after inspectors raised this.
“However, some risk assessments were not sufficiently detailed to provide guidance to staff about how to support people safely.” from the report
Management checks missed problems
needs fixingThe home had regular audits, but they did not find the medicine storage and care-record issues identified during the inspection.
“However, the checks were not all effective because they had not identified issues we found during our visit.” from the report
Some staff needed more specialist training
needs fixingSome staff were not confident explaining how they would support people with diabetes, catheter care and hydration. Further training was being arranged.
“some staff did not provide confident responses about how they would support people.” from the report
- 01Has all the fire alarm and fire door work identified in the report been completed, and can you explain what remains?
- 02How do you now monitor medicine storage temperatures during hot weather?
- 03How are choking risks and specialist diets recorded and shared with care and kitchen staff?
- 04What extra training have staff completed for diabetes, catheter care and hydration?
- 05How do your current audits check that care plans, risk assessments and medicine storage are correct?
This was a focused inspection of Safe, Effective and Well-led only; Caring and Responsive were not inspected and the overall rating also used ratings from the previous inspection. This explanation was written from the published report of 30 September 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, September 2020
Inspected but not rated; inspectors were assured that infection prevention and control measures were being followed.
The inspection took place on 26 August 2020 and was announced. It was a targeted inspection during the coronavirus pandemic, focused on infection prevention and control in the home.
Inspectors were assured that the home was managing visitors, social distancing, shielding, admissions, personal protective equipment, testing, hygiene and possible outbreaks safely.
The report gives examples of practical measures. Staff changed their working hours to reduce the number of people entering the home, and empty rooms were used for changing clothes. Staff also used dancing to help people feel less anxious about protective equipment.
The home was inspected but not rated. This means the report does not give an overall quality rating or full ratings for all five areas of care.
Helping people feel less anxious
Staff used dancing to make wearing additional protective equipment feel less worrying for people.
“Staff performed dances to reduce people's potential anxieties regarding staff wearing additional Personal Protective Equipment (PPE), which brought some light hearted fun to the situation.” from the report
Safer family visits
People could meet friends and family in the garden for short, socially distanced visits.
“People were supported to stay safe when they met their friends and/or family members by meeting socially distanced in the garden for a short period of time.” from the report
Reducing staff movement
Staff working hours were changed to reduce the number of different staff entering the home.
“Staff had adjusted their working hours to minimise the amount of different staff entering the building.” from the report
Changing facilities
Empty rooms were used as changing rooms, helping staff change clothes when entering and leaving the home.
“Empty rooms had been used as changing rooms for staff to safely change their clothes upon entering and leaving the building.” from the report
Inspectors raised no specific concerns in this report.
- 01Have the infection prevention and control arrangements from this inspection changed since August 2020?
- 02How are visits from friends and family managed now, including outdoor or socially distanced visits?
- 03How are staff working patterns and changing arrangements managed now to reduce infection risks?
- 04What arrangements are in place for testing residents and staff?
- 05What were the home's most recent full ratings for caring, effective, responsive and well-led care?
This was a targeted inspection of infection prevention and control measures only; the service was inspected but not rated and the other areas were not assessed. This explanation was written from the published report of 22 September 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
5 rated inspections over 7 years: the service has slipped, from Good to Requires improvement.
- September 2022Requires improvementcurrent ratingSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- September 2020Inspected but not ratedSafe: Inspected but not rated
- May 2019Requires improvementstayed Requires improvementSafe: GoodEffective: Requires improvementWell-led: Requires improvement
- June 2018Requires improvementstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- June 2017Requires improvementdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- April 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- August 2014
Report published without a new overall rating.
- June 2013
Report published without a new overall rating.
- September 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 20 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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