CQC report explained · a residential care home
What the CQC found at Manton 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
- Safeguarding incidents and other incidents were not always recorded clearly or followed through. Some care plans and risk assessments were missing, and there was not always a trained member of staff available to give medicines at night.
- Effective?
- Requires improvement
- Staff knowledge and training were variable, particularly around dementia, end of life care and people's specific health conditions. People were not always supported well at mealtimes, and staff did not have clear individual guidance about fluid needs.
- Caring?
- Requires improvement
- Inspectors saw some empathetic and kind interactions, but staff conduct and professional boundaries had caused concerns. Records did not consistently show that people had been offered personal care or received support that respected their individual needs.
- Responsive?
- Requires improvement
- Care plans were being updated but remained too generic and did not always explain what staff needed to do. Activities and communication support did not fully reflect people's past interests, dementia needs or sensory impairments.
- Well-led?
- Requires improvement
- The new manager had introduced improvements, but systems were not firmly embedded and some requested information was delayed or missing. The provider breached Regulation 17 because governance and oversight did not reliably identify and address risks.
What inspectors found, September 2021
Rated Requires Improvement; inspectors found risks in care records, staff skills, food and drink support, safeguarding and management oversight.
This was an unannounced inspection on 25 May 2021. It was brought forward after concerns about the home, its registration change and the care people were receiving. Inspectors observed care, spoke with people, staff, relatives and a health professional, and checked care, medicine, staffing and management records.
The home was not consistently safe, effective, caring, responsive or well-led. Inspectors found incomplete risk and care records, gaps in staff training and knowledge, weak recording of incidents and concerns about how low food and fluid intake was escalated. Some people had kind interactions with staff, but engagement and support were not consistent.
The home had made changes under a new manager, including improving the environment, infection control, staff supervision and quality checks. These changes were not yet firmly established. The provider breached Regulation 17 on good governance, because management oversight and quality systems were not robust enough.
Infection control
Inspectors were assured that the home used PPE safely, supported testing and had suitable infection prevention arrangements, including for outbreaks.
“We were assured that the provider was using PPE effectively and safely.” from the report
Medicine administration
Staff who administered medicines had been trained and assessed as competent. Audits helped check that medicines were given as prescribed.
“People were administered their medicines by staff who were adequately trained and assessed as competent to give medicines.” from the report
Manager-led improvements
The new manager had introduced daily handovers, spot checks, weekly meetings and reflective supervision to improve staff practice and oversight.
“At our inspection we found the manager was working hard to improve the service and they had a clear ethos for developing a person-centred culture.” from the report
Environment
People's rooms were individualised and maintained, with clear signs and areas of interest. Improvements had also made the garden a safe space.
“Improvements to the garden had been made which was now a nice, safe space for people to use.” from the report
Management oversight
seriousThe provider did not have strong enough systems to monitor care, incidents, records and improvements. This was a breach of Regulation 17.
“We identified a breach of regulation 17 Good governance of The Health and Social Care Act 2008, ( Amended in 2014.)” from the report
Safeguarding and risk records
seriousSome safeguarding incidents were not clearly investigated or recorded, and some care plans and risk assessments were missing or incomplete. This made it difficult to see how risks were being reduced.
“Safeguarding incidents were not always clearly recorded or show what actions were taken to reduce the likelihood of another incident.” from the report
Food and fluid support
seriousPeople sometimes waited a long time for meals and were not always encouraged to eat or drink. One person's fluid intake was dangerously low but had not been escalated appropriately at the time.
“Their fluid intake was dangerously low, and they have subsequently been seen regularly by the nurse and doctor.” from the report
Family communication
needs fixingRelatives said they were not kept informed about changes in the home, care reviews or their family member's health. Feedback surveys had not been completed for two years.
“Several relatives had no idea the previous manager had left or what was happening in the home in terms of their family members health.” from the report
- 01What has changed since the inspection to make sure safeguarding incidents are recorded, investigated and signed off properly?
- 02How do you now check that every person has complete care plans and risk assessments when they move into the home?
- 03How do you identify and escalate low food or fluid intake, and what individual fluid targets are recorded for each person?
- 04Which staff have now completed training in dementia, end of life care and people's specific health conditions?
- 05How will you keep relatives informed about care reviews, changes in management and their family member's health?
This was an unannounced inspection prompted by concerns and a change in registration, and inspectors assessed all five key questions as Requires Improvement. This explanation was written from the published report of 1 September 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 Manton House
5 rated inspections over 5 years: the service has held its Requires improvement rating throughout.
- September 2021Requires improvementcurrent ratingstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- April 2019Requires improvementstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: Requires improvementResponsive: GoodWell-led: Requires improvement
- December 2017Requires improvementup from InadequateSafe: GoodEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- May 2017Inadequatedown from Requires improvementSafe: InadequateEffective: InadequateCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- June 2016Requires improvementSafe: GoodEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- April 2020
Registered with the Care Quality Commission on 2 April 2020.
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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13 live-in carers within about an hour of Norfolk
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £990 to £1,120 a week. 9 can care for a couple. 14 years' experience on average.
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.