CQC report explained · a residential care home
What the CQC found at The Manor
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
What inspectors found, April 2018
Rated Good overall; inspectors found kind, safe care, but the home was not consistently well-led.
This was an unannounced comprehensive inspection on 21 February 2018. Inspectors spoke with nine people living in the home, two care staff, three relatives and the registered manager. They also checked records about staffing, training and quality checks.
The home was rated Good for Safe, Effective, Caring and Responsive. Inspectors found enough staff, safe medicine arrangements, suitable training, support with food and healthcare, kind care and personalised care plans.
The Well-led rating was Requires Improvement. The home had quality checks and a positive culture, but it had not always told CQC when people were subject to Deprivation of Liberty Safeguards. Inspectors also noted limited activities, incomplete end-of-life care plans and a risk of infection when medicines were handled.
The overall rating improved from Requires Improvement at the previous inspection. Earlier problems with guidance for as-required medicines and best-interest decisions had been addressed.
Safe medicines
The home had guidance for as-required medicines and managed medicines safely, including medicines given covertly.
“Guidance was in place to ensure people received their medicines when required. Medicines were managed safely.” from the report
Kind and respectful care
Inspectors saw staff offering reassurance, respecting people's choices and supporting privacy and dignity.
“Staff responded to people in a kind and sensitive manner.” from the report
Personalised care
Care plans reflected people's needs and preferences and were reviewed when these changed.
“Care plans were regularly reviewed to make sure that they accurately reflected people's changing needs and wishes.” from the report
Support with health and nutrition
People were helped to eat and drink enough and had access to doctors and other healthcare professionals.
“People had access to a range of healthcare services and professionals.” from the report
CQC notifications
seriousThe home had not consistently told CQC when people were subject to Deprivation of Liberty Safeguards. This was a management and regulatory shortfall.
“However notifications had not been sent to CQC regarding Deprivation of Liberty Safeguards.” from the report
Limited activities
needs fixingOn the inspection day, the staff member responsible for activities was unavailable. Three people raised concerns about the lack of activities.
“On the day of inspection the member of staff responsible for coordinating activities was not available which meant there were few activities for people to enjoy.” from the report
End-of-life care plans
needs fixingThe home was developing arrangements for end-of-life care, but care plans did not yet explain how people wanted this care to be provided.
“However we observed care plans were not in place to explain how people would like to receive their end of life care.” from the report
Medicine handling
needs fixingStaff handled tablets before putting them into a cup. Inspectors said this created a risk of spreading infection, and the manager said it would be addressed.
“However we observed when medicines were administered staff handled the tablets before placing them into a cup for people to take and there was a risk of infection being spread.” from the report
- 01What action has been taken to ensure all Deprivation of Liberty Safeguards notifications are sent to CQC on time?
- 02What activities are currently available each week, and what happens when the activities coordinator is unavailable?
- 03Have individual end-of-life care plans now been completed with each person and their representatives?
- 04What has changed to prevent staff handling medicine tablets before they are given to people?
- 05What improvements have been made to the signage, paintwork and outside paved areas mentioned in the report?
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 24 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, February 2017
Rated Requires Improvement; inspectors found kind, responsive care but weaknesses in medicines guidance and mental capacity records.
The inspection was unannounced and took place on 11 January 2017. Inspectors observed care, spoke with people, relatives and staff, and reviewed care plans, medicines, training records and quality checks.
People were generally safe, well cared for and treated with kindness and respect. Staff responded promptly, understood people's needs, supported healthcare and nutrition, and provided activities. Care plans were personalised and relatives said they felt welcome.
The home was not consistently safe or effective. Guidance for as-required medicines was missing, medicine records did not always show whether people had been offered these medicines, and some mental capacity and best-interest records were not specific. The overall rating was Requires Improvement, while Caring, Responsive and Well-led were rated Good.
Kind and respectful staff
People and relatives described staff as kind and compassionate. Inspectors observed staff reassuring people and supporting them sensitively.
“Staff were kind and sensitive to people when they were providing support and people had their privacy and dignity considered.” from the report
Personalised care
Care records included people's histories, interests and important dates. Staff used this information to support meaningful activities and daily routines.
“Care records were personalised and included information about people's life history and experiences.” from the report
Healthcare and staff training
People could access GP and specialist healthcare. Staff received training, induction and regular supervision to help them meet people's needs.
“People who used the service had access to local and specialist healthcare services and received on-going healthcare support from staff.” from the report
Open management
Staff, people and relatives said the manager and senior staff were approachable. Audits, meetings, surveys and action plans were used to monitor and improve the home.
“Staff said that they felt able to raise issues and felt valued by the registered manager and provider.” from the report
As-required medicines
seriousThere was no clear guidance for staff about when as-required medicines should be given. Medicine records did not always show whether people had been offered them, creating a risk of missed treatment.
“There was a risk that people would not receive their medicines when they needed them.” from the report
Mental capacity records
seriousBest-interest decisions did not clearly identify which decisions were being made for people who lacked capacity. The report gives bed rails and medicines as examples.
“It was not clear from the records what decisions were being made on people's behalf.” from the report
Choices at mealtimes
needs fixingPeople were offered meal choices, but inspectors found it was not easy for everyone to make choices. People's views about the food were mixed.
“It was not easy for people to make choices at mealtimes.” from the report
Access to complaints information
minorPeople could complain to staff or the manager, and there were complaint cards. However, the formal procedure was only in a written format, so it was not accessible to people who could not read.
“The complaints procedure was only available in a written format which meant that only people who could read were able to access it.” from the report
- 01What changes have been made to the guidance and records for as-required medicines since this inspection?
- 02How do you record best-interest decisions for people who cannot make decisions about bed rails, medicines or other care?
- 03How are residents helped to choose meals, and how are their food preferences acted on?
- 04How can someone who cannot read make a complaint or access the complaints procedure?
- 05What arrangements are now in place for activities, given that the activities lead post had recently become vacant?
This was an unannounced comprehensive inspection covering all five key questions, based on observations, discussions and records reviewed on 11 January 2017. This explanation was written from the published report of 3 February 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 The Manor
4 rated inspections over 3 years: the service has improved, from Requires improvement to Good.
- April 2018Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- February 2017Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- October 2015Requires improvementstayed Requires improvementSafe: Requires improvementWell-led: Requires improvement
- July 2015Requires improvementSafe: InadequateEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- July 2014
Report published without a new overall rating.
- December 2013
Report published without a new overall rating.
- June 2013
Registered with the Care Quality Commission on 10 June 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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9 live-in carers within about an hour of Lincolnshire
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.
8 can care for a couple. 10 years' experience on average.
“Martin was more than a carer, he managed the home and became my uncle's best friend, enriching his life during his last few years.”
“Magda was always positive and proactive about trying new things to keep dad busy. She also introduced new ideas for keeping dad healthy.”
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.