CQC report explained · a residential care home
What the CQC found at The Manor House Knaresborough
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found robust risk assessments, safety checks, safe medicines systems and infection control arrangements. They also found enough staff to meet people's needs, although some people felt there were not enough staff.
- Effective?
- Good
- Care needs were assessed in detail, staff had relevant training and people were supported with food, drink and healthcare. Mental capacity assessments and best-interest decisions were in place when needed.
- Caring?
- Good
- People were treated with compassion, dignity and respect. They were involved in decisions about their care and staff understood their routines and preferences.
- Responsive?
- Good
- People had choice and control over their daily lives, with a range of activities and support to reduce isolation. Complaints were responded to appropriately and information was provided in different formats.
- Well-led?
- Good
- The home had a supportive culture and regular audits, spot checks, supervision and team meetings. Managers involved people and relatives in changes and worked with other professionals.
What inspectors found, October 2022
The Manor House Knaresborough is Rated Good; inspectors found safe, kind and person-centred care, with some concerns about staffing levels.
This was an unannounced inspection on 18 and 30 August 2022. Two inspectors and an Expert by Experience spoke with 15 people, staff and managers. They reviewed medicines records, care plans, training records and quality checks.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found people were protected from harm, received medicines safely, had detailed care plans and were treated with dignity and respect.
There were enough staff to meet people's care needs, but some people felt staffing levels were too low. The home regularly used agency staff because of recruitment difficulties. Inspectors also found strong activities, including events for people living with dementia, and systems for learning when things went wrong.
This was the first inspection that gave the service a rating. An infection prevention and control inspection in January 2021 did not provide a rating.
Detailed, personal care
Care plans reflected people's choices, wishes and life history. Staff understood people's routines and preferences.
“People's care plans were very detailed and focused on the persons choices, wishes and life history.” from the report
Kind and respectful care
Inspectors found that people were treated with dignity and were involved in decisions about their care.
“People were actively involved in decisions about their care.” from the report
Safe medicines
Medicines were stored securely, given as prescribed and managed around people's preferences and routines.
“Medication was stored and administered safely with a focus on people's preferences and routines.” from the report
Activities and community links
The home offered varied activities and developed events involving babies, toddlers and local schoolchildren. Inspectors found these helped people living with dementia feel connected and supported nutrition.
“People received high quality activities and events which reduced social isolation and had positive outcomes for people.” from the report
Quality oversight
Managers used audits, spot checks, supervision and team meetings to monitor care and make improvements.
“Established systems were in place to monitor the quality of care provided.” from the report
Staffing pressure
needs fixingSome people felt there were not enough staff, even though inspectors found staffing was enough to meet care needs. The home regularly used agency staff because recruiting permanent staff was difficult.
“There were enough staff to meet people's care needs, but people felt there were not enough staff.” from the report
- 01How many permanent staff are currently working on each floor, and how often are agency staff being used?
- 02How will you make sure there are enough staff when several people need help at the same time?
- 03Are the same agency staff used regularly, as described in the report, and how are they introduced to each person's care needs?
- 04How are residents and relatives involved when menus, activities or other parts of the home change?
- 05How do you review falls, missed medicines or other incidents and share the lessons with staff?
This was an unannounced comprehensive inspection covering all five CQC questions and providing the home's first rating. This explanation was written from the published report of 21 October 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, February 2021
Inspected but not rated; inspectors found good infection-control measures but concerns about distancing, PPE use and staff movement.
This was an announced, targeted inspection on 22 January 2021. It looked at how prepared the home was to prevent and control coronavirus infection.
Inspectors found the home was clean, tidy and well maintained. Visiting arrangements, testing, admissions, cleaning and the infection-control policy were in place.
However, inspectors were not assured that social distancing was being promoted in all communal lounges. They also found that PPE was put on and removed in different places, and that staff were not consistently kept in separate groups.
The home was inspected but not rated. This means the inspection did not give an overall quality rating or a rated score for Safe.
Clean environment
The home was clean, tidy and well maintained. Cleaning took place at least daily, with high-traffic areas cleaned several times a day.
“The service was clean, tidy and well maintained.” from the report
Safer visiting
The home had several arrangements to reduce infection risks for visitors, including a visitor pod, temperature checks and visitor records.
“Systems were in place to ensure safe visiting.” from the report
Cleaning arrangements
A cleaning schedule covered the whole home at least once a day. Door handles and handrails were cleaned more often.
“The service had a cleaning schedule which made sure all the home was cleaned at least once a day.” from the report
Testing and outbreak planning
Inspectors were assured that the home was accessing testing and had arrangements to prevent or manage infection outbreaks.
“We were assured that the provider was making sure infection outbreaks can be effectively prevented or managed.” from the report
Social distancing
needs fixingIn two of the three communal lounges, chairs were less than two metres apart and sofas could seat more than one person. Inspectors were not assured that distancing rules were being promoted.
“In two of the three communal lounges, sitting chairs were positioned closer than two meters and sofas were not adjusted to prevent more than one person sitting on it.” from the report
PPE procedures
needs fixingPPE was stored or taken to people's rooms in different ways. This meant staff put on and removed PPE in different places.
“This meant staff were putting on and taking off PPE in different places depending on who they were supporting.” from the report
Staff movement
seriousStaff were not consistently kept in separate groups or areas. Inspectors said this increased the risk of infection transmission.
“This increased the risk of infection transmission.” from the report
- 01What changes have you made to keep chairs and sofas at a safe distance in all communal lounges?
- 02Where do staff now put on and take off PPE when supporting people in their rooms?
- 03How do you keep staff and areas separate to reduce infection transmission?
- 04How do you check that staff are following the current PPE and distancing arrangements?
- 05What infection-control changes have been made since the inspection on 22 January 2021?
This was a targeted inspection of infection prevention and control during the coronavirus pandemic, and the service was inspected but not rated. This explanation was written from the published report of 25 February 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 The Manor House Knaresborough
2 rated inspections over 6 years: the service has held its Good rating throughout.
- October 2022Goodcurrent ratingSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
Read what inspectors found at The Manor House Knaresborough →
- February 2021Inspected but not ratedSafe: Inspected but not rated
Read what inspectors found at The Manor House Knaresborough →
- March 2017GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- July 2019
Registered with the Care Quality Commission on 22 July 2019.
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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