CQC report explained · a residential care home
What the CQC found at The Manse
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 received medicines as prescribed, but some medicine records were incomplete or inaccurate. Recruitment checks also did not always clearly record or verify past employment dates.
- Effective?
- Good
- People received effective care, staff had suitable training and support, and the home worked with health and social care professionals. One changed dietary need had not been updated promptly in a care plan.
- Caring?
- Good
- The report does not give a separate rating for Caring. Inspectors found positive and caring relationships, respect for dignity and support for people's independence.
- Responsive?
- Good
- The report does not give a separate rating for Responsive. Staff knew people's needs and responded to changes, although some care plan information was not updated promptly.
- Well-led?
- Requires improvement
- Managers and staff were supportive and communicated important changes, but the medicine audit had failed to identify inaccurate and incomplete records.
What inspectors found, June 2023
The Manse is rated Requires Improvement; inspectors found enough staff and kind care, but medicines records and management checks were not reliable.
This was an unannounced inspection on 12 May 2023. The inspector reviewed two care plans and risk assessments, all staff training and supervision records, and other records about how the home was managed. They also spoke with people living there, staff, relatives and managers.
People received their medicines, had enough staff support and were protected by effective safeguarding systems. The home was clean, staff knew people well, and people were supported with their choices, independence, food and health needs.
There were important record-keeping problems. Medicines were not always recorded accurately, medicine checks had missed these issues, some care plans were not updated promptly, and recruitment records did not always show past employment dates clearly. The overall rating was Requires Improvement, with Safe and Well-led also rated Requires Improvement. Effective was rated Good.
Enough staff
Inspectors found enough staff on duty to meet people's needs and keep them safe. Staff responded to requests for help.
“There were sufficient numbers of staff employed and on duty to meet people's assessed needs.” from the report
Protection from abuse
The home had safeguarding systems, and staff knew how to report concerns. People and relatives said they felt safe.
“The service had effective systems in place to protect people from abuse.” from the report
Choice and independence
Staff sought consent, used the least restrictive approach and supported people to make decisions and remain as independent as possible.
“Staff supported people to be as independent as possible with making decisions about their care and support.” from the report
Clean surroundings
The premises were clean, well decorated and free from bad smells. Infection prevention arrangements were also judged satisfactory.
“We toured the premises and found the service to be clean and decorated to a good standard.” from the report
Good partnership working
The home made prompt referrals and worked with health and social care professionals when people's needs changed.
“The service worked in partnership with health and social care professionals to ensure people received support to meet their needs.” from the report
Medicine records
seriousSome medicines were not recorded correctly. Handwritten entries were not always checked by two staff, and some records did not show clearly whether medicines had been stopped or given.
“Some people's MAR's had medicines prescribed which did not have any record of them having been administered.” from the report
Medicine audits
seriousThe home's medicine audits did not check all the necessary records and had not identified the problems found by inspectors.
“The regular medicine audit also did not include a check of the Medicine Administration Records (MAR).” from the report
Recruitment records
needs fixingAlthough references and DBS checks had been completed, past employment dates were not always clearly documented or checked with referees.
“However, past employment dates provided by an applicant were not always clearly documented or verified by referees.” from the report
Care plan updates
needs fixingSome people's needs had changed but their care plans were not updated promptly. Staff knew people well and were still providing appropriate support.
“However, where one person's needs had changed, this had not been updated in their care plan.” from the report
- 01What changes have been made to medicine recording since the inspection?
- 02How are medicine administration records and medicines requiring stricter controls now audited?
- 03How do you make sure care plans are updated promptly when someone's needs change?
- 04How do you now verify applicants' past employment dates during recruitment?
- 05What action plan was sent to CQC, and what progress has been made?
This was an unannounced inspection that considered the overall service, with ratings given for Safe, Effective and Well-led; separate ratings for Caring and Responsive were not given in this report. This explanation was written from the published report of 14 June 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, March 2021
Inspected but not rated; inspectors found strong COVID-19 infection controls, but normal visits were not taking place.
This was an announced, targeted inspection on 11 February 2021. It looked only at infection prevention and control during the coronavirus pandemic.
Inspectors found the home was clean and hygienic. Furniture supported social distancing, cleaning had increased, and there were good supplies of personal protective equipment. Staff training and policies had been updated for COVID-19.
People and staff were tested regularly. New and returning residents received a negative test on the day. The home had plans for isolating people and managing an outbreak.
The service was inspected but not rated. This means the report does not give a Good, Requires improvement or Inadequate rating. It also does not assess the other four areas of care.
Clean environment
Inspectors found the home clean and hygienic, with increased cleaning and furniture arranged to support social distancing.
“The service was clean and hygienic in all areas. There were satisfactory procedures to ensure that infection control risks were reduced.” from the report
COVID-19 preparation
The home had updated infection control policies and training, good supplies of protective equipment and a plan for managing an outbreak.
“The service has good stocks of PPE and had a regular delivery to ensure there were consistent amounts available.” from the report
Testing and admissions
People and staff were tested regularly. New and returning residents received a negative test on the day, with isolation planned if someone tested positive.
“People and staff were being regularly tested in accordance with current guidelines.” from the report
Family contact
Although in-person visits were stopped under government guidance, the home supported contact through telephone calls and interactive technology where possible.
“However, the service ensured people communicated with families and friends using phone calls and interactive technology where it could be used.” from the report
Inspectors raised no specific concerns in this report.
- 01How can residents keep in touch with family now, and is the garden visiting room open?
- 02How are residents and staff tested for infections now?
- 03What happens if a resident tests positive or there is an outbreak?
- 04How do you support residents who have limited capacity to follow distancing and infection control measures?
- 05How often are infection control policies, staff training and cleaning arrangements reviewed?
This was a targeted inspection of infection prevention and control during the coronavirus pandemic; it did not rate the other care areas or give an overall quality rating. This explanation was written from the published report of 2 March 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 Manse
3 rated inspections over 7 years: the service has slipped, from Good to Requires improvement.
- June 2023Requires improvementcurrent ratingSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- March 2021Inspected but not ratedSafe: Inspected but not rated
- December 2018Goodstayed GoodSafe: GoodEffective: GoodWell-led: Good
- May 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- October 2014
Report published without a new overall rating.
- July 2014
Report published without a new overall rating.
- November 2013
Report published without a new overall rating.
- June 2013
Report published without a new overall rating.
- October 2012
Report published without a new overall rating.
- September 2011
Registered with the Care Quality Commission on 22 September 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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10 live-in carers within about two hours of Cornwall
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 £980 to £1,200 a week. 8 can care for a couple. 12 years' experience on average.
“He had been a little anxious before she arrived, but has since stated that he would be very happy for her to care for him again”
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.