Archived: Urmston Manor RH

Updated 11 April 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

The inspection took place on 27 and 28 February 2018. The first day of the inspection was unannounced and was undertaken by one inspector and an expert-by-experience. An inspection manager also accompanied the inspector on the first day of the inspection as part of an annual practice observation. We told the provider we would return the following day. The second day of the inspection was undertaken by one inspector. An expert-by-experience is a person who has personal experience of using, or caring for someone who uses this type of service.

The provider had completed a provider information return (PIR). The PIR is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We found the PIR was reflective of the service provided at the home.

Prior to our inspection visit we reviewed the information we held about the service. We looked at the statutory notifications the manager had sent us. A statutory notification is information about important events, which the provider is required to send to us by law. Following the inspection we contacted the local authority safeguarding and commissioning teams. They were positive about the changes and improvements made at the home by the manager.

We also contacted Trafford Healthwatch who did not have any feedback about Urmston Manor. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England.

We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us. We also observed the mealtime experience for people and interaction between people using the service and staff throughout the inspection.

During the inspection, we spoke with thirteen people who used the service, six people's relatives, five members of care staff, three visiting health professionals, the activities co-ordinator, two housekeepers, the chef, the operations manager and the manager.

We looked at records relating to the management of the service such as the staffing rota, policies, incident and accident records, two staff recruitment files and training records, three care plans, meeting minutes and auditing systems.

Updated 11 April 2018

This inspection took place on 27 and 28 February 2018 and was unannounced.

At our last inspection in June 2017 we rated the service as inadequate. We found five breaches of regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 with regard to safe care and treatment, person centred care, premises and equipment, recruitment, good governance staff supervision and training.

Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve all the key questions to at least good.

This service has been in Special Measures since our last inspection in June 2017. Services that are in Special Measures are kept under review and inspected again within six months. We expect services to make significant improvements within this timeframe. During this inspection the service demonstrated to us that improvements have been made and is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is now out of Special Measures.

Urmston Manor Residential Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Urmston Manor RH is registered to provide care to up to 24 older people, including people who may be living with dementia. The home has been operating since 1984. Accommodation is based over three floors and there is a passenger lift between the floors. At the time of our inspection there were 23 people living at the home.

There was not a registered manager in post at the time of the inspection. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are 'registered persons'. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

The current manager was in the process of purchasing the home from the provider. Their registration for this was being assessed by the Care Quality Commission at the time of our inspection and was due to be completed within the next two months. The current provider had no oversight of the home at the time of our inspection, with the current manager having taken on the responsibility for the home.

At this inspection we found improvements had been made in all areas; however there continued to be a breach in the regulation for good governance. The manger had introduced a system of audits at the service; however these were not detailed or robust enough to review and improve the quality of the service. The manager was aware of this and was working with staff to improve the quality of the audits and action plans. You can see what action we have told the provider to take at the back of the full version of this report.

People living at the service, their relatives, staff and visiting health professionals were all very positive about the changes made by the manager and the improvements made at the home. The manager had a clear vision and values for the home. Staff confirmed that they had received training on privacy and dignity and they were now more aware on how to support people in a dignified way. People and relatives were very complimentary about the staff and said they were supported with kindness, dignity and respect.

Building work had been completed to meet the fire regulations. A new fire alarm and call bell system had been installed. Evacuation plans were in place for each person and fire drills had been held. A business continuity plan was in place to identify the actions to be taken in the event of an emergency.

A legionella risk assessment had been completed by an external company and actions taken to reduce the risk of legionella disease at the home.

Risk assessments and care plans were up to date, reviewed monthly and reflected people’s care and support needs.

Medicines were administered as prescribed. Guidelines for when people may need an ‘as required’ medicine to be administered had been written. Recording sheets for the care staff to sign when they applied topical creams and added thickeners to drinks were introduced during our inspection. We have made a recommendation that medicine administration records are checked more frequently than after each four week medicines cycle so any issues are identified more quickly.

People said they felt safe living at Urmston Manor.

Staff received the training and support they needed to undertake their role. A safe recruitment system was in place to recruit staff who were suitable to work with vulnerable people. There were sufficient staff on duty to meet people’s assessed care and support needs.

Relative and staff surveys had been carried out. These showed a large improvement in the levels of satisfaction with the service and communication with the manager and staff team.

An activities co-ordinator was now in place who organised a series of activities both within the home and in the local community. People and relatives were very positive about the activities now available.

People were supported to maintain their health and nutrition. Visiting health professionals said staff now had the information they asked for and followed any guidance they were given. Referrals to health professionals, such as GPs and district nurses were appropriately made. Staff now supported people to attend appointments if their relatives were not able to do this. This meant appointments did not now need to be cancelled.

Dementia friendly signs had been purchased. Individualised posters had been made for people’s bedroom doors detailing a person’s favourite hobbies, food, drink and places. These would assist people living with dementia to orientate themselves around the home and provided staff with a prompt of topics of interest to the person when talking with them.

The service worked with social services and local hospitals for people assessed as medically fit to be discharged from hospital but needing an assessment of their care needs.

The service was working within the principles of the Mental Capacity Act (2005). People’s capacity to make decisions was assessed and applications made for Deprivation of Liberty Safeguards where applicable.