Archived: Manor House Residential Home

Updated 14 April 2016

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 was 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.

This inspection took place on 10 March 2016 and was unannounced. The inspection team consisted of two inspectors.

We looked at information we held about the service including information from commissioners of the service and members of the public. We received information of concern about the safety of the care provided and the management of the service and this meant that we bought our planned inspection forward.

We spoke with six people who used the service and two relatives. Not everyone who used the service was able to talk to us about their experiences so we spent time observing how care and support was offered to people in communal areas.

We spoke with three members of care staff, the manager and the unit manager. We looked at seven people's care records to see if they were accurate and up to date. We also looked at records in relation to the management of the service. These included quality checks, two staff recruitment files and other documents to help us to see how care was being delivered, monitored and maintained.

Updated 14 April 2016

This inspection took place on 10 March 2016 and was unannounced. At our previous inspection in August 2015 we found that the service required improvement.

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘Special measures’.

Services in special measures will be kept under review and, if we have not taken immediate action to propose to cancel the provider’s registration of the service, will be inspected again within six months.

The expectation is that providers found to have been providing inadequate care should have made significant improvements within this timeframe.

If not enough improvement is made within this timeframe so that there is still a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve. This service will continue to be kept under review and, if needed, could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement so there is still a rating of inadequate for any key question or overall, we will take action to prevent the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration.

For adult social care services the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.

Manor House Residential Home provides accommodation and personal care for up to 33 people. People who used the service were over 65 years old and have physical and/or mental health diagnoses. At the time of the inspection there were 19 people using the service. The service had recently been placed into administration.

There was a new manager in post who was in the process of applying for their registration with us. The person named on our register as the manager of the service was not the manager and they were not the manager at the last inspection in August 2015. 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.

People were not always protected from the risks of harm and abuse because incidents of possible abuse were not reported as required and action was not taken to protect people.

Risks to people’s health and wellbeing were not always identified and managed by staff safely. We found there were not always enough staff available to deliver people’s planned care or keep people safe, particularly at night time.

We found that medicines were not administered, managed and monitored in a safe manner to ensure that people got their medicines as prescribed.

The provider did not have effective systems in place to consistently assess, monitor and improve the quality of care. This meant that issues with the quality of the care were not identified and rectified.

People, relatives and staff did not feel supported by the manager. Staff reported that the manager was unapproachable and they had little confidence that action was being taken in relation to issues raised with them.

People were not supported to make decisions in line with the Mental Capacity Act 2005 (MCA) which meant that their legal and human rights were not protected.

People were not always treated with kindness and compassion and their dignity was not always respected.

Care was not always provided in line with people's preferences and routines within the home were not flexible to meet people's needs and preferences.

Staff were not supported and trained to deliver effective care to people. People had access to healthcare professionals though this was not always sought in a timely manner and professional advice was not always followed.

People had enough to eat and drink and were offered some choices but risks in relation to people's eating and drinking were not always minimised.

People's care plans were not regularly reviewed to ensure they were up to date and reflected changes in people's needs. Staff told us they did not have enough time to read people's care plans.

There was a complaints procedure in place but concerns raised were not always acted upon.

We identified seven breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.