About the service Ealing Manor Nursing home is a care home providing personal and nursing care to 31 people aged 65 and over at the time of the inspection. The service can support up to 33 people.
People’s experience of using this service and what we found
Medicines were not always well managed which meant some people did not always get their medicines as prescribed.
The home had a safeguarding policy however it had not been updated since 2011 which meant the registered manager had not always kept up to date with national guidance on safeguarding adults. We made a recommendation to the provider about this.
There were not always adequate numbers of staff deployed to provide appropriate care and support to people. Sometimes people had to wait to be supported to eat and people's dignity was not always maintained.
The home was undergoing a schedule of works to modernise the building however the provider had not ensured the design was dementia friendly despite many of the people living with dementia. We made a recommendation to the provider about this. The induction process of new staff did not clearly state what training they had completed.
People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.
People’s end of life wishes were recorded but the information was at times not very clear to make sure staff had all the information they needed to care for people appropriately. The provider did not ensure people’s communication needs were always being met as information was not always in an accessible format.
Since the last inspection the provider had developed some quality audits to monitor the service however, these had been ineffective because they had not identified the issues we found during our inspection.
Staff were aware of their responsibilities in relation to the reporting of abuse within the safeguarding policy. Staff understood how to prevent the spread of infection by using protective clothing such as aprons and gloves.
Accidents and incidents had been recorded and analysed to ensure lessons were learnt to prevent reoccurrence, including the action taken following an incident.
New staff trained and worked alongside experienced members of staff till they were competent. People were happy with the care they received, and they felt staff had the appropriate training and support. Families commented positively about the care their relatives received.
People's needs were assessed prior to them moving into the home. This helped to ensure the provider had the necessary information to decide if they could meet people’s needs and to plan their care accordingly. People’s health was well managed and If people became unwell staff took appropriate action.
The home had a complaints procedure and there had been no complaints since the last inspection. The registered manager and the provider acted promptly to rectify areas identified as needing improvement during the inspection. The home conducted regular staff meetings and staff told us this was a good way to keep informed of the changes in the home.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was requires improvement (published 16 January 2019). The service remains rated requires improvement. This service has been rated requires improvement for the last three consecutive inspections.
Why we inspected
This was a planned inspection based on the previous rating.
Enforcement
We have identified breaches in relation to safe care and treatment, need for consent, person centred care, staffing and good governance. Please see the action we have told the provider to take at the end of this report.
Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.
Follow up
We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.