Manley Court Care Home

Updated 15 September 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

This was a targeted inspection to check on concerns we had about staffing levels within the care home. As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by 2 inspectors.

Service and service type

Manley Court Care Home is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Manley Court Care Home is a care home with nursing care. CQC regulates both the premises and the care provided.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. This included significant incidents that occurred at the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We reviewed the previous inspection report and recent feedback from the local authority. We used all of this information to plan our inspection.

During the inspection

We reviewed a range of records related to staffing levels and within the home including rotas and shift allocation reports for the home. We also reviewed 6 people’s care plans and risk assessments and quality assurance records. We also reviewed key policies and examples of learning across the service.

We spoke with 6 staff members including the registered manager, the deputy manager, 2 regional directors, 3 nurses and 1 healthcare assistant. We carried out observations in relation to infection prevention and control procedures. We also reviewed records related to the management of infection control procedures across the home.

After the inspection we sent feedback surveys to all healthcare assistants to get their feedback about the service and we received 20 responses. We also spoke with a health and social care professional who worked with the service. We provided formal feedback to the registered manager on 10 August 2023.

Updated 15 September 2023

About the service

Manley Court Care Home is a residential care home. At the time of the inspection the service was providing personal and nursing to 80 people, some living with dementia or physical and learning disabilities. The service can support up to 85 people. The accommodation was spread over four separate units all with communal living and dining areas.

People’s experience of using this service

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people. We considered this guidance as there were people using the service who have a learning disability and or who are autistic.

Risks to people’s health and wellbeing were assessed and individual risk management plans were put in place to help mitigate risks. We found when some people became agitated staff could not support them effectively and others sufficient details were not included in their care records to support them.

People shared mixed views of whether they were happy living at the service. While some people said they felt safe and staff were caring others said staff were too rushed during the day to ask for help. The numbers of staff available were not always at the provider’s recommended levels to meet people’s needs safely. People told us that they were not enough staff on duty.

There were systems in place for people to have their medicines as planned. However, we found that some aspects of medicine management were not robust.

There was a safeguarding policy and process and staff had completed training on safeguarding and protecting people from abuse. Records showed that safeguarding log was not always up to date. This meant there was a potential risk that people were not effectively protected from harm and abuse.

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.

Staff followed infection control and prevention (IPC) guidance to protect people from infection including COVID-19. Staff wore protective personal equipment (PPE) and we observed the service was clean and hygienic throughout. The service’s IPC and COVID-19 policies were up to date. Managers contacted their local health protection team in a timely way when they suspected a COVID-19 outbreak.

Rating at last inspection

The last rating for this service was requires improvement (Report published 8 July 2021).

Why we inspected

We carried out an unannounced comprehensive inspection of this service on 8 March 2021. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve the concerns about staffing levels, the quality of care records and the monitoring of the service.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions safe and well-led which contain those requirements.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has remained requires improvement for the second consecutive inspections. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Manley Court Care Home on our website at www.cqc.org.uk.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service. We have identified continued breaches in relation to good governance and staffing and a new breach in safe care and treatment. We have made a recommendation in relation to person-centred care.

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 meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.