About the serviceManley Court Care Home is a residential care home. At the time of the inspection the service was providing personal and nursing to 75 people, some living with dementia or physical disabilities. The service can support up to 85 people. The accommodation was spread over four separate units.
People’s experience of using this service
People said they were happy living at the service. Relatives gave positive comments about the experience of care and the management of the service. A relative said, “Nothing is too much trouble for the staff, I have no worries about my [family member].”
The numbers of staff available were not always at the provider’s recommended levels to meet people’s needs safely. We observed delays in people receiving their meals in a timely way. Staff told us they often had to provide care alone when two staff members were required. This increased the risks to people receiving care and to staff.
Staff implemented the provider’s safeguarding processes and their training to identify and protect people from harm and abuse. The registered manager ensured allegations of abuse were reported to the local authority for investigation. However, we found the Care Quality Commission were not always sent safeguarding notifications as required by law.
There were systems in place to record assessments, plans of care, medicine administration and daily progress. These records helped staff to monitor people’s progress effectively. Staff assessed risks to people’s health and wellbeing and developed plans to mitigate these. However, we found that care and management records were not always organised in a logical way which made it a challenge to review them.
There were suitable measures to protect people from COVID-19, including the use of protective personal equipment (PPE), testing and vaccination. The service was clean and hygienic throughout, with enhanced cleaning of frequently touched surfaces to protect people from cross infection. The service had a designated infection prevention and control (IPC) lead who had been trained and was knowledgeable about the current guidance. 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.
People and their relatives were kept informed of changes and developments in the service. They were able to provide feedback about the quality of care and the service.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
Rating at last inspection
The last rating for this service was good (published 23 June 2020).
Why we inspected
We received concerns in relation to staffing levels and the management of the service. As a result, we undertook a focused inspection to review the key questions of Safe, Effective and Well-Led only.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.
The overall rating for the service has changed from good to requires improvement. This is based on the findings at this inspection. We have found evidence that the provider needs to make improvement. Please see the Safe, Effective and Well-led sections of this full report. We have made two recommendations about recruitment and engaging with staff. We found breaches of regulation related to good governance and staffing.
You can see what action we have asked the provider to take at the end of this full report.
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 breaches in relation to Staffing and Good governance.
Please see the action we have told the provider to take at the end of this report.
Follow up
We will request an action plan and 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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.