Archived: Manor Park Care Home

Updated 1 July 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 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.

This inspection took place on1 June 2016 and was unannounced. A further visit was carried out on 2 June 2016 and was announced.

The inspection team consisted of two adult social care inspectors and an expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Prior to the inspection we reviewed the information we held about the service. This included the notifications we had received from the provider. Notifications are changes, events of incidents the provider is legally required to let us know about.

Before the inspection we also contacted the local authority commissioners for the service and the local authority safeguarding team, the clinical commissioning group (CCG) and the local Healthwatch to gain their views of the service provided. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England.

During the inspection we spoke with 10 people living at the service and five relatives. We also spoke with the registered manager, the regional manager, one Care Home Advanced Practitioner (CHAP), one Personal Activity Leader (PAL), the deputy manager, five care staff, one handyman and one kitchen assistant.

We reviewed four people’s care records and five staff personal files including recruitment, supervision and training information. We reviewed medicine records, as well as records relating to the management of the service.

We carried out an observation using the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us. We undertook general observations of how staff interacted with people as they went about their work.

We looked around the home, visited people’s bedrooms with their permission and spent time with people in the communal areas.

Updated 1 July 2016

This inspection took place on 1 June 2016 and was unannounced. This meant the provider and staff did not know we were coming. A second day of the inspection took place on 2 June 2016 and was announced.

Manor Park Care Home is registered to provide accommodation and personal care for up to 49 people, including people who were living with dementia. At the time of the inspection there were 32 people using the service, 23 of whom needed nursing care. Manor Park consists of three units, Blanchland, Wynyard and Cameron. Each unit support and care for a mix of people who require either nursing or personal care needs. Cameron is a male only unit. .

A registered manager was in place at the time of our inspection. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

At the last inspection of the home in January 2016, we asked the provider to take action to make improvements. This was because we found the provider had breached a number of regulations.

We found risks to the health and safety of people who used the service, as well as staff and visitors. Risks had not been appropriately assessed and actions had not been taken to minimise those risks. Staffing levels were not sufficient to safely meet the care needs of the people who used the service. The assessed needs of people were not always accurate therefore the method of determining staffing levels could not be relied on. Staffing levels were not increased following the changing needs of people living at the home.

The registered manager did not ensure care and treatment was provided with the consent of the relevant person. Staff were not familiar with the principles and codes of conduct associated with the Mental Capacity Act 2005, or how to apply them for the people they were caring for. People were not supported in making decisions about their care and well-being.

The provider did not ensure staff received appropriate training and development to enable them to carry out the duties they are employed to perform. Care records did not always reflect people’s needs and preferences. The provider did not always ensure people’s nutritional and hydration needs were assessed. People’s choices were not respected in relation to nutrition. There were inadequate support facilities and amenities provided for the number of people using the service. We also found the provider did not have effective quality assurance processes to ensure that people received appropriate and safe care.

During this inspection we found the provider had continued to breach a number of regulations. Staffing levels were still not sufficient to safely meet the care needs of the people who lived at the home. Risks were not being recognised, therefore risks were not being assessed and mitigated against to minimise the risks to people, staff and visitors. Care records did not reflect people’s needs and preferences. We also found the provider’s quality assurance processes remained ineffective, failing to identify issues found during the inspection.

The registered manager conducted thorough investigations into safeguarding concerns and ensured all relevant authorities were informed.

The provider had a monitoring system in place to identify when reviews were required for people’s Deprivation of Liberty Safeguards (DoLS). Staff understood and applied the principles of the Mental Capacity Act and consent.

Personal Emergency Evacuation Plans (PEEPS) were in place and included an individual assessment of each person’s evacuation needs however these were not reviewed as stated by the provider’s own policy.

The provider had a robust recruitment procedure in place which included ensuring appropriate checks were undertaken before staff started work.

Mandatory training was up to date including safeguarding and moving and handling.

The home recently purchased and installed two purpose-built baths which people told us they enjoyed.

Communal areas within the service were clean and tidy. However, we found some equipment within the kitchen was dirty and cleaning records were incorrect.

People were not always offered an alternative meal if they declined to eat their first choice.

During meal times staff engaged with one person who was able to converse and hold a conversation but engagement with the other people who had limited verbal communication was functional and limited.

The provider had systems in place for the receipt, return, administration and disposal of medicines. Audits did not always identify gaps in the administration of medicines.

Where people had no family or personal representative we saw the service assisted people to obtain support from an advocacy service.

People had access to a range of activities including bingo, crafts, armchair exercises and going on outings. Staff supported people to maintain links with the local community.

The provider used an iPad feedback point called ‘Quality of Life’ to capture views about the quality of the service from people, relatives, external professionals and staff.

People told us they saw the registered manager around the home regularly. One staff member told us, “She’s always on the floor and if there’s anything that she can do – she’ll do it”.

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

The service 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.

Full information about CQC’s regulatory response to any concerns found during inspections is added to reports after any representations and appeals have been concluded.