We carried out a review of the data available to us about Mockley Manor Care Home on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Mockley Manor Care Home, you can give feedback on this service.
Mockley Manor is a residential care home providing personal and nursing care to 50 people at the time of the inspection. The service can support up to 63 people including younger and older adults, people with physical disabilities and dementia.
People’s experience of using this service and what we found
Staff received safeguarding training to help them identify and recognise potential safeguarding concerns. Overall, risk assessments provided staff with the information they needed to provide care in the safest possible way. Staff told us staffing levels enabled them to keep people safe and deliver the care outlined in people’s care plans. Medicines were ordered, stored and administered safely. We were assured by the infection, prevention and control procedures and there were no restrictions on visiting. Accidents and incidents were recorded, reported and analysed for trends or patterns to minimise the risk of them happening again.
People’s needs were assessed prior to moving to the home, to ensure these could be met safely. Staff shared key information about changes to people's health to ensure their care remained up to date and relevant to their needs. People received access to external healthcare when they needed it. Staff received training relevant to their roles and continuous training and development was promoted. People were given a choice of meals and supported to eat and drink enough to stay healthy. Nutrition champions received enhanced training to improve knowledge and care in this area.
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.
Staff understood the importance of person-centred care and recognised it was important to some people to maintain their preferred routines. People's communication needs were recorded and library books were available in large print and audio. The home had two dedicated staff members who were responsible for planning and supporting people with activities. Staff understood the importance of caring for people at the end of their life. Learning was taken from all complaints received across the provider group and this was shared with people and their relatives.
We received positive feedback from people and their relatives about Mockley Manor Care Home. The registered manager and provider had an open and honest approach if things went wrong with people’s care. Governance systems and checks provided effective monitoring and oversight of the quality and safety of care people received. Relative and resident meetings provided an opportunity for people to give their suggestions and views on how the service could improve. The provider and registered manager were committed to continuous learning and development, to improve care and people’s outcomes.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was good (published 13 November 2020).
Why we inspected
We received concerns in relation to pressure care and end of life care. As a result, we undertook a focused inspection to review the key questions of safe, effective, responsive and well led only. 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 the same.
We found no evidence during this inspection that people were at risk of harm from this concern. Please see the safe and responsive sections of this full report.
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.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Mockley Manor Care Home on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
Mockley Manor is a residential care home providing personal and nursing care to 63 people aged 65 and over at the time of the inspection. Some of the people being cared for at the home were living with dementia or physical disabilities. At the time of our inspection visit there were 35 people living at the home.
People's experience of using this service and what we found
Since our last inspection improvements had been made to governance and oversight systems to ensure the provider was mitigating risks to people in relation to their care. Audits highlighted actions to drive improvement and ensure the provider was meeting the legal requirements of the Health and Social Care Act 2008.
The provider had a clear focus on values-based management which gave staff the confidence to take ownership and responsibility for their delegated tasks. Improved management of human resource functions had dealt with staffing issues that had previously led to a culture in the home that was not always positive. Staff spoke of a better atmosphere and more confidence in the management and staff team.
The management and monitoring of individual risks associated with people's care had improved. There were enough staff with the appropriate skills, knowledge and experience to effectively and safely meet people's needs. Staff received safeguarding training and demonstrated they understood their responsibility to keep people safe. Medicines were managed in a safe way and staff followed good hygiene practices to minimise the risks of infections spreading.
Rating at last inspection (and update)
The last rating for this service was Requires Improvement (published 13 September 2019) and there were two breaches of the regulations. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
We carried out an unannounced comprehensive inspection of this service on 30 and 31 July 2019. 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 safe care and treatment and good governance of the home.
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 of safe and well-led which contain those requirements.
The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has changed from requires improvement to good. 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 Mockley Manor on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our reinspection programme. If we receive any concerning information we may inspect sooner.
We were assured that this service met good infection prevention and control guidelines as a designated care setting.
We found the following examples of good practice.
¿ A self-contained unit within the home could care for people safely who had tested positive for Covid-19 in hospital and needed to transfer to a care home under the Winter Discharge Designation Settings scheme.
¿ Staff were deployed to work solely within the unit. They did not work in other health or social care services which reduced the risk of cross transmission.
¿ Specialist cleaning equipment had been purchased to deep clean the environment. Use of the equipment meant items that were difficult to clean were effectively sanitised.
¿ Laundry arrangements meant people’s clothing and bedding would be laundered individually to reduce the risk of cross contamination.
¿ Regular support sessions had been held with staff. Support included signposting staff to a national charity for advice during the pandemic.
Mockley Manor is a residential care home providing personal and nursing care to 52 people aged 65 and over at the time of the inspection. Some of the people being cared for at the home were living with dementia or physical disabilities. At the time of our inspection visit there were 42 people living at the home.
People’s experience of using this service and what we found
Risk’s to people’s health were not always managed safely. We found risks associated with catheter care, skin damage and aspiration. Risk’s within the environment were not always managed safely. We found a risk of entrapment and a potential risk of cross infection due to people sharing slings. Some immediate actions were taken to protect people from the risk of harm and other action was planned to ensure records supported the management of risk.
People told us they felt safe. The registered manager and staff understood their safeguarding responsibilities to protect people from avoidable harm. People told us their medicines were managed safely. We found medicines were ordered, received, stored, administered and disposed of safely.
Staff told us they were recruited safely. People told us they felt there was a shortage of staff and some staff agreed. However, records demonstrated staffing levels met required dependency levels. Staff understood their responsibilities to report accidents and incidents, and analysis took place to identified patterns and trends.
The mealtime experience required improvements. There were missed opportunities to encourage people to eat and drink more.
People told us staff at Mockley Manor were caring and kind. Staff respected people’s rights to privacy and dignity and enabled them to make choices about how they wanted their care to be delivered.
People’s needs were assessed before being supported by the service. This meant the service could be sure they could meet people’s varying needs. Staff received appropriate training and guidance to complete their role well. 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 support this practice.
People told us they had access to medical professionals where required and referrals were made in a timely way. A healthcare professional confirmed their advice was followed.
People received personalised care and records supported this practice. Systems were in place to manage and respond to any complaints or concerns raised.
Systems and processes were in place to monitor the quality within the home. However, these had not always identified the issues we found during the first day of our visit. The registered manager understood their regulatory responsibilities and had informed us of significant events at the service since taking on the management role.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was good (published 08 February 2017).
Why we inspected
This was a planned inspection based on the previous rating. The overall rating for the service has changed from good to requires improvement. Please see the safe, effective and well-led sections of this full report.
Enforcement
Please see the action we have told the provider to take at the end of this report.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
The service provides accommodation, nursing and personal care for up to 52 older people who may live with dementia or physical disabilities. Forty-six people were living at the home on the day of our inspection.
The registered manager had been in post for seven years. 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.
At our previous inspection in November 2015, we identified improvements were required in keeping people safe, in delivering effective care and treatment and in the leadership of the service. We gave the home an overall rating of requires improvement. The provider sent us an action plan, setting out the actions they planned to take to improve the quality of the service. At this inspection, we checked whether the actions they had taken were effective.
Since our previous inspection, the registered manager had recruited additional staff. There were enough suitably skilled and experienced staff on duty to meet people’s care and support needs safely and effectively. The registered manager had sufficient time and support from the provider to carry out their management role effectively.
People’s medicines were managed, stored and administered safely and staff kept accurate records of people’s treatment, which evidenced risks to people’s health and wellbeing were managed effectively.
The registered manager assessed risks to people’s health and welfare and wrote care plans that minimised the identified risks. Accidents, incidents and falls were investigated and actions taken to minimise the risks of a re-occurrence. The premises were regularly checked to ensure risks to people’s safety were minimised.
People were safe from the risks of harm, because staff understood their responsibilities to protect people from harm and were encouraged and supported to raise concerns under the provider’s safeguarding and whistleblowing policies.
The registered manager checked staff’s suitability to deliver care and support during the recruitment process. People’s needs were met effectively because staff had the necessary skills and experience and received appropriate training and support from the registered manager.
Staff understood people’s needs and abilities because they worked with experienced staff until they knew people well. Staff were encouraged to reflect on their practice and to develop their skills and knowledge, which improved people’s experience of care.
The registered manager understood their responsibility to comply with the requirements of the Deprivation of Liberty Safeguards (DoLS). They had applied to the Supervisory Body for the authority to restrict people’s rights, choices or liberty in their best interests.
People were offered meals that were suitable for their individual dietary needs and met their preferences. They were supported to eat and drink according to their needs. Staff monitored people who were at risk of poor health and obtained advice and support from other health professionals to maintain and improve their health.
People were cared for by kind and thoughtful staff who knew their individual preferences for care and their likes and dislikes. Care was planned to meet people’s individual needs and abilities and care plans were regularly reviewed and updated when people’s needs changed. Complaints were responded to, investigated and appropriate actions taken to the satisfaction of the complainant.
Staff were guided and supported in their practice by a management team that they liked and respected. Quality audits included reviews of people’s care plans and checks on medicines management and staff’s practice.
The provider had taken action to improve by supporting the whole staff team to recognise how their contribution had an impact on the quality of care and treatment. Staff felt valued by the provider because their views and ideas were taken into account in planning continuous improvement plans.
We inspected this service on 30 November and 3 December 2015. Our inspection was unannounced.
Mockley Manor is registered to provide both nursing and personal care for a maximum of 52 older people. The home was set out over two floors and there was a separate unit for people living with dementia called Namaste. There were 39 people living in the home at the time of our visit.
There was a registered manager in post. 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.
We last inspected the home in January 2015. After that inspection we asked the provider to take action to make improvements to ensure people’s needs were met by sufficient numbers of appropriately skilled staff. At this inspection we found improvements had been made, but further improvements were still required.
Most people were happy with the staff, but acknowledged that staff were busy and they sometimes had to wait for assistance with personal care. Staff we spoke with said there were enough staff to support people safely and ensure they received the care they needed. Further improvements were needed in the allocation of staff to ensure there was oversight of communal areas at critical times.
People told us they felt well cared for and safe living at Mockley Manor. People told us staff were respectful and kind towards them and staff were committed to providing a caring environment. Staff protected people’s privacy and dignity when they provided care to people and staff asked people for their consent before care was given. There was a programme of activities and entertainment to support people’s social needs. Friends and family were welcomed into the home and encouraged to maintain a caring role in their relative’s life.
Care plans contained information for staff to help them provide the individual care and treatment people required, however not all records supported people’s changing needs. The management team had recognised this was an area for improvement and was taking action to address this.
Staff had a detailed handover between shifts when they were updated about people’s care needs so they could respond appropriately. Records of care and treatment delivery did not demonstrate that plans to manage identified risks were being consistently followed.
Assessments had been completed to determine people’s capacity to make certain decisions. The provider was meeting their requirements set out in the Deprivation of Liberty Safeguards (DoLS).
People were referred to other healthcare professionals and received their medicines as prescribed.
Care staff received training and support to meet the individual needs of people effectively. A newly recruited nursing team were being supported to ensure their competencies, but required a high level of clinical support to develop their confidence.
The registered manager was providing clinical and nursing support in the home which impacted on the effectiveness of their management of the service. Where checks, audits and feedback from people had identified issues, timely action had not always been taken to implement improvements. Following our inspection, the provider told us they were going to recruit two new clinical leads to the home to take over some of the registered manager’s clinical responsibilities. This would enable the registered manager to concentrate on the management of the home. We will continue to monitor the service to ensure these improvements are implemented and maintained.
This inspection took place on the 26 January 2015 and was unannounced.
Mockley Manor is registered to provide both nursing and personal care for a maximum of 52 older people. 45 people were living in the home at the time of our visit.
We last inspected the home in August 2014. After that inspection we asked the provider to take action to make improvements in care provision and to ensure people’s needs were met by sufficient numbers of appropriately skilled staff. At this inspection we found improvements had been made in these areas, but further improvements were still required.
A registered manager was in post. 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 told us they felt safe living at Mockley Manor and staff understood their responsibility to report any observed or suspected concerns. Where potential risks had been identified with people’s care, we saw the correct equipment was in place to reduce the risks such as mobility aids.
Although staff thought there were sufficient staff to meet people’s needs safely, we found there was a delay in responding to requests for support. Improvements were needed to ensure people received the same level of care throughout the day.
Staff received training in areas considered essential to meet people’s needs safely and consistently. However, there were limited training opportunities to develop staff knowledge of specific health issues. Staff had not received training in the Mental Capacity Act 2005 and their understanding of the legislation was not always clear.
The manager had made appropriate applications to the local authority in accordance with the Deprivation of Liberty Safeguards and was following legal requirements.
Staff were caring and compassionate in their approach to people. People were given choices about how they wanted to spend their day so they were able to retain some independence in their everyday life. Family and friends were able to visit when they wished and staff encouraged relatives to maintain a role in providing care to their family member.
There were a range of activities available for people living in the home that promoted their wellbeing. Staff responsible for providing activities were enthusiastic and encouraged the wider community to support the home.
Staff understood people’s healthcare needs and people were supported by external healthcare professionals to ensure their needs were fully met.
There was a stable management team in place who were consistent in their understanding of the challenges faced by the service. Staff felt supported by the registered manager and told us they would feel confident to raise any concerns or issues.
There were processes in place to assess the service which fed into an action plan to ensure improvements were made in the quality of service provided.
You can see what action we told the provider to take at the back of the full version of the report.
During our visit we spoke with the manager, the deputy manager, five staff, nine people who used the service and two relatives.
We spent time in the communal areas of the home and observed the care and support provided to people. We looked at care records and staff records. We used all the information we gathered during our visit to answer five key questions. Is the service safe? Is the service effective? Is the service caring? Is the service responsive? Is the service well led?
Below is a summary of what we found. If you would like to see the evidence supporting our summary please read the full report.
Is the service safe?
People who lived at Mockley Manor told us they felt safe living there. One relative told us, 'The doors are always open so we can have a word. That's what's nice about it, the open atmosphere.' During our visit we found people appeared comfortable and relaxed around staff.
Staff we spoke with demonstrated a good understanding of abuse and the different forms abuse can take. Staff told us they would report any concerns to the senior on duty or the management team.
The service had undertaken the necessary recruitment checks to make sure people were protected from possible harm by the staff delivering care to them.
We saw appropriate Deprivation of Liberty Safeguards applications had been made when any potential restrictions on a person's liberty had been assessed.
Is the service effective?
People and the relatives we spoke with were generally positive in their comments about the home. One person told us, 'It is alright. It is passable.' Another said, 'I think it is well run and it has every facility you need.' Another person described the home as 'beautiful'.
We spoke with staff who told us they had not read or accessed people's care records on a regular basis. This had the potential to place people at risk of receiving inappropriate care and support.
There were periods of time when we observed people were left on their own without staff presence.
The frequency of the staff training programme meant we could not be sure staff were up to date with current best practice in some areas.
Is the service caring?
There was a range of activities available within the home. On the day of our visit people in communal areas were engaged on both a group and individual basis. People were offered physical, mental, visual and sensory stimulation.
There was little evidence of social stimulation for those people who were looked after in bed or chose to stay in their rooms.
During our visit we saw staff provide kindly and caring reassurance to people who were upset.
Is the service responsive?
Care plans were in place in relation to people's mobility, continence, nutritional needs, and personal care needs. We saw where people had specific health needs there were plans in place informing staff how to meet those needs. Care plans were reviewed regularly by the nursing staff.
People told us they sometimes had to wait for staff to respond to call bells, especially in the afternoon.
Is the service well-led?
After a period of recruitment to the home, staff spoke positively about the staff team now in place. Staff we spoke with confirmed they felt supported by the management team. One staff member told us, "We all work as a team and it is getting better. Rachael (the manager) is absolutely marvellous. You couldn't ask for a better manager. She is very supportive."
People who lived at the home told us, 'I am happy here, it's nice' and 'They look after me very well.'
We saw staff were kind and attentive when they delivered care to people. We saw people were supported and encouraged to maintain their independence.
We looked at three people's care records and saw their care plans reflected their personal needs. We saw the members of staff supported people as detailed within their care plans.
We saw that people were provided with a good choice of food and they told us they were happy with the choices available to them.
We spoke with three staff members about what they thought abuse was and they showed they had a good awareness of the importance of keeping people safe. They understood their responsibilities for reporting any concerns regarding potential abuse.
Care staff had received training to enable them to look after people safely. Some staff told us they had not had a formal meeting with the manager on a one to one basis.
We found the service was well led and had systems in place to monitor the quality of service provided at Mockley Manor.