5 May 2015
During a routine inspection
We inspected Manor House Nursing Home on 5 May 2015. Manor House Nursing Home provides residential and nursing care for people with a diagnosis of dementia, over the age of 65. The home offers a service for up to 102 people. At the time of our visit 49 people were using the service. This was an unannounced inspection.
We last inspected in October 2014 following concerning information we received about the service. At the inspection in October 2014 we identified that people's care, welfare and nutritional needs were not always being met. Additionally people were not always being treated with dignity and respect. People did not always receive their medicines as prescribed and the provider and registered manager did not have systems to monitor and improve the quality of service people received.
Following our inspection in October 2014 we issued a warning notice to the provider and registered manager to tell them they must take action around people's care and welfare. At this inspection, in May 2015, we found the provider had taken action and made significant improvements. However, there were still some further areas where improvements were required.
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.
People were cared for by kind and compassionate care workers. Staff knew the people they cared for and what was important to them. People's choices and wishes were respected by care and nursing staff. However, the registered manager was aware improvements were required to ensure all staff fully engaged with people and proactively offered support.
The health needs of people were being met. Staff had received support from healthcare professionals and worked together with them to ensure people's individual needs were being managed. People received support to meet their nutritional needs.
Staff promoted choice around meals and ensured people had more food if they wished. People told us they had enough to eat and drink. Pureed food was not always presented in a way for people to see the individual food colours and to taste food individually. People's dietary preferences were not always followed.
People had access to a range of activities and events. We observed people enjoying activities in the home and the home had a welcoming and relaxed atmosphere. People told us they enjoyed activities and trips out of the home.
Staff ensured people received personal care in privacy. Systems were in place to ensure when people were being assisted by care staff they would not be disturbed. People were involved in their care .
People, their representatives and staff spoke positively about the management of the home and the improvements that had been made.
The registered manager had implemented a number of systems to improve the quality of care people received. These systems were having a positive impact on the lives of people living at the home. Staff were given the information they needed to meet people's needs.
The registered manager had made applications where people were being deprived of their liberty, these had been completed in accordance with the Deprivation of liberty safeguards. Deprivation of liberty safeguards is where a person can be deprived of their liberty where it is deemed to be in their best interests or for their own safety. Staff understood the principles of the Mental Capacity Act 2005.
Most staff had the training they needed to meet peoples needs, however some staff did not have the training to meet people's needs. The registered manager had a plan in place to ensure all staff would receive the necessary training Staff told us they felt supported by the registered manager and the provider.
We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.