Manor Hospital

We carried out this visit to check that improvements had been made and to confirm the service was now compliant.

During our visit we spoke with the ward matron and ward manager, five staff and three people using the services.

People we spoke with told us that they liked the staff and felt well care for.

Staff we spoke with were knowledgeable about people's care and support needs and told us that changes to the team make up and allocation of named nurses for people on each ward had had a positive impact on continuity of care for people.

Care plan files we looked at were well ordered and easy to navigate through. In general they were properly completed however there was still the occasional occurrence of forms and documents not having been signed, or signed inappropriately using a Christian name, by the author.

People told us that they appreciated the activities that were provided on the wards and welcomed the opportunity to participate.

Staff we spoke with were able to identify people that had hydration needs and were able to explain how these were being monitored and recorded.

We saw that care plans for hydration were in place within two of the files we looked at, where it had been identified that this was an area of need. Hydration record charts for these people were being completed on a daily basis.

People we spoke with told us that drinks were always available and that they could have a drink when they wanted.

The ward manager told us that the systems in place for managing medication were the same as on our previous visit with the exception of the process for receiving medication deliveries onto the wards. We were told that following the incident we had observed during our last visit the system in place for this had been reviewed and tightened up. We saw a new procedure that had been put in place for the receipt of medication deliveries onto the wards which had been signed by all of the staff employed across both wards.

Staff we spoke with confirmed that they had been made aware of the new system and were able to talk us through the process to be followed. We observed a medication delivery arrive onto one of the wards and noted that the process followed was as had been described.

We observed lunchtime on both wards. People we spoke to were complimentary about the food they received with one person commenting 'I enjoyed it, I do like a cooked breakfast, even if it is lunchtime', whilst another told us "the food's nice, I've put on weight". We saw that the tables were laid nicely with paper serviettes, condiments and a choice of drinks, and that staff were on hand to offer assistance. We saw that people were provided with good quality food based on their menu choices, with the option to provide alternatives available on the wards if necessary.

Our observations during our visit indicated that overall patients were receiving good care in line with their assessed needs and care plans. We saw staff treating people with dignity and respect. Where people were being cared for in isolation due the unpredictability of their behaviour we saw that staff were consistent in their approach towards meeting needs and reducing risk.

Whilst we were on the wards we identified concerns in relation to accurate recording within care plans, patient confidentially, medication storage, infection control and a lack of activities. We raised these with the ward manager and other senior staff whilst we were there, and have received plans from the trust identifiying how they intend to address these concerns.