This was an unannounced inspection of this location. This inspection took place on 22 and 23 September 2015.
The service was previously inspected on 11 September 2013 when no breaches of legal requirements were found.
At the time of the inspection the manager had submitted her application and was waiting to be interviewed. Following the inspection we received confirmation that the manager had been interviewed and registered. 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. A home manager was in place and an application to become registered had been submitted to the Care Quality Commission (CQC).
Marbury House is one of twelve care homes owned by Borough Care Limited, a not-for-profit registered charity. The home is registered to provide intermediate care and accommodation for up to 41 people who require care, support and rehabilitation following hospital treatment.
The home is a two storey building situated on the Marbury housing estate in Heaton Chapel Stockport near Manchester. There are forty single bedrooms located over two floors, ten of which have an en-suite toilet. The first floor can be accessed via a passenger lift. In addition there are communal bathrooms, toilets, rehabilitation kitchens, lounge and dining areas available in the home.
Some of the support services at Marbury House were provided by an intermediate care team who delivered services such as nursing care and occupational and physiotherapy.
An Intermediate Care team is a partnership of Health and Social Care enablement staff working together to prevent admissions or readmissions to hospital and facilitate timely hospital discharge. At the time of our visit 37 people were receiving intermediate care and support at Marbury House.
Some staff when asked were not confident about their duties and responsibilities in relation to the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS). The home manager advised us that she would arrange further staff training to help make sure staff confidence was increased in this topic.
Matters giving rise to concern identified at a coroner’s inquest in 2014 had been addressed and actioned by the provider to prevent the risk of future deaths occurring in similar circumstances. The provider had set out and followed an action plan for staff to undertake training to help make sure they were clear about and fully understood what constitutes a reportable incident. All of the organisations care home managers also received awareness training in the reporting of such incidents. The provider had also taken action to make sure that the door closers on all doors were made safe and were in good working condition.
This service was safe and people told us that they felt safe. Care plans highlighted the areas of support needed in detail and had associated risk assessments. Medicines were managed safely. We saw that a cleaning system in place helped to make sure the home was clean and there were no offensive odours apparent during our visit.
There was sufficient staff that had been recruited safely. Care staff had all received a thorough induction, training and support when they started work at the service and fully understood their roles and responsibilities, as well as the values and philosophy of the home. They understood what was meant by safeguarding and had undertaken training in adult safeguarding.
People were provided with care by staff who supported them to live as independently as possible. Staff working in the home understood the needs of the people who lived there and knew how to make sure the care provided to people followed best practice and written care plan instructions. We found that people’s care was delivered consistently by a multidisciplinary team of workers who knew how to support people and meet their assessed care needs.
People spoken with told us that the service was caring and we observed staff to be caring. We saw good relationships between individual staff and people who used the service and we saw that care was provided with kindness. Staff were respectful when speaking with people and maintained their dignity. We saw that staff responded promptly when people required assistance.
We found that the service was responsive to people’s individual needs and the care plans we looked at were person centred and up to date. Care instructions about how staff should support people’s needs were detailed and clearly written. People who used the service were engaged in meaningful activity to promote their wellbeing.
Staff were following the principles of the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS) when they cared for people who lacked the mental capacity to make their own decisions. Advocates were available to help people to support people in expressing their views where necessary.
Quality monitoring audits had been carried out for the service looking at medicines, the care provided, mealtimes and choice and involvement and records used to manage the service.
The provider encouraged feedback from people using the service and their families. Feedback was given in the form of complaints, comments and compliments. A care plan quality monitoring system in place was also used to help make sure the service met the overall requirements under the regulations.