Background to this inspection
Updated
18 October 2017
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider was 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 comprehensive inspection took place on 17 and 21 August 2017. The first day of the inspection was unannounced, which meant that the staff and provider did not know we would be visiting. We informed the manager of the date of our second visit.
The inspection was carried out by one adult social care inspector 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.
Before the inspection we reviewed all the information we held about the service, which included notifications submitted to CQC by the provider. Notifications are changes, events or incidents the provider is legally obliged to send us within required timescales. We contacted the commissioners of the service and other professionals to gain their views of the service provided.
The provider had completed a provider information return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We used this information to help plan for the inspection.
During the inspection we reviewed a range of records. This included three people’s care records including care planning documentation and medicines records. We also looked at three staff files, including recruitment, supervision, appraisal and training records, records relating to the management of the service and a wide variety of policies and procedures.
We spoke with staff, which included the manager, deputy manager, activity co-ordinator, volunteer co-ordinator, a nurse, a volunteer and generally to care staff. We spoke with 10 people who used the service and three relatives. We spent time observing staff interactions with people throughout the inspection.
Updated
18 October 2017
Marske Hall is registered to provide care and accommodation to a maximum number of 30 people who have a physical disability. The service also provides nursing care. At the time of the inspection there were 30 people who used the service.
At the last inspection in June 2015, the service was rated 'Good'. At this inspection we found the service remained 'Good'.
The service had a registered manager. 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 a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
People’s independence was actively encouraged. The manager and staff displayed clear resolve to make a positive difference to people's lives. Activities were invigorating, outings and events were well thought through, varied and in plentiful supply. Staff encouraged and supported people to access activities within the community. Staff were supported by many volunteers whose personalities and interests were matched with people who used the service to ensure a positive partnership.
Staff understood the procedure they needed to follow if they suspected abuse might be taking place. Risks to people were identified and plans were put in place to help manage the risk and minimise them occurring.
Medicines were managed safely with an effective system in place. We did note that the room temperature in which medicines were stored was on occasions too hot. We pointed this out to the manager at the time of the inspection who told us they would take action to address this.
Appropriate checks of the building and maintenance systems were undertaken to ensure health and safety was maintained. At the time of the visit we noted that water temperatures were taken and tested by the handyman infrequently. We pointed this out to the manager at the time of the inspection who took immediate action to address this. Water temperatures were taken and tested before people who used the service had a bath or shower to ensure they were of a safe temperature.
We spoke with people who used the service, relatives and staff and asked them if there were sufficient staff on duty to ensure people’s needs were met. We received a mixed response. Relatives told us the service was such a large building and this meant the staff had a large area to cover and at times made it difficult for them to find staff. We pointed this out to the manager who told us they would address relatives concerns and review staffing.
People were supported by a regular team of staff who were knowledgeable about people’s likes, dislikes and preferences. A training plan was in place and all staff had completed up to date training. The manager had identified any gaps in training and arranged for refresher training to be provided.
Staff had an understanding of the Mental Capacity Act 2005 and acted in the best interest of people they supported. Staff clearly understood their role in supporting people with communication to help them make as many of their own decisions as possible. Staff told us about people’s care preferences, which were also recorded in their care plans.
People were provided with a choice of healthy food and drinks, which helped to ensure that their nutritional needs were met. People were supported to maintain good health and had access to healthcare professionals and services.
There were positive interactions between people and staff. We saw staff treated people with dignity and respect. Staff were kind, caring and interacted well with people. Observation of the staff showed that they knew people very well and could anticipate their needs.
Care plans detailed people’s needs and preferences. Care plans were reviewed on a regular basis to ensure they contained up to date information that was meeting people’s care needs. People were actively involved in care planning and decision making. The service had a clear process for handling complaints.
Staff told us they enjoyed working at the service and felt supported by the manager. Quality assurance processes were in place and regularly carried out by the manager and provider to monitor and improve the quality of the service. The service worked with various health and social care agencies and sought professional advice to ensure individual needs were being met.