Archived: Marjorie Cobby House

Updated 26 September 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is 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 was a comprehensive inspection. We inspected the service earlier than scheduled because we had been informed of safeguarding concerns regarding possible delays with the identification of a person’s deteriorating health condition. This inspection took place on 28 and 29 June 2018. The first day if the inspection was unannounced and the second was announced. The service was previously inspected on the 29 February 2016 and was rated as ‘Good’ with no concerns identified.

The inspection was completed by one inspector and a specialist nurse advisor.

We used information the provider sent us in the Provider Information Return (PIR). This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. We also reviewed notifications sent to us by the provider. This is information that providers are required to send us in law.

We spoke to health and social care professionals and the police who attended the safeguarding adults meetings. We also spoke with a community matron, a community physiotherapist, two social workers, the registered manager, a deputy manager, three senior support workers, two carers, the admission and discharge officer based at the service and a paramedic practitioner who worked at the local GP surgery. We also spoke with six people who used the service and reviewed the records held for three people. Recruitment and training records were also reviewed for three members of staff.

We reviewed policies and procedures within the home, staff training, accidents and incidents, quality assurance audit outcomes and other daily records which included the staff handover report.

Updated 26 September 2018

Marjorie Cobby House is a residential care home for a maximum of 34 people. At the time of this inspection 14 people were staying at the home. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. This is a bespoke service model operated by West Sussex County Council [WSCC] that focused on the rehabilitation needs of people following their discharge from hospital. Marjorie Cobby House provides a short term service and people can stay there for up to 12 weeks, depending on the service criteria. Respite and emergency short term care can also be accommodated. The service works in partnership with the NHS, social workers, local GP surgery and intermediate care team to support people to meet their objectives.

The home was well maintained and spacious, with small lounges and a large communal dining area. Kitchen areas are available for people to use to support with daily living skills and rehabilitation. There are pleasant outdoor seating areas. A large assisted bathroom is also offered to community physiotherapists to support people who live in the local community to receive a bath safely and enable them to receive rehabilitation support.

The service accommodates up to 34 people on short-term basis for rehabilitation support. The 34 beds were divided to reflect people’s different level of need and the level of support required by them to be able them to return to their home. There were ‘discharge to assess’ [D2A] beds, ‘community transfer beds’ [CTB] which were contracted by health commissioners and also standard ‘interim’ beds for those people with the lowest level of rehabilitation needs. People were admitted after an initial assessment was completed by a ‘trusted assessor’ who was a health professional based at the local hospital from where people would be discharged before moving to this service. We were told that the service had supported more than two hundred people to receive rehabilitation or to move onto more appropriate accommodation to meet their needs in the previous 12 months before this inspection.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of Good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service had not changed since our last inspection. Despite a safeguarding concern raised by the local social services safeguarding team, following a formal complaint that was raised, we found that the service responded to and managed risk to people appropriately. Following the safeguarding concern and after this inspection, the senior management team for this service had worked to change the structure of the service provided which meant that risks were further reduced. The ‘trusted assessor’ approach which had been used by the service to enable people to be discharged from hospital more quickly, had been stopped which enabled staff from the home to assess people’s needs instead of health professionals based at the hospital. This ensured that staff felt more confident about meeting the needs of people who were referred to stay at this rehabilitation service.

People were protected from abuse by trained staff who understood the reporting procedures when concerns may arise. Staff received appropriate training for their roles and were recruited safely which further protected people from the risks of abuse.

People had access to healthcare when they needed it. There was a regular presence of community health care professionals which included GP’s, community matrons and a paramedic practitioner, at the home. Community physiotherapists and occupational therapists also visited people at the service to support with improving daily living skills and mobility to enable people to confidently return home following an operation, fall or illness which had resulted in them spending a period of time in hospital.

Risks to people were assessed and managed. Accidents and incidents were recorded and monitored. The management team reviewed accidents and incidents for any trends and appropriate preventative measures were taken to reduce risk and avoid reoccurrences. There was a complaints process. A large number of positive compliments were seen during this inspection.

People’s medicines were managed safely and people were positively encouraged to maintain their independence with daily living skills which included self-administering their medication when safe to do so. People had a choice of food and dietary needs were maintained with healthy food and drink snacks which were always available.

The home was clean and well maintained and risks of infection were managed by appropriate use of protective equipment such as gloves and aprons when staff supported people with personal care or cleaning tasks.

During this inspection we were told that people at the service had the mental capacity to make decisions regarding their daily lives. The registered manager was aware of how to support people who may lack mental capacity and was able to describe previous occasions when they had provided appropriate support to people. People staying at Marjorie Cobby House were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service support this practice.

The service was well managed by an open and transparent management team. Daily handovers provided detailed information about people’s changing needs and support required to enable them to return home. The registered manager engaged very professionally and positively with the recent safeguarding concerns and shared regularly updated action plans with the Care Quality Commission [CQC] and social services of the progress against the actions noted.

The service was previously inspected on 29 February 2016 at which time no concerns were identified. At this inspection we found the service remained Good.

Further information is in the detailed findings below.