Archived: Markham House

The provider was also registered to provide personal care to people living in their own homes. However at the time of our visit this service was not being provided to anyone, so we were not able to assess the quality of the care provided to people in their own homes.

We considered all the evidence we had gathered under the outcomes we inspected. This is a summary of what we found:

Is the service safe?

People had no concerns about their safety and were confident that staff would respond if they had.

Robust safeguarding procedures were in place. Staff understood their role and how to safeguard people from potential harm.

All staff had received training in managing behaviours that may challenge the service. Diversionary methods have been successful in de-escalating situations and avoiding potential harm to people.

Systems were in place to ensure the service learned from events such as incidents, complaints, concerns and investigations. This helped the service to continually improve quality and safety.

We monitor the operation of the Deprivation of Liberty Safeguards 2009 (DoLS) that apply to care homes. Two applications had been approved to ensure that people were accompanied by staff when visiting the community to ensure their health, safety and wellbeing. A further application was being submitted to the relevant body (local authority) for consideration.

Is it effective?

People's needs were assessed prior to using the service and they were involved in completing their care and support plans. Plans were reviewed monthly with the person and their key worker. We found that any changes or concerns were recorded and actioned.

People's health care needs were assessed and referrals were made to a range of external health care professionals where necessary. Advice from the professionals had been recorded and actions had been taken to ensure people had the quality of care they needed to meet their health care needs.

Mental capacity assessments were completed and where people did not have capacity to be involved in particular decisions about their care, relatives were involved with them to ensure their best interests were followed. An Independent Mental Capacity Advocate (IMCA) had been appointed concerning a complex decision, together with the person, their relative and other professionals.

Is the service caring?

Each person had a 'One-page profile' giving details about their life experiences which contained questions such as: 'What people admire about me?' 'What's important to me?' and 'How to support me well.' This ensured that care and treatment was provided in the way people wished. People's views were sought and acted upon.

We spoke with six people and asked their opinions about staff and the support they received. Feedback was positive. One person said, "I have no complaints at all about the staff, they always do their best for us". A relative told us, "Staff are excellent, they get results. Nothing is too much trouble for them".

Is the service responsive?

People met with their key worker regularly. Their care and support was reviewed with them and people had the opportunity to express any concerns they had. The meetings were recorded in care records.

When people's health care needs changed, external health care professionals were contacted. Their advice was recorded and actioned.

Monthly minutes of residents meetings were actioned to improve the quality of service. Regular staff meetings were held. Staff told us they felt confident in raising any concerns they had about the service.

Is the service well-led?

Systems were in place to monitor the quality of the service. We saw that shortfalls had been identified and addressed. This ensured the provider was able to protect people against the risks of inappropriate or unsafe care and treatment.

Staff were clear about their roles and responsibilities. They felt well supported with training and supervision and said they could speak with the manager at any time if they wished to.

Staff felt confident in their ability to meet people's needs. This ensured that people received a good quality service at all times.

The provider is also registered to provide personal care to people living in their homes. However at the time of our visit there were not providing this service to anyone so we were not able to assess the quality of the care provided to people in their own homes.

People were treated with dignity and respect. Staff were described as being kind, polite and respectful to people.

Care plans were detailed and considered people as individuals. People were consulted about their care and were given support to develop individual lifestyles and improve their independence.

There were suitable arrangements in place for the handling and administering of medicines. Staff were suitably trained and had access to information about medicines. People were supported to handle and administer their own medications to improve their independence.

There were robust recruitment procedures in place. This ensured that staff were suited to work with vulnerable adults.

There were systems in place to handle and respond to complaints appropriately. There were a range of ways available to people to enable them to raise and complaints or worries they had.

Both people we spoke with commented on their own rehabilitation progress and of the progress they had observed other people make during their time at the home. People told us about their individual lifestyles and the day to day decisions they made for themselves.

Most care plans were detailed and showed that people had been asked about their care needs and preferences. However we found that where there had been changes to the care people needed care plans had not always been updated.

Some people looked after their own medications however there were not suitable checks in place to ensure they people had a good understanding of their medicines in order to take their medicines as they were prescribed.

People were positive about the staff the home and the care they received. People told us staff were 'Brilliant', 'Lovely' and they 'Always ask how I feel'. The people we spoke with knew their key workers and said they met with them regularly.

People were asked to share their views about the service at community meetings, meetings with their key workers and through surveys.