Marsh Farm Manor Care Home

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

We reviewed 6 quality statements in this key question. People and relatives told us they were happy with the care provided and had been involved in managing their health needs. Whilst we observed staff working together, staff told us good teamwork depended on who was working on shift. Staff also told us communication amongst staff could be better. People told us they enjoyed the food and could eat where they wanted. People told us staff always asked their consent before providing care.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People and relatives had been involved in assessments before people moved to the service. Comments about assessments included, “Staff did ask lots of questions to find out all about [person]” and “Assessed before [person] came to live here, it was very thorough.”

The deputy manager told us people had an initial assessment completed by management prior to being offered a place at the service. The assessments were used to develop care plans and risk assessments with people. Staff said the assessments gave them good information about people’s needs when they first moved in.

The provider had an assessment template which was used to gather information about people’s needs. The deputy manager told us initial assessments could be completed at the service when people came to view the home, in hospital or in people’s homes. Records demonstrated people’s needs were assessed with them and regularly reviewed to ensure the level of support remained correct.

People told us they enjoyed the food at the service and liked being able to choose where to eat. We observed mealtimes and found they were a relaxed and inclusive experience for people. Comments from people and relatives about the food included, “Good choice of breakfast, a boiled egg if you want one, toast, all sorts” and “I am very impressed with the food.”

Staff told us they worked together with specialist providers and the community health teams to ensure care was provided in line with current guidance and best practice. Staff told us when menus needed to be changed people were involved in sharing their feedback and tasting new options.

The service had evidenced-based assessment tools embedded in their care planning system, for example, tools related to nutrition and skin integrity. These helped to ensure care was planned in line with current best practice guidance.

People had health care and support that met their needs. Staff completed timely referrals to various healthcare professionals when appropriate. During our site visit we observed an optician was visiting the service and staff were making sure those with appointments were supported to be seen.

Staff told us good teamwork was dependent on who was working on shift. Staff told us systems for communication within the service were variable. Some staff said they had raised this with the management team but were frustrated that the issues persisted. Comments from staff included, “There is teamwork some of the time, sometimes not. We all work it out between ourselves, and we try to get everyone to work as a team. I can get frustrated, but we don’t let it impact on the residents” and “Communication is not great, and teamwork could be better.” The registered manager told us there was good teamwork at the service and whilst the team was fairly new, staff were working together well. We shared feedback from staff with the registered manager who told us they were surprised staff felt this way, but they would take the feedback on board.

Professionals we contacted did not raise any concerns about this quality statement.

Care records demonstrated staff worked with other services to ensure people’s needs were met effectively. Staff had daily handovers and there was a head of department daily meeting. Information was shared with staff on any changes to people’s needs. Staff had regular meetings where any updates or changes to ways of working were discussed. Meeting minutes were kept and shared with staff who were not able to attend meetings.

People and relatives told us people had the support they needed to be actively involved in managing their health needs. GPs and community nurses visited the service regularly and if people wanted they could visit local surgeries for their appointments.

Staff told us if they identified any concern regarding people’s health they reported them to team leaders on shift. Team leaders would then contact healthcare professionals as needed. Staff said the systems worked well, and they could highlight when they thought people needed to see the GP or community nurse. Staff said there was a good relationship with community health services, who regularly visited the home. The registered manager told us they encouraged staff to get to know people well so they could identify any early signs of ill health.

People's care records demonstrated they had been supported to access relevant health services, including GP, community nurses and the Care Home Liaison Service (CHL). The CHL service supported people with dementia and mental health conditions. They provided specialist support to people and staff when people experienced distress. Information on specific health conditions was available to staff.

If people needed any monitoring this was completed and recorded in their care records. People had reviews of their care to make sure care delivery was meeting their needs. People told us they felt the staff knew them well and were on hand to offer help when needed. Comments from people included, “I feel that staff know me quite well; do most things myself but when I shower, they help me, I am a bit shaky”, “I get the help I need, and I know what I should get in the way of care” and “I have absolutely no complaint at all, they [staff] are always watching out for you.”

The deputy manager told us people’s health was monitored to identify any changes. This was recorded on the care planning system and was used to inform health professionals and review the care that people needed. Staff shared examples with us of the type of monitoring they completed and understood the reasons for the work they did. One member of staff told us, “People can be on food and fluid monitoring. This would be planned care, and we will get alerts on the handsets. We can see any red flags if people have not had enough food or fluids.”

People had regular reviews of their care which included a review of their care plan. Care records demonstrated monitoring was completed where necessary, for example food and fluid charts and repositioning charts.

People told us staff were consistently asking them consent before providing care and support. Comments from people included, “Yes staff always ask permission before carrying out care. Staff never just do something without saying is it alright if we do this or that” and “Staff come along and say what would you like me to do and always say is it alright to clean your room now or take your washing.”

Staff demonstrated a good understanding of the Mental Capacity Act 2005 (MCA) and consent issues. Staff understood the need to follow the best interest decision making process if people were assessed to lack capacity to consent to a specific decision. Comments from staff included, “I had training on this (MCA). A lot of our residents have capacity, but we do check if people lack capacity. We always ask people first, make sure they get choices with everything” and “Everyone should be assumed to have capacity. If people lack capacity, we might help them make choices.”

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. People’s care records demonstrated people had consented to their support plans. Where people lacked capacity, an assessment had taken place and decisions made in people’s best interest.