Archived: Marrams Also known as Mrs Jane Margaret Larter

Marrams is a residential care home providing personal care to 3 people aged 65 and over at the time of the inspection. The service can support up to 3 people.

People’s experience of using this service and what we found

We made a recommendation because systems to monitor and assess the safety and quality of the service were not comprehensive and were not effective at identifying shortfalls within the service. Risk assessments for the environment had not been completed. The provider assured us this would be addressed. Checks on the fire and water systems were undertaken to ensure they were safe. Individual risks to people’s health had been assessed.

Staff understood their responsibilities in relation to safeguarding and had received training in this. People were given their medicines as prescribed. Pre-employment checks had not always been carried out for new staff. The provider assured us this would be addressed. There were consistently enough staff to support people.

There was a person-centred culture within the home and people enjoyed living there. Staff enjoyed their work and felt supported by the provider. People, their relatives and staff were involved in providing feedback about the service.

Staff had not received training in health and safety but had completed other training relevant to their role. Assessments of people’s needs were completed prior to them moving into the home. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. People were supported to maintain a healthy nutritional intake and timely referrals to healthcare professionals were made when people became unwell.

People were cared for in a way which upheld their dignity and respected their privacy. Staff supported people to maintain their independence and knew people well as individuals. People were involved in the planning of their care and treatment.

People’s care was planned in a person-centred way and records of people’s care were regularly reviewed and updated. There were no restrictions in relation to people having visitors and people were supported to access their local community and maintain their interests. No complaints had been made about the service in the past year, but people felt able to raise a concern if needed.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The rating at the last inspection was good (published 14 June 2017).

Why we inspected

This was a planned inspection based on the previous rating.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Marrams on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Marrams provides accommodation, care and support for up to three older people who require support with personal care and their meals cooked. At the time of this inspection there were three people living in the home. The residential care home is situated on the ground floor of a large semi-detached house, which has its own private grounds. The provider lives in the upstairs part of the building and both environments have independent entrances.

As the service is operated by an independent sole provider, who oversees the running of the service on a daily basis, there is no requirement for a separate registered manager to be in post. The registered provider is therefore the ‘registered person’. 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.

There were enough staff working in the home to help ensure people's safety. Staff worked well together to ensure people's needs were met safely and appropriately. Proper checks were carried out when new staff were recruited, which helped ensure only staff who were suitable to work in care services were employed. Staff knew how to recognise different kinds of possible abuse and understood the importance of reporting any concerns or suspicions that people were at risk of harm appropriately. The provider also understood their role in addressing any issues.

Risks to people's safety were identified, recorded and reviewed on a regular basis. There was also written guidance for staff to know how to support people to manage these risks. Staff worked closely with healthcare professionals to promote people's welfare and safety. Staff also took prompt action to seek professional advice, and acted upon it, where there were concerns about people's mental or physical health and wellbeing.

People's medicines were stored and managed safely and administered as the prescriber intended. Staff were appropriately trained and competent to support people with their medicines, although some people managed and administered their own medicines.

People enjoyed their meals and were provided with sufficient quantities of food and drink. People were also able to choose what they had. If people were identified as possibly being at risk of not eating or drinking enough, staff would follow guidance to help promote people's welfare and input would be sought from relevant healthcare professionals.

Staff were trained well and were competent in meeting people's needs. Staff understood people's backgrounds and preferences and supported people effectively. New staff completed an induction and all staff had frequent one-to-one time with the provider, during which supervisions and appraisals of their work were undertaken.

Staff understood the importance of helping people to make their own choices regarding their care and support and consistently obtained people’s consent before providing support. All three people had full capacity to make all their own decisions at the time of this inspection. However, staff understood how to act in people’s best interests, to protect their human rights, should this situation change.

Staff had developed respectful, trusting and caring relationships with the people they supported and consistently promoted people’s dignity and privacy. People were able to choose what they wanted to do and when. People were also supported to maintain relationships with their friends and families. People engaged in activities of their choosing and were supported to maintain and enhance their independence as much as possible.

The service was well run and communication between the provider, staff, people living in the home and visitors was frequent and effective. People and their families and friends were able to voice their concerns or make a complaint if needed and were listened to with appropriate responses and action taken where possible.

The provider used a number of methods to ensure the quality of the service provided was regularly monitored. All aspects of the service were checked regularly by the provider and care staff, in order to identify any areas that needed improvement. Action was taken promptly to address any identified issues.