Marlow

Updated 10 September 2021

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

This inspection was completed by one inspector.

Service and service type

Marlow is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service did not have a manager registered with the Care Quality Commission. This means that the provider is legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We used all of this information to plan our inspection.

During the inspection

We spoke with one person who used the service about their experience of the care provided. As we were unable to communicate with other people, we observed staff interactions with people whilst ensuring we were working within social distancing guidelines. We spoke with six members of staff including the area manager, manager, team leaders and support workers.

We reviewed a range of records. This included three people’s care records and multiple medication records. We looked at three staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection

We are improving how we hear people’s experience and views on services, when they have limited verbal communication. We have trained some CQC team members to use a symbol-based communication tool. After the inspection, we checked that this was a suitable communication method and the person was happy to use it with us. We did this by speaking to staff and the person themselves. In this report, we used this communication tool with one person to tell us their experience.

We contacted four relatives and three staff to gather feedback about the service and received feedback from one healthcare professional who regularly work with the service. We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records.

Updated 10 September 2021

About the service

Marlow is a care home providing accommodation and personal care for up to 15 adults with learning disabilities and/or a variety of associated health and support needs.

People lived in separate parts of the building comprising the ground and first floor. Upstairs there were two self-contained flats for people who were supported to live more independently. At the time of the inspection there were 15 people living at the service.

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

People’s care and support was provided in a safe environment which met their individual needs. People were protected from abuse and poor care. People and relatives told us they had confidence in how staff kept people safe. Systems were in place and safeguarded people from the risk of abuse. Staff could recognise signs of abuse and knew actions to take. The provider ensured staff received safeguarding training and received opportunities for continual learning.

People were supported to be independent and had control over their own lives. Staff demonstrated person-centred support which included supporting people to manage risks. The service worked closely with medical professionals to review and manage specific health risks. People received medicine safely and staff proactively worked with health professionals which ensured medicines were reviewed appropriately. The service had enough skilled staff to meet people’s needs and keep them safe.

People were supported by staff who understood best practice in relation to learning disability and/or autism. Caring values were embedded in the service. A relative told us, “They are proactive, really good couldn’t fault them, [person] has a completely different life now.” Governance systems ensured people were kept safe and received a high quality of care and support in line with their personal needs. The interim manager was visible, approachable, knowledgeable and had ensured team morale remained positive. The provider had maintained effective oversight of the service which ensured the service continued to be well- led.

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.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right Support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

Based on our review of safe and well-led, the service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture.

Right support:

• Model of care and setting maximises people’s choice, control and

Independence.

People were supported to make choices. We observed staff supporting people to arrange equipment repairs and contact relatives at times of their choosing.

Right care:

• Care is person-centred and promotes people’s dignity, privacy and human

rights.

Care and risk plans were person centred. Staff demonstrated an awareness of people’s individual needs.

Right culture:

• Ethos, values, attitudes and behaviours of leaders and care staff ensure people using services lead confident, inclusive and empowered lives.

The needs and quality of life of people formed the basis of the culture at the service. Feedback from people, relatives, health professionals and staff confirmed people received genuine person-centred care supporting empowered lives.

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

Rating at last inspection

The last rating for this service was Good (published18 September 2018).

Why we inspected

The inspection was prompted in part to follow up on the management of safeguarding processes, incidents and how lessons had been learnt. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

We found no evidence during this inspection that people were at risk of harm from this concern. The service was able to demonstrate how incidents were managed safely; this included clear safeguarding processes, actions taken as a result and evidence of learning from incidents.

Please see the safe sections of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Marlow 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.