Marillac Neurological Care Centre

Updated 18 November 2022

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 Health and Social Care Act 2008.

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

The inspection team was made up of one inspector, a bank inspector, a specialist professional advisor, two pharmacist inspectors and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Marillac Neurological Care Centre is a ‘care home’. People in care homes receive accommodation and nursing and personal care as a single package under one contractual agreement dependent on their registration with us. Marillac Neurological Care Centre is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

Inspection activity started on 15 September and ended on 14 October 2022. We visited the location’s service on 22 September 2022 and 3 October 2022.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make.

We used information we had gathered as part of monitoring activity that took place on 18 May 2022 to help plan the inspection and inform our judgement. We used all this information to plan our inspection.

During the inspection

We spoke with seven people and five family members about their views of the service and observed the care and support being provided by the staff. We also spoke with 15 staff including the registered manager, director of nursing, director of estates and director of therapy, unit managers, nurses, the chef, care and housekeeping staff.

We looked at a range of documents relating to the management of the service, care plans, staff recruitment and training and a range of quality audits. After the inspection we received additional information from the provider, as requested. We had contact from two health and social care professionals for their feedback about the care provided at the service.

Updated 18 November 2022

About the service

Marillac Neurological Care Centre is a residential care home providing personal and nursing care and treatment for up to 52 people with complex neurological support needs. These included people over the age of 18 and those with a physical disability and sensory impairment. At the time of the inspection 51 people were living in the service.

The care home premises accommodate 52 people in three units within one adapted building and three small bungalows for people undertaking rehabilitation. It is set in a woodland area with landscaped accessible gardens.

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

Medicines were not always managed well. Effective systems were not in place to ensure people received their medicines safely.

Governance systems were in place to monitor the health and safety for everyone using and working in the service. Improvements to the auditing process in the areas identified in this inspection were needed.

The service had enough staff to meet the needs of the people. Staff had been safely recruited; however, we found some gaps in staff members employment history. These were identified and dealt with quickly during the inspection.

Staff understood about safeguarding people in their care and processes were in place to inform and notify the relevant authorities. Assessments of the risks to people’s health and wellbeing were undertaken and kept updated. The environment was clean and infection prevention and control measures were effective.

The provider had learnt lessons when things had gone wrong and made the necessary improvements.

People’s needs and choices were assessed and care, treatment and support was delivered in line with current legislation. The induction, training and supervision of staff was provided to ensure they had the knowledge and understanding to carry out their roles and responsibilities.

People’s nutrition and hydration needs were catered for and monitored. Staff teams within and across the service worked together and people had access to healthcare services which delivered effective care, support and treatment.

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.

The staff were caring and kind. They spoke about people in a warm and compassionate way. People’s dignity and privacy were respected.

People had an assessment of their needs which included their choices, wishes and preferences. This provided staff with the information they needed to respond to people in a safe and effective way.

Relatives and friends were encouraged to visit and get involved in the service, providing company and support. There was a range of social and leisure activities on offer and we saw the group activity sessions were well attended.

People were able to raise concerns and we saw complaints had been responded to. Peoples end of life care wishes had been recorded where these had been discussed.

People, relatives and staff spoke positively about the service and the management of it. Their views were sought through surveys, feedback and complaints. Improvements were made as a result of people’s feedback.

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

Rating at last inspection

This service was registered with us on 6 May 2021 and this is the first inspection.

The last rating for the service under the previous provider was good, published on 28 April 2017.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

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 have found evidence that the provider needs to make improvements. Please see the safe section of the full report.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified a breach of the regulations in relation to the management of medicines at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety.