Essex Care Consortium - Marks Tey

Updated 23 November 2023

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.

Inspection team.

The inspection team consisted of 2 inspectors.

Service and service type

Essex Care Consortium – Marks Tey is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Essex Care Consortium – Marks Tey is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was not a registered manager in post.

Notice of inspection

The inspection was unannounced.

What we did before the inspection

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 all this information to plan our inspection.

During the inspection

We spoke with 1 person using the service about their care and observed the experiences of people who were unable or did not want to talk with us. We spoke with 5 members of staff including the general manager responsible for supervising the management of the service on behalf of the provider, the acting manager, senior carers and care staff. We reviewed a range of records, including 4 people's care records, 3 staff files in relation to recruitment and staff supervision and a variety of records relating to the management of the service.

Updated 23 November 2023

About the service

Essex Care Consortium – Marks Tey is a residential care home providing the regulated activity, accommodation for people who require personal and nursing care to up to a maximum of 13 people. The service provides support to people with a learning disability and autistic people. At the time of our inspection there were 13 people using the service.

People’s experience of the service and what we found:

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessment and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

Right Support

Essex Care Consortium – Marks Tey had been developed and designed in line with the principles and values that underpin the Right support, right care, right culture guidance. The service is in a rural position and fits in the local residential area. There was nothing outside to show it was a care home. The building was a similar size to other properties with a large garden, which people had access to. Internally the premises were well designed for the people living there.

Staff showed a genuine interest in people's well-being and quality of life. 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. People were provided with as many opportunities as possible to gain new skills and become more independent.

Staff were kind, caring and nurturing and as a result we saw people were at ease, happy, engaged and stimulated. They worked well with other professionals to ensure people received the right level of support to manage signs of distress and or frustration. Staff were aware of subtle changes in people's behaviours and took action to diffuse incidents quickly.

Right Care

Systems to manage risks to people’s safety, the living environment and equipment needed to improve. People were kept safe from avoidable harm because staff knew them well and understood how to protect them from abuse. Staff had received training on how to recognise and report abuse. However, the provider did not have robust systems in place to ensure all safeguarding incidents were robustly investigated and learnt from.

The service had enough staff to meet people’s needs, including additional 1-1 hours to manage anxieties and access the community. However, improvements were needed to ensure the service had staff, with the right mix of skills, competence, and experience to support people to stay safe. Staff had received a wide range of relevant training. However, systems to assess staff’s understanding of training, including those whose first language was not English, needed to improve to ensure they had understood the training, and were competent to carry out their roles. Record keeping needed to improve to ensure staff recruitment documentation was complete and held centrally in one place and accessible.

We have made a recommendation about safe recruitment and induction training for new staff.

People's care plans were personalised, covering all aspects of their needs, including their physical and mental health needs. Staff delivered care in line with information in people's care plans and recognised models of care for people with a learning disability or autistic people. This ensured people were receiving care tailored to them which promoted a good quality of life. Staff understood people's individual communication styles and we saw they had developed a good rapport with them.

The service had effective infection, prevention and control measures to keep people safe, including good arrangements for keeping the premises clean and hygienic.

Right Culture

Staff understood their role in making sure that people were always put first. They provided person centred care and sought to protect and promote people's rights.

The service does not currently have a registered manager in post. The service has had 3 managers in the last 19 months. The frequent changes in management had impacted on staff morale and the quality of the service provided. Governance arrangements in place needed to improve to ensure effective oversight of the quality and safety of the service and used to identify and drive improvement.

People and their relatives were provided with the opportunity to be involved in decisions about their home and the support they received. Regular residents' meetings took place for people to have their say about how the service was run.

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 (published 08 August 2019).

Why we inspected

The inspection was prompted in part due to concerns received about the recruitment of staff and the management of medicines. A decision was made for us to inspect and examine those risks.

We undertook a focused inspection to review the key questions of safe and well-led only. For those key question not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

You can read the report from our last comprehensive inspection by selecting the ‘all reports’ link for Essex Care Consortium – Marks Tey on our website at www.cqc.org.uk.

Enforcement and recommendations

We have identified breaches in relation to safe care and treatment and good governance. Please see the action we have told the provider to take at the end of this report.

Follow Up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.