Archived: Martham Lodge Residential Care Home

We spoke with seven people who used the service, three relatives/friends and a number of staff from all staff groups. We reviewed four people's care records and charts and six staff files. We also reviewed a selection of other records that included staff rotas, satisfaction surveys and audit results.

We used the evidence we collected during our inspection to answer five questions.

Is the service safe?

The people who used the service told us that they felt safe and did not have any concerns. The manager and head of care had been trained and understood their obligation to apply the principles of the Mental Capacity Act (2005) and Deprivation of Liberty Safeguards (DoLS). We saw evidence that everyone who used the service had been assessed regarding their mental capacity. At the time of this inspection no person had been assessed as requiring a DoLS safeguard to be in place.

All of the people we spoke with who used the service and their relatives said that they felt there were sufficient staff on duty to provide care and support to people. During our inspection we observed people being cared for in a timely manner and there were no delays in people receiving the support that they needed. We observed an effective handover between the night and day staff. This helped to ensure people's continuity of care at all times of the day.

We noted that medicines were managed in an appropriate and safe manner. Medicines were securely stored and the arrangements for obtaining and disposing medicines adhered with the provider's policy. We did note two errors in relation to the administration of medicines but were satisfied that the manager took the appropriate steps to address these errors.

We saw evidence that there were effective recruitment and selection procedures in place. These included ensuring each employee had undergone a Disclosure and Barring Service (DBS) check, previously referred to as a Criminal Records Bureau (CRB) check.

There were processes in place to collect people's views about the care and support people received and we noted that these were acted on by the manager. Systems were in place to help ensure staff learnt from incidents and accidents and we noted that the provider took actions to help reduce the risk of a repeat occurrence.

There were effective procedures in place to manage and mitigate foreseeable emergencies. These included procedures in relation to fire and evacuation and the loss of utilities.

Is the service effective?

People's care records demonstrated that their needs had been assessed and there were detailed care plans and risk assessments in place. This helped to ensure that people's needs were met. Care and support was evidence based and included nationally recognised screening tools.

Plans of care and risk assessments were regularly updated in order to reflect any changes in people's needs. However, we did note that there were occasional gaps in people's daily records in relation to their food and fluid intake and personal care. We discussed this with the manager who told us that this would be addressed and that they would ensure all care staff documented the care and support they had given to people.

People who used the service were supported to be able to eat and drink sufficient amounts to meet their needs and we noted that people were given a choice of nutritious food and drink. During our observation of meal times we noted that there were sufficient staff to assist people in a timely and effective manner.

People's records were shared with other health and social care agencies, with their consent. This helped to maintain multi-disciplinary working to help ensure that all of the person's needs were being met.

Is the service caring?

All of the people we spoke with spoke positively about the staff and the care and support they received. One person who used the service said, 'I have no complaints and get well looked after. I am happy here.' Another person said, 'All the staff are lovely and I have no complaints. The food is very good. Sometimes there are activities going on in the home and I like to join in with them because they are fun.'

One person's friend who we spoke with said, 'I cannot fault this home. It is wonderful. The manager and the staff are fantastic and so friendly.'

We observed the interaction between the staff and the people who used the service. We noted that, at all times, staff were compassionate and respectful towards people. Staff promoted people's independence whilst ensuring they had the support they needed.

People's care plans were person-centred and people received individualised care and support.

Is the service responsive?

People's care plans responded to and reflected all of their needs.

We noted that the environment and activities within Martham Lodge were deigned to help meet the needs of people living with dementia. These included secure garden and patio areas, sensory boards, reminiscing activities and objects as well as pictures to help people understand what things meant.

There was information available to the people who used the service and their relatives that explained how to make comments or complaints. Although the service had not received any written complaints, there was evidence that the provider took account of any verbal concerns to improve the service.

Is the service well-led?

All of the people we spoke with who used the service and their relatives spoke positively about the management of Martham Lodge. The registered manager was supported by the 'head of care' for the service and the provider visited the home on a regular basis. We noted that the staffing arrangements and deployment of staff during the day time ensured that people's needs were met in a timely manner and by staff that were appropriately skilled and experienced. There were on-call arrangements that helped ensure staff could access senior help and support during the out of hours period.

The manager was knowledgeable about each person who used the service and we saw them interact with people on an individual basis.

The staff we spoke with told us that they felt well supported. We noted that the manager did not hold staff meetings for all grades of care staff and the feedback we received about this from staff stated that they thought it would be beneficial to the people who used the service, besides themselves, to have regular staff meetings.

The service has a system in place for monitoring the quality of the service. This included audits in relation to care plans, medicines management, the reporting of accidents and incidents and environmental audits.

During our observations we saw staff providing care and support to people in a kind, attentive and caring manner. We observed good interactions between the staff and people living in the home. People were encouraged to participate with their own activity, one person was dusting, another was having a manicure and a third person was completing a jigsaw. We saw several people enjoying a walk either round the corridor or in the garden. Comments included were; "The staff look after me very well, I need for nothing." "The staff are lovely here. I am very comfortable. I have no reason to complain I am well provided for."

The provider had introduced various objects throughout the corridors and communal rooms for people to explore and take as a memory jogger. The main lounge was furnished in an older style, in keeping with the home and people living there. Staff we spoke with were knowledgeable about the people they were caring for and the importance of reminiscence and individual activities for those who had a dementia diagnosis.