Marcris House

People’s experience of using this service: There were systems in place which provided guidance for staff on how to safeguard the people who used the service from the potential risk of abuse. Staff understood their roles and responsibilities in keeping people safe. Risk assessments were in place to identify how the risks to people were minimised. Staffing levels were kept under review to ensure there were sufficient staff that were suitably trained to respond to people's needs. Recruitment checks had been carried out to ensure staff were suitable to work with vulnerable people. People received their medicines safely. People were protected from the risk of infection.

People's needs were assessed and the service continued to support people to eat and drink enough to maintain a balanced diet. They were also supported to maintain good health and to have access to healthcare services. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. Refurbishment work at the service was ongoing.

During the inspection we observed staff to be kind, patient and friendly. People's dignity and privacy was respected by staff.

People were involved in the planning of their care and staff responded to people's preferences. Care plans contained sufficient detail, but work was being completed to ensure they were personalised. People had opportunities to engage in activities and planned events that interested them. Staff took steps to investigate complaints and to make any changes needed. People were supported at the end of their lives to have a comfortable, dignified and pain free death.

There were a number of audits and checks in place to help ensure standards were maintained. These were all clearly documented and records were up to date.

Rating at last inspection: Rated Good (Report published 12 August 2016).

Why we inspected: This was a planned inspection based on the rating at the last inspection. The service remained Good overall.

Follow up: We will continue to monitor the service through the information we receive until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.

A registered manager was in post at the service. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. 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 sufficient staff who had been recruited safely and who had the skills and knowledge to provide care and support in ways that people preferred.

Staff had received training in keeping people safe and they knew how to raise any concerns if they suspected someone was at risk of abuse or harm. Staff understood the risks people could face day to day and how they needed to ensure their safety.

The Care Quality Commission (CQC) monitors the operation of the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS) which apply to care homes. We found the provider had followed the MCA code of practice in relation to DoLS.

People knew how to complain and felt confident their concerns would be listened to and people's complaints were valued and used to improve the service.

People's medicines were managed safely, staff received training and the registered manager took prompt action in response to feedback from external pharmaceutical audits.

There were enough staff to meet people's individual needs, and staffing was adjusted when people's needs changed.

There were systems to monitor and improve the quality of the service. Checks were carried out to ensure care was delivered safely and effectively.

During our inspection on 25 October 2013 we noted that the home looked clean and there was no offensive odour present. Windowsills and furniture were dust free. We saw that the carpets in the lounges, corridors and the bedrooms we looked at were clean and free from stains.

We saw that the only staff members who had not received training on infection control in the 12 months prior to our inspection on 25 October 2013 were the cook, who had food and hygiene qualifications, and one care worker who was on maternity leave. This meant that the provider could be confident that there were effective systems in place to reduce the risk and spread of infection.

On the day of our inspection the home appeared to be clean, although we noticed that there was a slightly unpleasant odour. However, as we walked around the home we identified areas where the cleanliness was not of a satisfactory standard. We saw that chairs in the main lounge were dirty and stained. We saw that in some bedrooms there was no dispenser for paper hand towels in the en-suite bathrooms and these were left in piles on shelves.

Marcris House has a mix of converted and purpose built rooms. All of the purpose built rooms have en-suite bathrooms but some of the converted rooms in the older part of the home share bathroom and toilet facilities. Whilst all rooms were of an adequate size the proportions varied considerably,

The manager told us that the staffing levels needed were assessed using the dependency levels of the people who lived at the home. Agency staff were used when needed to ensure that staffing levels were maintained.

We saw that the manager had regular meetings with the people who lived at the home and had undertaken surveys of friends, relatives and professional agencies that came into contact with the home.

We spoke with three people at the service. People told us that they liked living at the home. One person said, “Staff are very helpful and friendly”. When we asked one person who lived at the service if their privacy and dignity was respected they told us “Yes, the staff here are all very good and look after me very well”. They also said that staff were “Very helpful”.

We found that people’s views and experiences were taken into account in the way the service was provided and delivered in relation to their care.

People’s needs were assessed and care and treatment was planned and delivered in line with their individual care plan.

People were protected from the risks of inadequate nutrition and dehydration.

People were protected from unsafe or unsuitable equipment.

There were enough qualified, skilled and experienced staff to meet people’s needs.

People were cared for by staff who were supported to deliver care and treatment safely and to an appropriate standard.

The provider had an effective system to regularly assess and monitor the quality of service that people receive.

There was an effective complaints system available. Comments and complaints people made were responded to appropriately.

People were protected from the risks of unsafe or inappropriate care and treatment.