Marcris House

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• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

We identified 1 breach of regulation in relation to supporting people’s independence, choices and control over their daily lives. People had not always been supported to maximise their independence. People told us they did not have a choice about how they spent their time, or opportunities to participate in activities that promoted their independence. This was a breach of regulation.

This service scored 62 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We did not look at Kindness, compassion and dignity during this assessment. The score for this quality statement is based on the previous rating for Caring.

We did not look at Treating people as individuals during this assessment. The score for this quality statement is based on the previous rating for Caring.

People told us they did not have a choice about how they spent their time, or opportunities to participate in activities that promoted their independence or wellbeing. One person told us, “There’s absolutely nothing to do, so are you surprised that I get fed up? At the very least it would be nice to get in the garden, but that’s not possible.” Another person told us, “I’d like to do gardening, but there doesn’t seem to be an opportunity to do anything and in fact nothing happens at all. I’m lucky because I’m quite self-sufficient, so I’m not lonely, but I look around and there are some people who just sit and do nothing.” Our observations confirmed people’s views and opinions about a lack of choice, independence or engagement.

The director managing the service agreed that staffing deployment was a significant factor in people not having much choice about their daily routine. They said that planned tasks were consistently late in being delivered. They said the previous registered manager took control over the deployment of staff and their allocations. When the registered manager left, staff had been disempowered to organise their shifts to meet people’s preferences around their routine. Staff worked in a task based manner to complete their work, meaning people did not receive care that met their choices or preferences. The director further said that the activity co-ordinator had resigned four months before this assessment. The absence of this key role placed additional pressures on care staff to engage with people. This was difficult for care staff to support people in a timely way with care related tasks to have the time to provide meaningful engagement to people. This led to people either being in their bedrooms, or within the communal lounges with little engagement or stimulation. The provider said they were seeking to appoint the previous activity staff and would reinstate engagement to meet people’s preferences and interests soon after this assessment. They acknowledged that people were not able to choose how they spend their daily lives.

Our observations confirmed the feedback we received from people. We saw no planned activities or things for people to do on the day of our visit. We observed task led functions and people 'moved' from one area to another with no discussion or choice, demonstrating a task led process as opposed to a person centred approach to supporting people's choice and control about their care. Many people sat in one lounge area, in close proximity to one another, with only a small television for stimulation. There was little interaction between people. When staff brought people to the lounge, they helped them get seated and then returned to providing care to others waiting in their rooms. Those people remained in their rooms in the morning waiting beyond 11:30am for personal care to be provided. These people were unable to join others in the lounge because they needed assistance in washing and dressing, therefore their decision about how they spent their day had been made for them. People told us they wanted to be outside enjoying the garden and for two people, wanting to get their hands dirty and help with some gardening. This, however was not possible due to the condition of the garden and a lack of staff to facilitate people's wishes. We observed no engagement between staff that would support people's wellbeing, such as sitting and talking, laughing, singing or meaningful touch when people appeared low or upset.

Systems operated by the provider did not ensure peoples independence was maintained or they have choice and control over their own care and wellbeing. The provider told us that the activity co-ordinator resigned in March 2024. At the time of the assessment, they had not been replaced and the provider had not temporarily filled this position. The provider said they were not aware the activity staff had left. This meant people were without meaningful and appropriate engagement for over 4 months. People confirmed this to us through their feedback. The provider did not have an organisational approach to proactive engagement when supporting people. For example, people living with dementia, were left alone, some in their rooms, most in a communal lounge with no staff presence, no planned activity, communication or other stimulation. People were not always given choice in their routine’s dependent on staff availability and an order of when they received personal care. Care plans did not give enough details on how people would like to be supported and had not been updated for a number of months. People’s life history and interests had been documented, but staff did not support people to pursue these. Due to our concerns about staffing levels at the home, we were not assured that there would be sufficient staff to support people’s diverse needs effectively. The provider acknowledged that engagement and treating people as an individual had not been carried out. They said this was because they had no activity staff but did not realise the staffing pressures meant that care was task orientated and did not seek to meet people's holistic needs.

We did not look at Responding to people’s immediate needs during this assessment. The score for this quality statement is based on the previous rating for Caring.

We did not look at Workforce wellbeing and enablement during this assessment. The score for this quality statement is based on the previous rating for Caring.