Archived: The Marillac Neurological Care Centre

The 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. At the time of the inspection 52 people were living in the service.

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

Risks relating to people’s wound and pressure care needs had been assessed. The provider had documentation in place to monitor the management of wounds and changes in people’s needs had been highlighted and acted upon.

People were protected from the risk of infection. The provider had processes in place to assess and monitor infection prevention and control risks in the service.

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 02 May 2017)

Why we inspected

We undertook this targeted inspection to check on a specific concern we had about the management of people’s wound and pressure care. The overall rating for the service has not changed following this targeted inspection and remains Good.

CQC have introduced targeted inspections to follow up on Warning Notices or to check specific concerns. They do not look at an entire key question, only the part of the key question we are specifically concerned about. Targeted inspections do not change the rating from the previous inspection. This is because they do not assess all areas of a key question.

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.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

The Marillac is a nursing home that provides accommodation, nursing and rehabilitation support for up to 52 people with complex physical and sensory disabilities. On the day of our inspection there were 51 people using the service.

The service had a registered manager in post. 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.

At this inspection we found risks were managed safely as there had been improvements made in how information around risk was recorded and shared. Staff demonstrated a good awareness of the risks to people and knew how to manage these safely.

The provider had systems in place to manage medicines and people were supported to take their prescribed medicines safely.

There were sufficient staff employed who had been recruited safely and who had the skills and knowledge to provide care and support that met people’s needs and preferences.

Staff were aware of their whistle-blowing and safeguarding responsibilities. They knew the signs to look for that might indicate that people were being abused and who to report any concerns to.

Staff received regular supervision and support from the management team which provided an effective method of assessing staff competency and promoting learning and development.

People were involved in making decisions about the care and support they received. Where people experienced difficulties with decision-making, they were supported by staff who were aware of their responsibilities under the Mental Capacity Act (2005) legislation.

The service was meeting the requirements of the Deprivation of Liberty Safeguards (DoLS), making applications when necessary.

People had access to food & drink that they enjoyed which matched their preferences and met any health needs.

The service supported people to maintain their health as they had access to a wide range of healthcare professionals.

Staff respected people’s privacy and choices and treated people with kindness and respect.

People were encouraged to be independent and take part in interests they enjoyed.

The service supported people to maintain relationships with friends and family and links with their community so that they were not socially isolated.

Robust quality assurance systems were now in place which meant that the service was effectively monitoring the quality and safety of the service and driving improvements.

There was an open culture and the provider encouraged and supported staff to provide care that was centred on the individual.

The Marillac is a nursing home that provides accommodation, nursing and rehabilitation support for up to 52 people with complex physical and sensory disabilities. On the day of our inspection there were 50 people using the service.

The service had a registered manager in post. 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.

Risk was not consistently well managed due to poor recording practices which meant that information held in peoples’ care plans was not always up to date and did not always reflect their current needs.

There were systems in place to monitor the quality and safety of the service however these systems had not always picked up on areas of concern.

There were suitable arrangements in place for medicines to be stored and administered safely, however the management of topical creams required improvement.

There were sufficient numbers of staff with the relevant skills and knowledge to effectively meet people’s needs.

Where people experienced difficulties with decision-making, they were supported appropriately in accordance with current legislation.

The service was meeting the requirements of the Deprivation of Liberty Safeguards (DoLs). Appropriate mental capacity assessments and best interest decisions had been undertaken. This ensured that any decisions taken on behalf of people were in accordance with the Mental Capacity Act (MCA) 2005, DoLs and associated codes of practice.

People were supported to maintain their health as had regular access to wide range of healthcare professionals. A choice of food and drink was available that reflected peoples nutritional needs, and took into account their preferences and any health requirements.

Staff had positive relationships with people who used the services. People’s privacy and dignity was respected at all times and people were treated with kindness and respect.

Care was personalised and met people's individual needs and preferences. People, or their representatives, where appropriate, were involved in making decisions about their care and support and felt listened to and included.

People were encouraged to follow their interests including religious practices and beliefs as well as activities they enjoyed and were supported to keep in contact with their family and friends.

The service responded appropriately to complaints and feedback from people who used the service.

There was a registered manager in post who encouraged an open culture and was approachable . Staff enjoyed working at the service and felt that they were included in the running of the home and that their views were valued.

We looked at the care records for three people who used the service. We found that people's care needs were assessed and monitored and they received care that met their needs. People's medicines were safely managed.

There were arrangements in place to minimise the risk of abuse or harm to people who used the service. People told us they felt safe at The Marillac. Effective systems were also in place to reduce the risk of infection.

People were supported by enough staff to meet their needs. We found that the staff team was well organised and effectively led to ensure people who used the service received the care they needed. A person who used the service told us, 'There are enough staff. You cannot legislate for good care. The staff themselves have to be caring people. Carers here have a graciousness about them. They are perfectly free of any gender bias. Male and female staff are equally caring. They all apply their skills and particular talents to their caring role.'

People were protected against the risks associated with medicines because the provider had improved arrangements in place to manage medicines.

People told us that their opinions were always sought, they were involved in decision making and they had choices available. People who used the service said that they were given dignity and respect at all times during their personal care, while they were being assisted to move and at meal times.

We found that robust recruitment procedures were in place and staff were given training. People told us that staff were skilled and looked after them well. One person said, "The staff are marvellous here and give so much warmth to my family member.' Another person said, 'The nurses know what they are doing here.'

We found that medicines were not safely managed for the protection and wellbeing of people who used the service. We found that records were not accurate and medicines were not securely stored or in an appropriate environment. The management team of The Marillac confirmed that the concerns would be addressed promptly.