The Martlets

Updated 22 May 2021

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 Care Act 2014.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by three inspectors who undertook an on-site visit.

The Martlets is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The home did not have a manager who was registered with the Care Quality Commission. The service had a new manager who had recently started working at the home having moved from another of the providers services. They had started the process to become registered manager at the Martlets. Until the new manager is registered, the provider is legally responsible for how the home is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the home since the last inspection. This included the monthly reports submitted by the provider in accordance with the conditions imposed on their registration. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We used all of this information to plan our inspection.

During the inspection

We spoke with eight people that used the service during and after the inspection to gain their views about their experience of care provided. We spoke with 13 members of staff including the manager, deputy manager, quality improvement manager, clinical lead, registered nurse, team leaders, carers, administrative staff and chef. We reviewed a range of records. This included 11 people’s care records and multiple medication records. We looked at two staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection

We spoke with another two staff members and five relatives about their experience of care provided. We received feedback from two healthcare professionals who had regular contact with the service.

We continued to seek clarification from the provider to validate evidence found and reviewed training data and quality assurance records.

Updated 22 May 2021

About the service

The Martlets situated in East Preston, West Sussex. It is one of a group of homes owned by a national provider, Shaw Healthcare Limited. It is a residential 'care home' providing care for up to 60 people who may be living with dementia, physical disabilities, older age or frailty as well as up to 20 people who may require nursing care. At the time of inspection there were 48 people living at the home.

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

Since our last inspection the provider had continued to receive support from the local authority and external healthcare professionals to improve the care people received and the overall governance of the service. At this inspection we found that significant improvements had been made to ensure that the risks identified during the last inspection were addressed. It was evident that the manager and staff had worked hard to raise standards and improve people’s care. Feedback from people, their relatives and professionals confirmed this.

Some improvements were still needed with regard to the providers understanding and implementation of the Mental Capacity Act. This meant that people were not always supported to have maximum choice and control of their lives, and staff did not always support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not always support this practice.

People told us they felt safe and were cared for by a consistent team of staff who knew them well. Significant improvements had been made to ensure that people received safe care and were protected from avoidable harm. When incidents or accidents had occurred, appropriate investigations were carried out and actions taken to reduce the risk of reoccurrence. Medicines were managed safely and given in accordance with prescriber’s instructions and care recommended by healthcare professionals was implemented and recorded appropriately. Staff had received training in infection prevention and control (IPC) and IPC practice within the home was in line with current guidance.

Staff were recruited safely and had the skills, training and competence to provide safe and effective care. The manager had recently recruited staff who received a comprehensive induction and were assessed as competent before supporting people. Agency staff had received the same training and were also assessed as competent before commencing work. Staff received regular supervision which provided opportunity for feedback, focused on their strengths and identified areas for development.

The culture of the service was positive, person-centred and promoted good outcomes for people. People told us they enjoyed a range of activities which considered their emotional and social needs, and they were treated with kindness and respect. Our observations of staff engaging with people confirmed this.

The provider had reviewed and revised their quality assurance systems which had improved oversight of the care and support people received. People and their relatives told us they received regular updates about the service and any changes required as a result of Covid-19. The manager provided leadership for the staff who felt valued, supported and part of a team.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last overall rating for this service was ‘Inadequate’ (report published 14 January 2021). The home had failed to make enough improvements to meet the requirements of the warning notice and remained in breach of multiple regulations. The home was placed in special measures and the provider served a notice to impose conditions on their registration. The provider was required to submit monthly reports to CQC to demonstrate what actions they were taking to improve, by when, and how this would be monitored. The home was required to make significant improvements within a six-month time frame to prevent us taking action in line with our enforcement procedures and starting the process of cancelling their registration.

At this inspection enough improvements had been made and the provider was no longer in breach of regulation 12 (safe care and treatment), regulation 18 (staffing) and regulation 17 (good governance).

Why we inspected

We undertook this unannounced, focused inspection on 8 April 2021 to check the provider had complied with the conditions imposed on their registration. We also needed to ensure that actions submitted in their monthly reports were embedded and confirm they now met legal requirements.

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.

The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has changed from ‘Inadequate’ to ‘Requires Improvement’. This is based on the findings at this inspection. As a result of these findings, the home is no longer in special measures.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for The Martlets on our website at www.cqc.org.uk.