The Marbrook Centre

Updated 20 January 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. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide 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. One inspector did not attend the site visit but undertook telephone calls to relatives and staff.

Service and service type

The Marbrook Centre is a care home. People in care homes receive accommodation and personal care as a single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager registered with the Care Quality Commission. The previous registered manager left in March 2020. This means the registered manager and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

The inspection was announced prior to us entering the home, so we could ensure that measures were in place to support an inspection and manage any infection control risks. The provider was not aware of our inspection prior to our visit on 17 December 2020.

What we did before the inspection

Prior to our inspection we reviewed and analysed the information we held about this service. This included reviewing statutory notifications the service had sent us. A notification is information about important events which the provider is required to send us by law. We also viewed the information sent to us by stakeholders. Feedback was requested from the local authority quality assurance and safeguarding teams.

We did not request a PIR for this inspection. A Provider Information Return (PIR) is key information providers are requested to send us on their service, what they do well and improvements they plan to make. This information helps support our inspections.

During the inspection

We spoke with six people who used the service, the registered manager, a service manager and spoke with five staff. We reviewed the medicines administration records (MARs).

After our inspection

We asked the provider for further documents and these were received within the requested timescale. We looked at three people’s care plans and associated risk assessments. We also reviewed, infection prevention and control policies and other records associated with the management of the service. We spoke with eight relatives and we sought information from three professionals. In addition, we spoke with ten staff including, nursing staff, senior care staff, care staff and members of the IT and housekeeping teams.

Updated 20 January 2021

About the service

The Marbrook Centre is a care home with nursing. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. The Care Quality

Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection. The Marbrook Centre delivers a service to up to 81 people.

The home is built on three floors: each floor can be divided into two separate units or used as one unit. Each unit has single bedrooms with ensuite facilities and shared lounge/dining/kitchenette areas. Each floor provides a service to people with specific issues. Mayfield (top floor) accommodates people living with dementia; Bray (middle floor) accommodates people with long-term rehabilitation and complex nursing needs; and Eden (ground floor) accommodates people with acquired brain injury, including stroke, who are funded for a short period of intensive rehabilitation.

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

People were safeguarded from harm by staff who were trained and knowledgeable about identifying and reporting any potential abuse. One relative told us how much difference it had made to their family member having enough skilled staff. Medicines were administered and managed safely.

Risks to people were identified and managed well. There were enough staff, who had been safely recruited and met people’s needs. Lessons were learned when things went wrong.

Medicines were managed safely, and the service had improved the processes for monitoring the administration of medicines. Care records were accurate and reflected the needs of people. Risk assessments were in place to help keep people safe.

Staff followed infection prevention and control policies. Due to the pandemic, additional processes and steps were taken by staff to keep people safe. Relatives told us that the service had actively engaged with them and they were assured that people were well looked after.

There were quality and assurance systems in place. The registered manager worked with the provider to monitor the safety and quality of care provided to people. Staff worked with other healthcare professionals to make sure people had the correct support they needed.

Staffing levels were appropriate to support people. There continued to be a robust recruitment process in place.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

The provider had ensured we were notified about events such as safeguarding. Audits in place were effective in identifying and driving improvements. People were involved in how the service was run. The provider worked well with others involved in people's care and support.

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 23 June 2018).

Why we inspected

We undertook a focused inspection to review the key questions of safe and well-led. This was because we received concerns in relation to the safety of people living in the service. Several safeguarding concerns had been raised with the local authority in relation to poor care. A decision was made for us to inspect and examine those risks. This report only covers our findings in relation to the key questions safe and well-led which contain those requirements.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

We found no evidence during this inspection that people were at risk of harm from these concerns. The provider had acted on safeguarding allegations and other concerns to help prevent the potential harm and risk of occurrences.

Please see the safe and well-led sections of this full report. The overall rating for the service has not changed from good overall but the safe domain has improved to good. This is based on the findings at this inspection.

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

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.