CQC report explained · a nursing home
What the CQC found at Marian House Nursing Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found safeguarding systems, enough staff, safe recruitment, individual risk assessments and safe medicines management. Infection control arrangements were also found to be in place.
- Effective?
- Good
- This area was not inspected during this focused visit. Its previous rating was used in calculating the overall rating.
- Caring?
- Good
- This area was not inspected during this focused visit. Its previous rating was used in calculating the overall rating.
- Responsive?
- Good
- This area was not inspected during this focused visit. Its previous rating was used in calculating the overall rating.
- Well-led?
- Good
- Inspectors found effective checks on quality, staff training and competence, and legal reporting. People, relatives and staff said the home was well managed and that their views were heard.
What inspectors found, April 2021
Rated Good; inspectors found safe, well-managed care and no evidence that the safeguarding concern had put people at risk.
This was an unannounced, focused inspection on 4 March 2021. Inspectors looked at Safe and Well-led after concerns about how safeguarding incidents were managed. They spoke with people, relatives and staff, observed care, and checked care records, medicines, staffing, incidents and quality checks.
The home was rated Good for Safe and Well-led. Inspectors found safeguarding systems, enough staff, safe recruitment, suitable risk assessments and safe medicines processes. Infection prevention arrangements were also in place.
People and relatives spoke positively about the care and management. Staff said they felt supported and able to raise concerns. Inspectors found no evidence that people were at risk of harm from the safeguarding concern that led to the inspection.
Safeguarding systems
Staff understood different types of abuse and knew how to report concerns. Inspectors found systems to protect people from avoidable harm.
“The provider had safeguarding systems in place and staff had a good understanding of what to do to make sure people were protected from avoidable harm or abuse.” from the report
Enough trained staff
There were enough staff to meet people's needs. Recruitment checks were completed, and staff training and competence were checked regularly.
“There were sufficient numbers of staff to meet people's needs.” from the report
Safe medicines
People received medicines as prescribed. Staff were trained, their competence was checked, and medicines were audited each month.
“Medicines were managed to ensure people received them safely and in accordance with their health needs and the prescriber's instructions.” from the report
Learning from falls
The manager investigated an increase in falls and introduced changes intended to reduce them, including improving information gathered before admission.
“Recommendations were implemented to reduce the number of falls such as amending pre admission paperwork to capture more details of people's needs.” from the report
Positive staff culture
Staff said they felt valued, supported and able to speak with managers. The report says their views were encouraged through team meetings.
“Staff told us they felt valued and their views were respected.” from the report
Inspectors raised no specific concerns in this report.
- 01How are safeguarding incidents currently reviewed, and how do you make sure any lessons are acted on?
- 02What changes were made after the reported increase in falls, and have these changes reduced falls?
- 03How often are medicines audits completed, and what happens when an error or concern is found?
- 04How do you check that infection prevention arrangements remain effective?
- 05Has the annual satisfaction survey mentioned in the report been issued, and what changes followed from people's feedback?
This was a focused inspection of Safe and Well-led only; Effective, Caring and Responsive were not inspected and their previous ratings were used in calculating the overall rating. This explanation was written from the published report of 7 April 2021 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, March 2018
Rated Good; inspectors found significant improvements since the previous inspection, with safe, effective, caring and well-managed care.
Inspectors visited on 8 and 9 February 2018. The first visit was unannounced and the second was announced. They spoke with people living in the home, relatives, staff and a healthcare professional. They also reviewed care records, medicines records, recruitment files, incident records and quality checks.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough suitably trained staff, safer medicines management, personalised care records and respectful relationships. People were supported with food, health needs, activities, communication and end of life care.
The previous inspection in February 2017 rated the service Requires Improvement overall. Inspectors said significant improvements had been made, especially in record keeping, care planning, staffing arrangements, caring practice and management checks.
Safer care and records
Care monitoring records were being completed more consistently, including records about repositioning. Managers had strengthened checks of records and staff practice.
“The management team had strengthened their regular checks of people's records and observations of staff practices which had helped to achieve more consistency in people's monitoring records being completed.” from the report
Kind and respectful staff
People and relatives described staff as caring. Inspectors saw patient, respectful support that took account of people's choices, privacy and dignity.
“Staff communicated with people in a friendly yet respectful way.” from the report
Personalised activities
The home offered activities such as music, reminiscence, gentle exercise, painting and quizzes. Staff recorded people's enjoyment so activities could be matched to their interests.
“We saw there were a variety of social and leisure activities, including music, reminiscence, gentle exercises and painting which were led by two dedicated staff members.” from the report
Good end of life support
People and families were involved in decisions about end of life care. Staff aimed to provide comfort, dignity and support for relatives as well as the person.
“We saw people who lived at the home and their relatives where appropriate had been consulted about how they wanted to be supported at the end of their life to make sure they had a comfortable, dignified and pain-free death.” from the report
Improved management checks
The management team had introduced stronger systems to monitor care, learn from incidents and improve staff practice. This was a major reason the overall rating improved from Requires Improvement to Good.
“The registered manager had made every effort to bring about the improvements required and had done this by effectively developing and regularly assessing and monitoring the quality of care.” from the report
Activities were still developing
minorInspectors found activities had improved but were still being developed to meet people's individual interests more fully.
“There were on-going developments in offering people things to do for fun and interest which met their particular needs.” from the report
Comfort of hoist slings
minorThe registered manager had not yet checked with people whether their individual hoist slings were comfortable. The manager said this would now be done.
“The registered manager had not thought to check with people if their individual slings were comfortable since these had been purchased and openly confirmed this to us.” from the report
- 01What checks are now made to confirm that each person's hoist sling remains comfortable and suitable?
- 02How have activities been developed since the inspection to reflect each person's interests, abilities and needs?
- 03How do you make sure the improvements in care records and monitoring have been maintained?
- 04How are staffing levels reviewed when people's needs change or staff are absent?
- 05How are families involved in decisions about end of life care and changes in health needs?
This was a comprehensive inspection covering all five key questions, including the premises and care provided; the report also compared findings with the previous inspection in February 2017. This explanation was written from the published report of 10 March 2018 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Marian House Nursing Home
4 rated inspections over 4 years: the service has improved, from Inadequate to Good.
- April 2021Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- March 2018Goodup from Requires improvementSafe: GoodWell-led: Good
- May 2017Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- January 2017Inspected but not ratedSafe: Inspected but not ratedEffective: Inspected but not rated
- November 2016InadequateSafe: Requires improvementEffective: InadequateCaring: InadequateResponsive: Requires improvementWell-led: Inadequate
- August 2013
Report published without a new overall rating.
- November 2012
Report published without a new overall rating.
- December 2011
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 26 January 2011.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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