CQC report explained · a nursing home
What the CQC found at Marie Louise House Nursing Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found that risks, falls, medicines, staffing, recruitment and infection control were managed safely. They noted that evidence of equipment checks was not always filed in an organised way.
- Effective?
- Good
- This question was not inspected during this focused visit. Its previous rating was used in calculating the overall rating.
- Caring?
- Good
- This question was not inspected during this focused visit. Its previous rating was used in calculating the overall rating.
- Responsive?
- Good
- This question was not inspected during this focused visit. Its previous rating was used in calculating the overall rating.
- Well-led?
- Good
- Inspectors found positive leadership, staff support and systems for listening to people, relatives and staff. The management team used feedback and checks to plan improvements.
What inspectors found, March 2022
Marie Louise House Nursing Home is rated Good; inspectors found safe care and stronger leadership, with only minor record-filing concerns.
This was an unannounced focused inspection. Inspectors visited on 31 January and 3 February 2022, spoke with people, relatives and staff, and checked care records, medicines, recruitment files, training and quality records.
The home was rated Good overall. Safe and Well-led were both rated Good. Inspectors found that people felt safe, medicines were managed safely, staffing levels were suitable, infection controls were followed and risks were monitored.
The previous inspection had rated the service Requires Improvement and found a breach relating to safe care and treatment. This inspection found enough improvement, so the provider was no longer in breach. The overall rating also used ratings for the other questions from the previous inspection because they were not reviewed this time.
People felt safe
People and relatives said they felt safe and liked living at the home. Staff understood how to recognise and report abuse.
“People and their relatives told us they felt safe and liked living at the home.” from the report
Safe medicines
Inspectors found that people received the right medicines at the right time. Staff were trained and assessed as competent.
“People received the correct medicines at the right time.” from the report
Suitable staffing
Inspectors saw safe staffing levels and staff who were responsive and not rushed. Recruitment checks were also in place.
“We observed safe staffing levels throughout the inspection and staff appeared unhurried and responsive to people.” from the report
Learning from incidents
The home investigated accidents and incidents, looked for patterns and used meetings to identify improvements.
“Where an incident or accident had occurred, the provider had robust procedures in place to investigate the cause, learn lessons and take remedial action to prevent a recurrence.” from the report
Open management
Staff said they were listened to and supported. People, relatives and staff were involved in suggesting improvements.
“There were a number of systems and processes in place for monitoring the quality of care and to plan improvements.” from the report
Equipment records were not well organised
minorInspectors saw that evidence of equipment checks and servicing was not always filed in an organised way. This made it harder for the provider to produce the information quickly, although the home had already identified the issue and was working on it.
“However, we did observe the evidence of these checks and services were not always filed in an organised way which made it difficult for the provider to produce the information easily.” from the report
- 01How have you improved the filing of equipment check and servicing records since the inspection?
- 02What was the home’s previous action plan for falls and medicines, and how do you check that the improvements are still working?
- 03What are the current ratings for Effective, Caring and Responsive, which were not assessed during this visit?
- 04How will you monitor staffing levels if agency staff are needed?
- 05How are relatives involved in care plan reviews and told about changes or incidents affecting their family member?
This was a focused inspection of Safe and Well-led, including infection control; the ratings for Effective, Caring and Responsive carried over from the previous inspection. This explanation was written from the published report of 22 March 2022 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, September 2020
Marie Louise House Nursing Home is rated Requires Improvement; inspectors found unsafe medicines and falls records, although care was effective in several areas.
Inspectors visited on 18 and 20 August 2020. They spoke with people, relatives, staff and healthcare professionals. They also checked care plans, medicines records, falls records, training and the home's quality checks.
The home was not always safe. Medicines were sometimes given late, drug keys were left unsecured, and falls were not always properly investigated or recorded. Staff deployment and meaningful activities also needed improvement. Infection control training was incomplete and people were observed sitting too close together in communal areas.
The home was rated Good for Effective. Inspectors found good support with eating, drinking, pain, healthcare appointments and staff training. The home was rated Requires Improvement for Safe and Well-led. Its overall rating fell from Good at the previous inspection in March 2018.
Protection from abuse
Staff understood how to recognise and report possible abuse. People and relatives generally said they felt safe.
“The service had taken appropriate steps to protect people from the risk of abuse.” from the report
Food and drink
People were offered regular drinks and snacks. Meals were adapted to medical needs and personal preferences.
“Menus were personalised to people's needs and preferences and people received a balanced diet.” from the report
Healthcare support
The home worked with GPs, dentists, opticians, specialists and other professionals to meet people's needs.
“Staff worked well with healthcare professionals to ensure people's healthcare needs were met effectively and consistently.” from the report
Open management
Managers accepted the inspection feedback and continued to provide information about improvements after the visit.
“The management team of the service were open, honest and had worked hard to develop robust systems to ensure people remained safe.” from the report
Medicines
seriousSome medicines were given late, which increased the risk of pain and worsening Parkinson's symptoms. Drug trolley keys were also left accessible.
“Medicines were not always administered at the correct times.” from the report
Falls management
seriousSome falls were not followed by proper checks, investigation or updates to risk assessments. Records did not always show that people's welfare had been monitored.
“People were not protected from the risks associated with falls.” from the report
Staffing and activities
needs fixingFeedback did not consistently show that staffing was safe or sufficient. Staff said people were often bored and activities were not frequently available.
“We could not be assured the deployment of staff was safe or suitable to regularly engage people in meaningful activity.” from the report
Infection control training
needs fixingNot all staff had completed up-to-date infection control training. Compliance was 76.83% during the inspection and later rose to 88%.
“Not all staff had received appropriate training in relation to infection control.” from the report
Care records
needs fixingRecords about skin care, medicines and falls were not always accurate or clear enough to guide staff.
“We found documentation relating skin integrity, the management of medicines and falls was not always recorded accurately, and at times did not provide useful guidance.” from the report
- 01How are you making sure medicines are given at the correct times, especially overnight and in the morning?
- 02How are drug trolley keys kept secure during medicines rounds?
- 03What happens after a resident falls, and how do you make sure their care plan and risk assessment are updated?
- 04How many staff are currently working on each shift, especially in the dementia area, and what activities are available each day?
- 05How many staff have completed infection prevention and control training now?
This inspection examined the concerns received about catheter care, falls, pain, nutrition and hydration, and reported ratings for Safe, Effective and Well-led; Caring and Responsive ratings were not given in the report. This explanation was written from the published report of 29 September 2020 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 Marie Louise House Nursing Home
6 rated inspections over 7 years: the service has improved, from Requires improvement to Good.
- March 2022Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
Read what inspectors found at Marie Louise House Nursing Home →
- September 2020Requires improvementdown from GoodSafe: Requires improvementWell-led: Requires improvement
Read what inspectors found at Marie Louise House Nursing Home →
- May 2018Goodstayed GoodSafe: GoodEffective: GoodWell-led: Good
- January 2016Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Good
- May 2015Requires improvementstayed Requires improvementResponsive: Requires improvement
- April 2015Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- July 2014
Report published without a new overall rating.
- October 2013
Report published without a new overall rating.
- February 2013
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 17 December 2010.
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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