What the CQC found at Marillac Neurological Care Centre

Inspectors saw staff being gentle and attentive. People said their privacy, dignity and choices were respected.

“We saw staff being gentle, understanding and sensitive.” from the report

Staff had training for complex neurological care, including tracheostomy care, PEG feeding, pressure ulcer and continence care. People also had access to therapy and healthcare professionals.

“Specialist training in complex nursing tasks such as tracheostomy care, percutaneous endoscopic gastrostomy (PEG) feeding, pressure ulcer and continence care was also provided.” from the report

Care plans described people's medical, physical, therapeutic, emotional and social needs. Staff knew these plans and supported people to make choices and stay independent.

“People's care plans were detailed, regularly reviewed and updated.” from the report

The building was clean, spacious and adapted to people's needs. People could use accessible communal areas, gardens and woodland.

“All areas were clean, spacious, bright and welcoming.” from the report

The provider investigated incidents and concerns, recorded lessons and made changes. Inspectors saw examples of action being taken to improve safety and maintenance.

“The provider had taken on board and incorporated into their lessons learnt advice from the local authority and from CQC's focussed inspection to improve safeguarding and quality assurance processes.” from the report

Stock was not always checked and rotated, and one person missed four doses because an expired medicine was not identified. Medicine risk assessments and pain-monitoring records were also not always easy to find or complete.

“One person missed four doses of their prescribed medicine because staff had not checked the medicine had passed its expiry date and a supply could not be sourced in time.” from the report

Audits of medicines had not identified the issues found by inspectors. Therapy records were sometimes illegible, and regular therapy audits were not being completed.

“Quality audits of the management and administration of medicines were completed but had not identified the issues we found during the inspection.” from the report

The home had enough qualified staff on shift, but it relied on agency nursing staff because permanent recruitment was difficult. Some people, relatives and staff were concerned that agency workers did not always know people well.

“There was, however, a reliance on agency nursing staff as the director told us they were having difficulty recruiting to permanent posts.” from the report

Some therapy notes were hard to read. This could make it difficult to understand the treatment given and the outcomes achieved.

“Some of the therapeutic notes were hard to read due to handwriting being illegible.” from the report

Activities were available, but some people and relatives said there were not enough meaningful conversations or suitable activities for people with more complex needs.

“A family member told us, "[Relative] would benefit from more 1:1 attention, as their condition puts them at a disadvantage of getting contact with others.” from the report