CQC report explained · a residential care home
What the CQC found at Markham House
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Risks were identified and actions were taken to reduce them. Medicines were administered as prescribed, but the medicine store temperature was often above the recommended level, and staffing shortages sometimes affected people's social and rehabilitation needs.
- Effective?
- Good
- Staff had suitable training, induction and support. People received help with food, health care, therapy and making decisions in line with their choices and legal rights.
- Caring?
- Good
- Staff were caring and respectful. People were involved in decisions, and staff supported privacy, dignity, independence and personal goals.
- Responsive?
- Good
- Care plans were organised around people's needs, preferences and goals. Activities and community outings were available, but staffing shortages limited flexibility.
- Well-led?
- Requires improvement
- The manager identified some problems through audits, but the provider had not acted on them quickly enough and there were no expected completion dates. Staff felt supported and people had opportunities to give their views.
What inspectors found, August 2019
Rated Good overall; inspectors found kind, person-centred care, but leadership needed improvement.
This was an unannounced inspection by one inspector on 30 July 2019. Inspectors spoke with four people, five staff and three visiting professionals. They reviewed two people's care records, management records, training information and quality checks.
People were found to be safe, supported by trained staff and involved in their care. Care plans were clear and helped people build independence. Staff treated people with kindness, protected their privacy and supported their health, diet and communication needs.
There were problems with staffing levels, the kitchen and some storage areas. The medicine store was often above the recommended temperature. The manager knew about several of these issues, but the provider had not dealt with them quickly enough.
The home was rated Good overall and Good for Safe, Effective, Caring and Responsive. Well-led was rated Requires Improvement, which means the service's management and improvement systems were not consistently effective.
People felt safe
People told inspectors they felt safe. Staff had safeguarding training and knew what to do if abuse was suspected.
“People we spoke with told us they felt safe living at the home.” from the report
Support for independence
Care was focused on rehabilitation and helping people develop practical and cognitive skills. Support plans reflected people's preferences and goals.
“Support plans had been developed with people which ensured their preferences and diverse needs were met in all areas of their support.” from the report
Kind and respectful care
Staff supported people to make choices and maintained their privacy and dignity.
“We observed staff interacting with people and asking permission to enter their bedrooms and explaining why they needed access to their private space.” from the report
Staffing limited activities
needs fixingStaff said there were times when staffing was not enough for people's social and rehabilitation needs. This meant some community outings and flexible activities could not happen.
“Staff we spoke with told us there were times when there were not enough staff working with them to meet people's social and rehabilitation needs.” from the report
Kitchen and cleanliness
needs fixingInspectors found the kitchen was worn and dirty, with food debris and a freezer needing defrosting. Cleaning and defrosting were addressed after the inspection, but kitchen repairs had no planned completion date.
“The main kitchen area was worn, and very old and dirt/food debris was embedded in to the wooden cupboards.” from the report
Medicine store temperature
needs fixingThe medicine store temperature was often above the recommended level and also affected the medicine fridge. The manager began considering solutions during the inspection.
“The temperature recorded was very often recorded as being above the recommended temperature for storing medicines.” from the report
Slow action on known problems
needs fixingThe manager's audits had identified some concerns, but the provider had not acted promptly and had not set dates for completing the work.
“However, the provider had not taken timely action to ensure the concerns were acted upon.” from the report
- 01How many staff are usually available for community outings, rehabilitation and social activities, and what happens when staffing is low?
- 02What work has been completed on the kitchen and storage areas since the inspection, and what work remains?
- 03How is the medicine store and medicine fridge temperature checked now, and what action is taken if it is too high?
- 04What dates were set for completing the improvements identified through the manager's audits?
- 05How will you make sure people continue to be involved in setting and reviewing their rehabilitation goals?
This was an unannounced inspection covering all five CQC questions, including the care provided and the home itself. This explanation was written from the published report of 30 August 2019 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, November 2016
Rated Good; inspectors found safe, kind and personalised care, but some important records and follow-up actions were incomplete.
This was an unannounced inspection on 19 October 2016. Inspectors observed care, spoke with six people, two relatives and staff, and reviewed care records, staff files, medicines records and management information.
The home supported up to 13 people with an acquired brain injury. Its focus was rehabilitation and reablement, helping people build practical and thinking skills and become more independent. Inspectors found Good ratings for Safe, Effective, Caring, Responsive and Well-led.
People and relatives said people felt safe and were treated kindly and with dignity. Staff understood risks, safeguarding and medicines. Care plans were personalised and health needs were supported. However, some best-interest decisions, one-to-one support, complaints outcomes and quality-audit actions were not fully recorded.
People felt safe
People and relatives said they felt safe. Staff understood safeguarding and the risks linked to people's conditions.
“People told us they felt safe living at Markham House.” from the report
Kind and respectful care
Inspectors saw positive relationships between staff and people. Privacy, dignity and personal choices were respected.
“We could see staff had developed positive and caring relationships with people and were supporting them in a kind and caring way.” from the report
Support for independence
The home used rehabilitation and reablement to help people regain skills and become more independent. Support plans were personal and included people's goals and preferences.
“People were supported and encouraged through the reablement process so they could be as independent as possible.” from the report
Safe medicines and recruitment
Medicines records were complete at the inspection, and recruitment checks included references and DBS checks.
“Medicines were stored and administered safely and accurate records were maintained.” from the report
Access to specialist support
People could access health professionals, including occupational therapy and physiotherapy. A therapy co-ordinator had been introduced to improve how therapy advice was passed to staff.
“Specialist health support was provided, including occupational therapy and physiotherapy, which was funded by the provider.” from the report
Best-interest decisions were not always recorded
seriousThe report found that some decisions made for people were not supported by the required best-interest assessments. This meant decisions were taken without the appropriate recorded authorisation.
“Not all the necessary best interest assessments had been carried out for people and action taken in line with those assessments.” from the report
Staff supervision was not frequent enough
needs fixingStaff supervision meetings did not always happen as often as the home's policy required. Inspectors said this could affect how well staff carried out their roles.
“However, we saw that supervisions were not held as frequently as the policy required.” from the report
One-to-one time was not clearly recorded
needs fixingOne person said they did not receive all their one-to-one hours. Records did not always show how this time was spent, so inspectors could not confirm that commissioned support had been delivered.
“As a result we were unable to confirm whether people received the care as it was commissioned.” from the report
Quality checks lacked action records
needs fixingThe home carried out audits, but records did not show what action was taken when they found a shortfall. The registered manager said this would be improved.
“There was no detail or evidence about what action had been taken when a lack of quality was identified in the audits.” from the report
Some requests were not followed up promptly
minorSome resident suggestions, including a flower-arranging course and lighting in the smoking shelter, had not been provided or completed. The report also noted that complaint outcomes were not recorded in writing.
“However, we found that these suggestions had not always been acted on in a timely way.” from the report
- 01How do you now make sure every required best-interest assessment is completed and recorded?
- 02How do you record each person's one-to-one hours and the activities completed during that time?
- 03How often do staff receive supervision, and how do you check that this follows your policy?
- 04When an audit finds a problem, where can families see what action was taken and whether it was completed?
- 05How are residents' requests and complaints recorded, answered and followed up?
This was an unannounced comprehensive inspection covering all five key questions and the overall rating. This explanation was written from the published report of 29 November 2016 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 Markham House
2 rated inspections over 3 years: the service has held its Good rating throughout.
- August 2019Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- November 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- June 2014
Registered with the Care Quality Commission on 30 June 2014.
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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62 live-in carers within about an hour of Derbyshire
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £1,010 to £1,260 a week. 51 can care for a couple. 12 years' experience on average.
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