CQC report explained · a nursing home
What the CQC found at Marlfield Care Home With Nursing
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, March 2022
Inspected but not rated; inspectors found infection controls, visiting arrangements and family contact support were in place.
This was a targeted, announced inspection on 7 February 2022. Inspectors gave the home one hour’s notice and focused on infection prevention, visiting arrangements and staffing pressures linked to COVID-19.
The inspectors were assured that the home was using protective equipment safely, managing testing, admitting people safely and keeping its infection control policy up to date. They also found that visiting followed government guidance, with booked visits and lateral flow testing.
The home supported people to stay in touch with relatives during lockdowns using iPads and other activities. Staff continuity was supported by redeploying workers from the provider’s day centres, with limited use of agency staff.
The service was inspected but not rated. This means the inspection did not give an overall rating or full ratings for the five areas of care.
Infection control
Inspectors were assured that the home had measures in place to reduce infection risks, including safe use of protective equipment, testing and an up-to-date policy.
“We were assured that the provider was using PPE effectively and safely.” from the report
Visiting arrangements
Relatives booked visits, completed lateral flow tests and were encouraged to become essential care givers so visits could continue during an outbreak.
“Relatives were encouraged to become essential care givers, to ensure people could continue to have visitors in the event of an outbreak.” from the report
Family contact
Staff helped people keep in touch with relatives during lockdowns through virtual contact and other activities.
“Staff supported people where possible to have virtual contact using the two iPads which were purchased.” from the report
Staff continuity
The home benefited from continuity in staffing and used few agency workers. Staff from the provider’s day centres were redeployed when those centres closed.
“People had benefited from continuity in staffing and the minimal use of agency staff.” from the report
Communication support
For people whose first language was not English, staff created pictorial communication books using words in the person’s first language.
“The books contained pictures of common items and issues the person wanted to communicate about, with the word in their first language.” from the report
Inspectors raised no specific concerns in this report.
- 01How are staffing pressures being managed now, and how much agency staff is currently being used?
- 02What are the current visiting arrangements, and can relatives still become essential care givers?
- 03How are people supported to keep in contact with their families if there is an infection outbreak?
- 04How will the reconfiguration to focus on people living with dementia affect the person’s care and accommodation?
- 05What are the home’s current ratings for the areas not covered by this targeted inspection?
This was a targeted inspection of infection prevention and control, visiting arrangements and COVID-19-related staffing pressures; the service was inspected but not rated and the other care areas were not assessed. This explanation was written from the published report of 2 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, January 2018
Rated Good overall; inspectors found kind, responsive care, but medicines management and some risk records still required improvement.
This was an unannounced inspection on 12 and 13 December 2017. Inspectors spoke with people living in the home, relatives and staff. They also observed care and checked care records, medicines, staffing, recruitment, training, incidents and management audits.
The home had improved its medicines management since the previous inspection in October 2016, but some problems remained. Guidance for medicines given when needed was not always detailed enough. Staff medicines competency checks were also not consistently completed. After one fall, the person's care plan and risk assessment had not been updated.
People generally said they felt safe and well cared for. Inspectors found kind and respectful staff, personalised care, activities, suitable staffing and effective management systems. The overall rating was Good, but Safe was rated Requires Improvement. Effective, Caring, Responsive and Well-led were all rated Good.
Kind and respectful care
People and relatives were positive about the staff. Inspectors observed compassionate interactions and found that privacy and dignity were respected.
“We observed kind and compassionate interactions.” from the report
Personalised support
Care plans included people's preferences, routines, communication needs and life histories. Staff knew people well and used this information when providing care.
“Each person had a care plan that was personal to them.” from the report
Activities and social contact
The home provided activities across seven days, including arts and crafts, games, church services and one-to-one conversations. Visitors were welcomed without restrictions.
“Activities were provided over seven days for people and staff told us this was varied.” from the report
Staffing and recruitment
Inspectors found enough staff to meet people's needs and saw that recruitment checks were completed. Call bells were answered promptly.
“Staffing levels and recruitment procedures reduced the risk of harm.” from the report
Support at the end of life
People's end-of-life wishes and preferences were recorded where they had chosen to discuss them. The home supported people to have comfortable and dignified care.
“People were supported at the end of their life to have a comfortable, dignified and pain-free death in accordance with their wishes.” from the report
Medicines given when needed
seriousGuidance for some medicines given when needed did not explain clearly enough when they should be used or what staff should try first. This included medicines for anxiety and pain.
“PRN protocols for the use of anti-anxiety medicines did not always describe the signs of agitation that people might display” from the report
Medicines competency checks
seriousChecks of some staff's ability to administer medicines were not completed consistently. Where problems had been found, there was no evidence of repeat checks to show they had been addressed.
“Issues relating to their competence had arisen during the assessments, however there was nothing in place to show how these issues had been fully addressed” from the report
Information after a fall
seriousInformation about one fall had not been added to the person's care plan or risk assessment. Inspectors said this could mean staff missed information about the risk of another fall.
“This meant staff may not have been made aware of the cause of the incident which increased the likelihood of it reoccurring.” from the report
Mental capacity records
needs fixingSome decision-specific capacity assessments and best-interest decisions had not been completed for equipment and restrictions such as bed rails and movement sensors. The home was given a recommendation to review its practice.
“we found some areas where capacity assessments had not been completed where required.” from the report
Communication guidance
needs fixingOne communication plan did not give staff enough detail about how to reassure the person when they showed behaviour that could challenge.
“one person's communication plan did not provide enough detail for staff on how to best communicate with the person.” from the report
- 01What changes have you made to the guidance for medicines given when needed, especially medicines for pain or anxiety?
- 02How do you check that every member of staff is competent to administer medicines, and what happens if a check identifies a problem?
- 03How quickly are falls and other incidents added to a person's care plan and risk assessment?
- 04How do you complete decision-specific mental capacity assessments and best-interest decisions for bed rails, movement sensors or other restrictions?
- 05How will you make sure each person's communication plan explains how staff should provide reassurance?
This was an unannounced comprehensive inspection covering all five key questions, with the previous medicines breach and the improvements made since October 2016 also reviewed. This explanation was written from the published report of 20 January 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 Marlfield Care Home With Nursing
2 rated inspections over a year: the service has improved, from Requires improvement to Good.
- March 2022Inspected but not ratedcurrent ratingSafe: Inspected but not rated
Read what inspectors found at Marlfield Care Home With Nursing →
- January 2018Goodup from Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
Read what inspectors found at Marlfield Care Home With Nursing →
- November 2016Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- June 2014
Report published without a new overall rating.
- July 2013
Report published without a new overall rating.
- January 2013
Report published without a new overall rating.
- June 2012
Report published without a new overall rating.
- January 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 10 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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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 £1,020 to £1,260 a week. 23 can care for a couple. 14 years' experience on average.
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