CQC report explained · a residential care home
What the CQC found at Marlow
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
What inspectors found, September 2021
Marlow was rated Good; inspectors found safe, person-centred care, but noted recruitment pressures and no registered manager at the time.
This was an unannounced focused inspection on 6 August 2021. Inspectors looked only at Safe and Well-led, following up on safeguarding, incidents and whether lessons had been learned. They spoke with people, relatives, staff and a health professional, and checked care, medicines, recruitment and management records.
The home was rated Good for Safe and Good for Well-led. Inspectors found people were protected from abuse, risks were assessed, medicines were managed safely and there were enough staff to meet people's needs. The provider had systems for reporting incidents, learning from them and checking the quality of care.
The other three areas were not inspected during this visit. Their previous ratings were used when calculating the overall Good rating. The overall rating was unchanged from the previous inspection, which was published in September 2018.
Safeguarding
Staff understood how to recognise and report abuse. The provider had investigated concerns and used them to improve safeguarding practice.
“Staff could recognise signs of abuse and knew actions to take.” from the report
Managing health risks
People's individual risks were assessed and reviewed. Staff worked with health professionals to support complex needs, including epilepsy and feeding tubes.
“The service worked closely with medical professionals to review and manage specific health risks.” from the report
Medicines
Inspectors found medicines were stored and given safely. Records were clear and accurate, and staff had been trained and assessed as competent.
“Medicine Administration Records (MAR) were well organised, clear and completed accurately.” from the report
Person-centred culture
Inspectors found that staff understood people's individual needs and supported choice, independence and control over daily life.
“The needs and quality of life of people formed the basis of the culture at the service.” from the report
Leadership and oversight
Management checks covered care practice, incidents, the environment, infection control, care planning and nutrition. Staff morale was described as good.
“The provider had effective oversight systems which monitored the quality of the service, mitigated risks, and developed a plan which addressed actions.” from the report
Recruitment pressure
minorSome staff said the home needed more permanent staff and inspectors noted recruitment difficulties linked to the COVID-19 pandemic. Inspectors still found staffing levels were sufficient during the inspection.
“They are really struggling to recruit; however, I am really impressed by the dedication of the team who go out of their way to support people.” from the report
No registered manager
minorThere was no manager registered with the CQC when the inspection took place. The provider had an interim manager and said an application to become the registered manager had been made.
“The service did not have a manager registered with the Care Quality Commission.” from the report
- 01How many permanent staff currently work at the home, and are there still recruitment difficulties?
- 02Has the manager's application to become registered with the CQC been completed?
- 03What changes were made after the safeguarding concern that prompted this inspection?
- 04How are people's complex health risks, such as epilepsy or feeding tubes, managed and reviewed now?
- 05What were the latest ratings or findings for Effective, Caring and Responsive, which were not inspected during this visit?
This was a focused inspection of Safe and Well-led only; the other three key question ratings were not inspected and previous ratings were used for the overall rating. This explanation was written from the published report of 10 September 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, February 2021
Targeted inspection found enough staff and infection controls were in place; the service was inspected but not rated.
This was an unannounced, targeted inspection on 11 January 2021. It followed concerns about staffing levels and safe working practices during a Covid-19 outbreak.
Inspectors found enough staff to meet people's needs. Staff were moved from other locations when needed. The home had plans for staffing during the outbreak, and inspectors found that people received their personal care.
Inspectors were assured that infection controls were in place. This included use of protective equipment, testing, cleaning, social distancing and plans for managing an outbreak. People were isolating in their rooms and visitors were not visiting because of the outbreak.
The home was inspected but not rated. This was because the inspection only looked at specific concerns, not the whole Safe question or the other four questions. The previous overall rating was Good, published in September 2018, and this inspection did not change it.
Enough staff
Inspectors found enough staff on the premises to meet people's needs, including during the Covid-19 outbreak.
“We saw that there were enough staff to support people safely” from the report
Infection controls
The home had measures covering protective equipment, testing, hygiene, social distancing and outbreak management.
“We were assured that the provider was using personal protective equipment (PPE) effectively and safely.” from the report
Individual support
Staff understood people's needs and preferences and offered choices that reflected different communication needs.
“Staff were knowledgeable about people's individual needs and preferences.” from the report
Breaks during an outbreak
minorThe home's contingency plan allowed staff breaks to be interrupted if people needed support. Some staff also stayed at the home for several continuous days, so families may want to ask how staff wellbeing and safe staffing are balanced.
“Breaks taken by staff who were on duty were subject to operational need and could be interrupted if staff needed to provide support to people.” from the report
- 01How would you make sure there are enough staff if several staff are absent during an outbreak?
- 02How are staff breaks managed when people need support, and how do you avoid breaks being interrupted too often?
- 03What arrangements are currently in place for visits if there is an infection outbreak?
- 04How are residents supported while isolating in their rooms?
- 05How often are staff and residents tested during an outbreak, and how is protective equipment used?
This was a targeted inspection of specific concerns about staffing and infection prevention and control; it did not assess the whole Safe question or the other four key questions, and it did not change the previous ratings. This explanation was written from the published report of 10 February 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.
Every inspection of Marlow
2 rated inspections over 3 years: the service has held its Good rating throughout.
- September 2021Goodcurrent ratingSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- February 2021Inspected but not ratedSafe: Inspected but not rated
- September 2018GoodSafe: GoodWell-led: Good
- June 2017
Registered with the Care Quality Commission on 1 June 2017.
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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28 live-in carers within about an hour of West Sussex
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 £1,170 a week. 23 can care for a couple. 11 years' experience on average.
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.