CQC report explained · a residential care home
What the CQC found at Marmora Care Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found enough staff, safer medicines systems, suitable safeguarding arrangements and improved risk assessments. They also found some unsecured wardrobes and wet mops left in buckets, although action was taken during the inspection.
- Effective?
- Good
- Staff training, supervision and support had improved. People received support with food, fluids and health needs, and staff understood mental capacity requirements.
- Caring?
- Good
- People and relatives described staff as kind and caring. Inspectors saw that privacy, dignity, independence, communication and personal preferences were respected.
- Responsive?
- Good
- Care plans gave staff detailed guidance and activities had improved. Complaints were investigated and dealt with appropriately, although records of end of life wishes could have been more complete.
- Well-led?
- Good
- Management oversight, audits and action plans had improved. People, relatives and staff were involved in the running of the home and gave positive feedback about the improvements.
What inspectors found, September 2018
Marmora Care Home was rated Good; inspectors found major improvements, with a few minor safety and maintenance issues still needing attention.
This was an unannounced inspection on 7 and 16 August 2018. Inspectors reviewed care records, staff recruitment files, management records and quality checks. They spoke with people living in the home, relatives, staff and a professional.
The home had improved substantially since the previous inspection in September 2017. Medicines, staffing, safeguarding, risk assessments, staff training and management checks had all improved. The home was compliant with the regulations at this inspection.
Inspectors rated all five areas Good: Safe, Effective, Caring, Responsive and Well-led. This means the inspectors found the care to be good overall, but it does not mean that every aspect was perfect.
Improved management
Inspectors found that management oversight had improved and that the management team acted on concerns and monitored the quality of care.
“Systems and processes had been implemented to monitor and improve the quality and safety of the service provided.” from the report
Kind and respectful care
Staff were described as kind and caring. Inspectors found that people’s privacy, dignity, independence and personal preferences were respected.
“People's privacy and dignity was respected and promoted.” from the report
Safe medicines and staffing
Medicines were managed safely and there were enough staff to meet people’s needs in a timely way.
“Medicines were now managed safely and people received their medicines as required and prescribed.” from the report
Personalised activities
People were offered a range of activities, including gardening, games, outings and reminiscence activities. Support was adapted to individual interests and needs.
“Opportunities to participate in activities had significantly improved since the last inspection and people were encouraged to be as active as possible.” from the report
Unsecured wardrobes
needs fixingSome bedroom wardrobes were not secure and items had been stored on top. Inspectors said this could create a risk of a wardrobe toppling over.
“However, in some bedrooms, the wardrobes were not secure and items were stored on top which could result in the wardrobe toppling over if someone tried to reach up.” from the report
Wet mops
minorWet mops had been left in buckets instead of being left to air dry. The manager dealt with this immediately.
“However, wet mops had been left in buckets and were not air drying.” from the report
Areas needing maintenance
minorSome sink sealant had come away and one bathroom had a broken radiator cover, cracked tiles and a stained floor. The manager said these issues would be addressed.
“However, some areas required maintenance.” from the report
- 01What has been done to secure the wardrobes, and how do you check that bedroom furniture remains safe?
- 02What action was taken to improve the bathroom and sink maintenance issues identified by inspectors?
- 03How do you make sure wet cleaning equipment is stored and dried safely?
- 04How will you record and review my relative’s end of life wishes in more detail?
- 05How do you monitor staffing levels when staff are absent or people’s needs change?
This was an unannounced inspection of the overall service and included the premises, care provided, records, staffing and quality monitoring; the report also checked improvements required after the September 2017 inspection. This explanation was written from the published report of 15 September 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.
What inspectors found, January 2018
Overall Requires Improvement; inspectors rated safe care Inadequate and found serious risks with medicines, staffing and risk management.
This was an unannounced, comprehensive inspection by two inspectors on 27 and 28 September 2017. They spoke with people, a relative, staff, the manager, the provider and healthcare professionals. They reviewed care records, staff files, training records and quality checks.
The inspectors found serious problems with medicines. On two consecutive nights, 15 people did not receive their prescribed medicines. There were also not enough staff at busy times, and risks linked to fire safety, infection control, nutrition, dementia care and people’s behaviour were not managed well.
People could access healthcare professionals when needed. Staff were often kind and respectful, but care was inconsistent and some people’s dignity was not protected. Care plans lacked important guidance, activities were limited and complaints were not used fully to improve the service.
The overall rating was Requires Improvement. Safe was rated Inadequate, while Effective, Caring, Responsive and Well-led were all Requires Improvement. The home had previously been rated Good in May 2015. A new manager had begun making changes, but the inspection could not show that these changes were fully established.
Healthcare access
People were supported to see healthcare professionals and receive continuing healthcare support when needed.
“Where people required access to healthcare professionals and on-going healthcare support, this was provided.” from the report
Staff recruitment
Checks and references were completed for newly appointed staff to assess their suitability to work with vulnerable people.
“The provider had a safe and robust system in place for the recruitment and selection of new staff.” from the report
Kind relationships
Inspectors saw caring interactions, and some people and relatives spoke positively about staff relationships.
“Staff had good relationships with people who used the service and their relatives.” from the report
Medicines were missed
seriousOn two consecutive nights, 15 people did not receive their prescribed medicines. This placed their health and welfare at risk.
“On two consecutive nights 15 people had not received their prescribed medicines.” from the report
Too few staff
seriousThere were not enough staff, particularly at busy times such as meals and when people needed help to get up or go to bed. This reduced supervision, support and social contact.
“There were not enough staff to provide the right level of care and staff were not deployed in a way that ensured people's safety.” from the report
Risks were not controlled
seriousRisk assessments and safety arrangements were not adequate for fire safety, infection control, contractors, people’s behaviour and some health conditions.
“Thorough risk assessments had not been carried out routinely to identify and mitigate risks in relation to people’s support needs, fire safety and infection control.” from the report
Dignity was inconsistent
needs fixingSome people were cared for in conditions that affected their dignity, including a room with an open commode and strong urine smells.
“People's dignity was not consistently respected and promoted.” from the report
Limited activities
needs fixingThere was not enough meaningful stimulation, especially for people living with dementia. Activities were not consistently tailored to individual needs.
“There was a lack of general activity to ensure people's wellbeing.” from the report
Weak quality checks
needs fixingAudits identified problems but did not set out the actions, deadlines or responsible people needed to put things right.
“The audits identified failings but had not been completed with corrective actions, target dates and who was responsible for taking the action.” from the report
- 01How do you now make sure every person receives their medicines on time and as prescribed, including medicines given only when needed?
- 02How many staff are on duty during meals, at bedtime and when people need help to get up, and how is this based on individual needs?
- 03What risk assessments and emergency plans are now in place for fire evacuation, contractors, falls, diabetes and behaviours that may put people at risk?
- 04How do you support people living with dementia when they are anxious or distressed, and what training have staff completed?
- 05What regular activities are available for each person, including people who stay in their rooms or need dementia-specific stimulation?
This was an unannounced comprehensive inspection covering all five key questions, with two inspectors reviewing the home, records, staff practice and feedback from people and professionals. This explanation was written from the published report of 10 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 Marmora Care Home
3 rated inspections over 3 years: the service has held its Good rating throughout.
- September 2018Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- January 2018Requires improvementdown from GoodSafe: InadequateEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- June 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- August 2013
Report published without a new overall rating.
- March 2013
Report published without a new overall rating.
- March 2012
Report published without a new overall rating.
- January 2012
Report published without a new overall rating.
- November 2010
Registered with the Care Quality Commission on 25 November 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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