CQC report explained · a residential care home
What the CQC found at Marrow House
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found that risks were assessed, medicines were managed safely, staffing levels were sufficient and recruitment checks were carried out. The home was clean and staff used protective equipment.
- Effective?
- Good
- People's needs were assessed before admission. Staff received training and support, people had access to healthcare, and weekly reviews involved health and social care professionals. Training records were not always up to date.
- Caring?
- Good
- People said staff were caring and respected their privacy. Inspectors found that staff encouraged people to make choices and remain as independent as possible.
- Responsive?
- Good
- Care was personalised and staff knew people's preferences. There were activities and support for communication needs. The home did not keep records of people's end of life preferences, and inspectors made a recommendation about this.
- Well-led?
- Good
- Inspectors found a positive, person-centred culture and systems for checking quality. Some care plan reviews had missed differences between records, and accident and incident monitoring was being strengthened.
What inspectors found, September 2019
Marrow House was rated Good; inspectors found safe, kind and personalised care, with some records needing improvement.
This was an unannounced inspection on 6 and 7 August 2019. One inspector spoke with people using the service, relatives, staff and a health and social care professional. They also reviewed care, medicine, recruitment, training and management records.
All five areas were rated Good: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough staff, safe medicines systems, good infection control, suitable care planning and access to healthcare.
People described caring staff who respected their privacy and encouraged independence. They enjoyed the food and activities, and said staff knew their likes and dislikes.
There were some record-keeping weaknesses. Training records were not always up to date, some care records did not match, and records of people's end of life wishes were not kept. The report made a recommendation about end of life care planning.
Safe care and medicines
Inspectors found that risks were assessed, medicines were managed safely and people felt safe. There were enough staff and recruitment checks were completed.
“People were protected from the risk of potential abuse and told us they felt safe at the service.” from the report
Good health support
The home worked with health and social care professionals. Weekly reviews helped staff support rehabilitation, independence and health needs.
“Weekly multi-disciplinary reviews for people were held which included community psychiatric nurses, occupational therapists and wellbeing assessors.” from the report
Personalised activities
Staff knew people's likes and dislikes, and people could take part in activities such as singing, word games and themed days.
“People received personalised care from staff that knew them well and enjoyed the activities on offer at the service.” from the report
Training records
needs fixingStaff said they had enough training, but the records confirming training were not always up to date. The deputy manager said action would be taken.
“However, records confirming training had taken place were not always up to date.” from the report
End of life wishes
needs fixingThe home did not support people at the end of their life, but some people had life-limiting illnesses. Their preferences about end of life care were not recorded, so inspectors made a recommendation.
“records were not kept of people's preferences in relation to end of life care.” from the report
Care plan accuracy
needs fixingSome reviews had not noticed that information differed between care documents and people's current needs. Staff knew people's needs, and the deputy manager had taken action to reduce the risk of this happening again.
“Some reviews of care plans had not identified where information did not match between documents about people's needs and their current support needs.” from the report
Accident monitoring
needs fixingNot all accidents and incidents had reached the provider for analysis. The home was putting a stronger monitoring system in place.
“not all these accidents and incidents had been received by the provider, so there could be risk they were not analysed accurately.” from the report
- 01How have you kept training records up to date since this inspection?
- 02How do you record a person's end of life wishes, including when the home does not provide end of life care?
- 03How do you check that information matches across all parts of a person's care plan?
- 04How are accidents and incidents now reported to and reviewed by the provider?
- 05How would the rehabilitation programme, activities and healthcare support fit my relative's needs?
This was an unannounced inspection that looked at all five CQC questions, including the care provided and the care home environment; all five ratings were Good. This explanation was written from the published report of 11 September 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, February 2017
Marrow House was rated Good; inspectors found safe, kind and personalised care, with improvements made since the previous inspection.
The inspection was unannounced and took place on 24 January 2017. Two inspectors and an expert by experience spoke with people using the service, relatives, staff and managers. They reviewed care records, staff files, medicines records, audits, complaints and other documents.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough trained staff, safe medicines arrangements, suitable risk assessments and support for people's health, food and drink needs.
The report says the home had acted on concerns from the June 2016 inspection. The three previous breaches had been addressed, and the provider was no longer in breach of any regulations. Inspectors also found respectful care, personalised support and systems to monitor quality.
Improvements since the last inspection
The provider completed the actions set after the previous inspection. Inspectors found that the three earlier breaches had been addressed.
“At this inspection we found that the actions had been met and the provider was no longer in breach of any Regulations.” from the report
Kind and respectful care
People described staff as kind and said they were treated with respect. Inspectors saw staff offering reassurance and supporting privacy and choice.
“People were treated with warmth and respect and had positive and meaningful relationships with the staff.” from the report
Personalised rehabilitation
People had goals linked to daily living and independence, such as making food or managing personal care. Staff recorded progress and reviewed needs weekly.
“On admission an assessment of people's needs was completed with the support of an occupational therapist.” from the report
Safe medicines and risk management
Medicines were stored securely and checked daily. Risk assessments gave staff clear instructions, which inspectors saw staff following.
“Medicines were stored in a secure trolley in a locked clinical room and administered safely by suitably trained staff.” from the report
Further training was planned
minorThe manager said more training would be provided to help staff support people when behaviour escalated. Ask whether this training has been completed and what it covers.
“The registered manager told us that further training for staff was going to be made available to support staff to care for people when their behaviour escalated.” from the report
Care plan format was still being developed
minorThe home's care plans were clear and regularly reviewed, but a working group was still developing a more person-centred format. Ask what changes have been made since the inspection.
“The registered manager informed us that a 'working party' was in the process of looking at the care plan format and to develop one that was more person-centred and supported staff to maintain people's safety.” from the report
- 01What further training have staff received to support people when their behaviour becomes distressed or escalates?
- 02How have you changed the care plan format to make it more person-centred?
- 03How will you check and review a new resident's Do Not Attempt Cardio Pulmonary Resuscitation decision after admission?
- 04How do you decide whether staffing levels are sufficient when a resident needs extra supervision?
- 05How will you measure and share my relative's progress towards their rehabilitation and independence goals?
This was an unannounced inspection covering all five CQC questions and the overall quality of the home; it also checked whether improvements from the June 2016 inspection had been made. This explanation was written from the published report of 21 February 2017 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 Marrow House
3 rated inspections over 3 years: the service has improved, from Requires improvement to Good.
- September 2019Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- February 2017Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- July 2016Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- March 2014
Report published without a new overall rating.
- October 2012
Report published without a new overall rating.
- November 2011
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 17 December 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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