CQC report explained · a nursing home
What the CQC found at Martha House
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found that risks were assessed and reviewed, medicines were managed safely and there were enough staff. They also found that the home had improved hydration records and handover arrangements since the previous inspection.
- Effective?
- Good
- Staff were trained and understood people's complex health, eating, drinking and communication needs. People had access to health professionals and were supported to make choices and maintain their health.
- Caring?
- Good
- People were treated with kindness, dignity and respect. Staff used tools such as eye-gaze systems to help people who could not speak express their wishes.
- Responsive?
- Good
- Care plans reflected people's needs, choices and goals. People took part in individual and group activities, went on outings and had information and complaints processes in accessible formats.
- Well-led?
- Good
- Inspectors found clear leadership, an open culture and effective audits. The provider had improved its governance and notification systems and was no longer in breach of the regulations identified at the previous inspection.
What inspectors found, May 2020
Rated Good; inspectors found safe, kind and personalised care, with improvements since the previous Requires Improvement rating.
Inspectors visited on 10 and 12 February 2020. The first day was unannounced and the second was announced. They inspected both houses on the site, spoke with staff, managers, visitors and relatives, and reviewed care, medicines, complaints and management records.
All five areas were rated Good: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough staff, safe medicines systems, clear risk assessments and staff who understood people's complex needs. People were supported to make choices, communicate in different ways and take part in activities.
The previous inspection had rated the service Requires Improvement and found three breaches. This inspection found that improvements had been made and the provider was no longer in breach of regulations. The report also says the buildings are larger than current best-practice guidance, although inspectors found this had been managed so it did not negatively affect people.
Staffing and safety
There were enough staff in both houses, including for one-to-one support. Recruitment checks, safeguarding arrangements and contingency plans were in place.
“There were enough staff in each house to provide people with the support they needed, when they needed it.” from the report
Kind and respectful care
Inspectors observed people appearing relaxed and confident. Staff supported privacy, dignity, independence and involvement in decisions.
“Respecting dignity and privacy was at the heart of the service's culture and values.” from the report
Improved management
Management had strengthened audits and checks since the previous inspection. The report says action was taken when shortfalls were found.
“A wide range of robust checks and audits monitored risks, the quality of service and staff performance.” from the report
Larger than current guidance
minorThe service was registered for up to 23 people and 22 people were using it at the inspection. Its size was larger than current best-practice guidance, although inspectors said the design and how it was run helped reduce any negative impact.
“The service was a large home, bigger than most domestic style properties.” from the report
- 01How would you assess and support my relative's individual communication needs if they cannot communicate verbally?
- 02How do you check that medicines, hydration records and individual health instructions remain correct?
- 03How would you keep care personal in a home supporting up to 23 people across two houses?
- 04What activities and community outings could be offered for my relative's interests and abilities?
- 05How would my family be involved in care reviews, best-interest decisions and changes to support?
This was a planned inspection of both houses and all five CQC questions, covering care, nursing, premises, records and management systems. This explanation was written from the published report of 7 May 2020 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 2019
Rated Requires Improvement; inspectors found kind, effective and responsive care, but unsafe medicine management and weak oversight remained.
Inspectors visited on 3 and 4 December 2018. The first day was unannounced. They spoke with relatives, staff, managers and health professionals, observed care, and checked care plans, medicine records, staff recruitment files and other documents.
The main safety concern was medicines. Some medicines were left in boxes on the floor and were not available when needed. Risk information was not always monitored or recorded consistently. The home was also still using paper and electronic care plans, which did not always match.
Inspectors found Good care in the effective, caring and responsive areas. Staff were trained, kind and respectful, and people had personalised support and activities. However, quality checks had not found important problems, and some required incidents were not reported to CQC. The overall rating remained Requires Improvement, for the second inspection in a row.
Kind and respectful staff
Inspectors saw staff communicate kindly, support people discreetly and protect their dignity and privacy.
“We saw that staff treated people with kindness and compassion.” from the report
Trained staff
Staff received induction, training, supervision and competency checks for important tasks such as moving and handling and medicines.
“Staff had the skills, knowledge and training they needed to support people.” from the report
Personalised support
Care plans included people's needs, choices and preferences. Staff knew people well and supported activities that people enjoyed.
“People's support plans were personalised and were based on their needs and choices.” from the report
Enough staff
Inspectors found enough staff to keep people safe and meet their needs. The home was recruiting to reduce its reliance on agency staff and overtime.
“At the time of the inspection there were enough staff to keep people safe and meet people's needs.” from the report
Medicines not always safe
seriousMedicines were left in boxes on the floor and one person missed a medicine because it had not been checked in. Medicines left after a person's death had also not been disposed of promptly.
“The system to check in medicines needed to be improved to make sure that people's medicines were stored safely and were available when needed.” from the report
Records did not always match
needs fixingDuring the move from paper to electronic care plans, paper records were not always updated even though staff were still using them. This could leave staff without important information about people's changing needs.
“We found a number of areas where the electronic care plan had been updated and the paper care plan had not.” from the report
Incidents not always reported
seriousSome incidents that should have been reported as safeguarding concerns were not sent to CQC or the local authority.
“Notifications had not always been sent to CQC.” from the report
Infection control work unfinished
minorThe home had started improvements after an infection control audit, but some work was still incomplete. Inspectors recommended that the outstanding improvements continue.
“We recommend that the service continues to make the improvements outlined in the providers infection control audit.” from the report
- 01What has changed since the warning notice about medicines being left in boxes and not being available when people need them?
- 02How do you make sure paper and electronic care plans contain the same, up-to-date information during the transition between systems?
- 03How are fluid records now checked, especially for people at risk of dehydration or urine infections?
- 04What system is now in place to ensure safeguarding incidents and other notifiable events are reported to CQC and the local authority?
- 05How have you improved communication with relatives, including about missing clothes and changes being made at the home?
This was a comprehensive inspection of both Martha House and Frances House, covering all five key questions and the overall rating. This explanation was written from the published report of 13 February 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.
Every inspection of Martha House
5 rated inspections over 5 years: the service has improved, from Requires improvement to Good.
- May 2020Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- February 2019Requires improvementstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- December 2017Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- August 2016Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- August 2015Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- October 2013
Report published without a new overall rating.
- December 2012
Report published without a new overall rating.
- May 2011
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 12 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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