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
- People were protected from avoidable harm, with suitable risk assessments, enough staff and safe recruitment. Inspectors found a gap in checking medicine storage temperatures after a new fridge was installed, and senior staff acted immediately.
- Effective?
- Good
- People's needs were assessed and reviewed, staff were trained, and people were supported with food, drink, healthcare and decisions about their care.
- Caring?
- Good
- This question was not inspected during this targeted inspection, so no new rating was given in this report.
- Responsive?
- Good
- This question was not inspected during this targeted inspection, so no new rating was given in this report.
- Well-led?
- Good
- Inspectors found an open, person-centred culture and systems for checking quality and learning from incidents. The provider had taken immediate action in response to the staff culture concern.
What inspectors found, June 2023
Martha House rated Good; inspectors found kind, person-centred care, with some medicine checks and staff culture actions needing attention.
The inspection took place without notice on 4 May 2023. It was a targeted inspection prompted by a concern about staff culture. Inspectors also checked infection prevention and control.
Inspectors spoke with one person living at the home, seven relatives, two health and social care professionals and 12 staff. They observed care and reviewed care records, medicine records, recruitment files, policies, audits and other safety records.
The home was rated Good overall. Safe, Effective and Well-led were each rated Good. Inspectors found people were supported by trained staff who knew them well, respected their choices and helped them lead meaningful lives.
Inspectors found no evidence that the culture concern had affected people. The provider had taken immediate steps to address it. They also found that medicine fridge temperatures had not been checked after a new fridge was bought, although this was addressed immediately.
Person-centred support
Staff understood people's needs, preferences and communication, and supported them to make choices and pursue interests.
“Staff knew and understood people well and were responsive, supporting their aspirations to live a quality life of their choosing.” from the report
Kind and attentive staff
People were supported by staff who knew them well and treated them with kindness. Relatives and professionals also gave positive feedback.
“People were supported by staff who knew them well and were kind and attentive to them.” from the report
Choice and independence
People were supported to make everyday decisions and were not physically restrained. Inspectors found that restrictions were used only when needed and in people's best interests.
“People's freedom was not unnecessarily restricted, and people were not physically restrained.” from the report
Staffing and recruitment
Inspectors found enough staff, a consistent staff team and safe recruitment checks. Staff were trained and supported in their roles.
“There were enough staff to care for people.” from the report
Open communication
Relatives said communication was good and that they were involved in decisions about their family member's care.
“They listen and take action if we were to raise things. There's never a crisis because they communicate so well.” from the report
Staff culture concern
needs fixingThe inspection was prompted by a potential concern about staff culture. The provider had taken immediate steps, including extra training, staff support and policy reviews, and inspectors found no evidence that people had been affected.
“We received one potential concern in relation to staff culture.” from the report
Medicine fridge checks
needs fixingChecks had not been completed to confirm medicines were stored at the right temperature after a new fridge was installed. Senior staff addressed this immediately and were reviewing medicine arrangements.
“Checks had not been undertaken to confirm people's medicines were stored within the appropriate recommended temperature ranges when a new fridge was purchased.” from the report
Recording daily checks
minorSenior staff carried out daily checks, but the registered manager said these checks would be recorded in future.
“The registered manager gave us assurances they would record these checks in the future.” from the report
- 01What changes were made after the concern about staff culture, and how do you check that these changes are working?
- 02How are medicine fridge temperatures checked and recorded now?
- 03How are daily senior staff checks recorded and reviewed?
- 04How do you make sure new staff receive safeguarding training when they start?
- 05How will you support my relative's individual interests, choices and access to the local community?
This was a targeted inspection of a concern about staff culture, with infection prevention and control also checked; Caring and Responsive were not inspected and their previous ratings carried over where applicable. This explanation was written from the published report of 8 June 2023 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, August 2021
Rated Good; inspectors found safe care and improved leadership, but some premises checks and bathroom surfaces needed attention.
This was an unannounced focused inspection on 08 July 2021. It followed concerns about management, staffing and family visits. The inspector reviewed care and medicine records, spoke with staff and relatives, and observed how people were supported. They could not speak directly with people living in the home.
Inspectors found enough staff, completed recruitment checks and staff who understood people's risks. Medicines were managed safely. Infection control was generally effective, although some bins needed replacing and porous bathroom surfaces needed attention. Some planned premises audits had also been delayed.
The overall rating remained Good. Safe was rated Good, and Well-led improved from Requires Improvement to Good. The other key questions were not inspected during this visit, so their previous ratings were used in the overall rating.
Staffing and recruitment
Inspectors found enough staff to support people and spend time with them. New staff had recruitment checks before working with people.
“there were enough staff to care for people who knew people's safety needs.” from the report
Medicines
Trained staff administered medicines, with regular checks of their competence and of medicine records, storage and disposal.
“People were administered the medicines they needed to remain well by staff who had been trained to do this, and whose competency was regularly checked.” from the report
Family involvement
Relatives said they were involved in care decisions and that staff listened to their views. Visits were being supported in line with current guidance.
“Relatives said they were fully involved in their family members care and their views listened to.” from the report
Bathroom surfaces and bins
needs fixingInspectors found some bins needed replacing and some bathroom surfaces had become porous. The manager agreed to address this to reduce infection risks.
“The home presented as clean, but we found some bins required replacement and some surfaces in bathrooms had become porous.” from the report
Delayed premises audits
needs fixingSome planned checks of the premises had not taken place on schedule during temporary management changes. Plans were made to complete them.
“There was no evidence of harm to people, but some planned premises audits had not gone ahead as scheduled, owing to temporary changes in the management team because of the COVID-19 pandemic.” from the report
Out-of-date website information
minorThe website did not show the current arrangements for visits. The manager said it would be updated without delay.
“the provider's website contained out of date visitation guidance.” from the report
- 01Have the porous bathroom surfaces been repaired or replaced, and when were the replacement bins provided?
- 02Have all delayed premises audits now been completed, and what did they find?
- 03What are the current arrangements for family visits, and has the website been updated?
- 04How are staffing levels reviewed when people's needs change or new people move into the home?
- 05How are medicine checks and notifications to the CQC monitored now?
This was a focused inspection of Safe and Well-led only; the other key question ratings were not inspected and previous ratings were used in calculating the overall rating. This explanation was written from the published report of 17 August 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 Martha House
5 rated inspections over 7 years: the service has improved, from Requires improvement to Good.
- June 2023Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- August 2021Goodstayed GoodSafe: GoodWell-led: Good
- June 2018Goodstayed GoodSafe: GoodEffective: GoodWell-led: Requires improvement
- February 2017Goodup from Requires improvementSafe: GoodWell-led: Good
- May 2016Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- April 2014
Report published without a new overall rating.
- February 2013
Report published without a new overall rating.
- March 2012
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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11 live-in carers within about an hour of Herefordshire, County of
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 £960 to £1,410 a week. 10 can care for a couple. 8 years' experience on average.
“She was very caring, kind and patient to all his needs, she built up a wondetful rapport with him, she was dedicated and was there for him through good times as well as through the tough times”
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