CQC report explained · a residential care home
What the CQC found at OSJCT Marden Court
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, June 2019
OSJCT Marden Court was rated Good overall, but Safe required improvement because some behaviour and incident records were incomplete.
The inspection took place without advance notice on 30 April and 1 May 2019. The inspector and someone with personal experience of care spoke with people living in the home, relatives, staff and other professionals. They also observed care and checked care, medicines, recruitment, training and management records.
People generally felt safe and said staff were available to help. Risks such as falls, malnutrition and access to stairs were assessed, and medicines were managed more safely than at the previous inspection. However, some people who showed challenging behaviour did not have care plans for staff to follow, and some behaviour and incident records were incomplete.
The home was calm and homely. Inspectors found kind care, personalised support, good access to health services, suitable staff training and activities. The home had improved from Requires Improvement at the previous inspection, but Safe was still rated Requires Improvement because there was limited assurance about some safety arrangements.
Kind and familiar care
People appeared comfortable with staff, who knew their preferences and life histories. Inspectors found the atmosphere calm and homely.
“The service was calm and portrayed a homely environment. People were comfortable in the presence of staff and approached them easily for support, to chat or share a joke.” from the report
Personalised care plans
Care plans explained how people wanted their care and support delivered. People were involved in decisions where they could be.
“People had care plans in place that clearly explained how they would like to receive their care, treatment and support.” from the report
Staffing and training
Inspectors found enough staff to meet people's needs, and most people and relatives said staff responded without long waits. Staff received induction, training and supervision.
“The home employed sufficient levels of staff to support people and meet their needs.” from the report
Improved medicines and oversight
The home was no longer in breach of the previous regulations about medicines management and quality monitoring. It had introduced audits and an improvement plan.
“At this inspection we found action had been taken and the service was no longer in breach of this Regulation.” from the report
Activities and outside contact
People could join activities, trips and one-to-one time. The home also worked with volunteers and other community groups.
“People had the opportunity to attend activities provided by activity staff.” from the report
Missing behaviour support plans
seriousNot everyone who showed physical or verbal challenging behaviour had a care plan explaining how staff should respond. This could make support less consistent and increase safety risks.
“Not everyone who displayed physical or verbally challenging behaviour had a care plan in place for staff to follow when supporting them.” from the report
Incomplete behaviour records
needs fixingSome records did not explain what happened after an incident or whether the response worked. This made it harder to learn from incidents and choose effective support.
“Behaviour recording forms were not always correctly completed.” from the report
Unexplained bruising not investigated
seriousA person's bruises had been recorded, but there was no investigation recorded at the time. The manager was asked to ensure incidents like this were fully recorded and investigated.
“One person had two bruises recorded on a body map, but the cause was unknown. There was no record of investigation into this.” from the report
Care monitoring records
needs fixingSome food, fluid and repositioning records did not contain enough useful information. Some repositioning records showed longer gaps than the person's care plan required.
“Some people's repositioning charts showed longer gaps than what their care plan stated they should receive support.” from the report
Limited evening activities
minorIn the late afternoon and evening, most activities were film watching because activity staff were not available then. The home was considering more suitable activities for people who might become restless.
“During late afternoon and evenings, we saw that most days the activity was film watching as no activity staff were available at that time.” from the report
- 01What behaviour support plans are now in place for each person who may show physical or verbal challenging behaviour?
- 02How do you make sure every behaviour incident records the outcome and whether the response worked?
- 03How are unexplained bruises, injuries and other incidents investigated and reported?
- 04How do you check that repositioning records match the times set out in each person's care plan?
- 05What activities are now available in the late afternoon and evening?
This was a planned inspection of the whole care home and all five key questions, following a Requires Improvement rating at the previous inspection. This explanation was written from the published report of 21 June 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, April 2018
Rated Requires Improvement; inspectors found kind and responsive care, but medicines management and oversight were not reliable enough.
Inspectors visited the home without notice on 22 February 2018 and returned on 26 February to complete their work. They spoke with people living there, visitors, staff, the manager and a community nurse. They observed care and checked care plans, medicines and management records.
The home was rated Good for Effective, Caring and Responsive. People were treated respectfully, involved in their care and supported by staff who understood their needs. There were enough staff, and people generally felt safe and positive about the care.
The home was rated Requires Improvement for Safe and Well-led. Three people missed prescribed medicines, and the home had not properly reviewed these incidents to prevent repetition. Two abuse allegations were also not reported to CQC promptly. The provider was in breach of Regulations 12 and 17.
Kind and respectful care
People described staff as kind and helpful. Inspectors saw staff respecting people's choices, privacy and dignity.
“We observed staff interacting with people in a friendly and respectful way.” from the report
Care was personalised
Care plans recorded people's needs, preferences and health conditions. People were involved in planning and reviewing their care.
“People were involved in planning and reviewing their care.” from the report
Activities and complaints
People could join activities they enjoyed and knew how to raise concerns. Complaints had been investigated and answered.
“Complaints received had been investigated and a response provided to the complainant.” from the report
Missed medicines
seriousThree medicine errors occurred in January 2018. Although staff contacted GPs and people suffered no ill effects, the incidents were not fully investigated and lessons were not recorded.
“People did not always receive the medicines they had been prescribed.” from the report
Weak incident oversight
seriousThe management systems did not ensure that incidents were reviewed properly or that action was taken to stop similar problems happening again.
“The systems for reviewing and managing incidents in the service were not effective.” from the report
Late notifications
needs fixingTwo abuse allegations had been reported to the local safeguarding team but not to CQC promptly. The required notifications were submitted after this was identified.
“The registered manager had not ensured that all allegations of abuse were reported promptly to the Care Quality Commission.” from the report
Incomplete care plan
minorOne care plan did not contain all the information needed about supporting a person who resisted personal care. Staff knew the person well, and the manager said this was being reviewed.
“There was one example of a care plan that did not contain all the necessary information about the support a person needed” from the report
- 01What changes have been made to prevent prescribed medicines being missed?
- 02How are medicine errors now investigated, recorded and reviewed by the management team?
- 03How do you make sure abuse allegations and other incidents are reported to CQC on time?
- 04What additional responsibilities do senior staff now have when the registered manager is away?
- 05Has the care plan identified by inspectors been updated, and how are all care plans checked for missing information?
This was an unannounced inspection covering all five CQC questions, with a second visit to complete the inspection; the home had last been inspected in February 2017. This explanation was written from the published report of 27 April 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 OSJCT Marden Court
4 rated inspections over 4 years: the service has held its Good rating throughout.
- June 2019Goodcurrent ratingup from Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- April 2018Requires improvementstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- April 2017Requires improvementdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- February 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- March 2014
Report published without a new overall rating.
- December 2012
Report published without a new overall rating.
- December 2011
Report published without a new overall rating.
- November 2010
Registered with the Care Quality Commission on 16 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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