CQC report explained · a nursing home
What the CQC found at The Marbrook Centre
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
What inspectors found, January 2021
The Marbrook Centre was rated Good; inspectors found safe, well-managed care, and said safety had improved after earlier concerns.
This was a focused inspection on 17, 23 and 24 December 2020. Inspectors looked only at Safe and Well-led because safeguarding concerns about poor care had been raised. They spoke with people, relatives, staff and professionals, and reviewed medicines, care plans, risk assessments and other records.
The home was rated Good for Safe and Good for Well-led. Inspectors found enough staff, safe recruitment, accurate care records and medicines that were managed safely. They found no evidence that people were at risk of harm from the concerns that led to the inspection.
The home had improved its medicines and risk management since the previous inspection. Infection control measures were in place during the Covid-19 pandemic. The overall rating remained Good, but the other three areas were not inspected at this visit and their earlier ratings were carried forward.
Improved medicines safety
Medicines records were accurate and regularly reviewed. Inspectors found that medicines management had improved since the previous inspection.
“Medicines were managed safely. People's records were accurate and regularly reviewed.” from the report
Safe staffing and recruitment
Inspectors found enough staff to meet people's needs and a consistent staff team. The home continued to carry out appropriate recruitment checks.
“There were enough staff available to meet people's needs. Care was provided by a consistent staff team.” from the report
Good infection control
The home was clean and staff were seen cleaning surfaces. Staff used protective equipment and the home had extra arrangements to reduce Covid-19 risks.
“Staff wore appropriate personal protective equipment (PPE) and had received infection prevention and control training and Covid-19 specific training.” from the report
Open management
The manager was described as approachable and kept families and staff informed. Quality checks were used to identify improvements.
“Quality and assurance systems in place, had been reviewed and embedded throughout the service and were used to continuously improve the service and quality of care provided to people.” from the report
Learning from incidents
Accidents and incidents were reviewed for patterns and learning. The findings were shared with staff.
“All accidents and incidents were reviewed to identify any trends and learning points.” from the report
Response times
minorAlthough inspectors found enough staff overall, one staff member said people could not always receive a response as quickly as staff would like. Ask how this is monitored for the person you are considering.
“We can't always respond to residents as quickly as we would like, but they are usually understanding.” from the report
- 01How do you make sure staff respond quickly when someone needs help, especially during busy periods or staff shortages?
- 02What changes were made to medicines management after the previous inspection, and how are staff competency checks kept up to date?
- 03How are safeguarding concerns investigated, recorded and shared with families when appropriate?
- 04How do you keep relatives involved in care reviews when a person's health or needs change?
- 05What arrangements are currently used for relatives visiting during infection outbreaks or other restrictions?
This was a focused inspection of Safe and Well-led only; Effective, Caring and Responsive were not inspected and earlier ratings were carried forward. This explanation was written from the published report of 20 January 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.
What inspectors found, June 2018
Rated Good overall, but inspectors found medicines and staffing were not always safe.
Inspectors visited the home without notice on 14 March 2018 and returned on 11 April 2018. They observed care, spoke with people, relatives, staff and health professionals, and checked care, medicine and management records.
The home was rated Good overall. Effective, Caring, Responsive and Well-led were all rated Good. Inspectors found kind care, good rehabilitation support, suitable training and strong management systems.
Safe was rated Requires Improvement. Medicine records did not always show that people had received medicines as prescribed. There were also not always enough staff on the Bray unit, and some risks had not been fully assessed.
The previous inspection in November 2016 and January 2017 rated the home Requires Improvement overall. Inspectors found improvements during this inspection, but said medicine improvements needed to be checked again and sustained.
Kind, respectful care
Inspectors saw warm relationships between staff and people. Staff supported privacy, dignity, communication and independence.
“People were cared for by kind, compassionate and caring staff.” from the report
Rehabilitation support
People receiving rehabilitation had goals, therapy programmes and discharge planning. The report said most people admitted for rehabilitation in 2017 were able to return home.
“Statistics reflected this, including that out of 35 people admitted for rehabilitation in 2017, only five people (14%) had been unable to return home.” from the report
Training and professional support
Staff received induction, training, supervision and appraisals. The home used therapists and worked with external health professionals.
“Staff received a thorough induction, which included several day's training followed by shadowing experienced staff, so that they were equipped to do their job well.” from the report
Food and choice
People had a choice of meals, special diets were catered for, and staff supported people to eat when needed.
“Healthy, nutritious and appetizing food was provided, with further choices available for people who did not want the choices being offered.” from the report
Visible management
Managers were regularly present around the home and listened to people, relatives and staff. Quality checks and improvement plans were in place.
“The registered manager and management team were visible, approachable and provided stable leadership to the staff team.” from the report
Medicine records and supplies
seriousRecords did not always explain whether medicines had been given or why they had been missed. Some medicines were unavailable, and guidance for some medicines was not detailed enough.
“This meant that improvements to the way medicines were managed were required before we could be assured that people were given their medicines safely and as they had been prescribed.” from the report
Staffing on Bray
needs fixingInspectors concluded that Bray did not always have enough staff to meet people's care, social and emotional needs. Relatives reported delays with getting up, breakfast and bathing.
“Nevertheless, we concluded that although for most of the time there were enough staff deployed on Mayfield and Eden, there were not always enough staff deployed on Bray and this situation needed further improvement.” from the report
Incomplete risk assessments
needs fixingSome potential risks had not been assessed or explained to staff. This included the risk of falling for a person who had previously fallen and fractured their ribs.
“However, we found that for some people, potential risks to their safety, such as the risk of falling, had not been assessed.” from the report
Missing care-plan details
needs fixingCare plans were generally personalised, but some instructions were incomplete, including information about cleaning stoma sites and dealing with blockages.
“However, we found that some details, for example about cleaning stoma sites and dealing with blockages, was missing from the guidance.” from the report
- 01What changes have been made to medicine checks since the inspection, and how do you make sure records show every dose and the reason for any missed dose?
- 02How many staff are normally working on the Bray unit at different times of day, and what happens when staff are absent?
- 03How are falls and other individual risks assessed and kept up to date?
- 04What activities are available for people on Bray, and how will staff support my relative to take part?
- 05How are detailed instructions about clinical care, such as stoma care or blockages, recorded and shared with staff?
This was a comprehensive inspection covering all five key questions, with visits on 14 March and 11 April 2018 and further information gathered afterwards. This explanation was written from the published report of 23 June 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. The report was longer than we could read in one go; the later sections may not be reflected.
Every inspection of The Marbrook Centre
3 rated inspections over 4 years: the service has improved, from Requires improvement to Good.
- January 2021Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- June 2018Goodup from Requires improvementSafe: Requires improvementWell-led: Good
- March 2017Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- March 2016
Registered with the Care Quality Commission on 21 March 2016.
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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Most charge £980 to £1,260 a week. 76 can care for a couple. 12 years' experience on average.
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