Archived: Marlow

Updated 5 October 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This was an unannounced, comprehensive inspection. The inspection was undertaken by one inspector and an expert by experience. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service. The expert by experience had expertise in learning disability and complex needs.

Before the inspection, the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and any improvements they plan to make. We checked the information that we held about the service and the service provider. This included previous inspection reports and statutory notifications sent to us by the registered manager about incidents and events that had occurred at the service. A notification is information about important events which the service is required to send to us by law. We used all this information to decide which areas to focus on during our inspection.

We observed care and spoke with people and staff. We spent time looking at records including five care records, two staff files, medication administration record (MAR) sheets, staff rotas, the staff training plan, complaints and other records relating to the management of the service.

On the day of our inspection, we met with two people living at the service, spoke with three relatives and another person who regularly visited the service. We chatted with people where they were able to speak with us and observed them as they engaged with their day-to-day tasks and activities. We spoke with the registered manager, a director of the provider, the area manager, the manager who oversaw the flats and two support workers.

Updated 5 October 2017

Marlow is registered to provide residential care for up to 15 people with a range of complex health needs, including people living with a learning disability. Accommodation is provided over two floors. On the ground floor, 11 people are accommodated in en-suite rooms, each equipped with overhead hoists. Communal areas include a large sitting room, dining room and quiet lounge. The first floor is split into two flats, each flat having two bedrooms, a kitchen and sitting room; each flat accommodates two people. The home has accessible patio and garden areas. At the time of our inspection, the home was at full capacity. Marlow is close to the town centre of Worthing and to the seafront.

At the last inspection, the service was rated Good overall and Good in each domain apart from Well-Led which was rated Requires Improvement. We found a breach of regulation relating to good governance and asked the provider to submit an action plan on how they would address this breach. An action plan was submitted by the provider which identified the steps that would be taken. At this inspection, we found that the provider and registered manager had taken appropriate action and the regulation had been met.

This inspection was undertaken on 12 June 2017 and was unannounced.

A registered manager was in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Medicines were not always managed safely. Some medicines had not been disposed of as required. One medicine had not been disposed of despite it being beyond the expiry date. Another medicine should have been disposed of following a single use, but was still in the fridge. These two people’s health may have been compromised because they were at risk of receiving medicines that were out of date. The temperature in the medicines room, on at least two occasions, was in excess of the maximum temperature of 25 degrees Celsius recommended under pharmaceutical guidance. Controlled drugs were not stored securely in line with the Misuse of Drugs (Safe Custody) Regulations 1973. Medicines were not stored safely in the manager’s office on the first floor. There was a gap in recording on one Medication Administration Record relating to the administration of a medicine to be taken as required.

A system of audits had been put in place to measure and monitor the quality of care delivered and the service overall. In the main, these were effective in identifying any areas for improvement and actions that needed to be taken. However, the audit in place in relation to the management of medicines had not identified the issues we found at this inspection.

People felt safe living at Marlow and staff had been trained to recognise the signs of potential abuse. They knew how to report any concerns and had been trained appropriately. People’s risks had been identified and assessed appropriately and there was guidance for staff on how to mitigate risks. There were sufficient numbers of staff on duty to keep people safe and robust recruitment systems were in place.

Staff completed a range of comprehensive training to enable them to support people effectively and safely. They were encouraged to study for additional qualifications and new staff followed the Care Certificate, a universally recognised qualification. Staff had regular supervision meetings with their line managers and attended staff meetings. Staff had been trained to understand the Mental Capacity Act 2005 and put this into practice. Staff routinely asked for people’s consent. People were supported to have sufficient to eat and drink and were encouraged to maintain a healthy diet. People had access to a range of healthcare professionals and services.

Staff were kind and caring with people and positive relationships had been developed. People were treated with dignity and respect. Staff knew people’s likes and dislikes and their cultural needs were catered for. Staff enjoyed spending time with people. If appropriate, and if people’s needs could be met at the home, then end of life care was available, in line with people’s last wishes.

Care plans provided detailed information about people, including their personal and social histories. Staff were familiar with the content of these care plans and provided care in a person-centred way. Some activities were organised for people at the home and other activities were arranged in line with people’s individual interests, for example, attending college or a day centre. Complaints were managed in line with the provider’s complaints procedures.

People and their relatives felt the home was well managed. They were asked for their views about the home through families and friends surveys. People’s views were obtained on an individual basis at 1:1 meetings with their keyworkers. Staff were asked for their feedback about the service. The home was in the process of being taken over by a new provider.