Archived: Marlowe House

Updated 7 December 2015

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check 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 inspection on 17 and 18 August 2015. It was undertaken by an 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.

Before our inspection we reviewed the information we held about the home, including previous inspection reports. We contacted the local authority to obtain their views about the care provided. We considered the information which had been shared with us by the local authority and other people who contacted the commission. We looked at safeguarding alerts which had been made and notifications which had been submitted. A notification is information about important events which the provider is required to tell us about by law.

During the inspection we reviewed the records of the home. These included staff files including staff recruitment, training and supervision records, medicine records complaint records , accidents and incidents, quality audits and policies and procedures along with information in regards to the upkeep of the premises.

We also looked at five care plans and risk assessments along with other relevant documentation to support our findings. We also ‘pathway tracked’ people living at the home. This is when we looked at their care documentation in depth and obtained their views on their life at the home. It is an important part of our inspection, as it allowed us to capture information about a sample of people receiving care.

During the inspection, we spoke with 10 people who lived at the home, and seven staff members including the registered manager and a visiting healthcare professional. Following the inspection we spoke with the provider and two healthcare professionals.

We met with people who lived at Marlowe House and observed the care which was delivered in communal areas to get a view of the care and support provided across all areas. This included the lunchtime meals. The inspection team spent time sitting and observing people in areas throughout the home and were able to see the interaction between people and staff. This helped us understand the experience of people who could not talk with us.

Marlowe House was last inspected in October 2013 and we did not identify any concerns.

Updated 7 December 2015

Marlowe House provides accommodation for up to 20 older people who required a range of personal and care support. Some people lived independent lives but required support for example with personal care and mobilising safely. People were able to stay at the home for short periods of time on respite care or can choose to live at the home permanently. Staff provided end of life care with support from the community health care professionals but usually cared for people who needed prompting and minimal personal care support. At the time of the inspection 10 people lived at Marlowe House.

People spoke well of the home and told us they were happy living there. There is a registered manager at the home. 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.

This was an unannounced inspection which meant the provider and staff did not know we were coming. It took place on 17 and 18 August 2015.

The provider had not ensured the home had been properly maintained it did not ensure people’s safety or enhance their well-being. Servicing contracts were not in place for electrical and gas services. There were no environmental audits to identify where maintenance was required. Individual and environmental risk assessments to maintain people’s health, safety and well-being were not in place for everyone and therefore placed people at risk.

There were no quality assurance systems in place. Therefore the provider had not identified the shortfalls we found. Risks to people’s safety, the management and quality of the home had not been identified. People and staff were not given the information they needed and there was a lack of communication and involvement from the provider regarding issues that affected their lives and work.

The provider had not responded to people’s feedback when they had identified areas for improvement. People had identified they would like to have an outside seating area however this had not been addressed.

During the inspection medicines were managed appropriately and people received the medicines they had been prescribed. However, staff told us about practices that may not be safe. We recommend the provider should take into account the National Institute for Health and Care Excellence (NICE) guidance 2014, Managing medicines in care homes.

Although there were enough staff on duty to look after people there was a reliance on staff covering each other’s roles and there was no flexibility in the staffing rota. Recruitment procedures were not in place to ensure staff employed were of good character.

Staff did not receive the appropriate training they required to meet people’s needs. They had not received recent training in relation to safeguarding, the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards. Therefore staff did not fully understand their responsibilities in relation to these areas.

People were looked after by staff who knew them well, were kind and caring. However, care plans were not updated to reflect people’s current needs and there no evidence people had been involved in developing their care plans.

Staff monitored people’s nutritional needs and people had access to food and drink that met their needs and preferences. People had access to appropriate healthcare professional and staff told us how they would contact the GP if they had concerns about people’s health.

The overall rating for this provider is ‘Inadequate’.

This means that it has been placed into ‘Special measures’ by CQC. The purpose of special measures is to:

• Ensure that providers found to be providing inadequate care significantly improve.

• Provide a framework within which we use our enforcement powers in response to inadequate care and work with, or signpost to, other organisations in the system to ensure improvements are made.

Services placed in special measures will be inspected again within six months. The service will be kept under review and if needed could be escalated to urgent enforcement action.

There were a number of breaches of the regulations. You can see what action we told the provider to take at the back of the full version of the report.