Marian House Care Home

We found the following examples of good practice.

There were suitable procedures for reducing the risks of infection from visitors. The staff carried out COVID-19 tests on visitors, provided them with personal protective equipment (PPE) and spaces where they could meet people safely. There were separate entrances for visitors. When people were unwell or dying visitors were able to spend time with them in their rooms for as long as they wanted and needed.

The provider had supported people to follow religious practices and meet their spiritual needs. Some of the sisters were able to facilitate services and offer communion to others at times when priests were not able to attend because of visiting restrictions. People had also accessed religious services and important meetings through internet video meetings. This enabled them to remain active members of their religious community and had also provided opportunities to join others from around the world in celebrating their faith.

Social distancing was maintained where possible. Communal rooms were set up for people to have their own chairs, tables and furniture which they always used. Furniture had been arranged to enable social distancing. People had large individual bedrooms and there were plenty of communal rooms, including spaces for prayer and a chapel. Signage on the entrance to rooms reminded people to social distance and stated the number of people who could safely use the room at one time. Staff were allocated into different groups and used separate facilities, such as break rooms and bathrooms. Perspex screening was available to be used if needed in visiting rooms and offices.

There were enough rooms throughout the building which could be used to care for people who needed to isolate away from others, including a self-contained flat with a separate entrance.

There were systems to help make sure people were safely admitted to the service, when they first moved there, following a hospital stay and after they had left the home for a holiday. These systems included regular testing and isolation. The provider had gained people's consent for this practice. Where people lacked the mental capacity to make decisions, the provider had met with a multidisciplinary team to make decisions in people's best interests.

There was enough PPE for staff and people living at the service (when they wanted this). Good supplies of PPE were situated throughout the home and were available in a range of sizes. Staff knew how to wear and dispose of PPE correctly and had received training in relation to this. The registered manager regularly checked they were following procedures. There were additional protocols and PPE available for staff to use in the event of an outbreak as well as mobile PPE stations which could be situated directly outside people's bedrooms. Hand sanitiser was available throughout the building and signage reminded people and staff to use this. The registered manager explained people using the service understood why staff needed to wear PPE. Some activities, such as communion and supporting people in chapel, were carried out by other sisters from the community (not those receiving care). They wore PPE and followed the same guidance as staff in order to help keep people safe from the spread of infection.

Staff and people using the service were regularly tested for COVID-19. The provider responded appropriately following any positive results, sharing the information with healthcare teams and making sure people received the treatment they needed. Some people were able to carry out their own tests and were supported to do this.

The layout of the building was suitable for helping to control the spread of infection. Corridors, bedrooms and communal areas were large and well ventilated. There were clear and detailed cleaning schedules and checks on cleanliness and infection prevention and control. The provider had purchased specialist equipment for deep cleaning areas. There were suitable systems for managing laundry.

Staff were trained and had information, so they understood about their roles and responsibilities during the COVID-19 pandemic. Care was provided by the same regular staff employed by the provider. During the pandemic, the staff had taken on different roles to support each other and to make sure all care and services were provided. They had training in order to learn different skills. The registered manager explained they had worked well as a team to provide a good service.

The registered manager had updated the provider's policies and procedures to make sure there was good infection prevention and control in line with government guidance. They liaised with other organisations and the local authority to develop best practice. They had assessed the risks relating to COVID-19 and other infections within the environment and had systems in place to help mitigate these, such as additional cleaning and regular audits.

Whilst they planned care for people in a personalised way and supported people when they became unwell, they had not specified whether their ethnicity, health conditions or any other factors placed them at more significant risk if they caught COVID-19. We signposted the registered manager so they could include this information within individual care plans and risk assessments. Risk assessments with these details had been completed for staff, and there were management plans where staff were at greater risk of severe illness. All people living at the home and staff had received COVID-19 vaccinations, which helped reduce the risk of them catching the infection or becoming seriously unwell.

People’s experience of using this service and what we found

People were fully engaged in meaningful activities of their choice. They were consulted about what they wanted to do and were listened to.

Staff were responsive to people’s individual needs and knew them well. They supported each person to achieve their wishes by spending time with them and listening to them. They ensured that each person felt included and valued as an individual.

The registered manager led a hardworking and dedicated team. Together, they met people’s individual needs and improved their quality of life.

People who used the service and their relatives were happy with the service they received. Their needs were met in a personalised way and they had been involved in planning and reviewing their care. People said that the staff were kind, caring and respectful and they had developed good relationships with them.

The provider worked closely with other professionals to make sure people had access to health care services. People received their medicines safely and as prescribed. People’s nutritional needs were assessed and met.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People's needs were assessed before they started using the service and care plans were developed from initial assessments. People and those important to them were involved in reviewing care plans. Risks to their safety and wellbeing were appropriately assessed and mitigated.

Staff were happy and felt well supported. They enjoyed their work and spoke positively about the people they cared for. They received the training, support and information they needed to provide effective care. The provider had robust procedures for recruiting and inducting staff to help ensure only suitable staff were employed.

There were systems for monitoring the quality of the service, gathering feedback from others and making continuous improvements.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

Marian House Care Home has recently been re-registered under a new entity. This is the first inspection of the service under the new provider. Previously it was registered under a different legal entity and the last rating for this service was good (published 1 February 2017).

Why we inspected

This was a planned inspection for a newly registered service and also based on the previous rating of the existing care home.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Marian House Care Home on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.