We carried out a review of the data available to us about Marsh House on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Marsh House, you can give feedback on this service.
Marsh House is a residential care home providing personal and nursing care to 28 people aged 65 and over at the time of the inspection. The service can support up to 33 people. The home is situated in a rural area close to the towns of Chorley and Leyland. There is a large dining room, communal areas and a conservatory area. A well maintained garden is available at the rear of the home for people's leisure.
People’s experience of using this service and what we found
The provider had various methods to assess, monitor and improve the quality of the service, however, these had not identified and addressed the issues we found. We have made a recommendation about this. We have also made a recommendation about the management of some medicines. The home was clean and hygienic, and staff were seen to wear appropriate personal protective equipment. Staff were employed following a safe and robust recruitment process. Safeguarding training was mandatory, and staff were aware of the processes to follow to ensure they could keep people safe.
Staff felt supported by the management team through the induction and ongoing training they received. 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. Mealtimes were relaxed and organised around people's individual daily routines. People were supported to have access to healthcare professionals and their healthcare needs had been met. The service worked in partnership with other organisations to ensure they followed good practice and people in their care were safe.
People and staff told us there was a very positive culture at Marsh House. One staff member explained, “[Registered manager] likes positivity, she wants a happy place for staff and residents.” The management team positively engaged in the inspection process and the registered manager clearly understood their regulatory responsibilities. The registered and deputy manager had been responsive in implementing positive change and working with health and social care professionals to improve people’s quality of life.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was requires improvement (published 11 February 2022).
The provider completed an action plan after the last inspection to show what they would do and by when to improve.
At this inspection we found improvements had been made and the provider was no longer in breach of regulation 12 (Safe care and treatment) and regulation 17 (Good governance).
Why we inspected
We carried out an unannounced comprehensive inspection of this service on 09 November 2021. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve safe care and treatment and staffing.
We undertook this inspection to check they had followed their action plan and to confirm they now met legal requirements. The overall rating for the service has changed from requires improvement to good based on the findings of this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Marsh House on our website at www.cqc.org.uk.
Recommendations
We have made recommendations related to the safe storage of controlled drugs and good governance.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
Marsh House is a residential care home providing personal and nursing care to 25 people aged 65 and over at the time of the inspection. The service can support up to 33 people. The home is situated in a rural area close to the towns of Chorley and Leyland. There is a large dining room, communal areas and a conservatory area. A well maintained garden is available at the rear of the home for people's leisure.
People’s experience of using this service and what we found
People told us they felt safe. However the provider failed to demonstrate that medicines were managed safely. Best practice for the administration of medicines was not consistently followed. The provider did not ensure risk was consistently managed. Ongoing recruitment led to a reliance on agency staff with contracted staff completing multiple roles within the home. Not all staff had received timely training to complete their roles.
The environment was not visibly clean in some areas. The home was being refurbished and people were consulted on the décor of their home. We received mixed feedback on the food. Checks were completed to help ensure prospective staff were suitable to work with people who may be vulnerable.
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 dignity was not consistently upheld. Language used by some staff did not promote people’s dignity and individuality. However, observations showed people were happy and relaxed in the company of staff.
People's individual needs were assessed, and most care records reflected people's preferences and wishes. People’s communication needs were considered and documented to ensure staff could meet people's individual needs and preferences. There was a complaints process and procedure which people and relatives were aware of.
The management team had auditing systems to maintain ongoing oversight of the service and make improvements where necessary. People received support with their healthcare and nutritional needs. The provider understood their responsibilities to keep CQC informed of events which may affect people and the care delivery.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
This service was registered with us on 19/07/2021 and this is the first inspection.
The last rating for the service under the previous provider was good, published on 29/03/2018.
Why we inspected
This was a planned inspection based on the service being newly registered and in part to concerns about medicines, staffing and governance. A decision was made for us to inspect and examine those risks.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
You can see what action we have asked the provider to take at the end of this full report.
The provider had taken action to lessen the risks identified and provide additional oversight to the service.
We have found evidence that the provider needs to make improvement. Please see the safe and effective sections of this full report.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Marsh House on our website at www.cqc.org.uk.
Follow up
We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.