Archived: Martin Hall Nursing Home

There was a registered manager 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.

At this inspection we found that the provider had failed to ensure that previous improvements had been sustained. We found that there were breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we have taken at the back of the full version of this report.

Medicines were not managed appropriately and safely. People did not always get their medicines as prescribed.

Staff were kind to people when they were providing support. People did not consistently have their privacy and dignity considered. We have made a recommendation about privacy and dignity. Staff were able to tell us about people’s needs. Staff knew how to safeguard people against abuse.

We found that people’s health care needs were assessed. People had access to healthcare professionals such as the district nurse and GP and also specialist professionals.

Staff were provided with training on core areas and training in areas specific to the needs of people who lived at the home such as care of people living with dementia. The provider had a training plan in place and staff had received supervision.

The provider did not always act in accordance with the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). The MCA provides the legal framework to assess people’s capacity to make certain decisions, at a certain time. If the location is a care home the Care Quality Commission is required by law to monitor the operation of the DoLS, and to report on what we find.

People had their nutritional needs assessed but were not always supported to eat their meals to keep them healthy. Where people had special dietary requirements we saw that these were provided for.

People had access to limited activities. Signage in the home was poor and not provided in a manner which assisted people with dementia to orientate themselves to their surroundings.

Records were not accurate. Care plans were not updated consistently and did not reflect the care people required.

Systems were not in place to adequately assess, monitor and improve the quality and safety of the services. Audits were in place for areas such as medicines and infection control however they had not consistently improved the quality of care. Accidents and incidents were recorded.

Staff felt able to raise concerns and issues with management. Relatives were aware of the process for raising concerns.

The provider had informed us of notifications as required by law. Notifications are events which have happened in the service that the provider is required to tell us about.

We carried out an unannounced focussed inspection of this service on 15 June 2016. Breaches of legal requirements were found.

At our previous inspection on 25 January 2016 we found that the provider did not have effective systems to assess and monitor the quality of service provided to people. We also found that there were not effective and safe systems in place for the management and administration of medicines. After the inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to the breaches. We undertook a focussed inspection on 15 June 2016 to check that they had followed their plan and to confirm that they now met legal requirements. At our inspection on 15 June 2016 we found the provider had not made the necessary improvements.

This report only covers our findings in relation to those requirements. You can see what action we have told the provider to take at the back of the full version of this report. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Martin Hall on our website at www.cqc.org.uk.

Marin Hall provides care for older people who have mental and physical health needs including people living with dementia. It provides accommodation for up to 40 people who require personal and nursing care. At the time of our inspection there were 29 people living in the home.

At the time of our inspection there was not a registered manager 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.

Systems were not consistently in place to assess and monitor the quality of the service to people. The provider told us what actions they would take to make improvements and we found at this inspection that the improvements had not been sufficient to meet legal requirements. The provider had started to carry out some audits on a regular basis however audits did not identify some of the issues we found at this inspection. The provider had not complied with their medicines policy.The provider did not have systems in place to ensure that people received their medicines as prescribed.

At the last inspection on 12 August 2015 we found that the provider did not have effective systems to assess and monitor the quality of service provided to people. We also found that there were not effective and safe systems in place for the management and administration of medicines. We undertook a focused inspection on 25 January 2016 to check that they had followed their plan and to confirm that they now met legal requirements. At our inspection on 26 January 2016 we found the provider had not made the necessary improvements.

This report only covers our findings in relation to those requirements. You can see what action we have told the provider to take at the back of the full version of this report. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Drovers Call on our website at www.cqc.org.uk.

Marin Hall provides care for older people who have mental and physical health needs including people living with dementia. It provides accommodation for up to 40 people who require personal and nursing care. At the time of our inspection there were 34 people living in the home.

At the time of our inspection there was a registered manager 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.

The provider did not have systems in place to safely manage the storage and administration of medicines. Medicine records were not accurate. People did not get their medicines as prescribed. Systems were not consistently in place to assess and monitor the quality of the service to people. The provider told us what actions they would take to make improvements and we found at this inspection that the improvements had not been sufficient to meet legal requirements. The provider had started to carry out some audits on a regular basis however audits for medicines had not been carried out.

At our last inspection of Martin Hall on 8 May 2013 we issued a compliance action, as we were concerned the provider did not have systems in place to protect people, staff and others against the risk of infection. We observed there were not effective systems to assess the risk of and to prevent, detect and maintain appropriate standards of cleanliness.

Following this visit we received an action plan from the provider to address the issues.

During this visit we spoke with the registered manager and inspected the facilities in the home. We checked a range of documentation and checked on the progress the manager had outlined in their action plan.

We found that most of the actions in the action plan had been completed. We saw where these had not been completed they were in progress.

To help us to understand people's experiences we used our Short Observational Framework for Inspection (SOFI) tool. The tool allows us to spend time observing and helps us to record how people spend their time. We carried out the tool for an hour. We

observed positive responses and contact with people.

Overall we observed that people were supported by skilled and experienced staff who understood their roles and responsibilities.

We heard staff ask people how they were and if they wanted anything. We also saw staff reassuring people when they were distressed.

We saw from the care plans people received care which was appropriate to their needs. We also looked at the cleanliness of the home and the systems which protect people from the risk of infections. We found there were not any systems and processes in place to protect people from the risk of infection.