Essex Care Consortium - Marks Tey

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. At our last assessment we rated this key question requires improvement. At this assessment the rating has changed to good. This meant people were safe and protected from avoidable harm.

This service scored 69 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider had a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt; however, improvements were needed to ensure a better understanding of themes and trends across the service to continually identify and embed good practice.

Systems were still being developed to evidence collective oversight of all incidents, including behaviour-related incidents, to identify themes and trends that may indicate wider, systemic issues across the service. The provider had already recognised this as a required action and had appointed an assistant general manager who would be assuming responsibility for this area, but this was yet to take place.Analysis of incidents at an individual level had improved and was more detailed. The registered manager had introduced a data-driven system that captured key information such as the location, duration and intensity of incidents. This information was used to identify root causes and inform actions to reduce risk and improve outcomes for people. For example, analysis for 1 person in March 2026 showed that loud noises escalated their anxiety and distress when they were overwhelmed. This identified the need for a quiet space to be available in future to help ease distress and to reduce the need for PRN (as required) medications.

Staff told us they were confident that incidents and accidents were thoroughly investigated and used as learning opportunities. One staff member said, “Yes, (incidents and accidents are investigated). We always know if there has been an accident or incident. There is lots of paperwork and good communication.”

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services.

People received continuity of care and good outcomes because the provider worked collaboratively with healthcare partners such as the GP, and community health teams. We saw that medical advice was sought promptly when required to ensure people’s overall safety and well being. Care plans and risk assessments were generally updated to include input from external professionals. For example, 1 person’s care plan showed that where a skin condition had been identified, medical advice was sought promptly and a dermatology referral made. Another care plan had been updated to include guidance and outcomes following a referral to healthcare professionals for support with managing a person’s continence needs. The provider also took steps to reduce health inequalities by ensuring people were involved in capturing essential information, including communication needs and tools, and key health details. This meant people’s needs and preferences could be clearly communicated when accessing other services, such as during GP appointments or hospital admissions. We saw a care plan which included information about the level of supervision required when attending health appointments and a personal statement which showed the person had been involved in determining the level of support they wanted and needed.

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider shared concerns quickly and appropriately.

Effective systems, processes and practices safeguarded people from harm. Staff described an open culture in which they felt confident raising safeguarding concerns with the manager and knew action would be taken. One staff member said, “We can go to our manager or take it to the director. She is a good manager; I can always go to her.” Despite posters including key internal and external safeguarding contacts being displayed prominently across the service, staff were not always clear about the correct external routes for escalating safeguarding concerns to the local authority safeguarding team. We identified one poster at The Vines that had not been updated with the correct local authority safeguarding contact details or the internal safeguarding champion. This was updated promptly once raised by inspectors.

A relative told us they felt their family member was safe at the home, saying, “Yes, [Person] is safe. I haven’t had to raise any concerns. The registered manager is marvelous; she always responds to my emails. Staff are really good. Their patience is beyond anything. It’s amazing.”

The service completed monthly safeguarding reviews and took appropriate action, including sharing information with relatives and external partners such as the local authority and the Care Quality Commission (CQC).

The provider did not always work well with people to understand and manage risks. Staff did not always provide care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

Some people’s care plans required more detailed information in line with their risk assessments to ensure staff had adequate information to be able to support people safely and respond to risk. For example, where 1 person’s risk assessment concluded that a person should receive a wellbeing check after a specified timeframe when using the bathroom due to an identified risk, the specific timescales had not been clearly recorded in the care plan. Where health monitoring was required, more guidance was needed to ensure staff knew when to identify risks to people’s health and how to escalate or respond. For example, we found 1 person’s care plan indicated that their fluid intake should be monitored by staff to minimise the risk of health conditions, but it did not contain important information such as the acceptable levels of intake or steps to take once those levels were exceeded. Staff told us that despite the issues we found in care plans, they were confident that they were kept up to date with any changes to people’s needs. One staff member said “If there are any changes we get notified. There is a lot of communication.” The registered manager took prompt action to review and update the care plans once raised by inspectors.

Holistic risk assessments were completed to enable people to stay safe whilst doing the things that mattered to them. They were person centred, proportionate and regularly reviewed. We saw positive risk taking was encouraged, and people were supported to discuss and understand risks to themselves and others. For example, resident meeting minutes showed that people were engaged in conversations about the associated risks of unhealthy food choices and smoking, providing them with information to make informed decisions and promoting autonomy to make their own choices.

The service was committed to minimising the use of restrictive interventions, including restraint; restraint was only used as a last resort. Incident analysis showed physical restraint was not relied upon to manage incidents of distress. Staff told us although they had received training in physical intervention, which had provided them with the skills to deflect physical confrontations or aggressive situations safely and effectively, this was not routinely used. A staff member said “I haven’t used restraint. We know people, so we can see it (behaviour that communicates a need) before it happens. We had training in physical intervention, but the manager will always put you forward if you need more. We can also contact the trainer if we need more support”.

Staff felt that they were safe at work, and the people they supported were safe. A staff member said, “Yes (I feel safe at work). If you’re feeling a bit off, there are always people to go to. We are a good team. If someone is distressed and we need help, the manager is there.”

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

Arrangements to monitor the safety and upkeep of the premises had improved. We saw works had been completed in line with our previous inspection findings, including improvements to bathroom windows where mould was identified and redecoration of a bedroom, which had been scheduled for a long period of time. New systems of auditing had also identified further work required in the home, such as a further bathroom renovation and the purchase of a new oven for the kitchen. New furniture, such as a wipe-able sofa and a round coffee table for the lounge, has been provided with consideration for people’s safety and comfort.

Recording of essential maintenance and safety checks had improved. The fire logbook showed that fire drills and alarm tests were being completed and recorded regularly to ensure the fire alarm system was working properly and to prepare people for a potential fire emergency. Environmental audits were being completed to a higher standard and evidenced completion of tasks and oversight from leaders. New systems of auditing and oversight had been introduced and included prompts for environmental checks to ensure safety and suitability of the home environment was continually reviewed. However, these systems were newly implemented, and more time was required to evidence that environmental concerns were being consistently identified and resolved.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs.

Systems to assess staffing requirements had improved and we observed there were enough staff on duty during our inspection, including for 1-to-1 provision and to support people to access the community. A dependency tool was being used by the registered manager to ensure the deployment of staff was sufficient to meet people’s assessed needs. This captured people’s needs and capabilities to identify the number of staff and key skills required at all times of the day. This included the provision of a qualified first aider and fire marshal in case of an emergency. People received care from knowledgeable staff who were trained in topics tailored to their specific needs, including end-of-life care, catheter care and mental health conditions. More time was needed to evidence that training requirements had been proactively identified and met by the provider in response to people’s changing needs.

Although nobody had commenced employment since our last inspection, we saw that improvements had been made to recruitment and interview systems to assess applicants’ suitability for the role. This included prompts to explore gaps in employment history, a revised set of questions based on values-based recruitment and a service specific skills test designed to gauge applicants’ role-based math and English skills.

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

Improvements to the premises had been made including replacing the windows in one of the bathrooms where mould was identified. Where the management team had identified further works were required in bathrooms this had been added to an ongoing plan of improvements for the service.

The service had made improvements to ensure infection control was being managed in line with best practice guidance. The registered manager was the designated Infection Prevention and Control (IPC) lead and had completed enhanced training to ensure they understood their role and responsibilities. They were completing regular IPC audits, including hand hygiene and mattress checks and acting where issues were identified. For example, where one audit showed a person’s mattress did not meet the IPC standards, a replacement was sourced. Staff had access to best practice guidance to protect people from the risk of acquiring infections as information was clearly displayed on a range of IPC topics such as hand hygiene, cough and respiratory hygiene, and common infections. Bathrooms had adequate supplies of personal protective equipment (PPE) and posters were displayed with best practice guidance for hand hygiene and donning and doffing (putting on and taking off) PPE. The service employed domestic staff to keep the service clean and hygienic throughout. We received feedback that cleaning supplies were adequate and ordered regularly, and there was enough time to keep the home clean. A staff member also told us that people were supported to help keep their rooms clean, where they were able. They said, “I do [person’s] room once per week, he likes to help me with the cleaning. [person] also helps me with his clothes. He’s great at folding them.”

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened.

Staff used risk assessments, mental capacity assessments (MCAs), and best interests’ meetings to support people to take their medicines safely and appropriately. Care plans were personalised and contained clear guidance, which ensured people received their medicines in ways that reflected their needs, preferences, and individual abilities, while respecting their wishes.

The service was aware of the Stopping Over Medication of People with a Learning Disability and Autistic People (STOMP) programme, a national NHS England initiative aimed at reducing the inappropriate prescribing of psychotropic medicines. Information about the programme was displayed prominently throughout The Laurels to support staff understanding and promote best practice.

We completed a medicines stock check, which was accurate and matched administration records. This provided assurance that people received their medicines as prescribed. The registered manager carried out regular medicines’ audits, which supported the identification of any concerns in medicines management. Where issues were identified, the service responded promptly and shared learning across the staff team to drive improvement. For example, staff meeting records showed that the team discussed a recent increase in medication errors to reduce the risk of re-occurrence.

PRN medicine protocols should clearly outline person-centred alternatives and supportive interventions to be considered before administering medicines. The service had reviewed and strengthened these protocols, ensuring they included guidance on de‑escalation and supportive strategies to manage anxiety or distress. These included distraction techniques, identifying unmet needs, and offering calming activities. One protocol stated, “Offer [Person] a distraction such as a cup of tea or listening to music. Talk to [Person] and ask what is upsetting them.”