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Inspection Summary


Overall summary & rating

Good

Updated 17 August 2018

The inspection took place on 10 and 11 July 2018 and was unannounced. The service was last inspected on 12 April 2016, where we found the provider met all the legal requirements but was rated requires improvement in Well-led domain. Following the last inspection, we carried out a focused inspection on 21 August 2017 which was prompted in part by notification of an incident following which a person who used the service had died and the incident indicated potential concerns about the management of risks in relation to the safety of the premises. At the focused inspection, we found the provider to be in breach of a regulation in relation to good governance.

Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the key question Well-led to at least good. At the inspection on 10 and 11 July 2018, we found that the provider had made improvements.

Mary Feilding Guild is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Mary Feilding Guild is registered to provide accommodation and personal care support to 43 people in an adapted building across five separate units, each of which have separate living areas and outdoor spaces including terraces, and a communal garden. Mary Feilding Guild is set up to provide a service to people who can maintain an independent lifestyle. People’s rooms have ensuite and kitchenette facilities. At the time of our inspection, 35 people were living at the service.

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.

People told us they felt safe living at the service. Relatives told us staff supported people safely. Staff were trained in safeguarding, health and safety and first aid. They knew their responsibilities in keeping people safe from avoidable harm and abuse. People’s risk assessments and risk management plans provided sufficient support to staff on how to minimise risks to people. People were supported with medicines by well trained staff. The provider had robust processes in place to record and learn from accidents and incidents. Staff wore correct personal protective equipment whilst providing care to avoid the risk of spread of infection. The service was clean and there was no malodour. The provider had made several premises improvements and were undergoing additional building works to ensure people and staff safety. Staffing levels during daytime were sufficient however staff told us night time staffing levels were not enough. We have made a recommendation in relation to staffing numbers.

People’s needs were appropriately assessed before they moved to the service permanently. Staff were aware of people’s needs and abilities. They received regular supervision and training to support people with their individual needs. People told us their needs were met and were happy with nutrition and hydration support. Most people told us they liked the food. The premises were adapted to meet people’s individual needs. The provider had processes in place to ensure people who deemed to lack capacity were supported in line with the MCA principles. People were offered choices and their consent sought.

People and their relatives told us staff were caring, helpful and friendly. Staff were trained in equality and diversity and told us they treated people with dignity and respect. People’s religious and spiritual needs were met by staff when requested and recorded in their care plans. Staff supported people to lead independent lives and respected their privacy.

People’s care plans were person-centred and comprehensive. The provider offered people a varied range of stimulating group and individual activities. People and their relatives knew how to raise concerns and complaints. The provider kept accurate records of complaints.

People, their relatives and staff told us the service was well managed and management was approachable. People and their relatives were asked for their feedback and the findings were used to improve the service. There were clear records of audits and checks to ensure the quality of care and people’s safety. The provider worked with healthcare professionals and other organisations to improve the service and people’s well-being.

Inspection areas

Safe

Good

Updated 17 August 2018

The service was safe.

People and their relatives told us they felt safe with staff. Staff were knowledgeable about risks to people and how to provide safe care. Staff knew how to protect people against harm and abuse. People's risk assessments were comprehensive and regularly reviewed.

The provider followed appropriate recruitment procedures. Although there were sufficient staff during daytime, staff told us the staffing levels were not enough at night.

Trained staff supported people with their medicine needs. Staff followed appropriate infection control practices. The provider had made a lot of changes to the premises and planned building works were being carried out to ensure people and staff’s safety.

Effective

Good

Updated 17 August 2018

The service was effective.

People’s needs were assessed and they told us staff met their needs. Staff received regular training and supervision to provide effective care. Most people liked the food.

Staff supported people to access ongoing healthcare services. The premises had adaptations that met people’s individual needs. Staff sought people’s consent before delivering care and gave them choices.

Caring

Good

Updated 17 August 2018

The service was caring.

People told us staff were caring and treated them with dignity and respect. Staff asked people’s views and involved them in making decisions regarding their care. The service had a relaxed atmosphere.

Staff encouraged people to maintain independent lives. People’s care plans gave information on their religious and cultural needs. Staff were trained in equality and diversity.

Responsive

Good

Updated 17 August 2018

The service was responsive.

People told us they received personalised care. Their care plans were regularly reviewed and were comprehensive and person-centred.

People were offered a range of varied activities and told us they enjoyed them. The provider followed their complaints procedure to promptly address people’s concerns.

People’s end of life care wishes were discussed and recorded in their care plans.

Well-led

Good

Updated 17 August 2018

The service was well-led.

The provider had made improvements since the last inspection and there were effective audit systems to ensure people's safety.

People and their relatives told us the management was approachable. Staff told us they felt listened to and supported.

The provider sought people's feedback and worked with other organisations to improve the services.