Archived: Marland Court

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Responsive – this means we looked for evidence that the provider met people’s needs.At our last inspection we rated this key question requires improvement. At this assessment the rating has remained requires improvement.This meant people’s needs were not always met.

The service was in breach of legal regulation in relation to person-centred care. Electronic care records were not always personalised and did not provide sufficient detail for staff. Care was not always person-centred, nor was this always dignified for people.

This service scored 43 (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 did not make sure people were at the centre of their care and treatment choices and they did not work in partnership with people, to decide how to respond to any relevant changes in people’s needs.

Care plans did not provide sufficient detail about people’s individual risks, some of which were complex, and actions staff could take to mitigate those risks were not recorded. Care records for people did not record how the staff team should support people consistently and in a person-centred way. Electronic care records were not always personalised and did not provide sufficient detail for staff. Care was not always person-centred, nor was this always dignified for people.

The service adopted the resident of the day approach, to thoroughly review all aspects of a person's care and treatment on a given day. The aim being to put people at the centre of their care. The examples we saw were not meaningful or complete. For example, the chef or kitchen staff did not always discuss food choices with people; nor were people’s views sought about any required repairs or issues they might have with their environment, as the home did not employ a maintenance person. One person we spoke with told us they had been ‘Resident of the Day’ but had not seen the senior carer or the cook. Processes to monitor and oversee this needed to be reviewed and made more robust to make sure any issues were identified and changes made where required.

We looked at a person’s care plan. It stated that they were unable to access the shower room as the doorway was not wide enough to accommodate their wheelchair. It was unclear what efforts were being made to rectify this, nor was it recorded how they were having their personal care needs met in relation to washing and bathing.

We did not look at Care provision, Integration and continuity during this assessment. The score for this quality statement is based on the previous rating for Responsive.

The provider did not always supply appropriate, accurate and up-to-date information in formats that were tailored to individual needs. We saw occasions when people’s communication needs were met. One person was provided with the evacuation process in the event of an emergency in their preferred language; these instructions were kept in their room. We saw no other guides or information however in their preferred language.

There was also a service user guide in people’s rooms. This outlined what services the home offered, details about the facilities and how to make a complaint. The service user guide made reference to another care home and needed amending to accurately reflect Marland Court. We did not see any other formats, for example easy read versions of the service user guide.

The provider did not always make it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff did not always involve people in decisions about their care or tell them what had changed as a result. Relatives shared that they had never been invited to take part in surveys.

Resident and family meetings were held by the provider which gave people an opportunity to offer feedback. Minutes from resident and relative meetings was negative regarding the laundering of clothes and one person told us, “I’ve had laundry go missing.”

However, there was no dedicated employee to oversee the laundry for the home; this role was completed by care staff, who were not able to give this the time and oversight needed to ensure people’s laundry was dealt with appropriately. We did not see any evidence that suggestions from people and family members had been acted upon.

We did not look at Equity in access during this assessment. The score for this quality statement is based on the previous rating for Responsive.

People were not supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life.

At the time of this assessment 2 people were deemed to be at end of life. Electronic care plans in relation to end of life care wishes had not been completed.The subject of end-of-life care planning can be distressing to discuss. There was no evidence to suggest people and their families had been approached to discuss their wishes for this stage of their life. If end of life wishes had been broached with relatives, any refusals to discuss this were not documented or recorded.There was no detailed information relating to people’s choices or preferences for the care they wished to receive from staff when approaching the end of their lives.

People were not supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life.

At the time of this assessment 2 people were deemed to be at end of life. Electronic care plans in relation to end of life care wishes had not been completed.The subject of end-of-life care planning can be distressing to discuss. There was no evidence to suggest people and their families had been approached to discuss their wishes for this stage of their life. If end of life wishes had been broached with relatives, any refusals to discuss this were not documented or recorded.There was no detailed information relating to people’s choices or preferences for the care they wished to receive from staff when approaching the end of their lives.