The Martins

The Martins is a residential care home providing accommodation, and personal care for up to 42 people across two floors consisting of four units. The service also provides specialist care to people living with dementia. At the time of our inspection there were 37 people using the service.

People’s experience of using this service and what we found

The management team conducted a variety of audits to assess the quality and safety of care provided. Managers and staff demonstrated a positive culture which was person-centred. The management team investigated incidents fully, and actions were identified to make improvements.

Managers and staff were clear about their roles; however, further work was needed to ensure the Care Quality Commission [CQC] was notified of significant events within timescales as required.

People, their relatives and staff were involved and engaged in the service. The provider had systems in place to monitor and review the service. The provider was working with health and social care professionals to meet people’s health, welfare and social needs.

There were sufficient staff available to meet people’s needs at the time of our inspection. Staff were safely recruited and checks were made on their suitability.

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.

Relatives spoke positively about the caring culture of the service and said their loved ones were safe and well supported. They also told us the service was managed well, communication was good and their opinions were sought in the planning and review of people’s care and treatment.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was outstanding (published 26 September 2017).

Why we inspected

This inspection was prompted by a review of the information we held about this service. As a result, we undertook a focused inspection to review the key questions of safe, responsive and well-led only.

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.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has changed from outstanding 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 The Martins on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

The service had comprehensive policies and procedures to manage any risks associated with the COVID-19 pandemic. This included the management of people with a COVID-19 positive diagnosis.

People living in the service and their relatives were supported to maintain contact.

The registered manager offered weekly Zoom calls to friends and relatives of people who used the service to provide information and updates, including changes in Government COVID-19 guidance.

There was a system of regular COVID-19 testing for both people who used the service, staff, and visitors. All visitors, including professionals were subject to a range of screening procedures, including showing evidence of vaccination and a negative lateral flow test before entry into the service to protect people from the risk of acquiring infections.

There was a plentiful supply of personal protective equipment [PPE] for staff and any visitors to use. Hand sanitiser was readily available throughout the service. Staff had received updated training in infection control and in the use of PPE. Staff were observed wearing PPE.

Daily cleaning schedules were in place and all staff were involved in undertaking regular touch point cleaning.

The service provides residential care for up to 42 people, some of whom are living with dementia. At the time of our inspection 40 people were using the service.

A registered manager was 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.

At our previous inspection in October 2014 we found that people were receiving high quality care which responded to people’s individual needs. At this inspection we have found that these standards had been maintained and in some areas further improved. This meant that people received an outstanding level of care which responded to their individual needs and preferences. Skilled and caring staff supported people in the way that they chose.

People received safe care which met their individual needs and preferences. There was a strong commitment to enabling people who used the service to be as independent as possible through robust risk assessment to keep them safe. Risks were assessed and documented in care plans and environmental risks were very well managed. The manager and staff demonstrated a very good oversight of risk.

Staff were trained in safeguarding people from abuse and the manager referred incidents appropriately to the local authority safeguarding team for investigation. Internal investigations into safeguarding incidents were carried out in an honest and transparent way. The service worked well with other professionals to investigate any safeguarding matters.

There were enough staff to keep people safe and to enable them to live their lives in the way they chose. Staff were recruited safely as there was a robust recruitment procedure in operation. The service was overstaffed by 10% to further ensure care and support was delivered consistently by staff who knew people well. Staff had time to spend with people and people’s needs were met promptly.

Medicines were managed safely and people received their prescribed medicines when they needed them. Staff were trained and verified as competent to administer medicines.

The service was clean and infection control measures were in place. All staff had a good understanding of how to reduce the risk and spread of infection.

Staff received an excellent work based induction and a variety of relevant and person centred training to help them carry out their roles. Training was innovative, challenged staff and was designed to drive continual improvement. Staff were supported with regular meetings, supervision and values driven appraisal of their performance. Staff were very positive about the training they received and felt valued by the manager and the organisation.

Staff had received training in the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). The MCA ensures that people’s capacity to consent to care and treatment is assessed. If people do not have the capacity to consent for themselves the appropriate professionals, relatives or legal representatives should be involved to ensure that decisions are taken in people’s best interests according to a structured process. DoLS ensure that people are not unlawfully deprived of their liberty and where restrictions are required to protect people and keep them safe, this is done in line with legislation. Practice related to MCA and DoLS was very good and in line with legal requirements.

People who used the service praised the food highly. People were referred to appropriate healthcare professionals, such as dieticians, promptly if they required this support. There was sensitive support at mealtimes for people who needed help or encouragement to eat and to maintain their weight. Oversight of people’s nutritional needs was good. Mealtimes were very chatty and sociable occasions which people clearly enjoyed.

People were promptly supported to access the health and social care professionals they needed. There was evidence of good partnership working with the district nursing team and other healthcare professionals. Feedback from healthcare professionals working with the service was very positive.

Staff were exceptionally caring and compassionate. They treated people respectfully and demonstrated great patience and empathy. Staff sought to ensure people’s self-esteem and dignity was maintained. The caring role was not limited to care staff but administrative staff and volunteers played an important part in the caring life of the service.

The Christian values of the service were evident throughout and this was very important to all of the people who used the service. Many staff shared the Christian values which were fundamental to the service. This provided a common bond between staff and the people who used the service. The staff also actively supported people to explore other faiths if they chose to.

Care was person centred and people’s individual needs were well documented. Staff demonstrated a good knowledge of these. Care was delivered holistically and staff caring for those people living with dementia never lost sight of the person inside and had received training related to this in particular. People living with dementia played a full part in the life of the service and the atmosphere was inclusive and caring.

People were extremely well supported at the end of their life. They experienced care which reflected their very specific preferences and met their needs at this most important time. The manager, supported by the staff team, focussed on ensuring people’s end of life care was given in line with their expressed wishes. Staff were proud of the end of life care that people received.

People who used the service, and their relatives, were involved in planning and reviewing their care and had opportunities to feedback about the service. The provider was proactive in seeking people’s views and acted on information they received in order to improve the service.

People were supported to follow a range of hobbies and interests and to take an active and purposeful part in the daily life of the service. Those living with dementia and those unable to go out independently were provided with appropriate stimulation and occupation. People were encouraged to remain part of their local community.

A complaints procedure was in place. No formal complaints had been made but informal issues were well managed and resolved quickly to people’s satisfaction. The manager gave people many opportunities to raise informal issues and was always looking to improve the service. People had the confidence to raise concerns and felt listened to.

A comprehensive system of audits and spot checks was in place to monitor the safety and quality of the service. Staff took pride in carrying these audits out regularly where they had been given the delegated authority to do so. The manager took overall responsibility for ensuring that any identified actions were put in place.

The exceptional manager acted as role model and was respected by people who used the service, relatives and staff. They led by example and clearly set out the standards they expected from staff. They had excellent oversight of the issues that affected this service, which has a history of positive inspections by CQC, and were able to motivate their team exceptionally well. The manager demonstrated a commitment to the ongoing improvement of the service. They aimed to ensure that people’s individual needs and preferences were met through the delivery of innovative and person centred care. The manager and staff took a pride in their work and clearly cared deeply about the people who used the service and their families.

Staff demonstrated a good knowledge of providing compassionate care to people with mental health needs and we saw that they communicated sensitively and positively with people. People were provided with a varied and nutritious diet and people's individual preferences and needs were catered for. Medication was administered promptly and recorded accurately.

During our visit on 25 October 2012, we used the Short Observational Framework for this inspection (SOFI) in order to understand the experiences of people living in Lark Close. SOFI is a specific way of observing care to help us understand the experiences of people who may not have been able to talk with us. We noted that staff treated people with dignity and respect. They ensured that people had time to make decisions about what they wanted to do. Staff supported people to make choices around food and joining in activities.

We found that the service was meeting people's care needs and so supporting their health and wellbeing. Staff were competent and communicated well with people using the service. Where appropriate, staff had received training in providing support to people with dementia. The service had interpreted the implications of the mental capacity act and applied them locally. People had benefited from regular access to other healthcare professionals including music therapists. People were able to maintain a good quality of life.