OSJCT Marston Court

We found the following examples of good practice.

Visitors had their temperature taken and were asked questions about their health to identify signs of infection. A sink and wall mounted hand sanitiser had been installed within the reception area and supplies of facemasks were readily available. Staff entering the building used a nearby room to change their clothes on arrival and put on appropriate personal protective equipment (PPE).

The premises were kept in a clean and hygienic condition throughout. Cleaning records showed areas posing a higher risk of cross-infection, such as surfaces and door handles, were sanitised at a minimum twice each day. Communal dining areas and shared bathrooms were cleaned frequently after use. The service had an infection prevention and control lead. This staff member regularly used equipment which could check the cleanliness of the environment and identify high touch areas. The home had also obtained specialist cleaning equipment such as a steam cleaner.

We observed changes made to the service’s environment to help promote social distancing. Seating in communal lounges and dining areas had been arranged to ensure people were seated at a safe distance. People using the service had been encouraged to form social ‘bubbles’ where they had friendships or enjoyed similar activities with others living at the service. The service is comprised of four units, and whilst some ‘bubbles’ meant people travelled between units, the registered manager confirmed people living within a unit would be isolated if someone developed a suspected infection, to minimise the risk of cross-infection between units.

We observed staff wearing appropriate PPE. Staff had received training on infection prevention and control. The infection prevention and control lead used a fluorescent lotion that when used with a UV lamp can check if staff have followed correct hand washing techniques. We learnt this had improved staff hand hygiene. PPE stock levels were monitored on a weekly basis, and the service used a central procurement team to order supplies.

The home was registered to regularly test staff and people using the service for COVID-19 infection. The service had agreed to participate in a national study investigating the impact of the pandemic on care homes. This would involve antibody testing for staff and residents over a 12-week period. Antibody tests are used to detect antibodies to the COVID-19 virus to see if it’s likely a person has had the virus before.

The service supported people to maintain contact with family members using digital technology. A visiting policy had been in place, but future visits were on hold due to the national lockdown. The service had focussed on maintaining people’s wellbeing during the pandemic. The activities team had organised small socially distanced group activities. People were also able to participate in virtual events such as concerts, tea parties and church services.

OSJCT Marston Court 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.

At this inspection we found the service remained Good.

Staff at Marston Court went to exceptional lengths to align individual activities to peoples wishes and dreams which helped people to physically reconnect with their past. As well as individual person centred activities the staff at Marston Court worked hard to ensure an extensive range of activities were accessible to all. Staff worked flexibly and often went the extra mile to ensure people were stimulated and not exposed to social isolation. The service was extremely responsive and staff worked flexibly to ensure people lived as full a life as possible. People's care plans were centred on their wishes and needs and continuously kept under review.

People told us that they felt safe. Staff were aware of how to safeguard people from harm and were aware of potential risks and signs of abuse. There were sufficient staff to meet people's needs. People received their medicines as prescribed.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service support this practice.

People's health care needs were taken care of and they had access to a range of healthcare professionals. Where required, appropriate referrals were made to external health professionals such as G.P’s or therapists. People told us they enjoyed the food provided by the home.

People and their relatives were very complimentary about the staff and management at the home. They told us staff were kind, caring and compassionate.

The provider had systems in place to receive feedback from people who used the service, their relatives, and staff members about the service provided. People were encouraged and supported to raise any concerns with staff or management and were confident they would be listened to and things would be addressed.

There was an open and inclusive culture in the home and people, their relatives and staff felt they could approach the management team and were comfortable to speak with the registered manager if they had a concern.

The service had a registered manager. 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 were safe. People were supported by staff who could explain what constitutes abuse and what to do in the event of suspecting abuse. Staff had completed safeguarding training and understood their responsibilities.

People received their medicines as prescribed. Staff administering medicines checked each person’s identity and explained what was happening before giving people their medicine. Where risks to people had been identified risk assessments were in place and action had been taken to reduce the risks. Staff were aware of people’s needs and followed guidance to keep them safe.

The service had robust recruitment procedures and conducted background checks to ensure staff were suitable for their role. There were sufficient staff to meet people’s needs. Staff were not rushed in their duties and had time to chat with people. Throughout the inspection there was a calm atmosphere and staff responded promptly to people who needed support.

Staff understood the Mental Capacity Act (MCA) and applied its principles in their work. The MCA protects the rights of people who may not be able to make particular decisions themselves.

The service sought people’s views and opinions and acted upon them. Relatives told us they were confident they would be listened to and action would be taken if they raised a concern. We saw complaints were dealt with in a compassionate and timely fashion.

People received person centred care. People were cared for by a service that understood the importance of getting to know the people they supported. There was a clear focus on the importance of knowing people’s histories.

Staff spoke positively about the support they received from the registered manager. Staff had access to effective supervision. Staff and the registered manager shared the visions and values of the service and these were embedded within service delivery. The service had systems to assess the quality of the service provided. Learning from audits took place which promoted people’s safety and quality of life.

People's needs were assessed and plans drawn up to meet their individual needs. We found that people were supported in accordance with these plans. One member of staff told us "we try to care for people as individuals, in the way they want to be cared for".

We found that staff knew how to report any concerns they had regarding people's safety and that the provider was able to respond appropriately to any concerns in order to protect people.

People told us there were enough staff to meet their needs. We were told that staff turnover was low and one staff member told us "we are good at keeping staff". We found that staff were trained and experienced and able to meet the needs of people supported.

We found the provider had in place systems to assess and monitor the quality of service provided. We were told of changes that had been put in place as a result of learning from accidents and incidents.