Archived: The Mariners

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

People’s experience of using this service:

Peoples experience of using the service remained good. People spoke positively about the opportunities they had to do things for themselves, try out new things and the support they receive from staff to enable them to take more control of their lives. A relative told us that they were very happy with the way their relative, who usually took time to adapt to change, had in fact settled quickly and was “really happy”, they found staff very supportive and they and other relatives said they were kept informed and involved. A visiting care manager undertaking a review of the care of someone at the service told us that they were very satisfied with the support the person was receiving and had no concerns at all.

The premises is a period building and as such there are limitations and restrictions on what can be done to modernise it. This aside, décor in communal areas is very tired and carpeting in communal areas needs updating. Peoples bedrooms however are personalised and decorated to their own specific preferences.

The service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. This ensured that people could live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence.

The registered manager provides continuity and consistency of leadership in the way the service is managed and developed, this had enabled trusted relationships to build between people and the registered manager. Staff felt well supported and received regular supervision and appraisal from their line manager. A trustee visit happens annually and a report of this was available to view. There is however, a lack of evidence of regular formal quality assurance oversight from the provider representative and how they could evidence their assurance that people received a safe and appropriate service for their needs. This is an area for improvement.

Staff encouraged positive risk taking for people to enable them to live as ordinary a life as possible. People were independent in most areas of their daily support and staffing levels reflected this, there were enough staff to meet people’s day to day needs. Medicines were managed safely and five people were empowered and enabled to take over the administration of their own medicines.

. People's needs were routinely reviewed and reassessed to ensure they had the right support and care was planned and delivered to meet their specific needs and preferences. Staff were well trained; staff retention was good and staff demonstrated excellent knowledge and understanding of people’s individual needs. People ate well, were encouraged to eat healthily and were supported to cook for themselves on some days.

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 supported this practice. When people were unable to make decisions about their care and support, the principles of the Mental Capacity Act (2005) were followed.

Staff showed themselves to be kind and caring in their interactions with people and fostered a warm and considerate attitude between people in the service. The atmosphere in the service was welcoming and staff and people were friendly to visitors. People and their relatives were informed and involved in decisions that affected peoples support. People had their own keys to their rooms and their privacy and dignity was respected by each other and staff. People were supported and enabled to form meaningful relationships with others.

People were supported and given choices to do things that interested them, they had access to a wide range of activities and entertainments and participated in voluntary work placements in a local café.

People were supported to remain well and were supported with routine and specialist health checks and appointments with health professionals. Staff were trained to support people with healthcare conditions such as Diabetes and epilepsy. People and relative’s concerns were listened to and acted upon to help improve people’s experience of care and support offered.

Rating at last inspection: Good (report published in October 2016)

Why we inspected: This was a scheduled inspection based on the previous rating. We found the evidence continued to support a Good rating overall.

Follow up: We will continue to monitor the service through the information we receive.

We last inspected The Mariners on 7 February 2014 where we found it to be compliant with all areas inspected.

A registered manager was in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 and associated Regulations about how the service is run.

People were happy and relaxed and supported to live safely in their home environment. There were sufficient numbers of staff to support them. Appropriate checks were undertaken to ensure staff were suitable to work within the care sector. Staff were knowledgeable and trained in safeguarding and the actions they should take if they suspected abuse was taking place. A range of appropriate training was provided to ensure staff have the skills and knowledge to meet people’s needs.

Staff had spent time with people, getting to know them, gaining an understanding of their personal history, their support needs and building rapport with them. People were able to access a choice of healthy food and drink ensuring their nutritional needs were met.

Medicines were managed safely and in accordance with current regulations and guidance. There were systems in place to ensure that medicines in use were stored, administered, and disposed of appropriately.

People’s needs had been assessed and detailed care plans developed. Care plans contained risk assessments for a wide range of daily living needs. People consistently received the care they required, and staff members were clear on people’s individual needs. Care was provided with kindness and compassion. Staff members were responsive to people’s changing support needs. People’s health and wellbeing carefully monitored and staff regularly liaised with a range of healthcare professionals for advice and guidance.

The CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. We found that the manager understood when an application should be made and how to submit one. Where people lacked the mental capacity to make specific decisions the home was guided by the principles of the Mental Capacity Act 2005 (MCA) to ensure any decisions were made in people’s best interests.

People were provided with opportunities to take part in a wide range of personal interests, activities and life skills and regularly accessed the local and wider area. People were supported to take an active role in decision making regarding their own routines and those of the home.

The registered manager was well supported by the provider and staff spoke positively about working at The Mariners and about the support they received from senior staff.

There were a range of systems to monitor the quality of service and enable senior staff to have clear oversight of areas that required attention.

People had their individual needs and wishes assessed and recorded before coming to live in the home. Our observations during the day showed us they were treated with dignity and kindness and their choices were respected.

People had their physical and emotional healthcare needs recorded in a person centred plan of care and risks to safety were assessed and monitored.

There were processes in place to protect people from the risk of abuse or harm and staff had received the relevant training. Staff that spoke with us were aware of their responsibilities.

In order to ensure that people were being supported in a safe manner, the home carried out a thorough recruitment and selection process and staff received training relevant to their role.

Processes were in place to audit and monitor the quality of service being provided.

A family member that spoke with us said. 'The care is excellent across the board. Our son is employed fully with a range of activities, his health conditions are looked out for and he has a much better quality of life that we could give him at home.'

In our discussions with staff they demonstrated a thorough knowledge of the people living at the service and showed that they were empowering people to live as they chose, within safe limits. This was confirmed by our observations and the record keeping. Records showed that all care and planning was centred around the person receiving the support and that people had daily opportunity to feed into this.

When people's needs changed we found that records had been updated to reflect this. We found that timely intervention from health professionals was undertaken, with the consent from the person requiring that support.

A good level of staff were employed to support people living at The Mariners. The rota demonstrated a consistent staff team, with back up from a pool of staff employed by Canterbury Oast. Staff had relevant qualifications and experience.

Records showed the provider regularly assessed and monitored the quality of the service and gained the views of those living within the home.