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Mariners Court Care Home Good

Reports


Inspection carried out on 13 August 2020

During an inspection looking at part of the service

We found the following examples of good practice.

The provider had implemented comprehensive processes to minimise the risk to people, staff and visitors from catching and spreading infection. This included regular checks of people who lived at the home and staff for any signs or symptoms of COVID-19. Personal protective equipment (PPE), hand sanitiser and hand washing facilities were available around the home. The provider had purchased equipment to aid in educating staff on the importance of hand hygiene and how germs can spread. The provider had invested in specialist cleaning products including the use of an ozone generating machine, as well as increased cleaning around the home, to help reduce the risk of infection spreading.

The home had signed up to a ‘whole home’ approach to testing for COVID-19. This meant all people and staff were screened on a regular basis for COVID-19, so timely action could be taken to minimise the spread of infection. People being admitted into the home were required to have a COVID-19 test before moving into the home and were subject to a period of isolation, in line with guidance. Where people were isolating, staff members were always available to them to support their wellbeing.

There was a focus on maintaining people's wellbeing and relationships between people and those important to them. The provider had set up a marquee in the back garden to facilitate safe visits. Those visiting people who lived at the home were sent information before their planned visit, which detailed the measures the provider had put in place and expectations of them during the visit. Visitors were screened before they could enter the marquee, to ensure they were fit and well and not displaying any signs of COVID-19. Additional restrictions applied where visitors lived in an area subject to local lockdown measures. Appointments for visits were time limited and restricted. The service provided alternative arrangements for people to keep in touch with those important to them. This included telephone calls, video calling, use of social media and visits where people could see their loved ones through a window at the home, in addition to regular newsletters and updates to relatives. Staff had been providing increased activities within the home to help maintain people's wellbeing.

The provider ensured social distancing and shielding guidelines were complied with as far as possible. No one was shielding at the time of our inspection. The registered manager was fully aware of guidelines and told us they would support people to shield as appropriate. People who lived at the home were all living with dementia. This meant sometimes people's capacity to understand social distancing guidance could be limited. The registered manager had reviewed the layout of the home to make sure it facilitated social distancing and staff supported people to follow distancing guidelines. Staff were encouraged and supported to maintain social distancing. They were provided with separate areas to take breaks, eat meals and meetings, such as handovers, were taking place in larger rooms. The provider supported staff to shield in line with guidance by retaining them on full pay for the duration.

PPE was used effectively to protect people who used the service and staff. We saw the service had enough stocks of PPE and saw staff used it in line with guidance. Staff had received training in infection control, how to use PPE properly and had received information about COVID-19, to enable them to work safely and reduce the risks. Staff explained people were initially anxious about the increased levels of PPE, but that everyone had become used to it as 'the new normal'. The registered manager considered the impact PPE, particularly face masks, could have on communication. They had assessed people's individual needs and planned care accordingly, to ensure their needs could be met effectively.

The provider carefully monitored people's wellbeing, staff w

Inspection carried out on 11 September 2019

During a routine inspection

About the service

Mariner’s Court Care Home is a residential care home, providing personal and nursing care to up to 26 older people. At the time of the inspection, the service was supporting 23 people who were living with dementia. The service is an adapted three storey building on the promenade at Fleetwood, with lift access to all floors.

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

Staff managed people’s medicines well and kept the home clean and tidy. Staff managed risks well and had plans to follow in case of emergencies. The service had systems to protect people from the risk of abuse and improper treatment.

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.

The service met people’s nutritional needs and worked with them to make sure food provision also reflected their preferences. Staff supported people with their healthcare needs and worked well with external healthcare professionals. People were cared for by staff who were well supported and had the right skills and knowledge to meet their needs effectively, following good practice guidance.

People were treated well, with kindness and compassion by staff who respected their privacy and dignity and promoted inclusion.

The service put people at the heart of the care they received. Staff used detailed assessments to identify people’s needs and preferences and worked to ensure people were happy with the care they received. The service made sure people were supported to communicate and planned activities to enhance people’s wellbeing.

The service was led by a registered manager was described as approachable, well-organised and caring. The culture at the service was open and inclusive. Staff understood their roles and responsibilities. The provider monitored the quality of the service using a range of systems.

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 good (published 15 March 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Inspection carried out on 30 January 2017

During a routine inspection

The inspection visit at Mariner’s Court took place on 30 January 2017 and was unannounced.

Mariner’s Court is a large detached residence, overlooking the boating lake in the seaside town of Fleetwood. The home provides 24-hour personal care and accommodation for up to 26 older people. Bedrooms have en-suite facilities and a through floor lift provides access to the first and second floors. There is a dining room, three lounges and an activities room on the ground floor. There is a secure garden to the rear of the property, with outdoor seating areas and car parking to the front of the property. At the time of our visit, 23 people lived at the home.

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.

A breach of legal requirements was found at the last inspection. The provider was in breach of Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Good Governance. The systems in place to monitor safety had not been effective. This was because we found two incidents had not been fully documented or reported and action had not been taken in response to a number of unwitnessed incidents. After the comprehensive inspection, the provider wrote to us to say what they would do to meet legal requirements. At this inspection on 30 January 2017 we checked that they had followed their plan and to confirm that they now met legal requirements.

We found the registered manager had systems to record safeguarding concerns, accidents and incidents and take necessary action as required. Staff had received safeguarding training and understood their responsibilities to report unsafe care or abusive practices.

We looked at the recruitment of two staff members. We found appropriate checks had been undertaken before they had commenced their employment confirming they were safe to work with vulnerable people.

Staff spoken with and records seen confirmed a structured induction training and development programme was in place. Staff received regular training and were knowledgeable about their roles and responsibilities. They had the skills, knowledge and experience required to support people with their care and social needs.

Individual risk assessments had been completed for people who lived at the home. This helped to ensure risks had been identified and measures put in place to reduce risks to people’s safety and wellbeing. Written plans of care provided a good level of guidance for staff with regard to supporting people safely.

The registered manager understood the requirements of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). This meant they were working within the law to support people who may lack capacity to make their own decisions.

The environment was maintained, clean and hygienic when we visited. We saw staff followed infection control guidelines.

We found sufficient staffing levels were in place to provide support people required. We saw staff members could undertake tasks supporting people without feeling rushed.

We found medication procedures at the home were safe. Staff responsible for the administration of medicines had received training to ensure they had the competency and skills required. Medicines were stored appropriately.

People who were able told us they were happy with the variety and choice of meals available to them. Relatives we spoke with were complimentary about the meals provided. We saw regular snacks and drinks were provided between meals to ensure people received adequate nutrition and hydration.

During our inspection we observed people were involved in activities which they appeared to enjoy. A range of activities

Inspection carried out on 13 and 14 January 2015

During a routine inspection

This inspection took place over two days on 13 and 14 January 2015. It was unannounced on 13 January 2015 and announced on 14 January 2015.

Mariners Court Care Home is registered to accommodate up to 26 older people who do not require nursing care. The home provides care and support for people living with dementia or how have physical disabilities. At the time of our visit there were 23 people who lived at the home. Mariners Court is a detached property that overlooks the boating lake on Fleetwood Esplanade and has panoramic views of the Irish sea and the Cumbrian hills. It is a three storey property and there is a lift to all floors.

There was a registered manager in place. 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. To support the registered manager there was a management team with responsibilities to oversee quality assurance across the group of seven care homes within the Century Healthcare organisation.

Staff spoken with understood the procedures in place to safeguard vulnerable people from abuse. However risks to one person were not being managed appropriately to keep them safe. We saw staffing levels were sufficient to provide a good level of care. However the planning of staff duties were not organised effectively to ensure there was oversight of people sat in the lounges. The systems in place to monitor safety had not been effective. This was because we found two incidents had not been fully documented or reported and action had not been taken in response to a number of unwitnessed incidents. You can see what action we told the provider to take at the back of the full version of the report.

During our visit we spent time in all areas of the home, including the lounge and the dining areas. This helped us to observe daily routines and gain an insight into how people's care and support was managed. During our visit we saw staff had developed a good relationship with the people they supported. Those people who were able to talk with us spoke very positively about the service and told us they felt well cared for. One person told us, “The staff give me one hundred percent. They are kind and caring.”

Suitable arrangements were in place to ensure safe recruitment practices were followed. Staff spoken with were positive about their work and confirmed they were supported by the management team. Staff received regular training to make sure they had the skills and knowledge to meet people’s needs.

We looked at how medicines were managed and found appropriate arrangements for their recording and safe administration. Records we checked were complete and accurate and medicines could be accounted for because their receipt, administration and disposal were recorded accurately.

People were involved and consulted with about their needs and wishes. Care records provided information to direct staff in the safe delivery of people’s care and support. However records needed to be kept under review so information reflected the current and changing needs of people.

Staff had a good understanding of people’s daily care needs and where necessary, ensured that people who used the service had access to community health care and support. Community professionals reported positive relationships with the service and felt staff were professional and cooperative.

Throughout the inspection, we consulted a variety of people, including people who lived at the home, visiting family members, members of staff in various roles and community professionals. The majority of people we spoke with expressed positive views about the service and spoke highly of staff and managers. However family members of three people who lived at the home told us they had not been happy with their experience of raising concerns.

The management team used a variety of methods to assess and monitor the quality of the service. These included satisfaction surveys, ‘residents meetings’ and care reviews. Overall satisfaction with the service was seen to be positive.

Inspection carried out on 6 August 2013

During a routine inspection

We spoke with a range of people about the home. They included members of the management team, staff members some people who lived at the home. There were no visitors at the home during the inspection process. We also asked for the views of external agencies in order to gain a balanced overview of what people experienced living at Mariners Court.

Some people had limited verbal communication and understanding and were unable to hold a conversation with us. To help us understand their experiences of living in the home we observed the care they received and the interaction by staff.

In order to gain a general overview of how care was being delivered around the home, we spent time in all the communal and dining areas. This helped us to observe the daily routines and gain an insight into how people's care and support was being managed.

We observed staff assisting people who required care and support with personal care. Staff treated people with respect and ensured their privacy when supporting them. They provided support or attention as people requested it.

Inspection carried out on 18 July 2012

During an inspection in response to concerns

We visited this home unannounced on Wednesday 18th July 2012. During the course of the site inspection we spoke with members of the management team, five staff members and three visitors.

People living at this home had a range of dementia conditions. This affected how they communicated with us. For this reason we spent time in communal areas, so we could observe how the home was operating and how staff communicated and helped people.

People we spoke with told us they were satisfied with the way the home provided care to their relatives. One person told us, "I�ve been coming here for a long time and I see the way everyone is cared for. They do a very good job.� Another person said, �Very caring, I would give them ten out of ten.�

We spoke with a number of staff working in the home and they all demonstrated an awareness of the needs of people living there. Staff spoke of the importance of treating people with respect and dignity. One staff member said, �Everyone is individual and we respect that.� A relative told us, "Staff working here are very patient with everyone.�

Inspection carried out on 22 June 2011

During a routine inspection

The manager told us all records have been updated and developed during the last twelve months.

Staff told us they have some responsibility for completing and updating some of the care planning records, and this is overseen by the manager, so that they make sure records are maintained and up to date.

Records we looked at and people we spoke to told us their needs were being met by the service, and people had access to a range of services which met their individual needs.

"I am very confident my relative�s needs are being met here�.

People we saw taking part in activity groups were seen to be very engaged in the event.

The activity coordinator told us they enjoy planning activities which are suitable for people with dementia conditions and she feels she provides a good choice and variety of activities on a daily basis for those people who want to be involved.

"There' are daily activities, and if people don�t want to join in they don't have to".

Staff told us they thought the home was well staffed so they have time to spend with people. We saw this reflected on the staffing rota, which demonstrated a good mix of staff on duty at any time of the day and night.

Staff we spoke to told us they liked the variety of work and felt they have the time to spend with individual residents, which helps them to get to know them more.

Staff we spoke to told us they have received training in safeguarding people. "Its part of our mandatory training, I think mine is getting ready for updating".

Staff we spoke to told us they felt they had the knowledge and skills to follow procedures if they felt there was any evidence of abusive practice taking place. "We have clear policies to follow, but I think I would report it if I had any suspicion of any abusive practice".

Staff we spoke to told us they have received training in medication practices before they were allowed to administer medication.

By speaking to people using the service we were told they are asked wherever possible about their care and treatment. "I feel we are asked about the care people receive here", "They seem to take on board what is said".

The staff told us they informally get the views of people just by talking to them." �It can be difficult getting to know what people think because of their dementia, but we do talk to relatives and they tell us what they think".

"You get to know when people aren't happy about something, usually by their behaviour"

Reports under our old system of regulation (including those from before CQC was created)