Archived: Mariners Court Care Home

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 wellbeing and the risks posed by COVID-19. They did this through regular checks, audits and communication between the home and head office. The service had not experienced any cases of COVID-19 during the pandemic. The registered manager and operations manager told us this was a testament, not only to the processes and procedures they had implemented, but also to the hard work and dedication of the staff team, who had worked tirelessly to ensure people received the support they needed since the pandemic began. The registered manager explained there had been some positives to take from the previous few months including, how the staff team had grown closer and how infection rates in general had declined.

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.

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 were provided at the home to help ensure people received a good level of stimulation.

The service had a complaints procedure which was made available to people on their admission to the home. Relatives we spoke with told us they were happy and had no complaints.

Care plans were organised and had identified the care and support people required. We found they were informative about care people had received. They had been kept under review and updated when necessary to reflect people’s changing needs.

We found people had access to healthcare professionals and their healthcare needs had been met.

We observed staff supporting people with their care during the inspection visit. We saw they were kind, caring, patient and attentive.

The registered manager used a variety of methods to assess and monitor the quality of the service. These included satisfaction surveys and care reviews. We found people were satisfied with the service they received.

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.