Marlborough House

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Responsive – this means we looked for evidence that the provider met people’s needs.At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant people’s needs were met through good organisation and delivery.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider made sure people were at the centre of their care and treatment choices, and they decided, in partnership with people, how to respond to any relevant changes in people’s needs.

People’s care plans reflected their physical, mental, emotional and social needs, including those related to their protected characteristics under the Equality Act 2010. People were involved in the planning of their care and decision making where possible and their care plans reflected their wishes and preferences. Staff adapted people's care plans as their needs changed.

Staff had all completed training in the provision of person centred care. We saw overall, there were person-centred interactions between staff and people and surveys completed by visiting professionals showed 92% agreed or strongly agreed that staff provided person-centred care.

The provider understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.

People's care delivery was well coordinated. Professionals confirmed staff kept them informed of any changes in people’s support requirements. This enabled them to ensure people were correctly funded for their needs.

Staff completed training specific to the needs of the people they supported. All staff had completed dementia training and mental health awareness. Where relevant staff had completed training in the prevention of pressure ulcers in people with dementia.

The provider supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

Staff assessed people’s needs for information to be provided in an accessible way, in line with the Accessible Information Standard. Staff made reasonable adjustments for people and information was available in formats such as large print and through the use of picture boards and whiteboards where required.

The provider’s complaints policy was also produced in an easy read format to ensure it was accessible to everyone.

The provider made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff involved people in decisions about their care and told them what had changed as a result.

People’s views were sought through processes such as their monthly resident of the day review, resident's meetings, relative’s meetings and surveys. As part of management’s daily walk around, feedback was sought from at least 1 person on each unit.

The provider had processes to acknowledge, investigate and respond to any concerns raised. People and relatives were provided with feedback on issues raised and actions taken; through a 'You said we did board'.

Minutes from a recent residents meeting showed staff were going to look into the possibility of restarting trips to garden centres in response to feedback they had received. We also received feedback that this would of interest to people.

The provider made sure that people could access the care, support and treatment they needed when they needed it.

The service had been extended over time and some of the downstairs corridors although wheelchair accessible were relatively narrow with gentle slopes. However, the upstairs corridors were wider. The registered manager ensured robust preadmission assessments were completed to ensure people could access all areas of the home. Staff monitored people's physical care needs and people were asked if they would like to move bedrooms if their needs changed and they required a different room.

Staff and leaders actively listened to information about people who are most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this.

All staff had completed equality and diversity training, to enable them to understand and uphold the principles of equality, diversity, and inclusion. Staff provided 1:1 sessions most mornings for those cared for in bed and an entertainer also visited people cared for in bed. This ensured they were included in the home’s activities and received social stimulation.

We noted people’s bedrooms only displayed their name and room number and lacked any other cues. The registered manager told us the provider was using an evidence based toolkit designed to create a dementia friendly environment, to evaluate and improve aspects of the home. They were in the process of making identified improvements and had changed the flooring in order to reduce the use of patterns and improvements were being made to the signage.

People were supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life.

Staff used a structured, evidence-based approach to identify and support people approaching the end of their life. They recognised the importance of open and sensitive conversations and planning. A staff member told us, “We are very good with relatives, we sit and talk with them and are empathic.”

People's wishes about their future care were recorded within their care plans where they were ready to have these discussions. If people lacked the capacity to discuss their wishes and preferences, best interest decisions had been made with their representatives.

Staff worked closely with the local surgery and ensured people had anticipatory medicines in place if required and that people were kept comfortable.