Marner House

The service specialises in providing rehabilitation to people that have an Acquired Brain Injury (ABI). An ABI can be the result of a traumatic brain injury from an accident, head injury or neurosurgery. The ABI can lead to permanent or temporary changes in a person’s functioning; their cognitive, physical, emotional or behavioural functioning. The service works closely with other professional organisations in providing the agreed rehabilitation care and support to people so that they can progress from living in the main house to one of the ‘step down’ flats before moving to supported or independent living accommodation. There were eleven people living in the home on the day of our inspection visit, four of which lived in ‘step down’ accommodation. For these eleven people, they received accommodation and 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.

There were a further four people who lived in supporting living accommodation, where they received only personal care from staff in their own homes, on the site. A further two people were supported in their community in their own homes by staff employed by the provider. These arrangements ensured people lived as independently as possible. People’s care and housing in these circumstances were provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support only for these six people.

There was a registered manager in post who had been at the service for approximately six months. A requirement of the service’s registration is that they have 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. We refer to the registered manager as the manager in the body of this report.

At our previous inspection in April 2016 we rated the service as Good, in all areas except Responsive. Responsive was rated as Outstanding. At this inspection we have rated the service Good in all areas.

The vision of rehabilitation was at the heart of the service and was shared by people at Marner House and the staff team. Staff were enthusiastic and positive about their work in enabling people’s brains to learn to do things, following acquired brain injuries such as from road traffic accidents.

People were encouraged and supported by caring and compassionate staff to follow their agreed rehabilitation plans. Staff were well trained and effectively used their skills and knowledge to develop trusting relationships with people using techniques in response to individual needs.

Staff understood their responsibilities to keep people safe and protect them from harm. Policies and guidance were accessible to staff to remind them how to raise concerns following the provider’s safeguarding and whistleblowing policies. Risks to people had been assessed. Staff were trained to support people to take positive risks; such as cooking and manage risks that could present a risk of harm or injury to people or others.

People had their prescribed medicines available to them, staff supported some people to take their medicines, other people were able to manage their own medicines and were encouraged to do so. Staff received training in the safe handling, administering and recording of people’s medicines.

People were involved in planning their care. Staff read people’s care plans and received an induction and training so that they knew people well. Further training took place to update and refresh staff skills and knowledge.

The manager and staff understood their responsibility to comply with the requirements of the Mental Capacity Act (2005) and worked within the principles of this. Management and staff had an understanding of the Deprivation of Liberty Safeguards (DoLS).

Health care professionals were involved in people’s rehabilitation plans care and staff followed guidance given by multi-disciplinary team professionals. People’s agreed rehabilitation care and support was reviewed when required and planned reviews also took place. Staff supported people to access healthcare appointments to maintain their wellbeing.

Staff understood the goal of person centred rehabilitation and promoted people’s independence whenever possible; toward achieving the overall goal. People were involved in making everyday choices about their activities, when they got up, and the food they ate.

People said staff were kind and respectful toward them. People’s feedback on the service was sought by the provider. People told us they felt they could raise concerns or complaints if they needed to.

The provider had quality monitoring processes which included audits and checks on medicines management, care records and staff practices. Where improvement was needed, action was taken.

Voyage 1 Limited is a large provider of care services. Marner House provides accommodation, personal care and rehabilitation support for up to 12 people; eight people in the main house and four people in supported living flats. The home specialises in providing rehabilitation to people that have an Acquired Brain Injury (ABI). An ABI can be the result of a traumatic brain injury from an accident, head injury or neurosurgery. The ABI can lead to permanent or temporary changes in a person’s functioning; their cognitive, physical, emotional or behavioural functioning. The service works closely with other professional organisations in providing the agreed rehabilitation care and support to people so that they can progress from living in the main house to one of the supported living flats before moving to other supported or independent living. There were 12 people living at the home on the day of our inspection visit.

There was a registered manager in post. 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.

The vision of rehabilitation was at the heart of the service and was shared by the staff team that supported people living there. Staff were enthusiastic and positive about their work in enabling people’s brains to learn to do things again following acquired brain injuries people had, such as from road traffic accidents. People were encouraged and supported by caring and compassionate staff to follow their agreed rehabilitation plans. Staff were well trained and effectively used their skills and knowledge to develop trusting relationships with people using techniques in response to individual needs.

Staff understood their responsibilities to keep people safe and protect them from harm. Policies and guidance were accessible to staff to remind them how to raise concerns following the provider’s safeguarding and whistleblowing policies. Risks to people had been assessed. Staff were trained to support people to take positive risks; such as cooking and manage risks that could present a risk of harm or injury to people or others.

People had their prescribed medicines available to them and staff supported people to take them unless people had been assessed to manage their own medicines. Staff received training in the safe handling, administering and recording of people’s medicines.

People had been involved in planning their care. Staff read people’s care plans and received an induction and training so that they knew people well. Further training took place to update and refresh staff skills and knowledge.

The registered manager and staff understood their responsibility to comply with the requirements of the Mental Capacity Act (2005) and worked within the principles of this. Management had an understanding of the Deprivation of Liberty Safeguards (DoLS), but some staff were unsure about what this covered and further training was planned for. Health care professionals were involved in people’s rehabilitation plans care and staff followed guidance given by multi-disciplinary team professionals. People’s agreed rehabilitation care and support was reviewed when required and planned reviews also took place. Staff supported people to access healthcare appointments to maintain their wellbeing.

People had agreed rehabilitation plans and were also involved in various hobbies and leisure activities. People were involved in menu planning and had choices about food and drink. People said the food was good. Staff understood the goal of person centred rehabilitation and promoted people’s independence whenever possible; toward achieving the overall goal. People said staff were kind and respectful toward them. People’s feedback on the service was sought by the provider. People told us they felt they could raise concerns or complaints if they needed to.

The provider had quality monitoring processes which included audits and checks on medicines management, care records and staff practices. Where improvement was needed, action was taken.