Marner 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 inspection we rated this key question good. At this inspection the rating has remained good. This meant people’s needs were met through good organisation and delivery.

This service scored 79 (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 received care and support that was tailored to their individual needs, preferences and goals. Care plans were personalised and contained information about people's backgrounds, routines, likes, dislikes and the support they needed.

Where appropriate, people and their relatives were actively involved in planning and reviewing care. This helped ensure care remained focused on people's wishes and reflected their life history, relationships and personal preferences. One relative told us, “They always involve me in what is happening, and when I visit, they are always asking me questions about [Name’s] life before the injury. There is a sense that they want to really get to know all about him.”

Staff knew people well and recognised each person had different needs, personalities and aspirations. They adapted their approach accordingly and understood the importance of providing care in a way that respected people's individuality and preferences. Staff spoke confidently about the people they supported and how care was tailored to meet their specific needs. One staff member told us, “The support plans are specific to the service user. They include what is important to them, their backgrounds. They are individual and tailored to their needs. They are reviewed and changed as goals are reached, new goals set or if we need a different approach because something isn’t working.”

Care plans were regularly reviewed and updated to reflect any changes in people's needs, preferences or goals. Staff worked collaboratively with people, relatives and relevant professionals to ensure support remained effective and focused on achieving positive outcomes. Where goals had been achieved, new goals were identified to encourage continued progress, independence and wellbeing.

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 received personalised care from staff who were familiar with their routines and communication needs.

People were allocated named key workers who took a lead role in overseeing their care, monitoring progress and contributing to reviews. This helped to promote consistency in care planning and provided people with a familiar point of contact who had a detailed understanding of their support needs.

Staff recognised the importance of continuity when supporting people with ongoing healthcare needs. For example, we were told 1 person attended regular hospital appointments and was consistently supported by the same members of staff. This enabled healthcare professionals to receive accurate information from staff who knew the person well, while also providing reassurance and familiarity for the person attending appointments.

The staff worked effectively with a range of external professionals to ensure people's needs were met and care was coordinated. People moved to Marner House from a variety of geographical areas and were funded by different local authorities. The provider worked collaboratively with commissioners, healthcare professionals and community services to ensure people experienced joined-up care.

Staff had developed positive working relationships with the local GP practice and a range of specialist services, including dietitians, speech and language therapists, orthotics teams and other healthcare professionals involved in people's care and rehabilitation. Staff shared information appropriately and acted on professional advice to support consistent outcomes for people.
 

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

People were supported to access information in formats that reflected their needs and abilities. For example, 1 person used a picture communication board and staff used this to support decision-making, increase understanding and promote choice.

Staff explained how communication tools also supported some people with memory difficulties by providing visual prompts and reminders. One staff member told us, "We use lots of different communication, pictures, writing, speaking and a combination. Communication needs change and we respond to that. [Name] has a communication board; it acts as a memory prompt.”

The registered manager described how information was adapted for different individuals. They explained 1 person benefited from a ‘rehearse and repeat’ approach, where information was provided repeatedly over time to support understanding, retention and informed decision-making.

Care records contained detailed information about how people communicated and understood information. Staff had access to guidance that helped them interpret communication accurately and understand individual expressions, behaviours and preferred ways of communicating. For example, specific care plans explained what certain words, phrases or expressions may mean for an individual, helping to ensure their views, wishes and feelings were understood consistently by all staff.

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 felt confident raising concerns and believed they would be listened to and acted upon. One person told us, “I could go to any of the staff if a thing wasn’t right and they would sort it.” Another person said, “The staff are excellent. They listen to me and things happen.”

People and their representatives were actively involved in planning and reviewing their care and support. People were encouraged to make decisions about their own lives and were given autonomy over their care wherever possible.

Relatives spoke positively about opportunities to share their views and experiences. They told us they were invited to participate in surveys, reviews and meetings. One relative described how they had raised a minor concern and action had been taken promptly to address the issue and make improvements.

Staff understood the importance of listening to people and responding to feedback. One staff member told us, “We don’t get many complaints because we work so closely with the residents. They will tell us if something needs to change and we deal with things before they become a problem. If there was a complaint and I couldn’t sort it, I would go straight to the senior or management.”

People were also given opportunities to influence how the home was run. Regular ‘house meetings’ enabled people to share ideas and make suggestions. Staff valued people's contributions and acted on their feedback where possible. One staff member said, “Every month we have a house meeting with the service users. They have some fantastic ideas, and we are able to implement them. It adds quality to their lives.”

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

People were supported to access a range of healthcare professionals and services to meet their individual needs. This included GPs, hospital consultants, therapists and other specialist support services such as counselling. Staff worked closely with people to ensure they were able to attend appointments, understand healthcare information and access appropriate support when required.

People accessed healthcare services when they needed them and received support to overcome any barriers that may affect their ability to do so. One person said, “I can see the doctor and I go to the hospital. The staff come with me and make appointments. They remind me about appointments. I feel safer when the staff are with me.”

People had access to rehabilitation facilities, including a training kitchen with height adaptable work surfaces and a gym, which provided opportunities for people to improve mobility, strength and physical wellbeing. The home also included 4 self-contained flats which enabled people to develop the skills required for more independent living in a safe and supportive environment.

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.

The registered manager and staff understood their responsibilities to advocate for people and promote equality in their experiences and outcomes. They worked to ensure people had access to the same opportunities as others and were supported to overcome barriers which could affect their wellbeing, independence or involvement in everyday life.

Managers and staff understood the importance of seeing people as individuals and ensuring a person's diagnosis or disability did not define them. The registered manager explained, “People can feel as though their brain injury stops them from being them. We see the whole person.”

Care records contained detailed information to help staff provide personalised support and achieve positive outcomes for people. This included guidance on important routines, personal preferences and any reasonable adjustments required to help people access appointments, activities and opportunities within the community. Care records also provided clear information about how people communicated and included guidance on the use of communication aids and tools where required.

People were given exceptional support to plan for important life changes, so they could make informed decisions about their future.

From admission, staff worked closely with people to identify meaningful goals, including returning home, moving into more independent accommodation and regaining skills lost following brain injury. Staff used a highly person led approach, breaking goals into manageable and achievable milestones which enabled people to experience success and maintain motivation.

The registered manager described how progress was continually celebrated and how goals evolved as people's confidence and abilities increased. Documented evidence held by the registered manager showed this approach had resulted in significant outcomes for several people, including successful moves to more independent living arrangements. The staff’s focus on ability rather than limitation helped people achieve outcomes that had a profound impact on their future wellbeing, independence and quality of life.

A therapy leader explained, “As an example, if someone’s goal was to walk again, but they were currently unable, that could seem a long way off. So, we would start with a goal of weight bearing, then increasing the amount of time this is possible for. The next goal would be to take a step, then five steps, then ten. Each target is achievable and can be recognised and rewarded.”

This approach enabled people to see their progress and build confidence as they worked towards longer-term objectives. Goals were regularly reviewed and adapted in response to people's development and achievements. The registered manager described a culture of continual progression, explaining that when someone consistently achieved a goal, the focus became, “What can you do next?” This demonstrated the commitment across the staff team to help people maximise their potential and achieve the best possible outcomes.

Achievements were actively recognised and celebrated. We saw examples of certificates created by staff to acknowledge when people had achieved personal targets. This helped to reinforce progress and promote self-esteem.