Marion Lauder House

Updated 8 June 2023

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection team consisted of 4 inspectors and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Marion Lauder House is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Marion Lauder House is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of the inspection, a new manager had been in post for 12 months and had submitted an application to register. We are currently assessing this application.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

During the inspection we reviewed 7 care records and nine medication records. We reviewed 7 staff recruitment records and records relating to staff induction, training and supervision. We looked at quality assurance audits and action plans and any improvements the provider planned to make. We spoke with 9 people who lived at the home and 18 relatives. We also spoke with the manager, the nominated individual, the area manager and the deputy manager. In addition, we spoke with 11 staff members working at Marion Lauder House. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

Updated 8 June 2023

Marion Lauder House is a care home providing personal and nursing care for up to a maximum of 79 people. The service provides support to older and younger adults and people living with dementia. At the time of our inspection there were 73 people using the service.

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

The recruitment of staff was not always safe as previous employment history was not always recorded and references were not always obtained from the most appropriate referees. Advocacy support had not been considered for one person when decisions were being made about their care and support.

The management of medicines was safe but further work was completed following the inspection to ensure medicines administered covertly were clearly recorded. Records in relation to fluid intake were not always accurately recorded. Quality monitoring processes had not highlighted the concerns found at this inspection.

People felt safe living at the home and told us staff were kind and caring. Internal and external health and safety monitoring of the home was regularly completed. Risks to people were identified and strategies implemented to reduce each risk. Infection control was well managed.

People received regular reviews from health and social care professionals. Relatives were regularly updated with information about their relations health. People received a healthy and nutritious diet. A programme of refurbishment was planned for the home. The home was fully accessible.

Staff promoted independence and we saw dignified interactions with people living at Marion Lauder House. Staffing levels were sufficient from our observations; however, we made a recommendation to review the staffing dependency tool to ensure it was suitable for the home. Staff received an induction, training and supervision. Staff felt supported by the manager.

There was a programme of activities in place, however, people from the nursing unit did not always take part. We made a recommendation; the provider reviewed the activity provision for people on the nursing unit. Care plans were in place and staff were aware of people’s needs. We made a recommendation; the provider ensures people, and their representatives are involved in reviewing their care records and advocacy support should be considered where people don't have any representation.

People and their relatives felt confident to raise any concerns they had with the manager or staff. Staff were aware of safeguarding processes. Relatives felt the manager was responsive. There had been a change in directors since the last inspection and an action plan was in place to highlight the improvements they wish to make and by when. We received positive feedback from professionals about the management and staff at the home.

People were mostly 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.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update The last rating for this service was requires improvement (published 28 August 2021).

The provider completed an action plan after the last inspection to show what they would do and by when to improve.

At this inspection we found the provider remained in breach of regulations.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

Enforcement and Recommendations

We have identified a breach in relation to good governance.

We have made recommendations the provider should review the dependency tool used to calculate staffing levels, provision for activities for people in receipt of nursing care and for people’s representatives to be involved in reviews of care and advocacy support should be considered where people don't have any representation.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.