• Care Home
  • Care home

Marnel Lodge Care Home

Overall: Good read more about inspection ratings

Carter Drive, Basingstoke, Hampshire, RG24 9US (01256) 471250

Provided and run by:
Barchester Healthcare Homes Limited

All Inspections

30 September 2019

During a routine inspection

About the service

Marnel Lodge is a residential care home providing personal and nursing care to 61 people aged 65 and over at the time of the inspection. The majority of people were living with a form of dementia. The service can support up to 62 people.

The care home accommodates people in one adapted building over two floors. The upper floor specialises in providing care to people living with more advanced dementia.

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

People and relatives told us the service was safe. One person told us, “I know I am safe, the staff know what they are doing and look after me very well.” Staff understood signs of possible abuse and how to raise concerns. Risks to people were assessed and known by staff. People were supported by staff who had undergone appropriate recruitment checks. Medicines were administered appropriately. Incidents and accidents were thoroughly investigated.

People experienced good outcomes because staff were well trained and involved the appropriate healthcare professionals. The service was following current best practice guidance. Staff experienced effective support including an induction, ongoing supervision and appraisal. This enabled them to provide good quality, effective care. People's hydration and nutritional needs were met.

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 registered manager and staff provided caring and compassionate support to people.

People were encouraged to remain as mobile and independent in their daily lives as possible. People and relatives confirmed to us that they were always treated with dignity and respect.

People's needs were holistically assessed and met by the care provided. People were treated equally and without discrimination. A variety of activities were available for people to participate in and people were supported to continue activities that were meaningful to them. The registered manager had created different themed areas in the service for people to enjoy. Complaints were well managed and responded to appropriately. End of life care was provided effectively and compassionately.

The service was well-led. The registered manager and staff promoted a positive, open and honest culture within the service and understood their regulatory responsibilities. People and relatives were appropriately involved in the service. There were appropriate systems in place to monitor and improve the service.

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 5 May 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.

18 January 2017

During a routine inspection

The inspection took place on the 18 and 19 January 2017 and was unannounced. At the last inspection on 2, 3 and 7 September 2015 we found the provider had breached two regulations associated with Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 (HSCA 2014). These breaches related to Regulation 12 (Safe care and treatment) and Regulation 17 (Good governance). The provider had not always ensured people’s medicines were managed safely and that complete and contemporaneous records were maintained in respect of each service user to ensure risks to their health and wellbeing were managed appropriately.

We told the provider they needed to take action and we received a report setting out the action they would take to meet the regulation. At this inspection we reviewed whether or not these actions had now been taken and found the provider was meeting the requirements of the HSCA 2014. We found improvements had been made regarding the storage and administration of medicines and the completion of documentation relating to the delivery of people’s care.

Marnel Lodge Care Home, to be referred to as the home throughout this report, is a home which provides residential and nursing care for up to 62 older people who have a range of needs, including those living with Parkinson’s disease, sensory impairments as well as epilepsy and diabetes. The first floor of the home provides specialist care to people living with dementia. The home is purpose built to meet people’s needs and is situated in a residential area on the outskirts of the town of Basingstoke. Facilities includes two dining rooms and two lounges on both floors with a secure rear garden and patio area as well as a café area for people, visitors and relatives on the ground floor of the home. At the time of the inspection 58 people were using the service.

The home has a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

People using the service told us they felt safe, relatives agreed they felt their family members were kept safe whilst living at the home. Staff understood and followed the provider’s guidance to enable them to recognise and address any safeguarding concerns about people.

People’s safety was promoted because risks that may cause them harm had been identified and guidance provided to manage these appropriately. Appropriate risk assessments were in place to keep people safe.

Overall, sufficient numbers of staff were deployed in order to meet people’s needs in a timely fashion. The registered manager was addressing unplanned staff absence, which at times had caused a staff shortage. Recruitment procedures were completed to ensure people were protected from the employment of unsuitable staff. New staff induction training was followed by a period of time working with experienced colleagues. This ensured staff had the skills and confidence required to support people safely.

People were protected from the unsafe administration of medicines. Nurses were responsible for administering medicines and had received additional training to ensure people’s medicines were administered, stored and disposed of correctly. Nurse’s skills in medicines management were regularly reviewed by managerial staff to ensure they remained competent to administer people’s medicines safely.

People were supported by staff who had relevant up to date training available which was regularly reviewed to ensure staff had the skills to proactively meet people’s individual needs.

People, where possible, were supported by staff to make their own decisions about their care and treatment. Staff were able to demonstrate that they complied with the requirements of the Mental Capacity Act 2005 when supporting people during their daily interactions. This involved making decisions on behalf of people who lacked the capacity to make a specific decision for themselves.

The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. The registered manager showed an understanding of what constituted a deprivation of person’s liberty. People had been appropriately assessed as to whether they could consent to living at the home prior to applications being submitted. Authorisations had been granted by the relevant supervisory body to ensure people were not being unlawfully restricted.

People were supported to eat and drink enough to maintain a balanced diet. We saw meals were prepared to meet people’s individual nutritional and hydration requirements. Staff followed guidance in people’s care plans to ensure they received a meal which met their needs. Alternatives were offered and prepared when people did not wish to eat one of the two main meals on offer and people were encouraged to eat and drink sufficiently to maintain their health and wellbeing.

People’s health needs were met as the staff and the registered manager had detailed knowledge of the people they were supporting. Staff promptly engaged with healthcare agencies and professionals when required. This was to ensure people’s identified health care needs were met and to maintain people’s safety and welfare.

Staff had taken time to develop close relationships with the people they were assisting. Staff understood people’s communication needs and used non-verbal communication methods where required to interact with people. These were practically demonstrated by the registered manager and staff during their regular and comfortable interactions with people.

People received personalised and respectful care from staff who understood their care needs. People had care and support which was delivered by staff using the guidance provided in individualised care plans. Care plans contained detailed information to assist staff to provide care in a manner that respected each person’s individual requirements. People were encouraged and supported by staff to make choices about their care including how they spent their day within the home.

Relatives knew how to complain and told us they would do so if required. Procedures were in place for the registered manager to monitor, investigate and respond to complaints in an effective way. Relatives and staff were encouraged to provide feedback on the quality of the service during regular meetings with staff and the registered manager. People and relatives were also asked to complete an annual quality assurance questionnaire to provide their views on the quality of the care and support provided.

People were supported to participate in activities to enable them to live meaningful lives and prevent them experiencing social isolation. A range of activities were available to people to enrich their daily lives. Staff were motivated to ensure that people were able to participate in a wide range of activities and encouraged them to participate where possible.

People living with dementia benefited from an environment that was adapted to meet their needs. A programme aimed at improving the care that people living with dementia experienced was underway at the time of our inspection. This included a comprehensive staff training programme to ensure all staff had the knowledge and skills to provide responsive and effective care for people living with dementia.

The registered manager ensured staff were involved in creating the values for the home, which included writing a ‘Philosophy of Care’ for both floors. These detailed the way in which care would be delivered to people and were openly displayed in communal areas of the home. Staff understood these and we saw these standards were evidences in the way care was delivered.

The registered manager fulfilled their legal requirements by informing the Care Quality Commission (CQC) of notifiable incidents which occurred at the service. Notifiable incidents are those where significant events happened. This allowed the CQC to monitor that appropriate action was taken to keep people safe.

Relatives told us the registered manager was competent in the efficient running of the home and staff confirmed they felt supported in their roles. The registered manager provided strong positive leadership and promoted the providers values.

Quality assurance processes were in place to ensure that people, staff and relatives could provide feedback on the quality of the service provided. The provider routinely and regularly monitored the quality of the service being provided in order to drive continuous improvement.

2, 3 and 7 September 2015

During a routine inspection

This inspection was unannounced and took place on the 2, 3 and 7 September 2015.

Marnel Lodge is a care home which provides nursing and residential care for up to 62 people who have a range of needs, including those living with epilepsy and diabetes. The care home comprised of two floors. The first floor of the home provided specialist care to those living with dementia. At the time of the inspection 57 people were using the service.

Marnel Lodge has 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.

People were not always protected from the unsafe administration of medicines. The provider did not always follow national guidance regarding the storage and administration of medicines. Topical medication charts for creams prescribed to be used directly on people’s skin were not always completed fully. As a result it could not always be identified whether people had received their medicines at the correct time and whether they had been administered as prescribed. Nurses responsible for supporting people with their medicines had received additional training to ensure people’s medicines were being administered, stored and disposed of correctly. Nurses skills in relation to medicines management were reviewed on a regular basis by appropriately trained senior staff to ensure they remained competent.

People were supported to eat and drink enough to maintain a balanced diet. People told us they were able to choose their meals and they enjoyed what was provided. Records showed people’s food and drink preferences were documented in their care plans and were understood by staff. People at risk of malnutrition and dehydration were assessed to ensure their needs were met. However, records for people who required food and fluid chart monitoring were not always completed fully. As a result it could not always be identified whether people were eating and drinking sufficient to maintain their health.

People using the service told us they felt safe. Staff understood and followed the provider’s guidance to enable them to recognise and address any safeguarding concerns about people.

People’s safety was promoted because risks that may cause them harm had been identified and managed. People were supported by staff who encouraged them to remain independent. Appropriate risk assessments were in place to keep people safe.

Robust recruitment procedures were in place to protect people from unsuitable staff. New staff induction training was followed by staff spending a period of time working with experienced colleagues to ensure they had the skills required to support people safely.

Contingency plans were in place to ensure the safe delivery of people’s care in the event of adverse situations such fire or floods. Fire drills were documented, known by staff and practiced to ensure people were kept safe.

People were supported by staff make their own decisions. Staff were knowledgeable about the requirements of the Mental Capacity Act (MCA 2005). The service worked with people, relatives and social care professionals when required to assess people’s capacity to make specific decisions for themselves. Staff sought people’s consent before delivering care and support. Documentation showed people’s decisions to receive care had been appropriately assessed, respected and documented.

People’s health needs were met as the staff and the registered manager promptly engaged with other healthcare agencies and professionals to ensure people’s identified health care needs were met and to maintain people’s safety and welfare.

The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. Appropriate applications had been submitted to the relevant supervisory body to ensure people were not being unlawfully restricted.

Staff demonstrated they knew and understood the needs of the people they were supporting. People told us they were happy with the care provided. The registered manager and staff were able to identify and discuss the importance of maintaining people’s respect and privacy at all times. People were encouraged and supported by staff to make choices about their care including how and where they spent their day.

People had care plans which were personalised to their needs and wishes. They contained detailed information to assist staff to provide care in a manner that respected each person’s individual requirements. Relatives told us and records showed that they were encouraged to be involved at the care planning stage, during regular reviews and when their family members’ health needs changed.

People knew how to complain and told us they would do so if required. Procedures were in place for the registered manager to monitor, investigate and respond to complaints in an effective way. People, relatives and staff were encouraged to provide feedback on the quality of the service during regular meetings with staff and the registered manager as well as the completion of customer satisfaction questionnaires.

The provider’s values and philosophy of care were communicated to people and staff. Staff understood these and people told us these standards were evidenced in the way that care was delivered.

The registered manager and staff promoted a culture which focused on providing individual person centred care. People were assisted by staff who were encouraged to raise concerns with the registered manager. The provider had a routine and regular monitoring quality monitoring process in place to assess the quality of the service being provided.

Staff told us they felt supported by the registered manager.

We found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.

25 June 2013

During a routine inspection

We spoke with seven people living in Marnel Lodge, one relative and two friends of people living in the home. We also spoke with three staff.

We saw that people were spoken to and treated with respect and dignity. We observed staff giving people choices and encouraging them to make decisions. We looked at four care plans and saw that people and their family members were involved in writing them. One person's relative we spoke with said 'the communication is very good, they keep me informed'.

People's needs were assessed. The care and support plans we looked at held information for staff on how to best support people. We saw that these were regularly reviewed and updated as people's needs changed. People we spoke with told us that they enjoyed living in Marnel Lodge. They said 'the staff are lovely'. Friends of one person told us 'we tell all our friends about this place, it's amazing. One of the nicest homes we've been to'. We saw that there was a schedule for daily activities. During our inspection there was a game of bingo, a trip to a garden centre and a visit from a pets as therapy dog.

We saw that people were offered food and drinks throughout the day. People were assisted by staff where appropriate. There was a system in place to ensure that risk of malnutrition was monitored.

There were sufficient staff to meet the needs of the people living in Marnel Lodge. One person said 'I don't have to call for staff, they are just there'.

There was an effective process for assessing and monitoring the quality of the service.

16 August 2012

During a routine inspection

We spoke with five residents of Marnel Lodge and they all told us that they were happy and they enjoyed living there. One person said 'it's not the same as home, but you are not likely to find a better place'. Another said 'there's not much to trouble about'. The residents told us that they could get up and go to bed when they chose and there was always help available if they needed it. They told us that they were involved in their care and could tell the staff if there was a problem.

29 July 2011

During an inspection in response to concerns

Residents that we spoke to were generally satisfied with the care that they received.

One resident, for example, said 'its not bad here, staff give me help and I like to be independent'. One person confirmed that they had been able to visit before they moved in and another resident said that their privacy was always respected

Residents we spoke with said that the home was always very clean.

One person told us that they were well looked after and that the nurse gave their medicines to them which were locked in a cupboard in their room.