Marquis Court

Marquis Court is a care home that provides personal care for up to 47 people, some of whom are living with dementia. At the time of the inspection there were 44 people living in the home.

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

People were safe and happy living in Marquis Court. People’s comments included, “I like living here. The girls are all lovely” and, “[Staff] are all lovely, I can't complain.” A ‘thank you’ card recently received from a relative described staff as, “Amazing” and, “Worth their weight in gold.”

Staff safeguarded people from abuse. Staff were confident in how to protect people and report any concerns and had received up to date training. There were enough staff to meet people’s needs. Infection control processes were embedded into the service and staff followed government guidance in relation to infection control and prevention practices, in particular, relating to COVID-19.

People were supported to have maximum choice and control of their lives, and staff supported them in the least restrictive way possible. The policies and systems in the service supported this practice.

Staff supported people in a person-centred way. People had person-centred care plans in place that detailed how they wished to be supported.

The home was well managed. People and staff felt the registered manager was open and approachable. One person said, “Oh she's lovely, you see her around a lot. I feel comfortable going to the girls or [registered manager] if I have any issues. They're all approachable.” An effective quality assurance process was in place.

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 30 April 2020).

Why we inspected

We undertook this targeted inspection to follow up on specific concerns we had about safeguarding, staffing levels, care planning and quality management in the home. A decision was made for us to inspect and examine those risks.

CQC have introduced targeted inspections to follow up on Warning Notices or to check specific concerns. They do not look at an entire key question, only the part of the key question we are specifically concerned about. Targeted inspections do not change the rating from the previous inspection. This is because they do not assess all areas of a key question.

We found no evidence during this inspection that people were at risk of harm from these concerns. Please see the Safe, Responsive and Well-Led sections of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Marquis Court on our website at www.cqc.org.uk.

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.

Marquis Court is a care home that provides personal care for up to 47 people, some of whom are living with dementia. At the time of the inspection there were 41 people living in the home.

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

People felt very safe living in the home and with the support they received from staff. People and relatives were very happy and spoke highly of staff members and the registered manager. Comments included, “Staff are exceptionally kind, professional, caring, everything you would wish for” and “In one word, they [staff] are exceptional.”

People were safeguarded from abuse. Risks to individuals and the environment were well managed. There were enough staff to meet people’s needs. The registered manager learned from accidents and incidents to mitigate future risks. Medicines were safely managed. Infection control processes were embedded into the service and staff followed government guidance in relation to infection control and prevention practices, in particular, relating to COVID-19.

People were well supported and cared for. Staff treated people with respect and supported them in a dignified manner and in line with their wishes.

The home was well managed. People, relatives and staff were complimentary about the home and felt the registered manager was pro-active, open and approachable. One relative told us, “The manager is exceptional, she is always available, very professional, keeps you informed on everything that’s going on with your relative. She explains things to us, and I think she runs a very tight ship. Their record keeping is outstanding”. An effective quality assurance process was in place.

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 30 April 2020).

Why we inspected

We undertook this targeted inspection to follow up on specific concerns which we had received about the service. The inspection was prompted in response to concerns received about staffing levels, medicines, risk management, safeguarding concerns, people’s dignity and overall management of the home. A decision was made for us to inspect and examine those risks.

CQC have introduced targeted inspections to follow up on Warning Notices or to check specific concerns. They do not look at an entire key question, only the part of the key question we are specifically concerned about. Targeted inspections do not change the rating from the previous inspection. This is because they do not assess all areas of a key question.

We found no evidence during this inspection that people were at risk of harm from these concerns. Please see the Safe, Caring and Well-Led sections of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Marquis Court on our website at www.cqc.org.uk.

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.

Marquis Court provides personal care and accommodation for up to 47 people, some of whom are living with dementia. At the time of the inspection there were 40 people living in the home.

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

People felt very safe living in the home and with the support they received from staff. They were happy and spoke highly of staff members and the registered manager. Comments included, “The care staff are really good, they’re wonderful.”

People were safeguarded from abuse. Risks to individuals and the environment were well managed. There were enough staff to meet people’s needs and they were recruited in a safe way. The provider learned from previous accidents and incidents to reduce future risks. Medicines were administered and managed safely. The premises were clean and tidy.

An assessment of people’s needs was completed before they moved into the home. Staff received regular training, supervisions and annual appraisals. People were supported to enjoy a balanced diet. People were supported to have maximum choice and control of their lives, and staff supported them in the least restrictive way possible. The policies and systems in the service supported this practice. Staff supported people to enjoy a balanced diet and to access a range of health care professionals.

People were well supported and cared for. Staff treated people with dignity and respect and encouraged them to maintain their independence. People were assisted to maintain relationships that were important to them and advocacy support was available, when needed.

People received care personalised to their individual needs and wishes. Staff knew how to communicate with people and most effective communication methods were detailed in care records. People and relatives knew how to raise concerns. Any complaints received were fully investigated and actioned. People enjoyed a range of activities inside the home and accessed the local community.

The home was well managed. People and relatives were complimentary about the home and felt the registered manager was open and approachable. A quality assurance process was in place. People, relatives and staff were regularly consulted about the quality of the care and support through surveys and meetings.

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 July 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.

We last inspected Marquis Court in April 2016. At that inspection we found the service was in breach of its legal requirements with regard to regulations 12 and 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This was because people were at risk of unsafe care and treatment, records did not accurately reflect people's care and support needs and audits were not effective. At this inspection we found that sufficient action had been taken in all the required areas to make sure the relevant legal requirements were met.

Marquis Court is registered to provide accommodation for personal and nursing care to a maximum of 47 older people, including people who live with dementia or a dementia related condition. Nursing care is not provided. There were currently 46 people living at the service.

A registered manager was 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 and staff told us they felt safe and there were enough staff on duty to provide safe and individual care to people. People were protected as staff had received training about safeguarding and knew how to respond to any allegation of abuse. When new staff were appointed, thorough vetting checks were carried out to make sure they were suitable to work with vulnerable people who needed care and support.

The necessary checks were carried out to ensure the building was safe and fit for purpose.

Risk assessments were in place and they identified current risks to the person. Records were in place that reflected people's care and support requirements and they were regularly reviewed to ensure they remained accurate. Staff knew the people they were supporting well. Care was provided with kindness and people's privacy and dignity were respected.

People had access to health care professionals to make sure they received appropriate care and treatment. Staff followed advice given by professionals to make sure people received the care they needed. People received their medicines in a safe and timely way.

Appropriate training was provided and staff were supervised and supported. Staff had a good understanding of the Mental Capacity Act 2005 and best interest decision making, when people were unable to make decisions themselves. People were able to make choices, where they were able about aspects of their daily lives. People received a varied and balanced diet to meet their nutritional needs.

Activities and entertainment were available for people. A complaints procedure was available. People told us they would feel confident to speak to staff about any concerns if they needed to.

People had the opportunity to give their views about the service. There was regular consultation with people and/ or family members and their views were used to improve the service.

The provider undertook a range of audits to check on the quality of care provided. Staff and people who used the service said the registered manager was supportive and approachable.

Communication was effective, ensuring people, their relatives and other relevant agencies were kept up to date about any changes in people's care and support needs and the running of the service.

Marquis Court is a purpose built care home without nursing which can accommodate 47 people. The home is a two storey building offering single bedrooms with en suite facilities. There are 23 bedrooms on the ground floor for people with general needs and 24 bedrooms on the first floor for people living with dementia.

At the time of the inspection there were 47 people resident at Marquis Court.

A registered manager was registered with the Care Quality Commission at the time of the inspection. They had been the registered manager prior to the new registration in July 2015 and were well established.

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.

Care plans and risk assessments were in place however they lacked detail. Care plans did not always specify how to care and support people with specific needs such as moving and handling. Risk assessments did not clearly identify the risk or how it should be managed, for example there was no information in relation to choking risks for people with specific requirements around their food.

There were no personal emergency evacuation plans to support staff to safely evacuate people in the event of a fire, nor was there any equipment to enable people with mobility needs who resided on the first floor to evacuate.

An electrical installation condition report completed in January 2015 had assessed the premises as unsatisfactory. The owner told us the work was being completed next month.

Quality assurance systems were in place but they were not effective in assessing and improving the quality of the service provided.

Safeguarding, accidents and incidents were all recorded appropriately, with actions taken and lessons learnt. Mental capacity was understood and where relevant, applications for Deprivation of Liberty Safeguards were completed.

Recruitment practices were safe and there were enough staff to meet people’s needs with contingencies in place to cover unexpected staff absence. Staff had the necessary training to ensure they could meet people’s needs and they said they were well supported.

Medicines were managed safely, although the dates creams were opened were not always recorded and temperature checks of the medicine room and fridge were not recorded. This was actioned straight away.

People told us the food was lovely and there was plenty of choice. People were supported at meal times and the chef understood people’s dietary requirements.

Activities were plentiful and varied, ranging from arts and crafts and singing to discussions about current affairs and asteroid deflection. The activities coordinator was passionate about their role and told us the people living at Marquis Court were their boss and they did whatever they asked them to.

Staff approach was kind, caring and compassionate. Staff knew people well and we observed warm and tender relationships with people.

You can see what action we told the provider to take at the back of the full version of the report.