Marigold House

On this page

• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

Caring – this means we looked for evidence that the provider involved people and treated them with compassion, kindness, dignity and respect. This is the first assessment for this service. This key question has been rated good. This meant people were supported and treated with dignity and respect; and involved as partners in their care.

This service scored 65 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Staff treated people with kindness, compassion and respect. Throughout our assessment, we observed positive interactions between people and staff. Staff demonstrated a good understanding of people's individual needs, preferences and routines and provided reassurance and support when required.

People spoke positively about the care and support they received. Records and observations demonstrated people were supported in a manner which promoted their dignity and wellbeing. Staff understood the importance of providing care that respected people's individual needs and preferences. A person told us, “Most of them go above and beyond what they have to do.” A relative told us, “The carers are lovely.”

People were treated as individuals and staff knew them well. Staff were able to describe people's personal histories, routines, interests and preferences and how these influenced the support they provided. Care records contained information about people's backgrounds, relationships and what was important to them. People were supported to maintain relationships with those important to them. Family involvement was evident within records we reviewed. A relative said, “It's the little things like that that show they know the residents.”

People were generally supported to make choices and maintain control over their day-to-day lives. Staff demonstrated a good understanding of people's histories, routines, interests and preferences. Care plans contained information about what people could do for themselves and how staff should support them to be as independent as possible. Feedback we received indicated people were generally supported in line with their individual needs and preferences.

However, during our assessment we identified one example where a person's known preference for bathing rather than showering was not always reflected in the care they received. Staff also told us the person preferred support from specific staff members, but there was limited evidence of forward planning to facilitate these preferences. Leaders told us historical concerns continued to influence how care was delivered despite these concerns not being evident or having been reviewed recently. While this related to an individual example identified during our assessment, it reduced assurance that care planning and review processes were consistently ensuring people's current preferences were reflected in the planning and delivery of their care. In response to our feedback, the provider reviewed the person's care records and told us they would ensure their preferences and support needs were more clearly reflected within care planning and documentation.

Staff understood people's needs and responded appropriately when people required support. Staff were able to describe personalised approaches used to support people when they became distressed, anxious or required reassurance. Observations demonstrated staff responded to people's requests for support and understood how to meet people's individual needs.
A staff member described how they supported a person who had become distressed and declined personal care. They said, “[Person] had declined personal care and become distressed. We stepped back and allowed them time to calm down before re-entering the room and encouraging them with a wash.” This demonstrated a patient and person-centred approach to supporting people when they required reassurance or were reluctant to accept support.

Staff feedback regarding management support was mixed. Several staff described leaders as visible, approachable and willing to provide support when required. Staff told us they received induction, training and supervision and felt able to raise concerns.

However, records showed and staff told us they had experienced incidents which included physical and verbal aggression towards them. Although most of these incidents were recorded and immediate actions taken to manage risks, there was no formal system in place to routinely debrief staff following significant incidents or review the impact on their wellbeing. This reduced opportunities to identify learning, recognise the cumulative impact of repeated incidents on staff and provide assurance staff wellbeing was consistently supported.

In response to our feedback, leaders recognised opportunities to strengthen support available to staff following significant incidents and told us they would review their current arrangements.