Marigold House

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.This is the first assessment for this service. This key question has been rated good. This meant people’s care, treatment and support achieved good outcomes and promoted a good quality of life.

This service scored 63 (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 did not always make sure people's assessed care and treatment needs were reviewed effectively. Whilst people's needs had been assessed and care plans were in place, records did not always reflect changes in people's needs, circumstances and preferences. This reduced assurance that people were receiving the care they required which met their needs and preferences.
In response to our concerns, the provider reviewed identified care plans and told us they would continue to strengthen oversight of care planning through governance processes, including their recently introduced ‘Resident of the Day’ reviews. We will check for sustained improvement at our next assessment.

However, staff demonstrated a good understanding of people's needs, preferences and routines. There was evidence of the provider carrying out pre-admission assessments and involving people and relevant stakeholders before they moved to Marigold House.

The provider did not evidence they delivered care and treatment in line with people's assessed needs or recognised good practice. Records did not consistently demonstrate people had received repositioning support in line with their assessed needs. We also reviewed records relating to a person who had experienced unwanted weight loss. Whilst actions had eventually been taken to support the person, including introducing a fortified diet and increasing nutritional support, leaders acknowledged these measures should have been implemented sooner. This reduced assurance that risks relating to nutrition and skin integrity were always recognised and responded to in a timely way.

In response to our concerns, the provider reviewed care records, they told us they would strengthen oversight of repositioning documentation. We will check for sustained improvement at our next assessment.

However, there was evidence of people receiving evidence-based care in other areas, such as helping people to manage the risks of falls. Staff monitored people's health needs, documented safety concerns and sought advice from healthcare professionals where required. A staff member demonstrated an understanding of how health needs could affect behaviour and wellbeing, saying they were, “Aware that pain may be exhibited as verbal aggression.” People had access to support from GPs, community nurses and other healthcare services to help maintain their health and wellbeing.
 

The provider worked with external healthcare professionals and partner agencies to support people's health and wellbeing. Records demonstrated involvement from professionals including GPs, specialist nurses, community services and mental health professionals where required. Staff sought advice when people's needs changed and worked with external professionals to support people's care and treatment. People had access to healthcare services when they needed them and there was evidence of joined-up working to support continuity of care. A staff member told us, “Communication works well between staff.”

People were supported to manage their health and wellbeing. Staff recognised changes in people's health and sought appropriate professional advice when concerns were identified. People were also supported to remain active and engaged. Although some improvements were needed to weekend activity provision, there was evidence of a varied programme of meaningful activities, outings and community involvement which supported people's wellbeing and quality of life.

The provider did not always effectively monitor people's care and treatment to ensure consistently positive outcomes. Our findings relating to care planning, medicines management, safeguarding oversight and risk management reduced assurance that information available to the provider was being used effectively to identify concerns and drive improvement.

However, prior to our assessment, the provider had recently introduced additional governance and quality assurance processes, including Resident of the Day reviews, which identified areas for improvement and generating actions. One relative described the positive impact of support provided to their family member and told us, "[Family member] has got a new lease of life."

Overall, the provider worked in line with the principles of the Mental Capacity Act 2005. Staff understood the importance of seeking consent and were able to describe how they supported people to make decisions about their care and treatment. People were involved in decisions about their care wherever possible and had access to external advocacy support where required to help ensure their views were understood and represented.