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Inspection Summary

Overall summary & rating


Updated 25 August 2017

This was an unannounced inspection and took place on the 26 June 2017. The inspection was planned in response to some concerns that had been shared with the Care Quality Commission.

The service provides care and support for up to seven people who may have a learning disability, a mental health condition or physical disabilities. Some people using the service displayed behaviours that were challenging to others and required interventions from staff to keep them and others safe. Some people could not speak with us due to their difficulty in communicating.

There is a registered manager at Marika House. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider.

The provider had outstanding arrangements in place to assess, monitor, analyse and learn from incidents where people’s behaviours challenged. Exceptional outcomes were achieved for people because the provider had gone the extra mile to implement excellent person centred training for staff which was specific to people’s individual health and social circumstances.

Staff received training appropriate to people’s needs and were regularly monitored by a senior member of staff to ensure they delivered effective care. Where people displayed physical behaviours that challenged others, staff responded appropriately by using redirection techniques and only used physical interventions as a last resort. Records showed the provider monitored incidents where physical interventions were used and had informed the local authority, behavioural support teams and healthcare professionals and the Care Quality Commission when these types of techniques were used.

Staff were knowledgeable about the requirements of the Mental Capacity Act 2005 and worked with advocacy agencies, healthcare professionals and family members to ensure decisions made in people’s best interests were reached and documented appropriately

People were not unlawfully deprived of their liberty without authorisation from the local authority. Staff were knowledgeable about the deprivation of liberty safeguards (DoLS) in place for people and accurately described the content detailed in people’s authorisations.

People were protected from possible harm. Staff were able to identify the different signs of abuse and were knowledgeable about the homes safeguarding processes and procedures. They consistently told us they would contact CQC and the local authority if they felt someone was at risk of abuse. Notifications sent to CQC and discussions with the local authority safeguarding team confirmed this.

Staff interacted with people and showed respect when they delivered care. Relatives and healthcare professionals consistently told us staff engaged with people effectively and encouraged people to participate in activities. People’s records documented their hobbies, interests and described what they enjoyed doing in their spare time.

Records showed staff supported people regularly to attend various health related appointments. Examples of these included visits to see the GP, hospital appointments and assessments with other organisations such as the community mental health team.

People received support that met their needs because staff regularly involved them in reviewing their care plans. Records showed reviews took place on a regular basis or when someone’s needs changed.

The service had an open culture where people told us they were encouraged to discuss what was important to them. We consistently observed positive interaction between staff and people.

Inspection areas



Updated 25 August 2017

The service remains safe. People felt safe because the provider had systems in place to recognise and respond to allegations of abuse or incidents.

People received their medicines when they needed them. Medicines were stored and managed safely.

There were sufficient numbers of staff deployed to ensure the needs of people could be met. Staff recruitment was robust and followed policies and procedures that ensured only those considered suitable to work with people who were at risk were employed.



Updated 25 August 2017

The service remains effective. Staff received training to ensure that they had the skills and additional specialist knowledge to meet people�s individual needs.

Staff understood their responsibilities in relation to the Mental Capacity Act 2005 and how to act in people�s best interests.

People�s dietary needs were assessed and taken into account when providing them with meals. Meal times were managed effectively to make sure people had an enjoyable experience and received the support they needed.



Updated 25 August 2017

The service remains caring. Staff knew people well and communicated with them in a kind and relaxed manner.

Good supportive relationships had been developed between the home and people�s family members.

People were supported to maintain their dignity and privacy and to be as independent as possible.



Updated 25 August 2017

The service was extremely responsive. The provider had outstanding arrangements in place to help and support people who displayed behaviours that challenged.

People�s needs were assessed before they moved into the home to ensure their needs could be met. Input and support from healthcare professionals when reviewing people�s care needs improved people�s quality of life significantly.

People received care and supported when they needed it. Staff were knowledgeable about people�s support needs, interests and preferences.



Updated 25 August 2017

The service was well-led. People felt there was an open, welcoming and approachable culture within the home.

Staff felt valued and supported by the registered manager and the provider.

The provider regularly sought the views of people living at the home, their relatives and staff to improve the service.