Marika House

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. At our last assessment we rated this key question good. At this assessment, the rating has remained good. This meant people were safe and protected from avoidable harm.

This service scored 69 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The service had a proactive and positive culture of safety, based on openness and honesty. They listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

We observed staff listening to people and responding to their concerns. Staff knew what incidents to report and how to report them.

The service investigated incidents thoroughly and shared outcomes with people and relevant stakeholders. We saw evidence of change as a result of incidents which had occurred.

The registered manager told us they received safety alerts from the government, local authority and CQC which informed them of upcoming risks along with themes and trends to ensure the provider could take appropriate action to mitigate these risks.

The service worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services.

The provider had an admissions policy in place. The registered manager was able to explain the process including assessing people’s needs to establish suitability, ensuring specialist equipment was available and staff had additional training if required.

People were consistently supported when they were distressed and there was a focus on planning for a good day and understanding what had caused people distress so positive changes could happen.

The service worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. They concentrated on protecting people’s right to live in safety, free from bullying, harassment, abuse, and discrimination.

Staff knew how to protect people from abuse and who they would report any concerns to both internally and externally.

The service shared concerns appropriately by following the correct process and ensuring these were reported to the relevant agencies. Where restrictive practices were in place Deprivation of Liberty Safeguards (DoLS) were in place or had been applied for, to legally authorise restrictions placed on people to keep them safe.

The service did not always work well with people to understand and manage all risks.

People were assessed for risks of falls, risk of choking and risks when using the kitchen. When risk had been identified guidance were available for staff and staff described how they supported people to stay safe such as providing additional equipment and the appropriate support as noted in people’s risk management plans.

However, some risk for example in relation to people’s unhealthy eating and limited activities had not been identified and comprehensively assessed to determine how people were to be supported to reduce the risk to their physical and mental health.

The service detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

Health and safety and fire safety risk assessments were completed and checks made of equipment to ensure it was safe to use. Regular audits were undertaken to ensure the environment and equipment remained safe to use. Any concerns were reported to the management team or appropriate person for further action.

Staff attended regular fire evacuation drills to ensure they could safely support people out of the home in the event of a fire.

The service made sure there were enough qualified, skilled, and experienced staff, who received effective support, supervision, and development. They worked together well to provide safe care that met people’s individual needs.

We received mixed feedback from staff and relatives about whether there were enough staff. We reviewed duty rotas which evidenced the provider ensured there were the correct number of staff on each day.

The registered manager had a training matrix in place which evidenced most staff had completed all their statutory and mandatory training and competency assessments to ensure they were able to meet people's individual needs. Where staff had not completed training, they were booked on to a session. The provider followed safe recruitment practices.

The service did not always assess or manage the risk of infection. They did not always detect and control the risk of it spreading.

We observed a person’s bedroom and en-suite which was in a poor state of repair. With significantly stained walls, flooring, and ceiling. The walls of the communal areas were stained along with the stair carpet. We spoke with the registered manager, who had been in post for 2 months, about this. They told us they had picked up these concerns prior to our inspection and had organised for the maintenance team to gather quotes for the works to be undertaken. We reviewed these quotes as part of our inspection process.

We observed people did not have handwashing materials in their bathrooms and bins containing personal protective equipment (PPE) did not have liners in them. We spoke with the provider and during the second day of inspection these issues had been rectified.

We received mixed feedback from relatives about whether the home was clean. We observed the cleanliness of the environment could be improved upon. We spoke with the registered manager about this who told us they were aware of the concerns and were in the process of organising for a company to come in and undertake a deep clean, which would them make it easier for staff to manage moving forward.

The service made sure that medicines and treatments were safe and met people’s needs, capacities, and preferences. Staff received medication training, and their competency was checked to ensure they understood the requirements for the safe administration of medicines.

Staff told us they felt well trained and confident to support people to receive their medicines safely. Staff supported and involved people to manage their medicines and followed best practice guidance for administering medicines. Records showed people had received their medicines as prescribed. The staff team were proactive at reporting any changes to people’s medicines promptly.

The registered manager told us, during people’s annual health reviews, Stopping Over Medication of People with a learning disability and/or autism (STOMP) plans were reviewed. This ensured people’s medicines were reviewed to ensure psychotropic medicines were not inappropriately prescribed or overused.