Marika House

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

Well-led – this means we looked for evidence that service leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture. At our last assessment we rated this key question good. At this assessment, the rating has changed to requires improvement. This meant the service management and leadership was inconsistent. Leaders and the culture they created did not always support the delivery of high-quality, person-centred care.

The service was in breach of legal regulation in relation to good governance.

This service scored 57 (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 clear shared vision, strategy and culture which was based on transparency, equity, equality and human rights, diversity and inclusion, and engagement.

However, although they understood the challenges and the needs of people; the care people received did not always reflect the service’s values and objectives as set out in their statement of purpose. People did not receive care that was always high-quality residential care or person centred.

The registered manager told us, “Our vision is about making sure everyone we support is happy and lives an inclusive life. Staff are now going to be engaging in meaningful activities that people want to do and listening to them. Vision and values are discussed during induction.”

The provider had inclusive leaders at all levels who understood the context in which they delivered care, treatment and support and strived to embody the culture and values of their workforce and organisation. The new registered manager had been in post for 2 months and had started working their way through service improvements. The registered manager told us they received ongoing support and development in this new role.

However, we identified breaches of the legal regulations and concerns in areas such as person-centred care and governance. Leaders had not independently identified and acted on all these concerns prior to our inspection. This meant some development was needed in their skills and knowledge to lead effectively.

Some relatives told us about the concerns they had relating to the turnover of managers and the inconsistencies this had caused. Relatives spoke positively about the new registered manager and were hopeful improvements would be made in the home now they are in post.

Staff members told us, the new registered manager was doing well, visible, approachable, and making improvements.

The service promoted a positive culture where people felt they could speak up and their voice would be heard.

People living in the services were asked for their views and were given the opportunity to speak up daily both informally and in meetings with their keyworkers, and through surveys. We reviewed people’s daily notes and noted people spoke up, and their decisions and choices were respected. We reviewed people’s surveys where they were encouraged to speak up. This meant people’s voices were heard.

The service valued diversity in their workforce. They worked towards an inclusive and fair culture by improving equality and equity for people who worked for them.

Staff felt supported to give feedback and were treated equally, free from bullying or harassment. They told us they had access to relevant policies. The registered manager gave us a couple of examples of how they had supported staff to be able to work more flexibly to aid with commitments in their personal lives.

The service did not always have clear responsibilities, roles, systems of accountability or good governance. They did not always act on the best information about risk, performance, and outcomes.

The provider’s own governance systems had failed to identify people were not always receiving effective care and prompt action had not been taken to make improvements.

Quality assurance audits had been completed, however, these had not always been effective in identifying the shortfalls we found at this inspection, such as people not receiving a healthy diet or food in line with professional guidance, MCA’s not being completed correctly or not always in place and the IPC concerns we found in relation to handwashing facilities. Although there was some confidence in the new manager, they required time to identify actions, make changes, and embed them into practice.

People did not always receive care and support in accordance with the principles of ‘Right care, right support, right culture’ guidance. Some people were not supported to eat healthily, and not all people were supported to engage in meaningful activities outside of their home.

The registered manager was able to confidently tell us how they ensured safe record keeping by following the principles of General Data Protection Regulation (GDPR).

The service understood their duty to collaborate and work in partnership, so services work seamlessly for people. They share information and learning with partners and collaborate for improvement.

Professionals, staff, and the registered manager shared with us positive examples of collaborative working in partnership. One professional told us, “The important thing was that the team referred a person to us for assessment and advice when their needs had changed.”

The service strived to focus on continuous learning and improvement across the organisation and local system. However, we found some concerns during the inspection which we have highlighted throughout our report. Although the provider was motivated to learn and improve the service for people, their overall ambition was limited by the lack of effective risk and quality monitoring systems. This meant they might not always be aware of shortfalls to enable prompt improvement and learning.

The provider was responsive during our inspection and told us they were taking learning from this inspection and would be sharing this across their organisation.

The registered manager shared with us several ideas of how they wanted to improve people’s experience, these included introducing new activities both inside and outside of the home, however, time was needed for these newly introduced practices to bring about the required improvements.