The Marbrook Centre

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Responsive – this means we looked for evidence that the provider met people’s needs. At our last inspection we rated this key question good. At this inspection,the rating has remained good. This meant people’s needs were met through good organisation and delivery.

This service scored 64 (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 and staff team made sure people received person-centred care that was in line with their preferences, likes and dislikes. However, not all aspects of staff support was person centred. Staff were not appropriately reporting when people were upset or when people were potentially causing harm to other people.Staff recorded they sometimes separated a person from communal areas if they were upset, before trying other methods listed in people’s care plans which was not person centred. Staff were not describing people in a person centred or dignified manner in daily records.The registered manager and management team took action to address these areas during our inspection.

However, staff were able to tell us how people liked to be supported and clearly knew people well.People’s care plans and risk assessments were personalised and contained information about people’s likes, dislikes and preferences.People and relatives were positive about how they were supported. One person said, ‘‘The staff know what I like and that is what I get down to how I like my cup of tea. No worries there.’’ A relative told us, ‘‘[Staff] know him well and the care plan reflects how he likes to be supported.’’

The provider understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity. Staff understood and respected people’s cultural support needs, in relation to the food they chose to eat and the religious practices they wished to follow. Care plans clearly stated how staff were to support people in relation to these support needs and preferences.The staff team was consistent,so people knew who was supporting them and had good continuity of care. Staff made efforts to include people in outings to the local community if they chose to do this. One person said, ‘‘I like it here and I do not feel rushed. There is always something going on like a quiz or something and staff take me to [places of interest] on the minibus as often as they can. Staff all work on the same floors and all day so there is good continuity.’ ’A relative told us ‘‘[Staff] are trying to give [family member] the best life possible. They care for them as a person rather than just caring for him.’’

The provider did not always supply appropriate, accurate and up-to-date information in formats that were tailored to individual needs. Whilst forms of communication such as pictures and objects were available to support people, we did not see these used by the staff team to support people. People would have benefited from using these to help them communicate.A relative said, ‘‘I do sometimes think staff could be a little more supportive to [family member].They are non-verbal and bed bound and staff don’t seem to use [support methods] to speak with them. I am not sure how much they understand.’’ The registered manager acknowledged this was an area they could improve on and already had plans in place to do this. For example, new easy ready picture menus were ready to be used, and care plans were being reviewed to make them more accessible for people.

We also observed staff speaking with people in a slow and relaxed way to help make sure people understood what was being communicated with them. People and relatives were invited to meetings to discuss what was happening at the service so information could be shared with them. Staff and the management team had daily meetings to discuss how people’s support needs may have changed or any other information they needed to know. One person said, ‘‘We are asked to go to meetings and staff are always asking us if there is anything else they can do for us.’’

The provider made it easy for people to share feedback and ideas, or raise complaints about their care, treatment, and support, however, could continue to improve in this area. People and relatives were invited to feed back in meetings and were also asked for their views about the service regularly by the management and staff team. People and their relatives were given the opportunity to be involved in discussing care plans and risk assessments. One person said, ‘‘If anything needs changing then you just talk to the staff,and it is sorted out very quickly.’’ A relative told us, ‘‘I was involved from the beginning with the care plan and am able to speak with the staff to amend it as time goes on if we need to.’’

The provider made sure that people could access the care,support, and treatment they needed when they needed it.Staff supported people to contact health professionals such as GP’s or speech and language therapists if necessary and supported them to attend appointments with these professionals. People had access to professionals such as physiotherapists who worked at the service and were supported to source and use equipment they needed. Professionals were positive about how the staff team worked with them to support people.

People’s experiences and outcomes were not always positive or consistent. Whilst there were opportunities for people to be involved in social engagement, this did not always interest people,and it was unclear how or what alternatives were offered to people if they did not want to take part. As a result of sometimes going longer periods of time without staff interaction people’s experiences at the service were sometimes not as positive as it could be. Staff were not always responding and reporting incidents which may have led to poorer outcomes for people. A relative said, ‘‘It would be good if staff could spend more time with [family member] doing individualised things as they are not interested in the [group social engagement]. I have told staff [family members] interests but I do not think much has happened yet.’’ The management team were responsive to our findings and sent us assurances they were starting to address this with the staff team.

However, we also observed some people to enjoy the social past times on offer such as quizzes, coffee mornings and going out in to the community. People using the rehabilitation service consistently had good outcomes and were supported to regain their skills and independence, enabling them to return home. One person said, ‘‘I am excited to be going home,and I could not be doing it if it wasn't for the help of the staff team.’’ One relative said, ‘‘I would say the staff want what is best for [family member]. They know what is important to them and help them to work toward this as much as possible. [Family member] certainly has more good than bad days since living at the service.’’

People were supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life. People’s care plans contained detailed information about how people would like to be supported at the end of their life. Staff had a good understanding of how to support people with dignity and respect at this time and who to contact for further help if needed. People’s future needs in relation to their rehabilitation were considered to make sure they achieved their desired future goals.