• Care Home
  • Care home

Archived: Marray House

Overall: Inadequate read more about inspection ratings

12-14 Essa Road, Saltash, Cornwall, PL12 4ED (01752) 844488

Provided and run by:
Marray House Care Services

Latest inspection summary

On this page

Background to this inspection

Updated 9 March 2015

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, looked at the overall quality of the service, and provided a rating for the service under the Care Act 2014.

We visited the home unannounced on 10 December 2014 and 12 December 2014. The inspection team consisted of two adult social care inspectors. On the first day we focused on speaking with people, their visitors, and with staff. We observed how people were cared for, and examined care and recruitment records. On the second day we reviewed staffing levels and looked in more detail at care and management records, and spoke with staff and the registered provider.

During our inspection we spoke with five people living at the home, one relative, four care staff, and the registered provider. Following our inspection two relatives provided us with written feedback. We observed care and support. We looked at four care plans, medicine records, policies and procedures, and five personnel and training files. We also looked at quality assurance and monitoring paperwork which the registered provider had in place.

Before our inspection we reviewed the information we held about the home. We reviewed information provided to us by health and social care professionals and notifications sent to us by the provider. Notifications are information about important events which the service is required to send us by law.

After the inspection we contacted local commissioners of the service who funded people who lived at Marray House to obtain their views and the local authority service improvement team. We made contact with one GP, one social worker, one mental health nurse, and the community district nursing team.

Overall inspection

Inadequate

Updated 9 March 2015

This was an unannounced inspection on 10 December and 12 December 2014. Marray House provides accommodation for up to 20 older people who require support in their later life or are living with dementia. There were seven people living at the home because the service was subject to safeguarding processes, and the local authority were not commissioning with the service at the time of our inspection. The home is comprised of two separate houses which are joined together by a kitchen. Accommodation is arranged over two floors, and there is a stair lift to assist people to get to the upper floor. The home has 20 single bedrooms. There are shared toilets, bathroom and shower facilities.

After our last inspection in September 2014 we told the provider to take action to make improvements to how the quality of the service was monitored. The provider sent us an action plan on 7 November 2014 confirming all the improvements had been made. During this inspection we looked to see if these improvements had been made, but they had not all been completed.

The service has not had a registered manager since September 2011. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations about how the service is run.

Staff did not understand how the Mental Capacity Act (MCA) and deprivation of liberty safeguards (DoLS) protected people to ensure their freedom was supported and respected. The MCA provides the legal framework to assess people’s capacity to make certain decisions, at a certain time. When people are assessed as not having the capacity to make a decision, a best interest decision is made involving people who know the person well and other professionals, where relevant. DoLS provide legal protection for those vulnerable people who are, or may become, deprived of their liberty.

People’s comments about the staff were variable; some people told us staff were kind and caring, whilst others felt differently. Relatives told us they were happy with the care their loved ones received, and like people who lived at Marray House, were complimentary of the provider. Relatives and professionals told us they always received a warm welcome when visiting. However,

people were not supported by sufficient numbers of staff who had the knowledge, skills, experience and training to carry out their role.

Staff were not aware of people’s individual nutritional needs and people were not always supported to drink enough. People had access to health care services however services were not always contacted in a timely manner. The provider did not have effective systems in place to ensure information about people’s health care needs were shared. This poor communication affected the ability of staff to meet people’s individual needs.

The provider did not always embrace feedback from health and social care professionals to enable learning and improvement to take place. For example, the provider had chosen not to implement changes as suggested by social care professionals to improve the care planning documents for people.

People did not receive care which was personalised to their needs because staff did not always follow advice from health professionals. Care plans and risk assessments were not individualised and did not give clear direction to staff about how to meet a person’s needs. This meant the care being provided was inconsistent between staff. People were not involved in creating and reviewing their own care plan. This meant people’s care plans were not reflective of their own choices.

People’s independence and social life were not promoted. People had requested trips outside of the home but no opportunities were provided.

People’s medicines were not managed well which meant people did not receive them at the correct time and documentation was inaccurate. People’s end of life wishes were not understood by staff and people’s care planning documentation was not reflective of their wishes. This meant people were not well supported at the end of their life and did not always receive consistent and compassionate care.

The quality monitoring systems in place did not help to identify concerns and ensure continuous improvement.

Staff were able to explain what action they would take if they suspected abuse was taking place. People were protected by safe recruitment procedures as all employees were subject to necessary checks which determined they were suitable to work with vulnerable people. People told us, if they had any concerns or complaints, they felt confident to speak with the staff or provider.

We found a number of breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. You can see what action we told the provider to take at the back of the full version of this report.<Summary here>