Archived: Martins House

Updated 4 May 2017

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

This inspection took place at Heath Lodge on 30 March 2017 and was unannounced. The inspection was carried out by two inspectors, a specialist nurse advisor whose specialism was with dementia and an expert by experience. An expert by experience is a person who has experience of using this type of service.

Before the inspection we reviewed information we held about the service including statutory notifications that had been submitted. Statutory notifications include information about important events which the provider is required to send us. We reviewed a copy of the action plan sent to us by the provider that told us how they would meet the legal requirements. We reviewed copies of regular monitoring audits we received from the provider, alongside reports from the local authorities serious concerns meetings held in partnership with the provider that set objectives to discuss and improve performance in the home. We reviewed safeguarding meetings that had been held in response to historical concerns about the care people received and we also reviewed the findings of a service monitoring audit carried out by the local authority. We sought additional feedback from social care professionals who supported people living in Martins House.

During the inspection we observed staff supporting people who used the service; we spoke with 12 people who used the service and the relatives of four people. We spoke with ten staff members, and one volunteer. We also spoke with the registered manager, the deputy manager, the provider and two visiting health professionals.

We also used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

We reviewed care records relating to eight people who used the service and other documents central to people's health and well-being and associated management records.

Updated 4 May 2017

We inspected Martins House on 11 August 2016 and identified breaches with the following areas, person centred care, obtaining consent, good governance and staffing levels, promoting peoples dignity, providing care in a safe manner, protecting people from abuse, effectively managing people’s nutritional needs and effective management of the service and organisation. We took action using our regulatory powers and urgently imposed a restriction to ensure Martins House took no further admissions, and sought urgent assurances to ensure people were kept safe. We also placed the service in Special Measures and kept the service under review along with referring our findings to the local authorities safeguarding and commissioning teams.

We carried out a comprehensive inspection at Martins House on 30 March 2017, this was unannounced. At this inspection we found that significant improvements had been made across the safe, effective, caring and responsive domains, although further improvement was still required in relation to the management of the service. Martins House is registered to provide accommodation and personal care for up 60 older people some of whom live with dementia. At the time of our inspection 28 people were living at the service.

Since our last inspection a new manager was appointed in August 2016 and had registered with the Care Quality Commission as they are required to do. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

People did not experience delays whilst waiting for their care to be provided, staff had sufficient time to carry out their tasks as the registered manager had recruited a significant number of staff to the home. They had reduced the number of temporary staff working in the home to zero hours prior to the inspection. People’s care plans had been developed to include more up to date information. However, these records still required work to ensure they included all the specific information about people's needs. Risks to people’s safety and wellbeing were positively managed with appropriate equipment in place to support people’s health needs. People were supported by staff who had undergone a robust recruitment process to ensure they were suitable to work with vulnerable people. People’s medicines were managed safely and people received their medicine as the prescriber intended.

People were supported by staff who were well trained and supported by effective leadership to develop their skills and provide effective care. Care staff received regular supervision of their conduct and practise. People's consent was sought however the service did not consistently work in accordance with MCA and DoLS legislation. People were happy with the food and drink provided to them and where people were at risk of weight loss, staff took appropriate the actions to support their welfare. People were supported by a range of health professionals who were positive about the improvements in the home.

Staff spoke and interacted with people in a kind and friendly manner, demonstrating a caring approach to meeting people’s individual needs. Staff ensured people’s dignity and privacy was maintained at all times and supported people's social needs. People felt able to raise a concern or complaint with staff who they felt would take appropriate action to resolve these. People were provided with regular opportunities to meet in order to discuss improvements in the home or be kept abreast of developments.

People did not always receive high quality care that was well led. People felt the service was well managed and that the management team were visible. Staff felt confident in approaching the registered manager and felt they were supportive of them. Governance systems in the home had been introduced and had improved in identifying areas of poor practise or risk to people, however these systems continued to be under review. People’s care records continued to require further development.