We carried out a review of the data available to us about Marian House on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Marian House, you can give feedback on this service.
We found the following examples of good practice.
The service works in partnership with relatives to ensure visits are facilitated in the most appropriate way for the people who live in the home.
Video calling and electronic messaging facilities were utilised by the service enabling people to communicate with loved ones.
Professionals visiting the home had to email their lateral flow device (LFD) results prior to arrival, provide evidence of vaccination status and wear personal protective equipment (PPE) when in the home.
PPE stations were placed at numerous appropriate points throughout the home and were well stocked.
Staff were observed wearing appropriate PPE and donning and doffing correctly.
We found the following examples of good practice.
To promote positive wellbeing, staff supported people with a range of arts, crafts and cooking. New sensory equipment was purchased and garden parties for staff and people to celebrate events such as Gay Pride and St George's day had been arranged.
A visiting protocol was developed in consultation and partnership with relatives to ensure this was developed in the best interests of people living at Marian House. The home was currently closed to visitors but during times of fewer restrictions, relatives were supported to have window visits and maintain contact through video and telephone calls and regular updates by email. A dedicated, indoor visitor's room had been identified for future use which affords people space to socially distance.
Professionals visiting the home had their temperatures taken on arrival and were informed of the procedure and expectations for visiting by a notice placed on the front door of the home.
Staff were given an alternative entry which took them straight into the garden and to the dedicated staff changing room. Staff were provided with scrubs and early on in the pandemic were given 'home packs' which included Personal Protective Equipment and hand sanitiser to minimise infection risks outside of work, particularly for those who used public transport.
The service has been developed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.
The service was a large home, bigger than most domestic style properties. It was registered for the support of up to 20 people. Nineteen people were using the service. This is larger than current best practice guidance. However. the size of the service having a negative impact on people was mitigated by the building design fitting into the residential area and the other large domestic homes of a similar size. There were deliberately no identifying signs, intercom, cameras, industrial bins or anything else outside to indicate it was a care home. Staff were also discouraged from wearing anything that suggested they were care staff when coming and going with people.
People’s experience of using this service:
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.
The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent. For example, people had a variety of activities of their choosing including attending day service to learn about daily living skills including cooking. A professional commented that people had a good choice of activities and the staff always found new and exciting activities for people to try.
Staff were committed to delivering care in a person-centred way based on people's preferences and wishes. There was a stable staff team who were knowledgeable about the people living at the service and had built trusting and meaningful relationships with them.
Staff were recruited safely and sufficient numbers were employed to ensure people’s care and social needs were met. Staff knew how to keep people safe from harm.
There was time for people to have social interaction and activity with staff. Staff encouraged people to maintain links with the local community, their friends and family.
People's care was individualised and focused on promoting their independence as well as their physical and mental well-being. People were supported to take positive risks, to ensure they had as much choice and control of their lives as possible.
The environment had been adapted to meet people’s individual needs and keep them safe from harm. For example, overhead hoists and specialist baths. Staff had received appropriate training and support to enable them to carry out their role safely, including the management of medicines.
People were supported to access healthcare services, staff recognised changes in people's health, and sought professional advice appropriately. People were involved in shopping, meal planning and preparation. Staff encouraged people to eat a well-balanced diet and make healthy eating choices.
Where restrictions had been put in place to keep people safe this had been done in line with the requirements of the legislation as laid out in the Mental Capacity Act (2005) and associated Deprivation of Liberty Safeguards. Any restrictive practices were recorded and regularly reviewed to check they were still necessary and proportionate.
There was a clearly defined management structure and regular oversight and input from senior management. Staff were positive about the management of the service and told us the registered manager was very supportive and approachable. Any concerns or worries were listened to, addressed and used as opportunities to make continuous improvements to the service.
Rating at last inspection:
The last rating for this service was good (published 21 December 2016). Since this rating was awarded the registered provider of the service has changed. We have used the previous rating to inform our planning and decisions about the rating at this inspection.
Why we inspected:
This inspection was a scheduled comprehensive inspection.
Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk