Background to this inspection
Updated
15 September 2018
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 is 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 unannounced inspection took place on the 7 and 16 August 2018. The first day was undertaken by one inspector and an expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service. On the second day, we made telephone calls to staff at the service.
Due to technical problems, the provider was not able to complete a Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.
We reviewed information we had received about the service such as notifications. This is information about important events which the provider is required to send us by law. We also looked at information sent to us from other stakeholders, for example the local authority.
During our inspection, we looked at the care records of seven people, recruitment records of two staff members and records relating to the management of the service and quality monitoring. We spoke with ten people living at the service, seven relatives, and one professional.
Where people were unable to speak with us directly we observed how staff interacted with people and used informal observations to evaluate their experiences and help us assess how their needs were being met. We spoke with seven staff including the registered manager and the deputy manager.
Updated
15 September 2018
We carried out an unannounced inspection of Marmora in September 2017 and found there were four breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Improvements were needed regarding safe care and treatment, safeguarding service users, staffing and good governance. The registered provider submitted an action plan to us about the measures they were taking to address the concerns found at the previous inspection.
At this inspection on 7 and 16 August 2018, we checked that the registered provider had made the required improvements. Since our last inspection of the service, improvements had been made and the service was compliant with the regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 (Part 3).
The management team had made significant progress to address the previous concerns and we have now rated this service overall, 'Good'.
Marmora is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The care home accommodates up to 27 older people who may have varying levels of dementia related needs. Marmora does not provide nursing care.
Marmora is situated in a residential area, close to the seafront and the town centre. The premises is on three floors with each person having their own individual bedroom and communal areas are available throughout. At the time of our inspection, 24 people were using the service.
There was a registered manager in post. 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.
Systems and processes had been implemented to monitor and improve the quality and safety of the service provided. The registered manager was pro-active, committed to continuous development and worked closely with the registered provider which had led to improvement in the managerial oversight of the service. Measures had been taken to strengthen the management team of Marmora and this had led to positive outcomes for people.
People and their relatives were very positive about the approach of the registered manager and the improvements they had made. Complaints and concerns were suitably investigated and dealt with and good records management was in place.
Staffing levels had been reviewed and there were adequate numbers of staff on duty to support people and meet their needs and people were provided with supervision, stimulation and meaningful activity. Staff had been recruited safely and were trained and supported to meet people’s needs.
Safe processes were in place for the administration of medicines and there were procedures in place to ensure the safety of the people who used the service. There were systems in place to safeguard people from abuse and the recruitment of staff was safely completed to make sure they were suitable to work in the service. Staff were aware of their responsibilities and knew how to report any concerns.
Staff demonstrated an understanding of the Mental Capacity Act (MCA) and Deprivation of Liberty Safeguards (DoLS.) People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. The policies and systems in the service support this practice.
Risk assessments and care plans provided detailed and relevant guidance for staff in the home. People were supported effectively with their nutritional needs and received personalised care from a staff team who were kind and caring, respected their privacy and dignity and promoted their independence.