Archived: Margaret House

Updated 10 December 2019

The inspection

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

Inspection team:

The inspection was carried out 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.

Service and service type:

Margaret House is a 'care home'. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager who was registered with the Care Quality Commission. A registered manager and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We spoke with nine people who used the service and three relatives about their experience of the care provided. We spoke with the registered manager, the regional manager, and five members of staff. We 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 a range of records. This included three people’s care records and medication records. We looked at three staff files in relation to recruitment. A variety of records relating to the management of the service were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at quality assurance records.

Updated 10 December 2019

About the service

Margaret House is a purpose-built residential care home providing personal care to 50 people at the time of the inspection. The service can support up to 51 people. The home has five units which are referred to as bungalows.

People’s experience of using this service and what we found

People were happy with the care and support they received. Staff were kind, friendly and attentive to people’s needs. People gave mixed views about if there were enough staff to meet their needs. Staff also felt more staff were needed to give people more attention. Staff were trained and felt supported.

People felt safe and staff were aware of how to promote people’s safety. Regular checks were in place to ensure staff worked in accordance with training and health and safety guidance was adhered to. However, some areas needed clarity and better communication, for example, to ensure all staff were aware of people’s recorded risks relating to choking and how to transfer a person safely in a wheelchair. This was completed on the day of inspection.

There were governance systems in place and these were used effectively in most cases. However, these had not identified all issues in relation to medicines at care team level. Feedback about the registered manager, and management team was positive. There was an open culture in the home and an expectation that people were supported in a person-centred way. Staff were clear about their roles and the management team positively engaged with the team and other agencies.

The environment was being developed to make it more homely with dementia care in mind, some areas had been completed. This included signage and items to stimulate people's minds and interests. There was plenty of communal space for people to enjoy, and people could walk through the whole house freely. People enjoyed the activities that were provided, however staff told us that they would like more time to support people in their rooms or those who don’t come off of their individual bungalows with activities.

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. Staff knew people well and worked in a way that promoted people’s preferences and wishes.

People were involved in planning their care and they, along with their relatives. The management team were working on ways to better capture people’s involvement. People had end of life care plans which were going to be further developed. Complaints were responded to appropriately and people felt confident to make a complaint if needed. Feedback was sought through meetings and the registered manager speaking with people and relatives.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

The last rating for this service was Requires Improvement (published 28 November 2018). At this inspection the service has improved to Good.

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.