OSJCT Marden Court

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

There were systems to keep people safe and learn from incidents. There was a safeguarding policy, staff had safeguarding training and told us how they would report any concerns. Staff told us they were confident all concerns would be dealt with appropriately. People had risk management plans in place which gave staff guidance on supporting them safely. There were enough staff to meet people's needs. Staff had been recruited safely and received appropriate training for their role. Systems were in place to support staff and make sure they had opportunities to develop their skills and knowledge. The home was kept safe through regular checks of the building and equipment. Staff followed good infection prevention and control practices and the home was clean. People were supported to safely take any medicines they were prescribed.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider had an effective system for tracking incidents and accidents in the service. Staff recorded details of all incidents, which were reviewed and investigated by the management team. Incidents were only closed when the manager had confirmed all actions from the investigation had been completed. There were systems to share learning from incidents across the organisation. The provider had learning and development advisors to support the management team in responding to incidents.

People told us staff reviewed the care they needed after accidents or incidents, to help make sure they stayed safe. One person said they had been supported to use a pendant alarm, so they could call staff if they needed support. This was introduced after they had fallen in their room.

Staff told us accidents and incidents were thoroughly investigated and action taken to learn lessons from them if needed. Staff said they were encouraged to raise any concerns about safety in the service and there were regular discussions in team meetings about learning from incidents.

People and their relatives told us they had received good support to move into the service. The staff had worked with other services to ensure people received continuity of care, for example, liaising with hospital staff, GPs, pharmacists and community nurses.

Community nurses reported the service worked well with them to ensure people received continuity of care. The local authority commissioning team reviewed processes for assessing people's needs before they moved into the service to ensure they received continuity of care. No concerns were identified in their report to the provider.

The manager told us they completed assessments of people's needs in person wherever possible, including visiting them in hospital, at home or in other care services. This helped the manager to gain as much information about people's needs as possible, including feedback from other professionals involved in their care. Where it was not possible to meet with the person, the manager used a 'trusted assessor' from the local authority, which they reported worked well. Staff reported they worked with other services to ensure people received consistent care when moving into the service. Examples included working with GPs and the pharmacy to ensure people received their medicines as they needed.

People's records demonstrated assessments of their needs were completed before they moved to the service. Assessments included details of the range of community health and social care services the person used and arrangements to ensure the support was maintained.

There were systems were to help keep people safe. A safeguarding policy was available at the service which staff were aware of. Where appropriate staff had applied to the local authority for Deprivation of Liberty Safeguards (DoLS) authorisations. The manager had a record of all DoLS applications, authorisations and any conditions that had been put in place. All staff had received safeguarding training which was mandatory. The management team were completing the local authority safeguarding training for managers of services.

Staff told us they had completed safeguarding training. Staff were clear about how to report any alleged abuse and they were aware of the whistleblowing policy and process. Staff were confident the management team would take action if they reported concerns.

People told us they felt safe living at Marden Court. People and their relatives had access to information about how to raise any concerns they might have. We observed people interacting with staff in a relaxed and comfortable way.

People had risk assessments and risk management plans, which set out the support they needed to stay safe. The plans had been regularly reviewed with people and their relatives to ensure the measures in place were up to date.

People told us they were involved in reviewing their risk management plans to help keep them safe. People told us staff followed these plans and said they felt safe.

Staff demonstrated a good understanding people’s risk management plans and the support they needed to stay safe. Staff said they felt risks were well managed in the service. The manager told us the ethos of the care and support provided was to balance protecting people with supporting them to maintain their independence.

We observed people being supported by staff who knew them well and who took action to ensure people remained safe.

We observed equipment in the home was in a good state of repair and had stickers indicating when they were due to be serviced. Staff locked equipment and chemicals away when not in use. External doors were secured to prevent intruders and the home was well maintained.

There were systems to check the environment and equipment in the service. We saw checks on fire doors, which indicated possible problems with some of them not closing properly, had not been reported correctly or followed up. We reported these concerns to the manager, who took immediate action to ensure external contractors assessed the fire doors and made sure all staff were aware of the correct reporting system for possible defects. All other environment and equipment checks had been completed as required and action taken to repair any defects identified. Checks included gas safety systems, water systems, lifting equipment and electrical systems.

Staff reported there were systems to check the environment and equipment in the service. No concerns had been raised about the safety of the environment by staff. Staff said repairs were completed quickly when needed, either by the maintenance team or specialist contractors.

People said they felt safe in the environment and had all the equipment they needed to keep them safe.

Staff told us there were enough of them to support people safely. Staff felt well supported and said they had regular meetings with their supervisor and an annual appraisal. Staff confirmed they had completed employment checks before they started work and told us they had completed training necessary for their role.

People told us there were enough staff available to provide the support they needed. People said staff had the right skills and knowledge to meet their needs.

There were systems to make sure staff had the required pre-employment checks before starting work. This included a check with the Disclosure and Barring Service (DBS). New staff received an induction which included training and shadowing experienced staff. Records demonstrated staff had regular supervisions and an annual appraisal. Staffing numbers were calculated dependent on people's needs and regularly reviewed. The manager had a record of training staff had completed and a system to plan when refresher courses were needed.

We observed there were sufficient staff to meet people's needs and to respond to requests for assistance. Staff demonstrated a good understanding of people's needs and we observed them supporting people to use equipment safely, for example when supporting people to use a hoist.

We observed staff following good infection prevention control procedures. Staff wore personal protective equipment (PPE) when needed and disposed of it safely. The home was clean and PPE was available for staff throughout the building.

Staff told us they had clear information about infection prevention and control procedures in the service. They were aware of the infection control lead and said regular infection control audits were completed, with the outcome and actions shared with all staff. Staff confirmed they had completed infection control training.

Infection prevention and control audits were completed monthly and reviewed by the manager and area manager. Records demonstrated any actions from the audits had been completed and signed off by the management team.

People were supported to safely take their prescribed medicines. Medicines administration records had been fully completed. These gave details of the medicines people had been supported to take and an accurate record of medicines held in the service. Where people were prescribed ‘as required’ medicines, there were clear protocols in place. These stated the circumstances in which the person should be supported to take the medicine. Records demonstrated staff had followed these protocols. Monthly audits of the medicines systems were completed, with action taken where any shortfalls were identified.

Staff told us the medicines systems worked well and people were supported to take any medicines they had been prescribed. Staff said the system for ordering medicines was completed in good time, to allow any errors to be resolved before people needed the medicine. Staff said they had received training in medicines administration and had regular competency assessments.

People told us they received good support to take their medicines. People were supported to taken their medicines at the right time and said staff helped them to apply medicated creams when needed. People said they were able to see their GP when they needed to review their medicines.