Marina View Care Home

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Staff considered consent throughout their care interventions and we saw Mental Capacity Act assessments in people's records. The manager made applications to the local authority to legally deprive someone of their liberty where appropriate. The manager used tools to monitor people's outcomes. Systems were in place to make sure people were supported to eat and drink healthily. However, people were left at risk of harm as there were gaps in care plans and risk assessments. Staff did not communicate well with external services, or provide support to make sure people lived healthier lives.

This service scored 54 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People's needs were assessed and reviewed regularly. However not all information was included and care plans lacked detail. Although audits had been completed they had not been effective enough to result in improvements. The new manager was aware and action was being taken immediately to review and update everyone's care plans and risk assessments.

Leaders were aware that improvements needed to be made and put an action plan in place to address. Staff told us they did not always have time to read care plans, and were not always involved in people's reviews of care.

New processes were being established and embedded to ensure needs were properly assessed and risks mitigated.

Responses from people and relatives were mixed. We spoke to 1 relative who said, "‘The speech and language therapist recommended a level 2 drink thickener without seeing him. My [relative] won't drink it as it changes the taste so much. He needs patience and time to support him with drinking ,the carers haven’t time to cope with this." Another relative said, "I feel that the home accepted [my relative] without having knowledge of the condition, or the expertise to manage complex needs."

Leaders told us they used recognised tools to assess people's needs such as assessments for malnutrition. It was difficult for us to see this due to how the electronic system was set up. Staff could speak about people’s nutrition and hydration needs and tell us how these were communicated amongst the team. However, we received mixed feedback around relevant training so could not be assured people’s needs were being met in line with current guidance. A staff member advised they did not have training for 2 people at the home with specific conditions. They explained the potential impact this had on their understanding of people’s conditions and delivering the appropriate care and treatment to ensure positive outcomes.

We saw there were some processes in place, for example falls management. There were some post falls guidance in the folder but were not sure whether staff regularly accessed this. Staff knew what to do and we saw post falls observations in daily notes.

People's and relative's feedback was extremely poor. We were told by 1 relative, "Communication between the relevant agencies, the GP, and the family has been diabolical." Another relative said, "I have asked for external health referrals to support [my relative] but as yet, although they thought it was a good idea, this hasn't happened. The GP calls every Thursday but doesn't always see the patient who has requested a visit. Instead, she talks with the nurse. Again, I feel this is down to poor communication from the home." A third relative told us they arrange all health appointments.

Staff confirmed there was a daily handover meeting in which people’s care, treatment and support needs were discussed and staff were allocated to people or specific care tasks with oversight from the nurses and senior carers. A staff member said, “There is an allocation sheet that is updated every day, and will inform staff in the handover about any appointments or [changing] needs etc.”

We received feedback from partners that there had been a breakdown in communication with external agencies. This was being addressed with support from different stakeholders.

The provider showed us relevant policies that were in place, however, our findings indicate these were not being followed effectively.

People told us that some services they expected when they moved in were not available and relatives arranged things privately. Relatives told us that sometimes concerns such as a red mark was not immediately observed by staff, leading to a pressure sore. Other relatives told us they had to request that their relatives received support to eat and drink, or to have a shower. People and relatives confirmed the food choices seemed healthy and well-balanced.

Staff said people were encouraged and supported to make healthier choices to help promote and maintain their health and wellbeing, but we saw limited evidence of this. A staff member said, “We try to provide education and promote this where we can. For example, if someone had diabetes we would try to educate them about healthy choices.”

We saw there were policies to support access to healthcare however it was not clear how effective these were.

Most people and relatives did not have feedback in this category however 1 relative said that a pressure sore was allowed to develop as sufficient care was not provided.

Staff and leaders told us they documented people's weights regularly which we saw evidence of. It was not clear what the system was to monitor and take action when a person's weight was of concern, although the new manager stated she had taken over monitoring this and making referrals to dietician's where necessary, again which we saw evidence of. We saw evidence of body maps and monitoring of falls.

There were processes in place to make sure staff documented people's weight, food and drink intake, falls, and observations.

Relatives told us they had been involved in best interest decision making and people told us they had signed consent forms such as for vaccines.

Staff understood the importance of obtaining consent before they delivered care or treatment. Staff gave appropriate examples of when they would seek consent. A staff member told us they would seek consent from people’s next of kin if people lacked capacity. We received mixed responses about training in The Mental Capacity Act 2005. However, staff seemed to have a good understanding of what this meant in practice and spoke about people’s right to refuse care and treatment. We were told by 1 staff, “I would ask another staff member to re-approach. If they have capacity, we would have to respect their decision and would document that care or medication has been offered and refused. I would never force care or medication.”

The manager had applied for legal authority to deprive people of their liberty where appropriate and in people's best interests, and this was monitored to re-apply when required.