We carried out a review of the data available to us about Martham 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 Martham House, you can give feedback on this service.
We found the following examples of good practice.
Pictorial stories had been developed for the service users and used to help to explain Covid-19 and its impact. This information was presented in different ways depending on the understanding of service users and included information on why staff were wearing masks at the home.
The provider had created a way for managers and staff to ensure they were always accessing up to date guidance on Covid-19. This included links to the national guidance for different subjects such as personal protective equipment (PPE), visitors and new admissions. There were individual risk assessments in place for all Black, Asian and minority ethnic (BAME) staff as well at the home as well as other staff who also wished to have an individual risk assessment or required one due to health reasons.
Further information is in the detailed findings below.
This was an unannounced inspection which took place on 17 May 2017.
During our inspection the registered manager was present. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.
People experienced exceptional care and support which enabled them to lead safe and fulfilling lives. The whole ethos at Martham House was one which place people at the heart of everything. People told us they felt lucky to live there and their relatives described their relief at having found such a great service to care for their loved ones.
Staff had an excellent understanding about how to safeguard people. There were robust systems in place to manage allegations of abuse and staff were confident about their responsibilities in keeping people safe from harm.
Risks to the health, safety and well-being of people were addressed in a personalised and enabling way that promoted their independence. Staff supported people with skill and expertise to ensure they could enjoy maximum freedom whilst remaining safe.
There were always enough staff on duty. Staffing levels were set with funding authorities according to people’s needs. Staff were rostered to work flexibly to enable people to follow their interests and hobbies. Recruitment processes ensured that people were always supported by suitable staff.
Medicines were managed safely and staff competently ensured that people received their medicines as prescribed. There were good systems in place to ensure that any medical emergencies could be handled safely.
Staff enjoyed working at the service and felt well supported in their roles. They had access to a wide range of training which equipped them to deliver their roles effectively. The registered manager was an excellent role model and there were sound systems in place to develop staff and promote reflective practice. Staff were proud to work at Martham House and this in turn led to the delivery of high quality support.
There were excellent systems in place to ensure that people’s human rights were protected. Wherever possible, staff supported people to make decisions for themselves. In situations, where this was not possible, appropriate processes had been followed to ensure any decision made was within their best interests. Where interventions were necessary to keep people safe, staff fully understood the impact and ensured support was always provided in the least restrictive way.
People were actively encouraged to be involved in making healthy choices about their food and drink. Where appropriate, people had opportunities to develop their cooking skills and take responsibility for the planning and preparation of their meals. Specialist dietary needs were understood and well managed.
People were proactively supported to maintain good health and experienced improved health outcomes as a result. The registered manager had excellent working relationships with other professionals to ensure that people received the very best holistic care. People had developed their independence as a direct result of the positive support they had received in respect of managing their specialist needs.
People and their relatives repeatedly praised the care and kindness of staff. The atmosphere in the service was relaxed and friendly with lots of fun and laughter being shared. Positive relationships between people and staff had been developed that were based on trust and respect. People’s diverse communication methods were understood and staff were proactive in the way they actively involved people in all decisions about their support. People’s privacy and dignity were upheld as a matter of routine.
People received a highly personalised service that was exceptionally responsive to their changing needs. Staff encouraged people to connect with their local community on a daily basis. People had excellent access to educational and leisure opportunities that were bespoke to their preferences and interests.
People benefitted from living in a well organised, forward thinking service where their needs were always at the centre. The culture of Martham House was open and people felt confident to express their views and opinions. The registered manager and team of directors provided clear leadership and direction to staff and were committed and passionate about providing high quality services to people.
Quality assurance processes were robust and action plans to improve the service were prioritised and completed quickly. Learning was shared from within and outside the organisation and community contacts were well established. National best practice legislation and local policies were referenced to set and measure standards of care.
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 and to pilot a new inspection process being introduced by CQC which looks at the overall quality of the service.
This was an unannounced inspection. Martham House is registered to accommodate up to nine people with learning disabilities, focusing on people with autism specific disorders. The premises are purpose built and comprise nine en-suite bedrooms, bathrooms, kitchen and communal areas. There were nine people living at the home on the day of our inspection.
The registered manager and deputy manager were present during the inspection. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service and has the legal responsibility for meeting the requirements of the law, as does the provider.
People were treated with respect and dignity by the staff. They were spoken with and supported in a sensitive, respectful and professional manner. Each person had a comprehensive set of support plans and risk assessments tailored to their individual needs. These plans highlighted any additional areas of support needed and involved the opinions of experienced staff, professionals and members of the family. People and their relatives confirmed that they had been involved, or had the opportunity to be involved, in assessments, care planning and reviews. One person told us “I have a care plan and staff talk about it with me.”
People told us they felt safe. Relatives said they felt confident and reassured that their loved ones were safe. One relative told us “Having a child in care, they are always going to be on your mind. However, I can honestly say that I now have the peace of mind knowing my son is safe and secure here and his needs are being met.”
The deputy manager told us that an individual’s dietary requirements formed part of their pre-admission assessment and people were regularly consulted regarding their food preferences. Menus and people's individual nutritional requirements were regularly discussed during residents' meetings. Healthcare professionals, including speech and language therapists and dieticians, had been consulted as required.
People were provided with choices such as whether they wished to join in with an activity and they told us their choices were respected. They had the opportunity to take part in a range of social and recreational activities, reflecting their interests and preferences, both in and outside the service.
Due to the complexity of their behaviours and needs and to ensure that individual behaviours were managed appropriately, there were detailed support plans in place which had input from the local physical and learning disability teams and behaviour specialists. People were also registered with local GPs and had access to other health care professionals, including speech and language therapists, practice nurses and physiotherapists, as required.
There were sufficient numbers of suitable staff to keep people safe and meet their needs. Staff told us they were supported to develop their skills and knowledge by receiving training which helped them to carry out their roles and responsibilities effectively. Training records were kept up to date and staff were encouraged and supported to develop their practice knowledge and skills of staff.
Staff told us that communication throughout the home was good and included comprehensive handovers at the beginning of each shift and regular staff meetings. They confirmed that they had received comprehensive training and support and consequently felt confident in their roles. Staff also told us they received regular formal supervision and felt valued and supported by the manager and deputy manager, who they described as “brilliant” and “very approachable.”
As well as regular “clients’ meetings” and satisfaction questionnaires, we saw examples of various internal quality monitoring audits, which the manager carried out on a regular basis, including care planning, medication and staff training. The manager told us that they operated an 'open door policy' so people who used the service, staff and visitors to the home could discuss any issues they may have.
We observed staff speak to people in a friendly and respectful manner. Staff demonstrated a good understanding of people's means of non verbal communication. People were supported to access a range of therapeutic and social activities. A person we spoke said they enjoyed playing snooker and that were attending college.
Person centred care plans had been developed which were detailed and provided clear guidance for staff to follow which enabled them to deliver people's care. There were good risk management systems in place.
People's nutritional needs were met. We found that the service provided a varied and balanced menu. At this inspection we saw that people were able to choose their favourite meals.
Procedures were in place for safeguarding vulnerable adults from abuse. Staff received training in safeguarding and they had a good understanding of safeguarding issues.
Systems were in place that ensured that any equipment used by people was reguarly checked which ensured that it was safe to use.
We found that people were supported by sufficient numbers of staff.
We observed good interaction taking place between staff and people using the service. Staff spoke to people using the service in a friendly and respectful manner.
We observed people and staff taking part in activities. One person was baking cakes in the kitchen with a member of staff. Staff showed that they had a good understanding of peoples needs and they were aware of their means of communication. We observed staff responding to peoples requests.
A person using the service said that they were invited to meetings. We spoke to the relatives of two people, who also said they were invited to care review meetings and they were kept up to date about their relative's care.
Two people said that they thought home was clean.
A person using the service said that there had been staff changes but they would talk to their key worker if they were not happy about anything.
Two relatives said they thought there was enough staff. One person said that when they visit they see staff spending time with people.
Relatives we spoke with said that they were aware of the home's complaint procedure. They said that staff listened to their views.
At the time of our visit some people went to London for the day with staff. Some people attended the local leisure centre and went out for lunch.
One person using the service told us that a few members of staff have left the service. They also told us that it can be quite noisy at night time as some people living in the service are not very quiet.
We observed a member of staff supporting a person to eat their meal in an unrushed manner.
We saw some people leaving the service to participate in activities and we observed people accessing areas of the home freely.
A person using the service entered the kitchen and helped themselves to a snack independently.