The Marbrook Centre

We have assessed the service against ‘Right support, right care, right culture’(RSRCRC) guidance to make judgments about whether the provider guaranteed people with a learning disability and autistic people respect, equality, dignity, choices, independence and good access to local communities that most people take for granted.

We completed this inspection due to the length of time since our last inspection.At our last inspection,this service was rated good. At this inspection we found a breach of regulations in relation to safeguarding people from abuse. The service has changed from good to requires improvement at this inspection.

Systems were not effective in identifying safeguarding incidents on one floor of the service which specialised in supporting people living with dementia. As a result,incidents were not being investigated to help safeguard people from abuse and promote learning to stop incidents from happening again. Medicines were not always being managed safely on this floor of the service.This issue was not prevalent on the other two floors of the service which supported people living with physical disabilities and people who used the service as a rehabilitation service to regain their skills and independence.The management team took immediate action to improve how safeguarding incidents were reported and investigated and how medicines were managed.People sometimes went for longer periods of time without meaningful engagement from the staff team.Staff did not always describe people with kindness in their daily care records. As a result of these issues some aspects of people’s care and the culture of the service were not always person-centred. We have asked the provider for an action plan in response to the concerns found at this assessment.

People and relatives told us they/their family member were safe at the service.People’s care plans and risk assessments were detailed and gave good guidance to staff about how to mitigate risks to people and keep them safe. There were enough staff to support people safely and they were trained and competent in their job roles. The service was safe and clean, and staff followed good infection and prevention control (IPC) practice. People’s needs were assessed when they started using the service. Staff supported people to live healthily, and people had good outcomes with their support in relation to their health needs. People were supported in line with the Mental Capacity Act (MCA). People and relatives told us staff were kind and caring and we observed people to be happy whilst they were supported.Staff knew people as individuals and efforts were made to support people with varied social past times and experiences.People living at the service had very positive outcomes in relation to being supported to rehabilitate during after an injury or achieve their desired goals and ambitions.The registered manager and management team were passionate about the service and wanted what was best for people. They took the findings from our inspection seriously and made some immediate improvements to the service based on our feedback.Audits and governance measures at the service were effective in identifying and driving improvements.