Marine Park View

Improvements had been to people's safety and to the environment. The culture of the service had opened as people were listened to, any concerns were addressed. Incidents and accidents were reported, investigated and lessons learned to reduce risk of re-occurrence. Systems had been strengthened to ensure people were kept safe and protected from the risk of harm and abuse. People were supported to understand and manage risk. Care plans were clear and provided detailed guidance to staff to keep people safe. Detailed information was collected before people moved to the service and was available to take with them if they moved to another service.There were appropriate staffing levels and skill mix to make sure people received consistently safe care that was person-centred. Staff received training that was relevant to their roles and responsibilities. They received supported and regular supervision with opportunities for personal development. Significant improvements had been made to the environment to ensure people’s safety and comfort. Medicines were better-managed, although further improvements were needed. There was more robust recruitment of new staff, but further improvement was needed to the some vetting procedures. There was better Infection and prevention control and the premises were clean and well-maintained. People received visitors.

People’s needs were assessed prior to using the service and reviewed on an ongoing basis, to ensure people’s needs were met. Passports had been prepared with relevant information if people moved between services to help ensure people’s needs were understood and continued to be met. Care plans were developed for each identified care need and staff had improved guidance in care records on how to meet those needs. Staff worked well with other health and social care professionals to ensure people’s care and treatment needs were met. Records included specialist advice and guidance, that had been obtained where people had additional support needs such as from the speech and language therapist or mental health team. Assessments were carried out, around people’s mental capacity and care records contained all relevant information and were documented in line with guidance. Staff ensured that people were involved in decisions about their care. They knew what they needed to do to make sure decisions were made in people's best interests. Advocates were involved as necessary. Systems were in place to ensure people received varied and nutritious meals. Improvements had been made to people’s dining experience and to menus and the variety of food in consultation with people.

People were now 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. People were well-cared for. Staff interacted calmly, attentively and warmly with people. People were treated with kindness and compassion. Visiting professionals also gave feedback that staff were kind and respectful when dealing with them.

Staff understood person-centred care and demonstrated how people were given choice and control in their lives. People’s care records were detailed and documented their history, preferences and health and mental health care needs. Records gave guidance about people’s daily routines if they could not tell staff themselves. This information assisted new staff, not familiar with people’s preferences, as they had guidance to provide appropriate care and treatment.

We observed staff chatting to people, responding to them quickly and supporting them to move around the service. The atmosphere was relaxed. Improvements had been made to activities and people had access to variety of activities which also benefited their physical health. The activities person was enthusiastic and there was a busy, lively atmosphere as people took part.

Staff said they were well-supported by the management team. They felt listened to and were involved in the running of the service

At the last inspection we found the provider was in breach of regulation 9 as the culture did not promote person-centred care. At this inspection the provider was no longer in breach of regulation 9, person-centred care. Substantial improvements had been made to systems and the culture of the service to promote person-centred care to people. Care and support was personalised and responsive to people’s individual needs and interests. People’s needs were regularly reviewed, and staff worked in close partnership with people, relatives and relevant professionals to make changes. Staff received training in equality and diversity and person-centred approaches to help them recognise the importance of treating people as unique individuals with different and diverse needs.There was a high level of awareness of and adherence to equality and human rights legal requirements in the service.

Staff supported people to access services they may require, and advocated, with other advocates if necessary, to ensure any additional care and treatment needs were assessed and met. Adaptations had been made to the building to provide 2 ground floor bedrooms, if people were unable to manage the stairs or the stairlift.

Guidance was available in people's care plans which documented how people communicated. Information was accessible and was made available in a way to promote the involvement of the person. Records gave guidance about people’s daily routines if they could not tell staff themselves. People were consulted individually and meetings took place with people and families to obtain feedback about people's experiences.

People's wishes to remain at the home were respected when they neared the end of their life. Records showed the relevant people were involved in decisions about a person's end-of-life care choices when they could no longer make the decision for themselves. Information was available about people's religion and cultural preferences if this support was required.

Substantial improvements, have been made since the last inspection and at this inspection we found the service was no longer in breach of regulations.

The Nominated Individual and new manager, who had applied to become registered with the Commission, had worked hard to change the culture. Leadership was now stable. The service now promoted a positive culture which was practised and promoted by the whole of the staff team. People and staff now said they were not afraid to speak up and they knew they would be listened to. Management and staff had worked collaboratively with the local authority and partner organisations in order to achieve the improved outcomes for people. There was an emphasis on learning and improving throughout the service.

People, their relatives, staff and external healthcare professionals were asked for their views and experiences of the service provided by Marine Park View. Feedback was listened to and addressed. Staff and managers worked in partnership with visiting health and social care professionals which provided good outcomes for people.

The service had inclusive leaders who embodied the culture and values of their workforce and organisation. There was a capable and compassionate management team who, with staff, worked to ensure good quality care for people in partnership with external professionals. Staff told us they felt supported by the management team. The service had accessible policies and procedures that staff were aware of and kept updated with. The service demonstrated that it valued diversity in its workforce and worked towards an inclusive and fair culture by improving equality and equity for its staff.

The service demonstrated effective processes in relation to responsibilities, roles, systems of accountability and good governance. Effective systems were in place to assess, monitor and improve the service, when shortfalls were identified by internal systems, these were addressed.