Marian House

The service is a residential care home providing support to up to 20 people with a learning disability and autistic people. At the time of the inspection 18 people were living at the service.

At this inspection we found 3 breaches of legal regulations in relation to safe care and treatment, premises and equipment, and good governance. Following this inspection the overall rating has changed from good to requires improvement.

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and access to communities that most people take for granted. ‘Right support, right care, right culture’ is guidance CQC follows to make assessments and judgements about services supporting people which providers must adhere to. We found the provider was not consistently meeting the principles of Right support, right care, right culture. People’s needs, preferences, aspirations and outcomes were not routinely reviewed in accordance with its principles. This limited people’s opportunity to live an ordinary life and be supported in ways that reflected their individual choices and goals. When the provider made changes and adjustments to the care home this guidance had not been fully considered.

Risks to people were not always assessed, monitored or managed effectively. Environmental safety checks and fire safety arrangements were not robust. Recruitment processes were not always followed, and no audits were in place for these. Governance systems were not effective enough to identify and address shortfalls, and the provider had limited oversight of risk and quality. Care plans and risk assessments lacked information to guide and inform staff about safe and effective care. People’s care records did not consistently detail goals, aspirations or opportunities for people to build their independence or develop new skills.

We observed staff interacting with people in a warm, caring and respectful way. All the staff we spoke with were kind and compassionate when speaking about the people they supported. The atmosphere in the home was friendly, and people told us they felt safe and happy living there. People were encouraged to maintain relationships with family and friends. Medicines were generally well managed. The environment was clean and staff worked well with external health and social care professionals to support people’s needs. The provider acted quickly when issues were identified for example, risk assessments were implemented, window restrictors were fitted, damaged chairs were replaced, storage of bags and coats reviewed, lockable storage for records in the lounge was provided and plans commenced regarding painting and decorating of the home. The provider had engaged with the local authority quality team and had begun making improvements to governance processes and documentation.

In instances where CQC have decided to take civil or criminal enforcement action against a provider, we will publish this on our website after any representations and / or appeals have been concluded.