About the service St Marguerite provides care and accommodation for up to 24 older people with care needs associated with older age, including dementia and memory loss. There were 18 people living at the service on the day of our inspection, including three people staying for a period of respite care. St Marguerite is an adapted building in a residential area of Eastbourne with a large patio and garden area.
People’s experience of using this service and what we found
We have made recommendations about the management of some medicines.
Audits and quality checks completed included internal and external audits. We found concerns relating to documentation which had not been identified by internal checks and audits. Actions identified in external audits had not been addressed promptly. A medicines audit identified that ‘as required’ or PRN medicines were not being consistently recorded when given, and a health and safety audit identified a window restrictor was required to a hallway window. However, these actions had not been addressed at the time of the inspection.
There was an over reliance on verbal information sharing between staff and management. People’s daily records were not consistently recorded to include all relevant information about people’s care. Staff told us they shared information and discussed peoples care needs. However, this information was not consistently documented.
At the time of the inspection the registered manager had not completed up to date safeguarding training and did not have access to local authority policies. They did not demonstrate a clear understanding regarding incidents which should be referred to The Care Quality Commission (CQC) should they occur.
People felt safe living at St Marguerite. One told us “I like my room, staff are lovely they look after me very well. Relatives said the registered manager was approachable and staff were caring. Commenting, “Staff have got to know mum, they are very nice.”
People were supported to have 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.
Risks to people’s health had been identified and recorded in care plans to ensure risk was minimised. There were systems for staff to follow in the event of an accident or incident. Staff told us if they saw anything that concerned them they would speak to a senior member of staff. A complaints procedure was in place. People and their relatives were aware of the process.
Staff knew people well, they treated them with kindness and respect and demonstrated an understanding of their needs. People were assisted to access healthcare services when needed.
Care plans included peoples care and support needs and personal preferences. The registered manager supported staff to meet people's care needs. Staff felt there were enough staff working to provide the support people needed, at times of their choice.
People were supported to continue with hobbies and activities of their choice. There was a programme of activities available for people to attend if they chose.
Recruitment procedures ensured only suitable staff worked at the home. Staff completed an induction which included mandatory training and had further training provided.
People told us staff were available when they needed assistance. Relatives felt that consistent staff meant staff knew people well.
People had the opportunity to feedback and discuss their needs. This included residents and staff meetings. Relatives told us the registered manager was available to speak to if needed.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was good (published 8 December 2016).
Why we inspected
This was a planned inspection based on the previous rating.
Enforcement
We have identified a breach in relation to the governance of the service.
Please see the action we have told the provider to take at the end of this report.
Follow up
We will request an action plan from the provider to understand what they will do to improve the standards of governance and safety. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.