We carried out an unannounced inspection of Marsden Heights Care Home on 29 and 30 August 2018.

Marsden Heights Care Home is an adapted residence located in a semi-rural area on the outskirts of Brierfield. There is a garden area and a small car parking space to the front of the property. The accommodation is mainly provided on one level and includes a lounge with linked dining area with a kitchenette and a separate ‘quite room’. There are 18 single bedrooms and one twin room. Further accommodation for up to four people is provided in a lower floor flat. This has two bedrooms with en-suite shower rooms and a shared lounge/dining room with kitchen area.

Marsden Heights is a 'care home' which is registered to provide care and accommodation for up to 24 people including people living with a dementia. People in care homes receive accommodation and nursing care as a single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided and both were looked at during this inspection. Nursing care is not provided at Marsden Heights Care Home. At the time of our inspection 20 people were using the service.

There was a registered manager at the service. A registered manager is a person who has registered with the 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.

At the last inspection on 24, 25 and 26 May 2017 the service was rated overall Requires Improvement. We found the provider was in breach of one regulation of the Health and Social Care Act (Regulated Activities) Regulations 2014. This related to a lack of robust recruitment procedures prior to staff starting work at the service. Following the inspection, the provider sent us an action plan outlining the progress to be made. At this inspection we found action had been taken to make improvements.

We found there were management and leadership arrangements in place to support the effective day to day running of the service.

Processes were in place to make sure all appropriate checks were carried out before staff started working at the service. People told us they felt safe at the service.

Arrangements were in place to promote the safety of the premises, this included maintenance, servicing and checking systems. However during the inspection, we identified some areas were in need of attention.

Staff were aware of the signs and indicators of abuse and they knew what to do if they had any concerns. Staff had received training on safeguarding and protection matters.

There were some good processes in place to manage and store people's medicines safely. We found some improvements were needed with record keeping, this was put right during the inspection.

There were enough staff available to provide care and support; we found staffing arrangements were kept under review and additional staff were being recruited.

People's needs were being assessed and planned for before they moved into the service. Each person had a care plan, describing their individual needs, preferences, behaviours and routines. This provided guidance for staff on how to provide person centred support. People's needs and choices were kept under review.

People were supported with their healthcare needs. Changes in people's health and well-being were monitored and responded to. Where necessary, people received appropriate medical attention.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems at the service supported this practice.

People made positive comments about the caring attitude of staff. They said their privacy and dignity was respected. Throughout the inspection we observed staff interacting with people in a kind, pleasant and fri

We carried out an unannounced inspection of Marsden Heights Care Home on 24, 25 and 26 May 2017. The first day of the inspection was unannounced.

Marsden Heights Care Home is a detached residence located in a semi-rural area on the outskirts of Brierfield. The service is registered to provide accommodation and care for up to 24 people. The service provides care for older people and older people with a dementia and does not provide nursing care.

The property is set in its own grounds, with far reaching views from the rear. There is a garden area and a small car parking space to the front of the property. The accommodation is mainly provided on one level and includes a lounge with linked dining area with a kitchenette and a separate quite/ visitor’s room. There are 18 single bedrooms and one twin room. One bedroom has an en-suite toilet. Further accommodation for up to four people is also provided in the lower floor flat. This has two bedrooms with en-suite shower rooms and a shared lounge/dining room with adjacent kitchen.

At the time of the inspection there were 21 people accommodated at the service.

The service was managed by a registered manager. A registered manager is a person who has registered with the Care Quality Commission 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.

At the last inspection, on 22 and 23 January 2015 we found the service was meeting all the standards assessed.

During this inspection we found the provider was in breach of one regulation of the Health and Social Care Act (Regulated Activities) Regulations 2014. The breach related to a lack of robust recruitment procedures prior to staff working at the service. You can see what action we told the provider to take at the back of the full version of this report.

We have also made recommendations for improved practice in relation to medicine management and person centred care planning.

We found there were good management and leadership arrangements in place to support the day to day running of Marsden Heights.

People made positive comments about the caring attitude of staff. During the inspection we observed staff interacting with people in a kind, pleasant and friendly manner and being respectful of people's choices and opinions.

There were some good processes in place to manage and store people’s medicines safely. We found some improvements were needed and most of these were put right during the inspection.

There were enough staff available to provide care and support and staffing arrangements were kept under review. There were systems in place to ensure all staff received regular training and supervision.

People told us they felt safe at the service. Staff were aware of the signs and indicators of abuse and they knew what to do if they had any concerns about people’s wellbeing and safety.

Arrangements were in place to promote the safety of the premises, this included maintenance, servicing and checking systems. However during the inspection we identified some areas were in need of attention.

People were happy with the accommodation at the service. We found some rooms had been upgraded and redecorated to provide for people’s comfort and wellbeing.

We found the home to be clean in the areas we looked at. However we noted there were some odours in parts of the home. The registered manager agreed to take action to pursue and rectify these matters.

The service was working within the principles of the Mental Capacity Act 2005. During the inspection we observed staff involving people in routine decisions and consulting with them on their individual needs and preferences.

People’s needs were being assessed and planned for before they moved into the service. People were supported with their healthcare needs and received appropria

People told us they were mostly satisfied with the care and support provided at Marsden Heights. We spoke with six people, three made the following comments: “It’s alright here”, “I feel safe here” and “It’s first class accommodation, for food, companionship and the general ambience is good”.

People were being involved as far as possible in planning their support and were enabled to make decisions about matters which affected them. People were encouraged to maintain and develop their independence skills.

We found people experienced some good care and treatment. They told us they were treated with respect. People were getting support with their healthcare needs and they had ongoing attention from health care professionals.

People were provided with satisfactory accommodation. Progress had been made in up grading the premises. However, some areas needed improvement for the comfort and well-being of people using the service.

We found there were enough experienced and skilled staff available to provide care and support.

People had been consulted about their experience of the service. We found checks of the services’ various systems and practises had been carried out.

During our visit we found people were content and relaxed and we observed staff treating people in a friendly and respectful way. We spoke with four people who lived in the home. They told us they were happy with the care and support they received and had no complaints about the service. Comments included, “I am looked after very well; I get the help I need when I need it” and “I like it here; I am looked after and have made some lovely friends”. One visitor said, "I am satisfied with the care given and I am kept up to date. It is a nice atmosphere. Staff are friendly and attentive and everyone seems to get on".

People told us there were opportunities for involvement in suitable activities either for small groups of people or on a one to one basis. Comments included, “People visit to entertain us; we have a laugh".

People's medicines were managed safely and their health was monitored. We found the service had good links with health care professionals to make sure people received prompt, co-ordinated and effective care. The home was clean and free from unpleasant odours and there were effective systems in place to reduce the risk and spread of infection. One person told us, "It's always nice and clean".

We carried out an unannounced inspection of Marsden Heights Care Home on 22 and 23 January 2015. The service is registered to provide care for up to 20 people. It specialises in the care of older people and older people with a dementia and does not provide nursing care. The service is also registered to provide personal care to people living in their own homes. At the time of the inspection there were 20 people accommodated at the service.

Marsden Heights Care Home is a detached residence located in a semi-rural area on the outskirts of Brierfield. The property is set in its own grounds, with far reaching views from the rear of the home. There is a garden and a small car parking area to the front of the property. The accommodation is provided on one level. There is a lounge with a linked dining area with a kitchenette and a separate quite/ visitor’s room. There are 18 single bedrooms and one twin room. One bedroom has an en-suite toilet.

At the previous inspection on 5 December 2013 we found the service was meeting all the standards assessed.

The service was managed by a registered manager. A registered manager is a person who has registered with the Care Quality Commission 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 indicated there was an open and friendly atmosphere at the service. One relative said, “It’s absolutely amazing, wonderful.” We found there were some good systems and arrangements in place to promote an efficient day to day running of the service. However we did find progress could be made with some auditing processes.

People told us they felt safe at the service and they made positive comments about the care and support they experienced. One person told us, “They really look after you it’s good is this place”.

We didn’t observe anything in the way staff treated and supported people, to give us cause for concern about safeguarding protection matters. People were receiving safe support with their medicines.

Recruitment practices made sure appropriate checks were carried out before staff started working at the service. We found sufficient numbers of staff were on duty. We found there was no formal process in place to asses staffing arrangements, to make sure there was always enough staff, however the registered manager agreed to address this matter.

People told us they experienced good care and support. People’s needs were being assessed and planned for before they moved into the service. We found arrangements were in place to monitor and respond to people’s health and well- being. The service had developed good working relationship with health care professionals.

People spoken with indicated they were treated with kindness and compassion. During the inspection we observed staff interacting with people in a kind, pleasant and friendly manner and being respectful of people's choices and opinions. People said their privacy and dignity were respected. However, we did find some improvements could be made with respecting people’s privacy of space.

During the inspection we observed staff involving people in routine decisions and consulting with them on their individual needs and preferences. Discussion meetings were held and people had opportunity to complete satisfaction surveys.

People were happy with the variety and quality of the meals provided at the service. Support was provided with maintaining a healthy diet in response to individual needs and preferences.

People told us how they were keeping in contact with families and friends. Visiting arrangements were flexible. Arrangements in place to provide activities and entertainment; however we found ‘dementia friendly’ activities were being further researched and considered.

Systems were in place to ensure all staff received regular training, supervision and support. Care workers spoken with understood their role in providing people with effective care and support.

People spoken with had an awareness of the service’s complaints procedure and processes. Arrangements were in place to investigate and respond to any concerns raised.

We looked around the premises and found there were some matters in need of attention. We were told these had already been identified. Following our inspection we received confirmation from the registered manager that the matters had been addressed.

During the inspection, we found changes had been made to some of the accommodation and the services provided at Marsden Heights. We therefore found it necessary to seek advice and guidance in respect of these matters.