6 September 2017
During a routine inspection
At the last Care Quality Commission (CQC) inspection of this service in May 2015, although we rated them ‘Good’ overall, we rated them ‘Requires Improvement’ for the key question ‘Is the care home safe’. This was because the provider had failed to store substances hazardous to health safely, which meant the people living at the home had been placed at unnecessary risk of harm. We undertook a focused inspection in November 2015 to check the provider had taken appropriate action to resolve this issue and found they met legal requirements. At this inspection we found the service continued to meet the regulations and fundamental standards and therefore remains rated ‘Good’ overall.
The service had a registered manager in post who had returned to work in June 2017 after being on maternity leave for the past year. In the registered manager’s absence the service’s deputy manager had been in operational charge of the home. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have a legal responsibility for meeting the requirements in the Health and Social Care Act and associated Regulations about how the service is run.
When people were nearing the end of their life, they received compassionate and supportive care. However, staff had not received any end of life care training. We discussed this with the registered manager who agreed to arrange for staff to attend this training to help them meet the needs and wishes of people nearing the end of their life. Progress made by the service to achieve this stated aim will be assessed at their next inspection.
People received personalised care that was responsive to their individual needs. Each person had a comprehensive and individualised support plan that encompassed all aspects of their lives. This set out clearly for staff how they should be meeting people's needs and wishes. This meant people were supported by staff who knew them well and understood their personal and health needs, food and drink preferences and social interests. Staff encouraged people to actively participate in meaningful leisure and recreational activities that reflected their social interests and wishes, and maintain relationships with people that mattered to them. In addition, the Eden Alternative Foundation recently accredited Murray House for its innovative work providing older people who lived there with person centred and fulfilling care and support. The Eden Alternative is an internationally recognised Foundation that promotes person centred care, independent living skills and accessing meaningful social activities for older people.
People remained safe at Murray House. There were robust procedures in place to safeguard people from harm and abuse. Staff were familiar with how to recognise and report abuse. The provider assessed and managed risks to people’s safety in a way that considered their individual needs. Although there had been a reduction in staffing levels there continued to be enough staff on duty to keep people safe. Medicines were managed safely and people received them as prescribed.
Staff continued to be suitably trained and received all the support they needed to perform their roles effectively. People were supported to have enough to eat and drink to meet their dietary needs. They also received the support they needed to stay healthy and to access healthcare services.
People continued to be treated with dignity and respect by staff. People’s privacy was maintained particularly when being supported by staff with their personal care needs. People were supported to have maximum choice and control of their lives and staff helped them in the least restrictive way possible.
The registered manager and deputy manager continued to provide good leadership and led by example. The service had an open and transparent culture. People felt comfortable raising any issues they might have about the home with staff. The service had arrangements in place to deal with people’s concerns and complaints appropriately. The provider also routinely gathered feedback from people living in the home, their relatives and staff. This feedback alongside the provider’s own audits and quality checks was used to continually assess, monitor and improve the quality of the service they provided.
Further information is in the detailed findings below.