Archived: Merrill House

Updated 14 July 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection site visit took place on 29 May 2018 and was unannounced. We returned on 30 May 2018 to complete the inspection. The inspection team consisted of an inspector and an expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service. Our expert by experience had experience of the care of older people.

We reviewed the provider’s statement of purpose; this is a document which includes a standard required set of information about a service. We also reviewed the notifications submitted to us; these are changes, events or incidents that providers must tell us about. We looked at information received from local authority commissioners. Commissioners are responsible for finding appropriate care and support services for people.

During the inspection visit we spoke with five people who used the service and two relatives. We made direct observations at meal times and used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us. We spoke with the registered manager, the area manager, a visiting district nurse, three care staff and the cook.

We looked at records relating to all aspects of the service including care, staffing and quality assurance. We also looked in detail at three people’s care records.

Updated 14 July 2018

Merrill House provides personal care and accommodation for up to 40 people. On the day of the inspection the registered manager informed us that 13 people were living at the home.

At our last inspection in April 2017 we rated the service overall as ‘Requires Improvement’. At this inspection the service had improved to ‘Good.’

The home provides personal care and accommodation for older people, people with disabilities and sensory impairment.

A registered manager was in post. This is a condition of the registration of the service. 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 and associated Regulations about how the service is run.

People's risk assessments provided staff with information on how to support people safely, though some assessments were not fully in place. Lessons to prevent incidents occurring had been learnt from past events. Staffing levels were sufficient to ensure people's safety.

Staff had been trained in safeguarding (protecting people from abuse) and, in the main understood their responsibilities in this area. Staff were subject to pre-employment checks to ensure they were appropriate to work with the people who used the service. People were protected from the risks of infection.

People using who used the service and the relatives we spoke with said they thought the home was safe. They told us medicines were given safely to them and on time. We found this to be the case.

Staff had been trained to ensure they had the skills and knowledge to meet people's needs. Staff understood their main responsibility under the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) to allow, as much as possible, people to have an effective choice about how they lived their lives and they were of all their responsibilities under this law.

People had plenty to eat and drink and everyone told us they liked the food served.

People's health care needs had been protected acted on by referrals to health care professionals when necessary. A visiting district nurse said that staff ensured that the standard of health care provided to people was good.

People told us they liked the staff and got on well with them. We saw many examples of staff working with people in a friendly and caring way., though there was one occasion where staff had not shown respect for a person’s choice which the registered manager followed up. People and their representatives were involved in making decisions about their care, treatment and support.

Care plans were individual to people and covered their health and social care needs. Activities were organised to provide stimulation for people and they had opportunities to take part in activities in the community if they chose.

People and relatives told us they were confident that if they had any concerns these would be followed up.

People, relatives and staff were satisfied with how the home was run by the registered manager. Management carried out audits and checks to ensure the home was running properly to meet people's needs and provide a quality service.