Merrifield House Residential Care Home

We found the following examples of good practice.

Staff had received training in relation to infection prevention and control. Staff were observed to be wearing the correct Personal Protective Equipment (PPE) and following hand hygiene guidance during the inspection.

People had been supported to access the vaccination and booster program and all staff were vaccinated as per the regulatory requirement.

People were supported to go out and return to the home safely.

The provider had a robust contingency plan to manage the impacts of COVID-19.

The provider had developed a system to support staff with affective zoning of areas during outbreaks of COVID-19.

The provider has installed a number of visitor pods to ensure visiting for people during an outbreak of COVID-19 could be well supported. Video calling, voice messaging and sharing of photographs was used to help people stay connected with their family and friends.

The provider had installed an air filtration system to ensure the building was well ventilated.

Merrifield House is a residential care home providing personal care to 41 people aged 65 and over at the time of the inspection. The service can support up to 62 people across three separate units.

People’s experience of using this service and what we found

People play an active role in the running of the Care Home. Person Centred Care is the foundation of their strategy. Systems and processes were in place to ensure people were protected from abuse. Risks were well managed. All the people we spoke with told us they felt Merrifield House provided a safe environment. All staff spoken to were committed to non-discriminatory practices and throughout our discussions, all identified a commitment to providing good quality care, based on knowledge and the sharing of good practice. Inspectors found the service to be very clean. People received their medicines from staff who were trained to do so, and medicines were stored safely.

People's needs were assessed thoroughly and in good detail. Peoples desired outcomes and wishes were recorded and cross referenced into the care plans. Staff received an induction and ongoing training. People were supported to receive the nutrition and hydration they needed to stay healthy. Observations of the dining experience during the inspection was positive. People were supported to access a wide range of healthcare support. The service was working within the principles of the Mental Capacity Act (MCA). People were supported to have maximum 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.

Merrifield house facilitates placements to students from the local College, University and schools. Staff welcome and support volunteers of all backgrounds, experiences and ages. People have been involved with environmental improvements to support visual stimulation. Inspectors observed information about the importance of hydration displayed within the service. Staff told us people were informed about their own hydration needs. There were suitable numbers of staff, who were recruited safely and in line with current legislation. Staff had been trained to meet people's needs and consent to care was sought and recorded.

People were clearly at the heart of the service. The service encouraged people to make decisions in the day to day operations. People were free to voice their opinions. People participated in meal planning groups and interviews of new staff. People were involved in their care. The service was extremely well led by managers who were dedicated to providing a service which was responsive to need. People’s views were listened to and acted upon. In the development of the service, people and their relatives had been involved in forums to improve the care for those people with dementia. The service had strong links with the village and local community. The wider community had been invited to regular events.

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 19th June 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Merrifield House provides accommodation for older people requiring support with their personal care. The service can accommodate up to 44 people. At the time of our inspection there were 42 people living at the home.

The service had 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 received care from staff that were kind, compassionate and respectful. Their needs were assessed prior to coming to the home and individualised care plans were in place and were kept under review. Staff protected people’s dignity and demonstrated an understanding of each person’s needs. This was evident in the way staff spoke to people and the activities they engaged in with individuals. Relatives spoke positively about the care their relative received and felt that they could approach management and staff to discuss any issues or concerns they had.

Staff were supported through regular supervisions and undertook training which helped them to understand the needs of the people they were supporting. People were involved in decisions about the way in which their care and support was provided. Staff understood the need to undertake specific assessments where people lacked capacity to consent to their care and / or their day to day routines. People’s health care and nutritional needs were carefully considered and relevant health care professionals were appropriately involved in people’s care.

There were appropriate recruitment processes in place which involved the people living in the home and people felt safe and secure. Staff understood their responsibilities to safeguard people and knew how to respond if they had any concerns.

There were sufficient staff to meet the needs of the people; staffing levels were kept under review to ensure that people’s needs were met in timely way.

There were systems in place to monitor the quality and standard of the service; action was taken to address any shortfalls. The provider and registered manager were visible and encouraged feedback, actively looking at ways to improve the service.

Merrifield House Residential Care Home provides personal care for up to 44 older people, including people living with dementia. When we inspected there were 44 people living at the service.

The service had 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 had risk assessments in place regarding their care and support; however they did not always provide members of staff with guidance or control measures to help manage and reduce the level of risk people faced. People were protected from abuse or improper treatment. Staff had been trained in safeguarding and understood the recording and reporting principles associated with this. Staffing levels were sufficient to meet people's needs and ensure they received the care they needed. Staff had been recruited following safe and robust procedures to ensure they were appropriate to work at the service. There were systems in place to ensure people received their medication correctly.

People were asked for their consent by members of staff; however there were not sufficient systems in place to ensure the principles of the Mental Capacity Act 2005 were followed when people lacked mental capacity. Staff members received regular training and support, such as supervisions, to ensure they had the skills and knowledge they needed to perform their roles. The service supported people to have enough to eat and drink so that they had a balanced and nutritious diet, based on foods and drinks that they enjoyed. If people required support to see healthcare professionals, the service supported them to make appointments both at the service and in the local community.

Management systems at the service were not always based on current legislation, regulations and guidance, meaning staff had out-of-date policies to refer to. The provider had a system of checks and audits in place, including a satisfaction survey, to monitor the quality of care being provided and identify areas for improvement. People, their family members and staff were positive about the culture and ethos of the service. The registered manager was involved in the running of the service and implemented systems to ensure they were meeting their regulatory obligations.

There was a relaxing and homely atmosphere at the service; staff treated people with kindness and compassion and worked to develop positive professional relationships with the people they cared for. People were provided with the information they needed about their care and were involved in producing their own care plans, with input from family members where appropriate. People were treated with dignity and respect and steps were taken to ensure their privacy was upheld at all times.

People received person-centred care which was specific to their individual needs, wishes and preferences. Care plans were written in a person-centred way and were reviewed regularly with input from the person and their family, to ensure that it remained reflective of the way they wished to be cared for. There were a number of different activities available at the service, based on people's different needs and wishes. Staff encouraged people to take part in activities both in group and one to one sessions. The service was open to receiving complaints and used them as a tool for developing the service.

With their agreement, we met with three people individually and in private. They were able to tell us about their experience of living in 'Merrifield' and said they received 'very good' care and support. They told us that the staff were kind, thoughtful, and friendly. They said they felt safe and happy living in the home.

We also spoke with two visitors who praised the 'excellent' care their relatives had received and the commitment of the manager and the staff team to provide and maintain good standards of care. They said they were always made welcome when they visited 'Merrifield' and had only praise for the way the staff conducted themselves.

We found that people's privacy, dignity and independence were respected and that people were involved in decisions about their care. We found that people's needs had been assessed and care plans to meet their needs were put in place and acted upon.

We found that 'Merrifield' consistently provided safe, effective, and appropriate care.

We saw that the home was efficiently managed and that people were well looked after throughout the day and night.