Merrie Loots Farm Residential Home

We inspected the service on 22 November 2018. The inspection was unannounced.

Merrie Loots Farm Residential Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The service accommodates 28 people.

On the day of our inspection 27 people were using the service.

At our last inspection on 11 and 12 April 2016 we rated the service ‘good.’ At this inspection we found the evidence continued to support the rating of ‘good’ overall. There was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

People were protected from avoidable harm by a staff team trained and confident to recognise and report any concerns. Potential risks to people were assessed and minimised.

Staff were only employed after satisfactory pre-employment checks had been obtained. There were enough staff to ensure people’s needs were met safely and in a timely manner.

People were supported to manage their prescribed medicines by staff who were trained and had been assessed as competent to administer medicines. Staff followed the provider’s procedures to prevent the spread of infection and reduce the risk of cross contamination.

Staff knew the people they cared for well and understood, and met, their needs. People received care from staff who were trained and well supported to meet people’s assessed needs. Staff had the skills and knowledge to provide effective care.

People were supported by staff to have enough to eat and drink. People were assisted to have access to external healthcare services to help maintain their health and well-being Staff worked within and across organisations to deliver effective care and support.

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 in the service supported this practice. People were fully involved in making decisions about their care and support. People and their relatives were involved in the setting up and review of their or their family member’s individual support and care plans.

Staff treated people in a kind and friendly way. Staff respected and promoted people’s privacy, dignity and independence.

People’s individual needs were assessed and staff used this information to deliver personalised care that met people’s needs. People were supported to engage in meaningful activity and with the local community. People’s religious and cultural beliefs were respected and supported.

Staff supported people to have the most comfortable, dignified, and pain-free a death as possible. Staff worked in partnership with other professionals to ensure that people received joined-up care.

People’s suggestions and complaints were listened to, investigated, and acted upon to reduce the risk of recurrence.

Staff liked working for the service. They were clear about their role to provide people with a high-quality service and uphold the service’s values.

The registered manager sought feedback about the quality of the service provided from people. Audits and quality monitoring checks were carried out to help drive forward improvements.

Further information is in the detailed findings below.

A registered manager was in post. 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.

Staff had good knowledge of their responsibilities and how to keep people safe. People were cared for by staff who had been recruited and employed after appropriate checks had been completed. Staff had access to personalised, up to date information about people’s needs which meant they were effective in delivering appropriate care. People and relatives were involved in the planning of their care and treatment which was delivered in a way that was intended to ensure people's safety and wellbeing. Any errors were addressed by the service which ensured safe management of medicine administration and secure storage of medicines.

Effective care was provided by care staff. People’s rights were protected because management and staff understood the framework of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). Management applied such measures appropriately.

Staff had received regular training and were knowledgeable about their roles and responsibilities. They had the skills, knowledge and experience required to support people with their care. People had enough to eat and drink and staff understood and met their nutritional needs. Staff and managers ensured access to healthcare services were readily available to people and worked with a range of health professionals to maintain good health of the people.

Privacy and dignity was valued by staff and who were observed to be respectful and compassionate towards people. Staff had positive relationships with people who were supported to be as independent as they chose to be. People knew how to make a complaint and processes were in place to deal with them.

The manager had a number of ways of gathering people’s views including talking with people, staff, and relatives. They carried out quality monitoring audits to help ensure the service was running effectively and to make improvements.

This is a summary of what we found based on our observations during the inspection. We looked at written records, which included people's care records, staffing rosters and quality assurance documentation. We spoke with six people who lived at the home and two relatives who were visiting. We also spoke with the manager, the proprietor and six other members of staff.

We considered our inspection findings to answer the five questions we always ask: Is the home safe? Is the home effective? Is the home caring? Is the home responsive? Is the home well led?

If you want to see the evidence supporting our summary, please read the full report.

Is the home safe?

The accommodation was adapted to meet the needs of the people living there and was suited to caring for people with some limited mobility. The home was warm, clean and appropriately maintained.

There were sufficient numbers of suitably qualified, skilled and experienced staff on duty. There was a robust process in place to assess people's capacity to consent and to protect people's liberties in accordance with the Mental Capacity Act (2005) and Deprivation of Liberty Safeguards (DoLS).

Is the home effective?

People we spoke with were satisfied with the care and support they received. No one raised any concerns with us. All of the staff we spoke with were knowledgeable about individual people's care needs, and this knowledge was consistent with the care plans in place. This meant people were supported in line with their care plans.

Is the home caring?

We spoke with six people who used the service and two close relatives. One person said to us, "There is nothing but kindness here; the staff are really caring." Another person said, "I have no complaints at all. I am well looked after and I don't have to worry about anything." One relative said, "I visit regularly and have always found the staff to be very kind and hard working."

We observed the care and attention people received from staff. All interactions we saw were attentive, respectful and friendly and there was a calm atmosphere throughout the home. People's dignity was respected and their independence was promoted.

Is the home responsive?

We saw that care plans and risk assessments were informative, kept up to date and regularly reviewed. This meant people were supported in line with care plans that were kept up to date. The manager responded in an open, thorough and timely manner to complaints. Therefore people could be assured that complaints were investigated and action was taken as necessary. Staff told us the manager was approachable and they would have no difficulty speaking to them if they had any concerns about the home.

Is the home well led?

Staff said that they felt well supported by the manager, there was a good team ethic and they were able do their jobs safely. The provider had a range of quality monitoring systems in place to ensure that care was being delivered appropriately by staff, that the service was continuously improving and that people were satisfied with the service they were receiving.

Throughout our inspection the atmosphere at Merrie Loots Farm Residential Home was observed to be calm and relaxed. Staff interactions with people who used the service were noted to be positive and it was evident that staff had a good knowledge and understanding of people's care and support needs.

Each person was noted to have a care plan in place detailing their care needs and how they were to be supported by staff. Records also showed that people who used the service were supported with their healthcare needs.

The provider was noted to have safe systems in place for the management of medicines, recruitment of staff and complaints management. We also found that the provider had an effective system in place to monitor the quality of the service provided.

We directly observed care within the service, so as to help us determine what it was like for people living there. We found that staff interactions with people who live at the service were generally positive and staff were seen to have a good rapport with individuals. Staff on duty at the time of our visit were observed to have a good understanding and awareness of people's support needs. People told us that they liked living at Merrie Loots Farm and found staff to be kind and caring. Staff confirmed to us that they liked working at the service and that staff morale was good.

Further steps are required to ensure that medicines management is improved and that staff receive regular supervision and appraisal. Effective quality assurance may assist the provider in recognising where there are gaps and areas for development.