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Archived: Merryhill House Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

Updated 2 February 2015

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 was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, and to pilot a new inspection process being introduced by CQC which looks at the overall quality of the service.

The inspection was unannounced, which meant the staff and provider did not know that an inspection was planned on that day.

This provider is registered to provide personal care and accommodation for up to 35 people. At the time of our inspection 26 people lived at the home. Ten people were provided with personal care and accommodation on a permanent basis. Sixteen people were provided with a respite and rehabilitation service on a short stay basis.

The home had a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider.

The registered manager told us that the service had been in transition over the last twelve months. The service was moving from a residential care home to promoting short stays to enable people to have respite and rehabilitation before returning to the community.

Some people’s diverse language needs had not been fully considered prior to admission to the home. Some people wished to undertake activities and trips which could not be achieved due to a lack of funding. The provider had not ensured consistent planning and delivery of care to meet people’s individual needs.

There was enough staff to meet the needs of people who used the service. A high percentage of staff were sourced from external agencies. The provider used additional agency staff to complement its existing workforce to ensure it met the needs of people admitted on a short stay basis, with high dependency needs

Staff received on-going supervision and appraisals to monitor their performance and development needs. One member of staff told us that they had not received regular supervision.

Staff were kind, caring and respectful to people when providing support and in their daily interactions with them. We observed several areas where dignity awareness could be improved for staff.

There were processes in place intended to drive service improvements. The registered manager could not always ensure service delivery improvements due to funding constraints.

People knew who to speak to if they wanted to raise a concern and there were processes in place for responding to complaints.

We discussed the legal requirements of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS) with the registered manager. The MCA and the DoLS set out the requirements that ensure where appropriate, decisions are made in people’s best interests when they are unable to do this for themselves. No-one who used the service was subject to a DoLS application at the point of our inspection. The staff and registered manager had received training to enable them to follow the legal requirements of the MCA and the DoLS.

Records showed that we, the Care Quality Commission (CQC), had been notified, as required by law, of all the incidents in the home that could affect the health, safety and welfare of people.

We found a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. You can see what action we told the provider to take at the back of the full version of this report.

Inspection areas

Safe

Good

Updated 2 February 2015

The service was safe.

Staff received training in safeguarding adults. Staff understood how to identify potential abuse and understood their responsibilities to report any concerns to the registered manager.

Staffing levels were adequate to ensure people received appropriate support to meet their needs.

Recruitment records demonstrated there were systems in place to ensure the staff were suitable to work with vulnerable people.

Effective

Requires improvement

Updated 2 February 2015

The service was not consistently effective.

People could make choices about their food and drink. The majority of people were provided with a choice of food and drink.

Supervision and appraisal processes were in place to enable staff to receive feedback on their performance and identify further training needs. One member of staff we spoke with told us they had not received regular supervision.

Arrangements were in place to request heath, social and medical support to help keep people well.

Caring

Requires improvement

Updated 2 February 2015

The service was not consistently caring.

People told us they were treated with respect and dignity by staff. We saw some examples of where practice could be improved in this area.

Care was provided with kindness and compassion. People could make choices about how they wanted to be supported and staff listened to what they had to say.

Responsive

Requires improvement

Updated 2 February 2015

The service was not consistently responsive.

People could raise concerns with the provider but the provider had not always taken account of people’s views to improve the quality of care.

People’s diverse needs had not been consistently responded to by the provider.

Well-led

Requires improvement

Updated 2 February 2015

The service was not consistently well led.

The registered manager was not always able to ensure that the service could continually drive service improvement due to difficulties obtaining funding.

The staff were confident they could raise concerns about poor practice and these would be addressed to ensure people were protected from harm.

There were systems in place to make sure the staff learnt from events such as accidents and incidents, whistleblowing and investigations. This helped to reduce the risks to the people who used the service and helped the service to continually improve and develop.