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Melrose Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

Updated 8 January 2020

Melrose is a care home that provides personal care to people living with mental health needs. There are 29 bedrooms over two floors and at the time of the inspection, there were 25 people living there.

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

On the first day of inspection we found that the environment was not always safely maintained. The heating was not working in some parts of the home and people told us they were cold. Changes made to the smoking area had left a door to the home unsecure. These issues were raised with the registered manager and on the second day of the inspection, we found that they had been addressed. People were supported by a sufficient number of staff who had been safely recruited and were knowledgeable about safeguarding procedures. People told us they received their medicines when they needed them.

Staff had been assigned training to help ensure they had the knowledge to support people effectively, although this had not all been completed. People told us it could be a long time from tea until breakfast the following morning. We discussed this with the registered manager and on the second day of the inspection, people told us toast was now regularly available at suppertime. 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.

New checks had been implemented to monitor the quality and safety of the service, however they were not always effective in identifying areas of the service that required improvement. The registered manager had worked hard to address areas of concern raised at the last inspection and was responsive to feedback provided during this inspection. People knew the registered manager and told us they could raise any issue they had with them.

People told us they were treated well by staff. People were involved in decisions regarding their care and were aware of their care plans. Staff knew people and their needs well. Systems were in place to gather feedback from people and people felt able to share their views.

Care plans were in the process of being reviewed and rewritten to ensure they were detailed, accurate and person centred. New care plans reflected people’s preferences in relation to their care. People were supported to access activities in the community if required, to help prevent social isolation. No formal complaints had been received since the last inspection, but records showed they had previously been investigated and responded to.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was requires improvement (published 4 July 2019). We identified breaches of Regulations 12 (Safe care and treatment) and 17 (Good governance) at the last inspection. The provider completed an action plan to show what they would do and by when to improve. At this inspection, we found that improvements had been made, but additional concerns were identified, and the provider was still in breach of regulations.

The service remains rated requires improvement. This service has been rated requires improvement for the last six consecutive inspections. We met with the provider following the last inspection and found that although still rated as requires improvement, measures had been taken to drive forward the quality of the service in areas raised at the last inspection.

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

We have identified breaches in relation to the safety of the environment and the systems in place to monitor the quality and safety of the service at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will continue to monitor information we receive about

Inspection areas

Safe

Requires improvement

Updated 8 January 2020

The service was not always safe.

Details are in our safe findings below.

Effective

Requires improvement

Updated 8 January 2020

The service was not always effective.

Details are in our effective findings below.

Caring

Good

Updated 8 January 2020

The service was caring.

Details are in our caring findings below.

Responsive

Good

Updated 8 January 2020

The service was responsive.

Details are in our responsive findings below.

Well-led

Requires improvement

Updated 8 January 2020

The service was not always well-led.

Details are in our well-Led findings below.