Archived: Melrose

Updated 25 May 2022

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by two inspectors.

Service and service type

Melrose 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.

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

At the time of our inspection there was a registered manager in post .

Notice of inspection

This inspection was unannounced.

What we did before inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and local safeguarding team. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.

During the inspection

We spoke with five people who used the service about their experience of the care provided. We spoke with three members of staff, two relatives and two external health professionals as well as the registered manager.

After the inspection

We continued to review documentation relating to the quality and assurance systems in place.

Updated 25 May 2022

About the service

Melrose is a care home providing accommodation for persons who require nursing or personal care to up to 29 people. The service provides support to people living with mental health needs. At the time of our inspection there were 17 people using the service.

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

There was a lack of effective monitoring of the quality and safety of the service. Oversight and governance of the service was not always clear and robust. The registered manager acted to quickly address the issues raised during the inspection and had a plan in place to make improvements.

We have made a recommendation about the signage used in the home. This was because signage used did not promote person-centred care for people.

People, relatives and staff were complimentary of how the service was managed and were confident that if they had any concerns they would be listened to and action taken.

There were sufficient numbers of staff to support people safely and meet their needs. However, due to recent increased workforce pressure the home had been through a difficult period of challenges in retaining and recruiting staff. People were supported with their medicines safely and to access healthcare.

The registered manager and staff had safely managed all risk associated with COVID-19.

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.

Regular meetings enabled people to provide their feedback about the service. The registered manager and staff team worked with other health and social care professionals to ensure people's needs were met and made relevant referrals when required.

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 requires improvement (published 8 April 2021)

Why we inspected

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

The inspection was prompted in part due to concerns we received about unsafe care people were receiving at the service. A decision was made for us to inspect to ensure people received safe care and to check monitoring systems were in place. As a result, we undertook a focused inspection to review the key questions of safe and well-led and examine those risks.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has stayed the same based on the finding from this inspection.

We found no evidence during this inspection that people were at risk of harm from this concern. Please see the safe and well-led sections of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Melrose on our website at www.cqc.org.uk.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.