Archived: Merafield View Nursing Home

Below is a summary of what we found. The summary is based on our observations during the inspection, our speaking to people who use the service, their relatives, the staff supporting them, and from looking at records.

When we visited there were 36 people residing in the home. We spoke with seven people and three family members. Some people were unable to speak with us due to their condition or because they were resting. We observed how people were being cared for in the lounge and at lunch. We read four care plans in detail. We checked to ensure the care plan was accurate in respect of the care they received.

We considered our inspection findings to answer the following questions:

' Is the service safe?

' Is the service effective?

' Is the service caring?

' Is the service responsive?

' Is the service well-led?

Is the home safe?

People told us they felt safe in the home and well cared for. People stated they felt safe when being given personal care and when equipment was used, such as a hoist or wheelchair.

We found that staff were employed in a way that ensured their history, qualifications and ability to carry out the role was assessed before they started to work in the home. We found there was sufficient staff to meet people's needs. Staff were well trained, supervised and appraised. Where there had been concerns about practice we saw that the home ensured risk assessments were in place and more frequent supervision and observations of practice were put in place.

Staff told us that they were able to raise concerns about people's health and welfare with the registered manager and deputy manager and these would be looked at and appropriate responses made. They told us they would use the whistleblowing policy if they were concerned about the care offered by a colleague and would contact the Care Quality Commission if required.

Is the home effective?

We found that people's consent to their care and treatment was clearly recorded. People or their representative had their care plan discussed with them and were able to sign they agreed with this. This meant the home was ensuring the care was appropriate and safe.

People who were unable to give their consent due to their condition had their mental capacity assessed. Meetings in respect of what was in the person's best interest took place as required and who took part in those decisions clearly documented. This meant the home ensured the decisions made on behalf of people were lawful and agreed.

There were clear care plans in place that detailed people's wishes and feelings. These were audited on a monthly basis or more often if the person's needs changed. We found the care given was consistent to that which was documented.

We found people's nutritional and fluid needs were met and people were able to have drinks and snacks at different times of the day. People requiring a special diet or their food prepared in a specific way had their needs met.

Is the home caring?

People told us 'I love it here' and 'The care is very good'. They told us that their care was given at a pace that was unrushed.

We found that the staff treated people kindly and with respect. We observed that staff interacted well with people. For example, staff asked how people were and if there was anything else they could do for them at lunch.

We also observed staff using the hoist to support people to move from their chair to wheelchair and observed this was carried out carefully. People's attention was carefully sought before starting the process and conversations were held with the person who was included in each stage of the process.

Relatives told us they felt the home was a support to them as well. We were told that they were always welcomed and felt listened to when they had questions or felt guilty about their relative having to move to the home.

Is the home responsive?

People told us the home was able to offer as flexible care as possible. For example, they could sleep in or get up earlier if they had an appointment to attend.

People were reviewed by external professionals as required. We found that people had regular contact with their GP, for example and the home would seek further assessments from other professionals as required. Professionals we spoke with spoke highly of the home and told us that recommendations were always put into practice.

People and relatives told us they would speak to the care staff and registered or deputy manager if there was an issue and felt this would be resolved.

Relatives told us that if their family member was ill or at the end stage of their life, the home would ensure they spent as much time as possible with them.

Is the home well led?

We found there was strong leadership in place from the registered manager and provider.

People, relatives, other professionals and staff all spoke highly of how the home was run.

One relative told us 'the home is extremely well led from the top' adding 'the communication is very good' and the ethos of the registered manager 'is very good and she leads from the top; seeing everyone on a regular basis'.

We found there was regular auditing of all aspects of the home to ensure the home was delivering safe and appropriate care. Where concerns were identified we saw that action plans were put in place and reviewed. This meant people were further safeguarded as a result.

Professionals who visited the home told us they felt the home was well led. They stated that they found all staff were knowledgeable and well informed.

On the day of the inspection we spoke with nine of the people who lived at Merafield View Nursing Home. Many of the people were not able to speak with us due to their health care needs. We were able to speak with eleven people's relatives.

In total, thirteen people who we spoke with were happy with standards of care. However seven of the people we spoke with said there were some grounds for improvement, although this entire group said some or most aspects of the service were satisfactory or good.

The majority of the people we spoke with said standards of care were very good. Comments we received included 'The care is brilliant'I cannot fault it,' and 'It is very good'the staff are lovely,' and 'It is very good'everybody is so friendly and helpful.'

There were several concerns raised about staff support. Most people said the staff did their best, although a minority of people said staff attitudes could be 'variable.' Eight people (relatives and people who lived in the home) raised concerns that there were at times 'not enough staff' and this had a negative impact on people's experience of living in the home. We also judged there were concerns about staffing levels.

Most people liked the food, although a minority of people said it could be improved.The accommodation was furnished, decorated and maintained to a good standard. The home was very clean and there were no offensive odours. Health and safety standards were maintained appropriately. Staff training provision was to a satisfactory standard.

We saw that people were supported through an individualised care planning process to have their needs met and people told us " Yes the staff meet my needs".

Staff had been trained in the protection of vulnerable adults (POVA) and there was a policy in place to assist staff in raising any concerns of this nature. People confirmed to us that they felt safe living in the home.

Recruitment processes were in place that helped to ensure that staff had suitable skills and experience to undertake the role and staff were provided with training and supervision to assist them in completing their role fully.

There was a quality assurance system in place that included the views of the people who lived in the home and resident meetings took place. These systems helped to ensure that people were informed and consulted about the home they lived in.