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Inspection carried out on 13 October 2017

During a routine inspection

Merryfield House Nursing Home is situated on the outskirts of Witney and is registered to provide care and support for up to 24 older people. The bedrooms, bathrooms and toilets of the service are situated over two floors with stairs and passenger lift access to the first floor. Communal areas including lounges, a conservatory and a dining room are available to people.

At the last inspection, the service had been rated Good.

At this inspection we found the service remained Good.

Why the service is rated good:

People remained safe living in the home. There was a sufficient number of staff to meet people's needs and staff were recruited safely. Risk assessments were carried out and promoted positive risk taking which enable people to live their lives as they chose. People received their medicines as prescribed.

People continued to receive effective care from staff who had the skills and knowledge to support them and meet their needs. People were supported to have choice and control of their lives. Staff provided people with support in the least restrictive way possible and the procedures in the service supported this practice. People could access health professionals when needed. Staff worked closely with people's GPs and other professionals to ensure people’s health and well-being were monitored.

The service continued to provide support in a caring way. Staff members supported people with kindness and compassion. Staff respected people as individuals and treated them with dignity. People and, where appropriate, their relatives were involved in making decisions about people’s care needs and the support people required to have their needs met.

The responsiveness of the service was outstanding. Regular monitoring and reviews helped to ensure referrals were made to appropriate health and social care professionals and, where necessary, care and support were changed and implemented to accurately reflect people's needs. Care planning was fixed upon having the individual at the heart of their support. The service identified how people wished to be supported so they received meaningful and personalised care. Activities were plentiful and meaningful, enabling people to live as full a life as possible. A range of group and one-to-one activities were available for those who liked to participate. People and relatives appreciated the activities co-ordinator. Staff had maximised stimulation for people who lived with dementia to give positive meaning to their lives.

The service was led by a registered manager who promoted a service that put people at the forefront of all the service did. There was a positive culture that valued people, relatives and staff, and promoted a caring ethos.

Inspection carried out on 14 September 2015

During a routine inspection

We inspected Merryfield Nursing Home on the 14 September 2015. Merryfield House Nursing Home is situated on the outskirts of Witney and is registered for up to 24 older people. This was an unannounced inspection.

There was a registered manager in post at the service. However this manager was currently being deployed in another service for the provider and another member of staff was in the process of registering as the manager for this service. 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.

We were told consistently that people felt safe and were supported safely by staff that understood the risks in relation to their needs. People medicines were stored impeccably and administered in line with the documented guidelines. Staff understood what constituted abuse and what action they should take if they suspected abuse was occurring. Staffing levels were kept under review and there was adequate staff to meet people’s needs.

Staff felt supported and had access to appropriate training. Staff were actively encouraged to develop professionally and access areas of interest. People benefitted from a culture that was working in line with the Mental Capacity Act (MCA) 2005. The MCA provides a legal framework for ensuring people right to make their own decision is protected.

Staff were consistently described as caring by people and their relatives. We observed numerous positive relationships between people and staff and residents were also encouraged to maintain positive friendship amongst each other.

The services responsiveness was described by relatives and professionals as outstanding. The service was responsive to people’s needs and actively sought people views in order to improve the service. Ongoing improvement was seen as essential to the service. Peoples care and support was person centred and took into account their wishes and preferences whilst also respecting their life history and experiences.

The service had effective quality and monitoring systems in place. Everyone we spoke with spoke highly of the leadership within the home and felt the management provided the foundation for the quality care people experienced.

Inspection carried out on 14 August 2013

During a routine inspection

On the day of our visit the home was at its full occupancy level of 19 people. Half had dementia but most were able to express their views about the service.

We asked about consent to care and treatment and although we were shown copies of consent forms none of the residents we spoke with were aware that they should be giving consent. One member of staff told us that ‘as far as humanely possible’ people were in control of their care and had the right to refuse care.

We looked at the way people were cared for and how staff interacted with people. All the people we spoke with very very happy with their level of care. One person told us that he particularly liked the fact that ‘I can relax and not have to worry about anything. Another said that ‘everyone can speak their mind’. We checked people’s care plans and these were all complete and kept up to date.

We looked at the management of medicines and able to look at how medicines were stored and at records for each person who used them. We also discussed a recent incident involving a nurse who had self-medicated.

We looked at staffing levels and basic care qualifications and were satisfied that there was sufficient staffing to cover each shift.

Finally we looked at how the provider monitored and assessed quality and were given details of how people who used the service, relatives and staff fed-back their views. We also looked at a number of audits and reports relating to service quality.

Inspection carried out on 5 February 2013

During a routine inspection

We found people were treated with dignity and respect. We found people were involved in making choices and decisions about their everyday life. One person told us “there are lots of activities and plenty to do; I like to walk to the shops”.

One person told us “I am so lucky to end up here, it’s free and easy here you can wander about without people telling you what to do”, another person told us “it’s a great place, I can have what food I want”.

We found that care was delivered safely and people told us they felt safe in the home. A relative we spoke with said “she is very safe; she couldn’t be in a better place”.

Staff were trained and supported to deliver good care. One person we spoke with told us “the staff are good here they always come quickly”. A relative we spoke with said “staff are definitely well trained here”.

We found there was an effective complaints system available. People told us they had no complaints about the quality of care provided. A relative told us “I have no complaints, I have direct access to the nurses, they always find time to talk to me and action any queries”.

Inspection carried out on 18 February 2012

During a routine inspection

People we spoke with told us that they knew of the home and some had chosen it themselves. People we spoke with were either from the locality or had relatives living nearby. People told us that care was given in a dignified manner in the privacy of their own room. People told us they liked the food and the variety. People told us they were asked what they wanted to eat on a daily basis and that there was always a choice. People told us that relatives and friends were made welcome and there were no set visiting times. People told us they had access to health services and could either go to the surgery or see the doctor in the home.

Reports under our old system of regulation (including those from before CQC was created)