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Archived: Mercers Place Good


Inspection carried out on 22 January 2015

During a routine inspection

We inspected this service on the 22January 2015 and this inspection was unannounced. Mercers Place provides support and care for up to for up to seven people who have a learning disability. At the time of our inspection there were five people living in the service.

There was a registered manager in post. 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.

People received care that was personalised to them and met their needs and aspirations. The atmosphere in the service was friendly and welcoming.

People felt safe, were treated with kindness, compassion and respect by the staff. People were supported to maintain their health and well-being and encouraged to attend appointments with other healthcare professionals.

Staff listened to people and acted on what they said. Staff knew how to recognise and respond to abuse correctly. People were protected from the risk of abuse because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening. Staff understood how to minimise risks and provide people with safe care. Appropriate arrangements were in place to provide people with their medicines safely.

People were supported by sufficient numbers of staff with the knowledge and skills to meet their needs. Staff respected people’s privacy and dignity and interacted with people in a caring and respectful manner.

People were supported by the manager and staff to make decisions about how they led their lives and how they wanted to be supported. People voiced their opinions and had their care needs provided for in the way they wanted. Where they lacked capacity, appropriate actions had been taken to ensure decisions were made in the person’s best interests.

People were provided with a variety of meals and supported to eat and drink sufficiently. Staff encouraged people to be independent but where additional support was needed this was provided in a caring, respectful manner.

People were encouraged to pursue their hobbies and interests and participated in a variety of personalised, meaningful activities. People knew how to make a complaint and any concerns were acted on promptly and appropriately.

There was an open and transparent culture in the service. The manager planned, assessed and monitored the quality of care consistently. Systems were in place that encouraged feedback from people who used the service, relatives, and visiting professionals and this was used to make continual improvements to the service.

Inspection carried out on 2 September 2014

During an inspection looking at part of the service

We carried out this inspection in response to concerning information and to follow up and see if improvements had been carried with regard to the safe management of medicines. We therefore focussed our activities on these two areas.

During the inspection we spoke with one person using the service and two members of staff. Following the visit we spoke to the registered manager and the local authority safeguarding team. We considered all the evidence we had gathered under the outcome�s we inspected. We have used the information to answer the five questions we always ask;

� Is the service safe?

� Is the service effective?

� Is the service caring?

� Is the service responsive?

� Is the service well led?

This is a summary of what we found:

Is the service safe?

There were systems in place to ensure people�s safety. The staff had received training on protecting vulnerable adults from abuse and there were clear policies and procedures setting out how staff should respond if they suspected or witnessed abuse occurring in the home.

People's care records showed that care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare. Normal assessment and care planning arrangements considered people's capacity, needs and abilities. Where people were unable to make day to day or significant decisions, we saw that Mental Capacity Act (MCA) 2005 assessments had been undertaken; however some of these required review.

The Care Quality Commission is required by law to monitor the operation of the Deprivation of Liberty Safeguards (DoLs). We were told that nobody living at the service was subject to a DoL decision. Staff spoken with told us that they had received training and understood the Mental Capacity Act 2005, its Codes of Practice and DoL Safeguards. However, they were unsure of the changes relating to DoLS following a supreme court judgement in March 2014 and during discussion felt that this may apply to one person using the service. The registered manager informed us after the inspection that this was being addressed.

Is the service effective?

People�s care records were regularly reviewed and updated which meant that staff were provided with up to date information about how people's needs were to be met. From our observations and time spent at Mercers Place we saw that the people living there were receiving the care and support they needed in an individual way and wherever possible staff tried to facilitate choice.

Is the service caring?

We found the home provided a very happy, inclusive and homely environment that enabled people to live a normal lifestyle. We saw that the staff interacted with people living in the service in a caring, respectful and professional manner. We found that staff were understanding of people�s individual needs and cared for their wellbeing. Whilst people had detailed and personalised care plans in place that guided staff as to the type and level of support they needed, improvement was needed to ensure care plans incorporated people's emotional and psychological needs and how best these could be met by staff.

The staff spoken with demonstrated empathy and compassion in relation to their recent experience of end of life care. Records showed that there were clear care planning arrangements in place in order to guide staff on how to deliver the best care at that time.

People told us they had a good relationship with the staff. Staff spoken with demonstrated a good understanding of people�s needs and were aware of their personal preferences, choices and behaviours.

Is the service responsive?

We found that care and support provided met people�s wishes and needs. We also saw that where concerns about their wellbeing had been identified the staff had taken appropriate action to regularly review care plans. This included seeking support and guidance from relevant health care professionals.

Records showed that staff took the lead from health professionals and worked in partnership during a recent event in delivering end of life care.

People using the service were provided with the opportunity to access the community and participate in activities which suited their individual needs. This included attending social clubs and therapeutic activities. Staff were responsive to people�s needs.

Is the service well led?

The service was well led. The home had a registered manager and there was a clear hierarchy of staff. The registered manager was not on duty during our inspection, however the team leader was very knowledgeable and able to assist us effectively and efficiently in their absence.

Prior to our inspection we received information enquiring about the appropriateness of some decision making in relation to the delivery of end of life care. The local authority under their safeguarding role looked into the issues raised. They found that end of life care was delivered appropriately and in conjunction with specialist palliative care services. The provider told us that communication and training was the lesson to be learned in this instance with regards to areas of care where staff may have a knowledge gap, assurance was given that this was being addressed.

Inspection carried out on 16 October 2013

During a routine inspection

We observed that staff were attentive to people�s needs and treated them with respect and dignity calling them by their name. We saw that staff sought people`s agreement before providing any support and assistance. We saw that the provider gave due consideration to people's capacity to consent, and that the provider had taken the relevant action to ensure that they complied with the Mental Capacity Act 2005.

We saw that staff were knowledgeable about people�s needs and promoted their independence. We found that they had a good understanding and awareness of people�s care needs and preferences. We saw that care plans and risk assessments were regularly reviewed and updated. One person told us: "The staff always talks to me about my care and support; they are going to help me to move back home."

People told us that there were sufficient numbers of staff on duty to meet the needs of the people who lived in the service. One person who used the service told us, "The staff always have time to talk to me and take me to appointments."

We found that people were not protected against the risks associated with medicines because the provider did not have appropriate arrangements in place to manage medicines.

Inspection carried out on 29 January 2013

During a routine inspection

We talked with four of the people living in Mercers Place, they told us that they liked living in the service. People also told us that they got on well with the staff, who supported them to go out, to follow their favourite activities, to be part of the local community and to go on holiday. They also told us that their bedrooms were comfortable and that they had their own belongings around them. One person told us that, �I�ve lived here a long time and like it.�

We observed that the staff were attentive to people�s needs. Staff interacted with people in a friendly, respectful and professional manner. We saw that staff sought people�s agreement before providing any support or assistance. The people we saw were relaxed and engaged with their surroundings.

Inspection carried out on 19 October 2011

During a routine inspection

We spoke to two people who use the service. One person was very happy with their care and life at the home. The second person said that although staff were very nice, they would like to move to a home nearer Colchester town centre, as there was not enough to do at the home. This was discussed with the manager who showed us the person�s activities for the week and said that they do take part in other activities outside of the care plan. They also said that activities took place every day at the on-site activities centre but they chose not to take part all the time. The manager said they had met with social services about providing another home for the person in Colchester, but when they saw the options available they had decided to remain at Mercer�s Place.

Other people were unable to provide a verbal response or tell us their experiences, as a result of their limited verbal communication or poor cognitive ability. We noted their non-verbal cues and these indicated that people were relaxed and comfortable and found their experience at Mercer�s Place to be positive.

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