Merlin Court Care Home

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

At our last assessment we rated this key question requires improvement. At this assessment the rating has changed to good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

People’s needs were assessed prior to them moving into the service. This helped to make sure staff would be able to provide people with the care they needed. Assessments were ongoing and updated if people’s needs changed. Staff had daily handovers which helped them get information on people’s changing needs.

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards.

People’s needs were assessed using nationally recognised tools. For example, in relation to assessing risks of pressure damage and to assess people’s risks of becoming malnourished. People who were high risk of being malnourished were identified and discussed at monthly meetings with leaders and the chef. This meant actions were agreed to help people gain weight such as more regular weight monitoring, referrals to the GP and providing fortified diets. A fortified diet is when extra calories, proteins and vitamins are added to everyday foods to help people gain weight.

We observed mealtimes and saw the food looked appetising. People were supported to make choices by staff showing them plates of the options. This was particularly helpful for people with dementia to enable them to visually see what was available and smell the choices. There were snacks and drinks around the service in communal areas for people to help themselves. People’s feedback about the food was positive and they said they could eat where they wanted. Comments included, “The food is fine, I like it. There is a good choice” and “I have breakfast in my room and lunch in the dining room, the food is varied and we get a choice of meals.”

The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

Staff had daily handovers before starting their shifts and there was a daily head of department meeting. Information was shared with staff on various areas such as admissions and discharges, incidents and safeguarding. Records were kept so the information could be shared with staff who were not attending.

There was communication with healthcare professionals. Staff from the local GP surgery visited weekly or more if needed and staff knew who to contact for any advice, guidance and support. People’s care records demonstrated a wide range of healthcare professionals were involved in their care.

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.

Staff planned a range of activities which helped people stay mobile and get exercise if they wanted it. There was a regular Tai Chi class which people enjoyed. Staff told us they had seen an improvement in people’s mobility and balance from attending this class. One person said, “I am trying to get more mobile, and I do exercises and they [staff] support me.”

The provider promoted healthy eating with a varied menu for people to choose from. If people needed healthier diets such as reduced sugar, this was also available.

The provider routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

If people had agreed plans of care to improve areas such as skin integrity, staff were taking actions such as re-positioning people. We found monitoring records demonstrated staff were consistently moving people as per the agreed plan. There was monitoring taking place for other health outcomes such as weight monitoring and food and fluid monitoring. Any concerns about people’s outcomes were identified at weekly clinical risk meetings and shared with people’s GP.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment.

Staff were provided with training on the Mental Capacity Act 2005 (MCA) and understood how it applied to their work. The registered manager had identified that some staff needed further guidance on the principles of the MCA to support their understanding. They had produced small cards with the principles recorded and shared them with all the staff.

People’s capacity to make their own decisions had been assessed and recorded. Where people lacked capacity there was evidence of best interest processes. Whilst these recorded who had been involved in decision making it did not record all of the options discussed. This meant it was not always possible to see decisions were the least restrictive. We shared this feedback with the provider who said they would review the records.