Merlin Court Care Home

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant people were safe and protected from avoidable harm.

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 had a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

Incidents and accidents were recorded and reviewed by leaders. The provider also had access to records which gave an additional layer of oversight. Leaders told us they reviewed all incidents and looked at what had gone well and what could be done differently to prevent recurrence. Information was shared with all staff and if additional support or training was needed this was organised.

Leaders said they were looking for trends and patterns. For example, falls analysis was completed which reviewed what time of day people were falling and where. This helped staff understand what was happening during periods of time people were most at risk of falling.

The provider had an email bulletin called ‘in the know’. This was sent out to all services with information on learning from other services or nationally.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services.

Staff had processes to follow when people were admitted or discharged from hospital which enabled the safe transfer of information. For example, if people were admitted to hospital, transfer documents recorded a summary of people’s needs which was shared with hospital staff. When people were discharged from hospital, staff obtained a discharge document and if needed re-assessed their needs. Leaders told us when people returned to the service, their care records were reviewed and updated if needed.

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider shared concerns quickly and appropriately.

Information on safeguarding was available around the service and in staff rest rooms. Staff were provided with training on safeguarding and their responsibilities to report any concerns. Leaders had shared safeguarding concerns with the local authority and notified CQC when needed.

People told us they felt safe at the service. Comments from people and relatives included, “I always feel [person] is safe, no doubt in my mind” and “I feel safe, the staff seem trustworthy and I am impressed with the work they do, so helpful.”

People can only be deprived of their liberty to receive care and treatment with appropriate legal authority. In care homes, this can be done through a procedure called the Deprivation of Liberty Safeguards (DoLS), which is part of the Mental Capacity Act 2005 (MCA). We checked whether the service was working within the principles of the MCA and how they managed DoLS within the service. We found that applications for DoLS had been sent to the local authority appropriately. Where DoLS were authorised, the service was meeting conditions.

The provider worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

People who experienced distress had behaviour support plans which had been written in a respectful way. They gave staff clear guidance on strategies to use to reduce incidents of distress. People had personal emergency evacuation plans which recorded how staff would evacuate people in the event of an emergency. All risk management plans were being regularly updated.

Risks to people’s safety had been identified and there were risk management plans for staff to know what support to provide. However, guidance in some risk management plans was not always consistent. We shared this feedback with leaders who took action to address this shortfall. We found no evidence of harm, however, consistent guidance for staff to follow reduces the risk of harm.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

Regular health and safety checks were being completed. Equipment and premises were serviced regularly by external contractors. For example, fire systems and emergency lights were regularly tested and serviced.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs.

We observed there were enough staff to safely meet people’s needs. Staffing numbers were monitored by the registered manager and could be increased if needed. There were no agency staff being used.

Staff had been recruited safely and were provided with an induction when starting work. Various training courses were provided covering a wide range of topics and where needed there were regular refreshers. The registered manager told us they interviewed all new staff and aimed to greet them on their first morning of work. They liked to explain the required standards to staff and inform them about the speak up culture and process. Staff were provided with regular supervisions and other types of support such as staff meetings and daily handovers.

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

The service was clean and well maintained. A team of domestic staff had cleaning schedules which helped make sure all areas of the service were cleaned regularly.

Staff had training on infection prevention and control good practice. There was plenty of personal protective equipment (PPE) for staff to use when needed. We observed staff following good practice by regularly washing their hands, wearing PPE appropriately and disposing of waste safely.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened.

People’s medicines were managed safely and people said they were happy with the support they had from staff. There were no gaps in recording and people on time sensitive medicines consistently had their medicines at the correct time. People were supported to manage their own medicines where safe and appropriate. Risk assessments had been completed which made sure people had discreet support from staff. If people were prescribed paraffin-based emollients, there were risk assessments to help inform staff of the risks and actions to take.

If people needed their medicines covertly this had been agreed with the person’s GP and there was clear guidance available for staff to follow. The guidance told staff to administer medicines covertly as a last resort. Records for covert medicines did not state if the medicine had been given covertly or not. We shared this feedback with leaders who said they would review how this type of medicine was recorded. People having anti-psychotic medicines had regular reviews by the prescriber.