2 December 2020
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.
The inspection team consisted of two inspectors on site and was supported by three inspectors off site.
Service and service type
Merevale House Residential Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
Notice of inspection
We gave the service 24 hours’ notice of the inspection. This was so documents could be made available to us on arrival to minimise time spent at services during the COVID-19 pandemic.
What we did before the inspection
We reviewed information we had received about the service since the last inspection and sought feedback from the local authority. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.
During the inspection
We spoke by telephone with four relatives about their experience of the care provided. We spoke with nine members of staff including the provider, registered manager, team leaders, a new member of day care staff, a member of night care staff and experienced care staff. We reviewed a range of records. This included the electronic medication system and a variety of records relating to the management of the service.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We looked at training data, quality assurance and records relating to the management of the service and four people’s care plans. We spoke with one professional who was recently involved in arranging accommodation for someone at Merevale House Residential Home.
2 December 2020
About the service
The service provides accommodation, support and personal care for up to 31 people. There are three buildings at the location which provide specialist care for people living with dementia. Merevale House provides care for up to 15 older people living with dementia. Merevale Lodge provides care for up to 12 people living with early–onset dementia, and 5th Lock Cottage provides care and rehabilitation for up to four people living with alcohol related dementia or other mental healthcare needs. On the day of our inspection there were 29 people living at Merevale House Residential Home.
People’s experience of using the service and what we found
Relatives gave positive feedback about the quality of care and were reassured their loved ones were kept safe during times of imposed visiting restrictions. One relative said, “We have been very happy, we have visited during the summer, and when it was safe, outside,” and another relative said, “They have personalised safe visiting plans. It’s really reassuring”.
Staff knew people well and were able to respond quickly to support them. People were encouraged to maintain their hobbies, interests and skills and the provider encouraged staff to help people contribute to general household maintenance tasks if they were able to. One relative commented, “There is real stimulus for [person] there as well, [person] has games, entertainers and staff interacting with them.” Staff had time to be with people and the provider helped staff learn how to care for people using a positive approach to risk. People felt confident to raise concerns knowing they would be listened to and the provider’s system for monitoring accidents and incidents meant trends or patterns could be identified quickly and acted on to review risks to people.
The provider had improved their training and staff gave positive feedback about the support they had to look after people whose needs could challenge the service. We found improvements in how risks to people’s health and safety were assessed and managed and the implementation of an electronic medication system improved the safe management of medicines. Quality assurance systems gave greater oversight of care practice so risks and quality of care could be continuously monitored and improved.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
Rating at last inspection and update: The last rating for this service was requires improvement (published 13th February 2020) and there were multiple breaches of the regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
We carried out an unannounced comprehensive inspection of this service on 12th September 2019. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve safe care and treatment, safeguarding, good governance and notifications of other incidents.
We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to coronavirus and other infection outbreaks effectively.
The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has changed from Requires Improvement to Good. This is based on the findings at this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Merevale House Residential Home on our website at www.cqc.org.uk.