Merry Den

Updated 12 January 2021

The inspection

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.

Inspection team

This inspection was carried out by one inspector.

Service and service type

This service provides care and support to people living in eight ‘supported living’ settings, so that they can live as independently as possible. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

We gave a short period notice of the inspection because some of the people using the service could not consent to a home visit from an inspector. This meant that we had to arrange for a ‘best interests’ decision about this.

Inspection activity started on 9 November 2020 and ended on 11 November 2020. We visited the office location on 9 November 2020.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We 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. We used all of this information to plan our inspection.

During the inspection

We observed three people interacting with staff and spoke to five relatives about their experience of the care provided. We spoke with four members of staff including a representative of the provider, registered manager and two staff members.

We reviewed a range of records. This included four people’s care records and multiple medication records. We looked at two staff files in relation to recruitment and staff supervision. A variety of records relating to staff development and training and the management of the service, including policies and quality assurance systems were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found in relation to internal quality monitoring processes.

Updated 12 January 2021

About the service

Merry Den is a supported living service providing personal care and support to 15 people at the time of the inspection. People live in single or small multi occupancy homes.

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

People’s experience of using this service and what we found

Since our last inspection, improvements had been made to the development and support of staff and the management of people’s risks and quality of care.

The new registered manager had been instrumental in implementing new systems and directing the quality of care being provided to achieve positive outcomes for people.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the guidance CQC follows to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

The service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture. People were involved in decisions about their care and supported to make choices about their day to day living. The culture of the service promoted independence, choices and empowerment for all people who received a service from Merry Den. People’s care was focused around their needs and wishes.

People’s needs had been assessed and were being met in line with current guidance. People’s individual risks and medicines requirements were comprehensively recorded, monitored and known by staff.

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. They were supported to make choices about their lives such as activities and were encouraged to have a healthy and balance diet. Staff monitored people’s well-being and supported people to access health care services as required.

Systems were in place to ensure people continually received their funded support hours.

People were empowered to raised concerns and discuss their views with staff. Staff were aware of their responsibilities to report any allegations of abuse or concerns. Relatives praised the caring nature and approach of staff. One relative said, “We have absolutely no concerns and are very happy with how they [staff] managed throughout the pandemic.”

Effective infection control practices and extra measures had been implemented to prevent the spread of infection and to assist people in understanding the restrictions related to COVID-19.

Staff had been safely recruited. They confirmed and records demonstrated that staff had received the training and support they required to meet people’s individual needs.

The registered manager and provider were committed to improving the service and learning from any incidents. Effective operational quality monitoring systems and policies were in place which enabled the registered manager to evaluate the service being delivered and to direct staff in good practices

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection (and update)

The last rating for this service was requires improvement (published 23 April 2019). 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

This was a planned inspection based on the previous rating.

We carried out an announced comprehensive inspection of this service on 29 March 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 in areas relating to staff development and support and the quality monitoring systems to manage and monitor people’s risks.

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 of Safe, Effective and Well-led which contain those requirements.

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.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Merry Den on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our inspection programme. If we receive any concerning information we may inspect sooner.