Merecroft

Merecroft is a residential care home providing regulated activity personal care to up to 9 people. The service provides support to younger adults with mental health needs, learning disability and/or autism. The main house accommodates 8 people and there is a self-contained bungalow in the grounds which provides separate accommodation for 1 person. At the time of our inspection there were 8 people using the service.

People’s experience of the service and what we found:

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and 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 supporting people with a learning disability and autistic people and providers must have regard to it.

Right Support: People’s needs were assessed, and care plans were developed with them, and their relatives where required. These were currently being reviewed and updated. People’s safety risks were considered. However, some areas of risk needed further developing in relation to guidance to support staff to effectively record, monitor and escalate any concerns. Cleaning of the environment required further enhancing in some areas, to ensure effective infection prevention and control measures. People were supported by staff that were trained to carry out their roles effectively. 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. Staff enabled people to access specialist health and social care support in the community. Staff supported people to maintain relationships that were important to them and engage in activities they enjoyed.

Right Care: People received kind and compassionate care. Staff protected and respected people’s privacy and dignity. Staff understood and responded to people's individual needs. Staff understood how to protect people from poor care and abuse. Staff had training on how to recognise and report abuse and they knew how to apply it. There were enough appropriately skilled staff to meet people’s needs and keep them safe. People could communicate with staff and understand information given to them because staff understood their individual communication needs. The manager was passionate about enhancing people’s communication further to ensure they had the appropriate communication tools and approaches to fully be able to express their needs and wants. People could take part in activities and pursue interests that were tailored to them. The management team explained their challenges in relation to recruitment, and recruiting staff who were able to drive.

Right Culture: The provider’s systems and processes to monitor quality and safety required embedding and sustaining. There had been changes to staffing and the management team. The new manager and provider had identified some improvements were needed and action was being taken to address these. A local authority visit had identified improvements were required. The management team were working with the local authority through these actions. Management were open and visible and were committed to developing people's care further. Staff knew and understood people well, were responsive, and supported their aspirations to live a quality life of their choosing.

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

Rating at last inspection

The last rating for this service was good (published 12 February 2021).

Why we inspected

The inspection was prompted in part due to concerns received about staffing, management and care for people that lived there. A decision was made for us to inspect and examine those risks.

We found no evidence during this inspection that people were at risk of harm from this concern. Please see the safe, effective, caring, responsive and well-led sections of this full report.

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

Follow Up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Merecroft provides accommodation, care and support for up to nine younger adults with mental health needs, a learning disability or autism. There were nine people living at the home at the time of our inspection.

People were accommodated in a house with their own bedrooms and communal facilities. One person's accommodation was located in a separate bungalow on site. A large garden provided personalised areas for people’s enjoyment, including sports facilities.

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

People looked happy and relaxed in the home. Relatives we spoke with said their family members were safe. Staff were trained in safeguarding people from abuse. They understood how to recognise the signs of abuse and how to report any concerns to keep people safe.

There were sufficient numbers of staff to ensure people's care needs were met. Many people required one-to-one staff support and this was provided. The provider carried out checks on prospective staff to ensure they were suitable to work with people.

Potential risks to people had been identified and staff understood how to support people safely. People received their medicines from staff who had received training to administer medicines safely. Staff followed good infection control practices to reduce the risk of infection.

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.

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.

The management team were working to further develop a person-centred approach to each person’s care and support. We observed people making choices about, for example, where they spent their time and whether they wanted to engage in activities.

Staff were complimentary about how the registered manager was developing the service. Staff were clear about their roles and responsibilities and told us teamwork had improved. The provider and registered manager were developing their audits, and putting action plans in to place to further enhance people’s experience of care.

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

Rating at last inspection

The last rating for this service was good (published 04 July 2019).

Why we inspected

We received concerns in relation to the safety of people living at Merecroft and how their risks were managed. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

We found no evidence during this inspection that people were at risk of harm from these concerns. Please see the safe and well-led sections of this full report.

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 overall rating for the service has remained 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 Merecroft 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 re-inspection programme. If we receive any concerning information we may inspect sooner.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

People’s experience of using this service:

People continued to be kept safe and well supported. Staff had a good understanding of how they protected people from harm and recognised different types of abuse and how to report it. Potential risks to people had been identified and people and their relatives had been involved with decisions in how to reduce the risk of harm. There were enough staff on shifts to keep people safe and meet their needs. People’s medicines were managed and stored in a safe way. Safe practice was carried out to reduce the risk of infection.

People’s care continued to be assessed and reviewed with relatives and healthcare professionals involved throughout. People were supported to have a healthy balanced diet and had food they enjoyed. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service support this practice. Staff worked with external healthcare professionals and followed their guidance and advice about how to support people following best practice.

Staff treated people as individuals and respected the choices they made. People’s care was delivered in line with their preferences, with any changes in care being communicated clearly to the staff team. The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent. People had access to information about how to raise a complaint.

The management team were approachable and effective. The checks the manager made to ensure the service was meeting people’s needs focused upon people’s views and experiences.

Rating at last inspection: At the last inspection in November 2016 the service was rated Good.

Why we inspected: This was a planned inspection based on the previous rating.

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

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

Merecroft is registered to care for up to nine people with mental health needs or learning disabilities. At the time of our inspection there were six people living at the service.

There was a registered manager for this service. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered providers and registered managers 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.

We carried out an unannounced comprehensive inspection of this service on 2 September 2015 when we found that they were in breach of the law because the provider did not have effective arrangements in place to monitor and improve the quality and safety and welfare of people using the service. The provider wrote to us to say what they would do to make the necessary improvements. At this inspection we saw that the actions required had been completed and the regulations were now met.

Relatives we spoke with said their family member had support from regular staff who knew them well. Staff we spoke with recognised the different types of abuse. There were systems in place to guide staff in reporting any concerns. Staff were knowledgeable about how to manage people’s individual risks, these focussed on supporting people’s well-being. People were supported to receive their medicines by staff who were trained and knew about the risks associated with people’s medicines.

Staff had up to date knowledge and training to support people living at the home. Staff always ensured people agreed to the support they received. The management team regularly reviewed how people were supported to make decisions. People were encouraged to make their own choices about the food they ate. Relatives told us staff would access health professionals as soon as they were needed.

We saw staff were caring and patient with people living at the home. Relatives told us staff had built positive relationships with their family member, and treated them with dignity and respect. They said they were welcome to visit whenever they chose to.

Staff told us how they sought people’s views on how they were supported. The management team were developing further adaptations to support people to communicate their views. Relatives we spoke with knew how to raise complaints and the management team had arrangements in place to ensure people were listened to and appropriate action taken.

Staff were involved in regular meetings and one to one time with the management team to share their views and concerns about the quality of the service. Relatives and staff said the management team were accessible and supportive to them. The staff team were adaptable to changes in peoples’ needs and knew people well to recognise when additional support was needed.

The registered manager encouraged a culture of openness and inclusion for people living at the home and staff. The management team had systems in place to identify improvements and action them in a timely way.