Murreyfield Care Centre

Updated 16 September 2020

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. As part of this inspection we looked at the infection control and prevention measures in place. This was conducted as part of our Thematic Review of infection control and prevention in care homes.

Inspection team

The inspection was completed by one inspector.

Service and service type

Murreyfield Care Centre 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.

The service had a manager registered with the CQC. This means 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

This inspection was announced from outside of the service. We did this to discuss the safety of people, staff and inspectors with reference to Covid-19.

What we did before the inspection

We used information we received about the service and information the provider had sent us 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

This inspection was carried out by conducting a site visit, speaking to staff and relatives remotely and reviewing various records remotely. We spoke with two people who used the service and two relatives. We spoke with eight staff members including four care staff, the cook, the activities co-ordinator, the registered manager, a director and the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

We reviewed a range of records. This included two people's full care records, four people’s care records in part and three people’s medicine records. We looked at three staff files in relation to recruitment. We reviewed a range of records and polices regarding the management of the service.

After the inspection

We continued to seek clarification from the provider to validate evidence found.

Updated 16 September 2020

About the service

Murreyfield Care Centre is registered to provide accommodation and personal care to adults who may be living with mental health needs, a learning disability or dementia.

The service supports up to 23 people and there were 18 people using the service at the time of our inspection. The service is larger than recommended by best practice guidance. However, we have rated this service good because people received person-centred care and where possible people were supported to access leisure and education services in the community. The service applied the principles and values of Registering the Right Support which supported people to achieve the best possible outcomes and live a full and meaningful life.

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

Since the last inspection, the provider had implemented systems to monitor the safety and quality of the service. Improvements were evident, though some shortfalls continued to be found in records and risk monitoring. For example, hot water temperatures were too high. We have made a recommendation about monitoring systems.

People’s medicines were administered safely, care plans contained appropriate guidance and systems were in place to protect people from abuse. Staff understood what to do in the event of a fire and the support people needed.

The provider’s recruitment processes helped ensure only suitable staff were employed. Staffing levels were safe. However, they were lower at evenings and weekends which meant staff had less flexibility to support people. We have made a recommendation about staffing.

Staff had the relevant skills and knowledge. They supported people appropriately to meet their needs and access healthcare services. People were happy with the support they received. They were offered a healthy diet and alternative options which met their dietary needs.

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.

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, inclusion and developing people’s independence.

For more details, please see the full report which is on the Care Quality Commission’s (CQC) website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was requires improvement (published 5 March 2020). The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection 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 between 8 January and 24 January 2020. Breaches of legal requirements were found, which included safe care and treatment, staffing, fit and proper persons employed and good governance.

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, 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. 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 Murreyfield Care Centre 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.