Merchant House

Updated 29 December 2022

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 Health and Social Care Act 2008.

Inspection team

The inspection was carried out by one inspector and one Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Merchant House is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Merchant House is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 13 people who used the service and three relatives about their experience of the care provided. We spoke with four members of staff including the registered manager, deputy manager and compliance and care strategy manager.

We reviewed a range of records. This included five people's care records and Medication Administration Records (MAR). We looked at three staff files in relation to recruitment, training and staff supervision. A variety of records relating to the management of the service, including audits, policies and procedures were reviewed.

We spent time in the communal lounge observing interactions between staff and people We also walked around the building observing the environment.

Updated 29 December 2022

Well-led – this means we looked for evidence that service leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture.

At our last inspection we rated this key question Requires Improvement. At this inspection the rating has changed to Good. This meant the service was consistently managed and well-led. Leaders and the culture they created promoted high-quality, person-centred care.

Promoting a positive culture that is person-centred, open, inclusive and empowering, which achieves good outcomes for people

¿ People, their relatives and staff expressed confidence in the management team. Comments included, “Yes, it’s well managed. I know (name) the registered manager and (name) the deputy.", “It’s well organised” and “It’s friendly has a happy atmosphere like a big family”.

¿ Staff told us, and we observed morale was high. Staff told us the management team were approachable and supportive. One staff member told us,“(Registered Manager) is absolutely brilliant, I can go to him with anything, he is approachable. He’s the best boss I’ve ever had”.

¿ The registered manager and staff team promoted a person-centred culture to ensure people received personalised care and support. People told us they were happy living at Merchant House, and we saw they were relaxed and happy with staff.

How the provider understands and acts on the duty of candour, which is their legal responsibility to be open and honest with people when something goes wrong

¿ The CQC sets out specific requirements that providers must follow when things go wrong with care and treatment. This includes informing people and their relatives about the incident, providing reasonable support, providing truthful information and an apology when things go wrong. The provider understood their responsibilities.

Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirements, Continuous learning and improving care

¿ The registered manager and staff understood their roles and responsibilities and strived to ensure care was delivered in the way people needed and wanted it.

¿ There were effective communication systems in place along with clear lines of responsibility and accountability across the staff team.

¿ The service had governance arrangements in place. Both the registered manager and provider recognised the importance of systems being effective to strengthen the quality of the service that people received.

¿ Regular audits were carried out by the registered manager and the provider. These included audits of care plans, medication and the day to day running of the service. Findings from audits were analysed and actions were taken to drive continuous improvement.

Engaging and involving people using the service, the public and staff, fully considering their equality characteristics

¿ From our observations and speaking with staff, the provider demonstrated a commitment to providing consideration to people’s protected characteristics.

¿ There was a positive open culture at the service that valued people as individuals and looked for ways to continually improve people's experience.

¿ Staff told us that they were involved in the development of the service, through discussions at individual supervisions and staff meetings.

Working in partnership with others

¿ The service worked in partnership and collaboration with a number of key organisations to support care provision, joined-up care and ensure service development.

¿ Records showed the provider worked closely and in partnership with multidisciplinary teams to support safe care provision. Advice was sought, and referrals were made in a timely manner which ensured there was continuity of care.