CQC report explained · a nursing home
What the CQC found at Mercia Grange
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found that risks were assessed, safeguarding systems were in place, medicines were generally given safely, and staff recruitment checks had been completed. Infection prevention arrangements were also found to be satisfactory.
- Effective?
- Good
- People received support from trained staff, had enough food and drink, and were helped to access healthcare. Some best-interest records did not clearly show that relatives or advocates had been involved.
- Caring?
- Good
- This key question was not inspected during this focused visit. The report says the rating from the previous inspection was used when calculating the overall rating.
- Responsive?
- Good
- This key question was not inspected during this focused visit. The report says the rating from the previous inspection was used when calculating the overall rating.
- Well-led?
- Requires improvement
- The management team was approachable and staff felt supported, but quality checks were not reliable enough. Records about incidents, care and medicines were sometimes inconsistent, and prompt corrective action was not always taken.
What inspectors found, December 2023
Mercia Grange is Rated Good overall; inspectors found safe, effective and caring support, but governance and record checks require improvement.
This was an unannounced focused inspection on 17 October 2023. Inspectors spoke with 11 people, 16 relatives and 9 staff. They reviewed care, medicines, recruitment and management records, including eight people's care records.
People were generally kept safe. Staff understood safeguarding and people's risks, medicines were usually administered safely, and staffing and recruitment checks were appropriate. People received support with food, healthcare and activities, and staff knew their preferences.
The main weakness was management oversight. Some accident, incident, care and medicines records were inconsistent, and action was not always taken quickly when problems were found. The overall rating changed from Outstanding at the previous inspection to Good. The well-led rating was Requires Improvement.
People felt safe
Staff understood safeguarding and people's risks. Inspectors found that risk assessments gave staff clear instructions for keeping people safe.
“People were protected from potential abuse by staff who had regular safeguarding training and knew about the different types of abuse.” from the report
Food and drink
People had choices and enough food and drink during the day. Inspectors found that people enjoyed the food.
“People had choices and access to sufficient food and drink throughout the day. Food was well presented, and people we spoke with told us they enjoyed it.” from the report
Staff training
Staff had completed relevant training, inductions and shadowing. Relatives told inspectors they were confident staff had the skills to meet people's needs.
“New staff had completed an induction programme which involved training and shadowing more experienced staff members.” from the report
Personalised environment
The home had different spaces for activities, family visits and privacy. Bedrooms and dementia areas were adapted to people's preferences and needs.
“People's bedrooms were decorated and furnished to meet their personal tastes and preferences, for example having family photographs and artwork.” from the report
Quality checks
seriousThe systems used to monitor quality and safety were not consistent enough. Some incidents were recorded or analysed incorrectly, which delayed a safeguarding referral.
“Audits undertaken in relation to accident and incidents required improvement to ensure the appropriate action had been completed.” from the report
Medicines records
seriousSome medicines records said medicines had not been given or were unavailable when they had actually been administered. Inspectors said this could lead to a missed dose or an extra dose.
“The incorrect recording on medicines documentation increases the risk people will not receive their medication or be given more than the prescribed amount.” from the report
Best-interest records
needs fixingSome records did not show that relatives or advocates had been involved in decisions for people assessed as lacking capacity. The manager said these records would be improved.
“Some people's best interest decision records did not always demonstrate people who were assessed as lacking capacity had their relatives or advocates involved in the decision-making process.” from the report
- 01What changes have you made to check that medicines records accurately show what was given?
- 02How do you make sure incident records are consistent and that safeguarding referrals are sent without delay?
- 03How are relatives or advocates involved in best-interest decisions, and where is this recorded?
- 04What recent audits can you show that demonstrate the identified record-keeping problems have been corrected?
- 05Which Caring and Responsive ratings were carried over from the previous inspection, and when will these areas next be assessed?
This was a focused inspection of Safe, Effective and Well-led; Caring and Responsive were not inspected and their previous ratings were used to calculate the overall rating. This explanation was written from the published report of 9 December 2023 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, June 2019
Rated Outstanding; inspectors found exceptionally effective care and leadership, with safe, kind and personalised support.
This was an unannounced inspection on 03 April 2019. Three inspectors, a nurse specialist and an expert by experience visited the home. They spoke with people, staff and visiting professionals, observed care, and checked care, medicines, recruitment and management records.
The home was rated Outstanding overall. Effective and Well-led were Outstanding. Safe, Caring and Responsive were Good. Inspectors found people were treated with dignity, supported to make choices and helped to stay independent and socially connected.
People had good access to activities, suitable food, healthcare and well-maintained surroundings. Staff understood people's needs and received training and support. This was the first inspection since the home registered in May 2018.
Personalised support
Staff knew people well and adapted care to their preferred routines, including when they wanted to get up or go to bed. People were encouraged to make choices and remain independent.
“This flexibility meant people could be assured their choices were responded to.” from the report
Activities and community links
People could choose from varied activities and were supported to maintain links with families and the wider community. The home also welcomed local groups and intergenerational events.
“Staff were highly committed to ensuring people lived fulfilling lives and were protected from social isolation.” from the report
Skilled and supported staff
Staff had induction, regular supervision, appraisals and training linked to people's needs. People were also involved in some staff recruitment decisions.
“Staff were skilled and knowledgeable and were passionate in sharing their knowledge to improve understanding and raise awareness.” from the report
Strong leadership
Managers had a detailed understanding of the service and supported open communication, teamwork and continuous improvement.
“The registered manager had an excellent oversight of what was happening in the service and demonstrated an in-depth knowledge of all areas.” from the report
Inspectors raised no specific concerns in this report.
- 01Is the nursing suite now fully operational, and what staffing and nursing support are available there?
- 02How will you assess and review my relative's risks while still supporting their independence?
- 03What activities and community links would suit my relative's interests, health and communication needs?
- 04How will you support my relative with food, drink and any clinical nutrition or hydration needs?
- 05How can my family raise a concern, and how will the home record and resolve it?
This was an unannounced comprehensive inspection of the care home with nursing and covered all five CQC questions; it was the first inspection since registration. This explanation was written from the published report of 20 June 2019 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Mercia Grange
2 rated inspections over 4 years: the service has slipped, from Outstanding to Good.
- December 2023Goodcurrent ratingdown from OutstandingSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- June 2019OutstandingSafe: GoodEffective: OutstandingWell-led: Outstanding
- May 2018
Registered with the Care Quality Commission on 31 May 2018.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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