CQC report explained · a residential care home
What the CQC found at Merevale House
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found enough staff, safe medicines practice and suitable checks to protect people from abuse and avoidable harm. One diabetes care plan was missing important information, but this was corrected during the inspection.
- Effective?
- Good
- Staff had improved training and support, helped people access health services and supported good nutrition. Staff were also found to follow the principles of consent and least restrictive care.
- Caring?
- Good
- People described staff as kind, friendly and helpful. Staff promoted privacy, dignity, independence and people's individual choices.
- Responsive?
- Good
- Care plans were personalised and staff understood people's backgrounds, preferences and communication needs. People were offered activities, trips and time with staff based on their interests.
- Well-led?
- Requires improvement
- Management changes had led to gaps in quality checks, records, training and staff support. New audits, meetings and an electronic care system had been introduced, but these improvements were not yet fully established.
What inspectors found, December 2019
Rated Good overall; inspectors found kind, personalised care, but the home’s leadership and quality checks required improvement.
Inspectors made an unannounced visit on 3 December 2019. They spoke with people using the home, staff and managers. They observed care and checked care plans, medicines records and management records.
The home was rated Good for safe, effective, caring and responsive care. Inspectors found enough staff, safe medicines practice, personalised care plans and kind support that promoted people's independence.
Well-led was rated Requires Improvement. There had been several management changes, and quality checks, records, staff training and support had not always been maintained. A new management team had introduced improvements, but these systems were still new and needed to become established.
The overall rating stayed Good, the same as at the previous inspection. The report says CQC would continue to monitor the home and could inspect sooner if concerns were received.
Enough staff
Inspectors found staffing levels allowed staff to provide personal support and spend time with people.
“There were enough staff to keep people safe.” from the report
Personalised support
Care plans reflected people's individual needs and helped staff support independence and personal preferences.
“People's care plans were personalised and showed an appreciation of people as individuals.” from the report
Improved medicines practice
People received medicines as prescribed. New weekly and monthly audits had improved medicines management.
“The new manager had introduced a system of weekly and monthly audits.” from the report
Activities and social contact
People could take part in activities, trips and events that interested them, or spend time doing things they chose at home.
“People were offered opportunities to engage in activities and events they were interested in.” from the report
Management changes affected oversight
needs fixingSeveral managers had left in the previous year. During this period, quality checks, records, staff training and staff support were not consistently maintained.
“During the period of managerial change, the provider's policies and procedures to ensure the quality of the home had not been implemented effectively.” from the report
New quality systems not yet established
needs fixingThe new audits and monitoring systems had brought improvements, but the management team said they were still very new and had not yet produced enough information about trends.
“However, the management team recognised these systems were very new and needed to become embedded to drive improvement.” from the report
Missing diabetes information
needs fixingOne person's care plan did not initially explain their usual blood sugar levels or signs of becoming unwell. A diabetes care plan was added during the inspection.
“We found the care plan did not contain information about what the person's normal blood sugar levels should be, or the signs that might indicate they were becoming unwell.” from the report
- 01What quality checks and audits are now used, and how do you act on any problems they identify?
- 02How do you make sure staff training and supervision stay up to date?
- 03How do you check that each person's care plan contains current information about health risks, including diabetes?
- 04How do you make sure there are enough staff for one-to-one support and activities?
- 05How are people and relatives involved in reviewing care plans and giving feedback?
This was an unannounced inspection covering all five CQC questions, with accommodation and nursing or personal care both considered. This explanation was written from the published report of 24 December 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.
What inspectors found, August 2017
Merevale House was rated Good overall; inspectors found kind, person-centred care but safety improvements were needed.
The inspection was unannounced and took place on 11 July 2017. One inspector spoke with all seven people living in the home, a relative and staff. They also checked care plans, medicines records, training records and quality checks.
The home remained Good overall, as it was at the previous inspection in June 2015. Effective, caring, responsive and well-led were all rated Good.
Safe was rated Requires Improvement. Inspectors found that some risk plans were incomplete or not followed, and they identified problems with medicines checks and food storage. The manager took immediate action on several issues during the visit.
Kind and respectful care
People said staff were kind, and inspectors saw staff speak with people and treat them respectfully. Staff supported privacy, dignity and independence.
“We saw staff supported people with kindness and respect.” from the report
Personalised support
Care plans included people's histories, interests and family relationships. Staff supported people to choose activities and take part in everyday tasks.
“People's living plans were personalised to them and contained detailed information about their earlier lives, interests and family relationships.” from the report
Dementia care skills
Staff had received dementia care training and said they felt able to provide calm, effective support.
“Staff had received the 'dementia care matters' training programme to support them in their knowledge of working with people with dementia.” from the report
Enough staff
People and staff said staffing levels were sufficient. Recruitment checks, including criminal record checks, had been completed.
“People and staff felt there were sufficient numbers of staff on shift.” from the report
Risk plans were not always followed
seriousSome risks did not have clear assessments or agreed actions. Staff also failed to remove a lighter from someone whose plan said they were not safe to have one.
“Staff did not consistently follow the agreed actions to minimise risks to people.” from the report
Medicines checking
seriousA pharmacy delivery was recorded as containing 112 tablets when only 110 had arrived. One person also lacked guidance for an as-required medicine.
“This meant the tablets would have ran out two days before the end of the month.” from the report
Smoking safety
seriousPeople did not always use the designated smoking area. Cigarette ends had collected near the kitchen door, creating a potential risk that the manager acted on during the visit.
“Numerous cigarette ends had been discarded by people in a small wall space opening in the brickwork next to the kitchen door.” from the report
Food storage
needs fixingFresh vegetables were stored in a dusty shed with laundry and cleaning chemicals, where the temperature was unsuitable.
“Some food items were not stored in a suitable place.” from the report
Complaints information
minorThe complaints procedure existed but was not displayed at the home when inspectors visited. The manager said a replacement copy would be put up.
“The provider had a complaints procedure, however, this was not displayed at the home.” from the report
- 01What changes have been made to ensure every person's risk assessment has clear, up-to-date actions?
- 02How do you now check pharmacy deliveries and make sure as-required medicines have clear guidance?
- 03How do you make sure people use the designated smoking area and that smoking materials are kept safely away from the house?
- 04Where are fresh vegetables stored now, and how is food storage checked?
- 05Is the complaints procedure currently displayed and how can families raise a concern?
This was an unannounced inspection covering all five CQC questions and the overall rating; the previous inspection had rated the home Good overall in June 2015. This explanation was written from the published report of 5 August 2017 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 Merevale House
3 rated inspections over 4 years: the service has held its Good rating throughout.
- December 2019Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- August 2017Goodstayed GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- September 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Outstanding
- November 2013
Report published without a new overall rating.
- February 2013
Report published without a new overall rating.
- May 2011
Registered with the Care Quality Commission on 18 May 2011.
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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