CQC report explained · a residential care home
What the CQC found at Merevale House Residential Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People felt safe, staff understood safeguarding procedures, and there were enough staff. Some risk assessments needed more detail, and staff did not always date opened topical medicines as recommended.
- Effective?
- Good
- People's needs were assessed, staff were trained, meals and drinks were provided, and people received healthcare support. This rating improved from Requires Improvement at the previous inspection.
- Caring?
- Good
- This question was not inspected at this visit, so no new rating or findings were given.
- Responsive?
- Good
- This question was not inspected at this visit, so no new rating or findings were given.
- Well-led?
- Requires improvement
- Management was open and committed to improving care, but governance checks did not always identify problems promptly. Fire safety records had been misplaced and further improvements were needed in auditing and compliance.
What inspectors found, September 2022
Rated Good overall; inspectors found safe, effective care, but the home needed to improve its leadership and oversight.
Inspectors visited on 21 and 26 July 2022. The first visit was unannounced. They spoke with people living at the home, relatives, staff and health professionals, observed care, and checked care records, medicines, recruitment files and quality checks.
The home was rated Good for Safe and Effective. People were supported by enough staff, received their medicines, had access to healthcare, and were involved in choices about their care. Infection control arrangements were also found to be suitable.
Well-led was rated Requires Improvement. The home's checks did not always identify problems quickly. These included missing fire safety records, incomplete checks on medicines and food labelling, and some risk assessments that needed more detail. The provider began making improvements during and after the inspection.
The overall rating stayed Good. Caring and Responsive were not inspected at this visit, so their previous ratings were carried forward. Effective improved from Requires Improvement to Good, while Well-led fell from Good to Requires Improvement.
Enough staff
People, relatives and staff said staffing levels were sufficient. Staff had time to support people with their interests and spend time with them.
“People, their relatives and staff told us there were enough staff and they had time to support people with their interests in a person-centred way.” from the report
Health support
The home worked with healthcare professionals and made timely referrals. People's health needs, including oral health, were recorded.
“We do find that the staff complete referrals in a timely manner...Merevale engage in weekly ward rounds with the district nursing service and the GP” from the report
Choice at mealtimes
People were offered choices, alternatives and regular drinks and snacks. Staff supported people to eat and drink in an unhurried way.
“There were enough staff present at mealtimes to support people in an unhurried way.” from the report
Respect for choice
Staff asked for consent and worked within the Mental Capacity Act. People were supported to make choices wherever possible.
“Staff had received up to date MCA and DoLS training and were aware of their duties and responsibilities in relation to the MCA and DoLS.” from the report
Management checks
needs fixingThe home's monitoring systems did not always find problems promptly. The provider responded quickly to some issues and introduced extra checks.
“Systems to identify areas of improvement could have been more effective, to ensure improvements were identified and made promptly.” from the report
Fire safety records and actions
seriousFire risk assessment and procedure records from 2021 had been misplaced. A fire authority had identified improvements, with a plan due for completion by the end of September 2022.
“A recent change to the maintenance team resulted in the provider not identifying required improvements for fire prevention.” from the report
Risk plan detail
seriousSome risk assessments and management plans did not contain enough detail to ensure staff always had the information needed to prevent avoidable harm.
“Some risk assessment and risk management plans could have been more detailed to ensure staff always had the information they needed to protect people from avoidable harm.” from the report
Medicines and food labelling
needs fixingStaff did not always date opened topical medicines. Food items in shared kitchen areas were also not always marked when opened, so extra checks were introduced.
“However, staff did not always follow the recommended guidance in labelling topical medicines with the date they were opened.” from the report
Dementia signage
minorThe home had some memory aids, but inspectors found limited signage to help people with dementia find their way around independently.
“However, there was limited dementia signage around the home.” from the report
- 01Has every action in the fire safety improvement plan been completed, and can you show us the updated records?
- 02How are you checking that risk assessments and risk management plans contain enough detail for each person?
- 03How do you make sure opened creams and other topical medicines are dated and disposed of safely?
- 04How are the new daily food checks working, and who reviews them?
- 05What progress has been made in appointing and using a compliance manager?
This inspection covered Safe, Effective and Well-led; Caring and Responsive were not inspected at this visit and their previous ratings were carried forward. This explanation was written from the published report of 21 September 2022 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, December 2020
Rated Good; inspectors found safer care, improved medicines management and stronger oversight after the previous Requires Improvement rating.
Inspectors carried out an unannounced focused inspection on 10 November 2020. They checked Safe and Well-led, including infection control during the COVID-19 pandemic. They spoke with relatives, staff and a healthcare professional, and reviewed care plans, medicines records, training information and management records.
The home was rated Good for Safe and Well-led. Inspectors found better risk assessments, safer medicines systems, improved safeguarding processes and effective infection control arrangements. Staff knew people well, had time to support them and helped them keep interests and daily activities.
The home had previously been rated Requires Improvement, with breaches linked to safeguarding, safe care and treatment, governance and reporting incidents. Inspectors found enough improvement had been made and said the home was no longer in breach of those regulations.
This was a focused inspection. The other key questions were not inspected at this visit, and their previous ratings were carried forward when calculating the overall rating.
Safer medicines
The home had introduced an electronic medicines system. Staff competency was checked regularly, and there were clearer arrangements for medicines given when needed.
“The system supported safe practice in medicine administration and ensured people received their medicines at the right time.” from the report
Risk management
Risks to people's health and safety were assessed with clear guidance for staff. Accidents and incidents were reviewed to identify patterns and take action.
“Risks to people's health and safety were assessed and included strategies for staff to manage those risks.” from the report
Meaningful support
Staff knew people well and supported their interests, hobbies and skills. People were also encouraged to take part in suitable household activities.
“Staff were encouraged to be more proactive by giving people purpose and meaning in their daily lives.” from the report
Family contact
Relatives received updates and were supported to keep in touch during visiting restrictions through telephone and video calls.
“We have phone calls and video calls about three times a week.” from the report
Improved leadership
The provider had better quality monitoring and a plan for improvement. Staff said management was open, approachable and supportive.
“The provider had a service improvement plan to drive improvement in standards within the home.” from the report
Staff turnover
minorThe provider reported an increase in staff turnover during the pandemic. Inspectors noted a stronger focus on training and development to help retain new staff.
“The provider experienced an increase in their staff turnover as a result of the pandemic.” from the report
- 01How do you make sure the improved medicines system continues to record every dose and any missed medicines?
- 02How do you assess and review risks for someone with dementia who may become confused or want to leave?
- 03How are staff turnover and new staff training affecting the care team now?
- 04What improvements from the service improvement plan are still being monitored, including personal care standards?
- 05How will you keep relatives informed and support visits or video calls if restrictions return?
This was a focused inspection of Safe and Well-led, including infection control; Effective, Caring and Responsive were not inspected and their previous ratings were carried forward. This explanation was written from the published report of 2 December 2020 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 Residential Home
5 rated inspections over 7 years: the service has slipped, from Outstanding to Good.
- September 2022Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
Read what inspectors found at Merevale House Residential Home →
- December 2020Goodup from Requires improvementSafe: GoodWell-led: Good
Read what inspectors found at Merevale House Residential Home →
- February 2020Requires improvementdown from OutstandingSafe: Requires improvementEffective: Requires improvementWell-led: Requires improvement
- September 2017Outstandingstayed OutstandingSafe: GoodEffective: GoodCaring: OutstandingResponsive: OutstandingWell-led: Outstanding
- October 2015OutstandingSafe: GoodEffective: GoodCaring: OutstandingResponsive: OutstandingWell-led: Outstanding
- November 2013
Report published without a new overall rating.
- February 2013
Report published without a new overall rating.
- January 2013
Report published without a new overall rating.
- December 2011
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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