CQC report explained · a residential care home
What the CQC found at Murreyfield Care Centre
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Medicines, recruitment, infection control and safeguarding systems were generally safe. Inspectors found that hot water temperatures were above safe limits, although the provider addressed this immediately.
- Effective?
- Good
- Staff had the skills and training to support people. People's dietary, healthcare and communication needs were considered, and people were supported to make choices.
- Caring?
- Good
- This question was not assessed during this focused inspection. The report says people had positive and supportive relationships with staff.
- Responsive?
- Requires improvement
- This question was not assessed during this focused inspection. The report describes personalised care, support for people's routines and help to access education and leisure activities.
- Well-led?
- Good
- The provider had introduced systems to monitor quality and had followed its improvement plan. Some checks still failed to identify problems with temperatures and fire safety records.
What inspectors found, September 2020
Murreyfield Care Centre was rated Good; inspectors found safe, supportive care, but identified issues with hot water, staffing flexibility and monitoring records.
This was an unannounced focused inspection visit on 14 August 2020. One inspector visited the home, spoke with people, relatives and staff, and reviewed care, medicine, recruitment and management records. Infection control measures were also checked during the visit.
The home was rated Good for Safe, Effective and Well-led. Medicines were administered safely, staff had the right skills, people were supported with healthcare and food, and systems to protect people from abuse were in place. People were supported to make choices and work towards greater independence.
The home had improved since its previous inspection, when it was rated Requires Improvement and was in breach of several regulations. It was no longer in breach at this inspection. However, hot water was initially too hot, staffing was less flexible in the evenings, and some monitoring systems did not identify problems.
Skilled staff
Staff had relevant training, supervision and knowledge of people's needs. New staff completed an induction and mandatory training.
“Staff had the skills and knowledge to appropriately support people. New staff completed an induction programme and mandatory training.” from the report
Choice and independence
People were encouraged to make decisions and were supported in the least restrictive way. Staff helped people work towards personal goals, education and independent living skills.
“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.” from the report
Positive relationships
Inspectors found that staff had supportive relationships with people. People spoke positively about the help they received.
“Staff had developed positive and supportive relationships with people.” from the report
Improved management
The provider had acted on the previous inspection action plan. Checks had improved in areas including medicines, staff training and staff deployment.
“The provider had implemented systems to monitor the quality of the service and drive improvements.” from the report
Hot water was too hot
seriousWater temperatures were above safe limits and created a risk of scalding. The provider dealt with the immediate risk, but this was not found by the home's own monitoring.
“Water temperatures were found to be above safe temperature limits and placed people at risk of scalds.” from the report
Less flexibility at some times
needs fixingStaffing levels were considered safe overall, but evenings had not been fully planned for when managers and administration staff were unavailable. Inspectors recommended reviewing staffing systems.
“Staffing levels had increased on a weekend, though staff deployment had not fully accounted for evenings when managers and administration staff were not available to give additional support.” from the report
Monitoring did not find every problem
needs fixingMost audits identified and dealt with shortfalls, but checks did not identify issues with temperature monitoring and fire safety records.
“Though shortfalls relating to the monitoring of temperatures and fire safety records had not been identified.” from the report
Some relatives were not informed
minorThe manager reported information appropriately overall, but not every relative was kept informed about accidents and incidents.
“The registered manager understood the regulatory requirements and reported information appropriately, though not all relatives were kept informed of accidents and incidents.” from the report
- 01How do you now check and record hot water temperatures, and what action is taken if they are too high?
- 02How many staff are available in the evenings and at weekends, and how do you provide extra support when managers are not on site?
- 03How do your checks identify problems with fire safety records and other safety monitoring?
- 04How will you make sure relatives are told promptly about accidents and incidents?
- 05What progress has been made with the planned improvements to bathing and showering facilities?
This was a focused inspection of Safe, Effective and Well-led, with infection control also checked; the other ratings were carried over from the previous comprehensive inspection. This explanation was written from the published report of 16 September 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.
What inspectors found, June 2020
Rated Requires Improvement; inspectors found kind care, but serious problems with medicines, staffing, risk management and oversight.
This was an unannounced inspection over three days. Inspectors spoke with people using the home, staff and managers. They looked at care records, medicines records, staff recruitment and training files, the building, cleanliness and how the home was managed.
The home was not consistently safe. Medicines were not always stored or recorded safely. Risks such as weight loss, hot radiators and fire safety were not always properly managed. Some staff had started work before all checks were complete, and there were not always enough suitably trained staff.
Inspectors found that people were treated with kindness and respect. Staff supported people to make choices, access healthcare and maintain independence. However, care plans did not always contain enough information, end of life wishes had not been discussed, and some people did not get enough support to access the community.
The overall rating was Requires Improvement, and all questions except Caring were rated Requires Improvement. The home had the same overall rating at the previous inspection and had not made enough improvement. CQC said it would monitor progress and return to inspect again.
Kind and respectful care
People said staff listened to them and did not pressure or judge them. Inspectors saw staff being kind, positive and respectful.
“Staff were kind and passionate about providing people with good care.” from the report
Choice and independence
People were encouraged to make decisions, follow their own routines and maintain their independence. Staff respected people's preferred names and genders.
“People were encouraged to make decisions and choices about their care.” from the report
Access to healthcare
Staff referred people to relevant health professionals and followed professional advice. People were supported to attend appointments.
“People were supported to access appropriate healthcare services.” from the report
Activities and relationships
People were supported with hobbies, education, volunteering and family relationships. The home arranged outings for people who wanted to attend.
“The inclusion co-ordinator had arranged trips out to the cinema, shopping, museums, theatre and football matches for people who wanted to attend.” from the report
Unsafe medicines management
seriousStaff did not always record when medicines prescribed for occasional use were given. Some medicines were stored in a fridge that was too warm, and guidance for some medicines was missing.
“Medicines were not managed safely.” from the report
Risks were not managed
seriousThe home did not always identify or monitor risks such as weight loss, burns from hot radiators and fire safety. Some required checks and records were missing.
“Risks to people's health and wellbeing were not always identified and monitored.” from the report
Staffing and training
seriousSome staff worked before all recruitment checks were complete. There were not always enough staff with the right skills, and training and supervision were not up to date.
“Staff did not have the required skills and training to safely meet people's needs.” from the report
Incomplete care planning
needs fixingCare plans did not always contain enough information about people's needs, routines or communication. One person lacked appropriate capacity and best interest records.
“People's preferred routines and person-centred information was not always recoded in people's care plans.” from the report
End of life planning
needs fixingPeople's wishes about end of life care had not been discussed or recorded. Most staff had not been trained to provide this support.
“People's wishes, and preferences had not been discussed, and care plans were not in place.” from the report
Weak quality oversight
seriousAudits and other checks had not identified or resolved problems with medicines, staffing, training, care plans and incidents. Staff also reported feeling undervalued and unsupported.
“Systems had not ensured people received a quality service or addressed problems.” from the report
- 01What changes have been made to record the time occasional medicines are given and to keep refrigerated medicines at the correct temperature?
- 02How do you now make sure every staff member has completed the required recruitment checks before working with people?
- 03What is the current staffing level on each shift, and how do you ensure staff have the right training and skills?
- 04Have every person's risks, preferred routines, communication needs and mental capacity decisions been reviewed and recorded?
- 05How are you discussing and recording people's end of life wishes, and what training have staff received for this?
This was an unannounced inspection covering all five key questions, including the premises and care provided; the report says Caring stayed Good, while Responsive fell from Good to Requires Improvement and the other ratings remained Requires Improvement. This explanation was written from the published report of 9 June 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 Murreyfield Care Centre
3 rated inspections over 2 years: the service has improved, from Requires improvement to Good.
- September 2020Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Good
- June 2020Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementWell-led: Requires improvement
- January 2019Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- November 2017
Registered with the Care Quality Commission on 8 November 2017.
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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