We carried out a review of the data available to us about Merrivale Farm on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Merrivale Farm, you can give feedback on this service.
Merrivale Farm is a residential care home near Ledbury providing personal care for up to eight people with learning disabilities or autistic spectrum disorder in one adapted building. At the time of our inspection, there were seven people living at the home.
The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.
People’s experience of using this service and what we found
Staff were clear how to identify and report any potential abuse or discrimination involving people who lived at the home. The risks associated with people’s individual care needs had been assessed, recorded and plans put in place to manage these. Staff arrangements at the home ensured people received safe, person-centred care. Any accidents or incidents involving people were reported by staff to the management team, who took action to keep people as safe as possible. People had the support they needed to take their medicines safely and as prescribed. Measures were in place to protect people from the risk of infections.
People’s individual care needs were assessed and reviewed to achieve positive outcomes for them. Staff received training and ongoing management support to enable them to work safely and effectively. People were involved in decisions about what they ate and drank, and they helped to produce the home’s weekly menus. Staff and management worked in partnership with a range of community health and social care professionals to ensure people’s care needs were met. People had the support they needed to attend medical appointments and routine health check-ups. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
Staff treated people with kindness and compassion, and were committed to people’s continued happiness and wellbeing. People were encouraged to express their views about their care, and these were listened to and acted on. People’s rights to privacy, dignity and independence were understood and promoted by staff. Staff recognised the need to avoid any form of discrimination in planning and delivering people’s care.
People received personalised care and support from staff who knew them well. People’s care plans were individual to them, and staff confirmed they read and followed these. People had support to participate in a range of social and recreational activities, based around their interests and preferences. People and their relatives knew how to raise any concerns or complaints with the management team. People’s wishes and choices about their end of life care were explored with them.
The management team promoted a positive and inclusive culture within the service, based upon open communication with others. People, their relatives and community professionals had confidence in the management of the service. Staff felt well-supported and valued by the management team. The provider had quality assurance systems and processes in place to enable them to monitor and address the quality and safety of people’s care.
Rating at last inspection
The last rating for this service was Good (report published 7 March 2017).
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
Merrivale Farm provides accommodation and personal care for up to eight people who have a learning disability. At the time of the inspection, eight people were living at the home.
The service is required to have a registered manager and there was a registered manager in post when we inspected. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run
People were protected from avoidable harm and abuse. Staff understood how to recognise and report abuse, and supported people to raise any concerns about their safety or wellbeing. The risks associated with people’s individual care and support needs had been assessed, recorded and plans implemented to control these. The provider involved people in decisions about risks and recognised the need to keep restrictions on people to a minimum. Staffing levels at the service enabled the provider to meet people’s individual needs safely and flexibly. The provider followed safe recruitment procedures to ensure prospective staff were safe to work with people. Systems and procedures were in place to make sure people received their medicines safely.
Staff had the knowledge, skills and experience needed to carry out their roles effectively in line with best practice. They received ongoing training, guidance and support from the management team. People’s rights under the Mental Capacity Act 2005 were recognised and promoted. People had enough to eat and drink, and their dietary and nutritional requirements were assessed and met. Staff played a positive role in helping people to maintain good health and access healthcare services whenever needed.
Staff knew people well and adopted a caring and compassionate approach towards their work. People’s involvement in decisions about their care and support was encouraged and facilitated. People were treated with dignity and respect and their independence was actively promoted.
People received care and support that was shaped around their individual needs, wishes and preferences. Their care plans reflected an individualised approach and were understood and followed by staff. People had the support they needed to pursue hobbies and interests and spend time doing things they found enjoyable. People and their relatives knew how to raise concerns or complaints with the provider, and felt confident these would be acted upon. The provider actively sought people’s feedback on the service.
The management team promoted a positive and open ongoing dialogue with people, their relatives and the staff team. People and their relatives found the management team approachable and had confidence in their ability to deal with issues fairly. Staff understood what was expected of them and felt well supported by the management team. The provider made use of effective quality assurance systems to improve the quality of the service people received.
The inspection took place on 4 March 2015, it was unannounced.
The home provides accommodation and personal care for up to eight people who have a learning disability. At the time of the inspection eight people were living at the home.
It is a requirement that the home has a registered manager. There was a manager in post who was registered with us. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
People felt safe at the home and could tell staff if they had any concerns. Staff understood their responsibility to protect people from harm and knew how to report any abuse. People were supported by staff in sufficient numbers to meet their needs. Staff knew how to assist people and help them stay safe. People’s safety and risks were considered when their care was planned and their medicines were looked after appropriately.
Staff felt supported in their work and were provided with training to help them meet people’s needs.
People’s consent was sought before support was provided. When people did not have the capacity to make decisions for themselves the legal principles to protect their rights had been followed.
People liked the food and mealtimes were homely and relaxed. They were supported to make choices about what they ate and to be involved in making their own meals and drinks. A healthy diet was encouraged. People were enabled to access health services including routine preventive health checks. They felt staff were caring when they were ill and staff worked closely with external professionals to meet more complex health care needs.
People had good relationships with the staff who they found caring. They were involved in planning and reviewing their support and their privacy and independence was promoted.
People’s preferences and individuality was respected and staff took these into account when providing support. They were supported to make choices about how they wanted to spend their time and encouraged to try new things. Any concerns were picked up quickly and addressed.
People and their relatives felt the service was well run and their views were welcomed and listened to. They and staff felt able to raise any issues with the registered manager and providers. There was a clear management structure in place and the providers were monitoring the service. The environment had been improved during 2014 and further improvements were planned.
We found that the provider had systems in place to gain the consent to care and treatment of people who used the service.The staff we spoke with had an understanding of the needs of people who used the service. We found care and treatment was planned and delivered in a safe way which met people's individual care needs. People we spoke with were positive about the care they received. One person told us, "I get support if I need it. I am involved in planning my care."
We found that care staff were aware of safeguarding procedures and knew how to keep people safe. People who used the service told us they felt safe.
All staff had received training so that they had the knowledge to support the people safely in the way that they chose.
Systems were not in place for monitoring and improving the quality of the service.
The staff engaged pleasantly with people and encouraged them to be independent where possible. There was a calm atmosphere and the house was homely.
We found that people were fully involved in decisions about how they spent their time and most were attending meaningful activities of their choice. One person told us how much they enjoyed the project where they tended animals. Two others had an interest in fishing and had recently taken up this hobby. One person told us, 'I like it here and I enjoy going out to see shows'.
People were encouraged to be involved in planning their care and support and then reviewing how well things were going. Suitable systems were in place to support people with their daily medicines.
People were encouraged to give their views and to raise any concerns. There were systems in place should a concern or complaint be made.
The staffing levels were suitable to support people while at home and when out in the community. Checks were carried out on new staff and they were given time to get to know people before taking on responsibility for their care.
We saw that staff interacted with people who use the service in a friendly, courteous and respectful manner. Care workers demonstrated they were aware of people's care and support needs.
We saw people involved in their activities such as one person taking a planned trip into town on the bus, while others were busy hanging out the laundry, cleaning the kitchen or working in the vegetable garden.
Staff working on the day of the visit told us that most of the staff team had worked for this service for many years, with the most recent member of staff joining the team some two years ago. People living at the home had been there for many years and because of this staff had developed their knowledge and an understanding of people's care and support needs.
We saw that people were very relaxed and at ease with staff and within their home environment. The atmosphere was calm, relaxed and very homely.
We looked at care records for three people living at the home and found their records provided clear and up to date information that staff would follow to help them give people the care and support they needed.