Archived: Meresbeck

Meresbeck is a care home managed by SKR Limited. It is located in the small town of Carnforth, north of Lancaster. The home is registered to provide care and support up to a maximum of twenty people. At the time of the inspection visit there were fifteen people residing at the home.

There was a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

We last carried out a comprehensive inspection of the service 18 and 19 November 2015. At this inspection we rated the service as requires improvement as we identified several concerns. The registered manager had failed to have appropriate systems to lawfully deprive a person of their liberty. Processes were not in place to ensure CQC was notified of all significant events. We also made a recommendation that improvements were made to the living environment to ensure it was safe and suitable for people. We carried out a focussed inspection 18 May 2016 to ensure all improvements had been made. We found the service had made all the required improvements.

At this inspection carried out in March 2017, people and relatives spoke positively about the care delivered. We observed staff being patient and spending time with people who lived at the home. People who lived at the home looked comfortable and happy in the presence of staff.

Arrangements were in place for managing and administering medicines. However, systems did not always reflect good practice guidelines. We have made a recommendation about this.

People told us staffing levels met their needs. We observed call bell waiting times and noted these were answered in a timely manner. Staff told us they had time to build quality relationships with people who lived at the home.

Staff treated people with kindness and compassion. People who lived at the home and relatives all commended the caring nature of the staff team.

People told us they felt safe and secure. Arrangements were in place to protect people from risk of abuse. Staff had knowledge of safeguarding procedures and were aware of their responsibilities for reporting any concerns.

Recruitment procedures ensured the suitability of staff before they were employed. Staff told us they were unable to start their employment without all the necessary checks being in place.

People’s healthcare needs were monitored and managed appropriately by the service. People told us guidance was sought in a timely manner from health professionals when appropriate.

Care plans were in place for people who lived at the home. Care plans covered support needs and personal wishes. People who lived at the home and relatives said they were involved in the care planning process. Plans were reviewed and updated at regular intervals and information was sought from appropriate professionals as and when required.

Feedback on the quality of food provided was positive. People were happy with the variety, quality and choice of meals available to them. People’s nutritional needs were addressed and monitored.

Social activities were offered to people who lived at the home. We saw a variety of outside agencies visited the home to provide entertainment.

We saw improvements had been made to the living conditions at the home. The registered manager told us the refurbishment programme was ongoing. Certificates viewed showed us premises and equipment were appropriately maintained.

The registered manager had a training and development plan for all staff. Staff told us they were provided with relevant training to enable them to carry out their role.

Systems were in place to ensure people who were deprived of their liberty were done so lawfully.

The registered manager held regular meetings with people who lived at the home to receive feedback on the service being provided. We saw evidence changes were made following people’s suggestions.

The registered manager had a range of assurance systems to monitor quality and effectiveness of the service provided. They fed back to the nominated individual any concerns so improvements could be made.

People who lived at the home, relatives and staff all provided positive feedback about the registered manager’s skills and personal attributes. They said the registered manager ensured high quality care was provided.

Staff were positive about ways in which the service was managed. Staff described teamwork as good and said there was regular communication between senior management and staff.

This unannounced focused inspection took place on 18 May 2016.

Meresbeck is a care home managed by SKR Limited. It is located in the small town of Carnforth, north of Lancaster.

There was a registered manager in place. 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.

There were sixteen people residing at the home at the time of the inspection.

The service was last inspected on 18 and 19 November 2015. At this comprehensive inspection we found the registered provider was not meeting all the fundamental standards. We identified a breach to Regulation 13 of the Health and Social Care Act 2014 as the registered provider did not have systems in place to lawfully deprive people of their liberty. We also identified a breach to Regulations 16 and 18 of the Care Quality Commission (Registration) Regulations 2009 as the registered provider had failed to report notifiable events to the Care Quality Commission.

Following the comprehensive inspection in November 2015, we asked the registered provider to submit an action plan to show what changes they were going to make to become compliant with the appropriate regulations. The registered provider returned the action plan to demonstrate the improvements they intended to make. We used this focused inspection to look to check if the action plan had been completed and to ensure all fundamental standards were now being met.

At this focused inspection carried out in May 2016, we found improvements had been made.

Improvements to the living environment had commenced. Decoration within the building had started and unused equipment had been removed from communal areas. We were advised work to the environment was on-going. Following the inspection we asked the registered provider to send us a copy of the planned on-going maintenance plan to demonstrate when all works would be completed.

Systems had been implemented to ensure the registered provider worked in accordance with the Mental Capacity Act and followed the Deprivation of Liberty Safeguards. (DoLS.)

People who lived at the home told us they felt safe and they no longer felt their privacy and dignity was being compromised.

Systems had been implemented to ensure all notifiable incidents were relayed to the Care Quality Commission in a timely manner.

We looked at care planning, complaint systems, meal arrangements and recruitment of staff. We also talked with residents about the home. Comments were positive and included, 'The staff and manager are all caring people nothing is too much trouble.' Also, 'The cook is first class, always homemade food and cakes and plenty of it.'

We found care plan records were up to date and people were happy with the service they were receiving. We found people were supported by staff who had been properly recruited and received induction training. One staff member we spoke with said, 'I know all my checks had to be completed before I commenced work at the home. I had a thorough induction training period as well.'

The home had a complaints procedure which was available to residents. This was confirmed through talking with residents. It explained how to make a complaint and how this would be handled. A record of compliments and complaints was shown to us. No complaints had been received for over three years.

There were a range of audits and systems in place to monitor the quality of the service.

During our inspection we contacted the Lancashire contracts monitoring team. They told us they had no concerns about the service.