Melbury House

Updated 29 June 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by 1 inspector, 1 assistant inspector and 1 Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Melbury House is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Melbury House is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was not a registered manager in post. The new manager was in the process of applying to register with the Commission.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

During the inspection we spoke with 12 people who used the service about their experience of the care provided and 2 relatives. We spoke with 10 members of staff including the nominated individual, the manager, the deputy manager, 5 care workers including 1 senior care worker, 1 activities person and the cook. We received feedback from 1 visiting health and social care professional. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

We reviewed a range of records. This included 4 people’s care records and multiple medicines records. We looked at 4 staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including training information and policies and procedures were reviewed.

Updated 29 June 2023

About the service

Melbury House is a residential care home providing accommodation and personal care to up to 34 older people, including people who may live with dementia, or a dementia related condition. At the time of our inspection there were 29 people using the service in one adapted building.

People’s experience of using this service and what we found

Staff knew people well, but people were not always consulted or involved in daily decision making.

People were not always 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 did not always support this practice.

Improvements were needed to some systems including to people’s care records to ensure more person-centred care was provided. We discussed with the management team, care plans should be more person-centred detailing how staff were to provide care in the way the person wanted and needed support to be provided.

We have made a recommendation about ensuring systems are in place to provide choice and promote people’s involvement in their daily living requirements, whatever the level of need.

Medicines were managed safely. Medicines records required more information for the use of ‘when required’ medicines.

We have made a recommendation about protocols being available for the use of ‘when required’ medicines.

There was a welcoming and cheerful atmosphere in the service. A person told us, “It’s just like being at home. We all get along with each other.”

Risks were assessed and mitigated to keep people safe. Staff recruitment was carried out safely and effectively.

People and relatives were complimentary about the care provided by staff. They trusted the staff who supported them. They said staff were kind, caring and supportive of people and their families. A person told us, “I love it here. I love everything about it, I couldn’t ask to be better looked after.”

Staff were following safe infection prevention and control procedures to keep people safe. Staffing capacity was sufficient and staff deployment was effective to ensure people's needs were met in a safe, timely way. A person told us, “There are lots of staff always buzzing around.”

There was evidence of collaborative working and communication with other professionals to help meet people's needs. A visiting professional commented, “Staff are very responsive, they always follow our advice, any referrals are made without delay.”

Staff spoke very positively about working at the home and the people they cared for. They said communication was effective to ensure they were kept up-to-date about any changes in people’s care and support needs.

A quality assurance system was in place to check the quality of service provision. A person told us, “I think it’s run very well. They [staff] do what they say they are going to do. This is the best one I’ve been in, I’ve been lucky.”

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 14 September 2017).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has remained good based on the findings of this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Melbury House on our website at www.cqc.org.uk.

Recommendations

We have made a recommendation about ensuring systems are in place to provide choice and promote people’s involvement in their daily living requirements, whatever the level of need.

We have made a recommendation about protocols being available for the use of ‘when required’ medicines.

We have made a recommendation that the locking of all bedroom doors, when people are not in them, should be reviewed, so people can easily access their bedrooms.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.