Archived: Murray House

Updated 14 October 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This was a comprehensive inspection, which took place because we carry out comprehensive inspections of services rated Good approximately every two years. This inspection took place on 6 September 2017 and was unannounced. It was carried out by one inspector.

Before the inspection, the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. Prior to our visit we reviewed the information we held about the service. This included reports from previous inspections and statutory notifications submitted by the provider. Statutory notifications contain information providers are required to send to us by law about significant events that take place within services.

During our inspection we spoke with six people who were living at the home, the registered manager, the deputy manager, a senior team leader, three care workers, the activities coordinator and the cook. We also undertook general observations of staff interaction with the people who lived at Murray House throughout the day. During lunch 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.

Records we looked at included five people’s support plans, which included two for people on short stay assessment placements, a range of staff files and other documents that related to the overall governance of the service.

Updated 14 October 2017

Murray House is a local authority run care home that can provide permanent or short stay respite or hospital discharge rehabilitation assessments (between six to eight weeks) for up to 38 people. The service specialises in supporting older people living with a range of health and social care needs, including dementia, who require varying degrees of personal care and support. At the time of our inspection because the service was not accepting any permanent admissions there were only 12 people living at the home either permanently or on a temporary basis.

At the last Care Quality Commission (CQC) inspection of this service in May 2015, although we rated them ‘Good’ overall, we rated them ‘Requires Improvement’ for the key question ‘Is the care home safe’. This was because the provider had failed to store substances hazardous to health safely, which meant the people living at the home had been placed at unnecessary risk of harm. We undertook a focused inspection in November 2015 to check the provider had taken appropriate action to resolve this issue and found they met legal requirements. At this inspection we found the service continued to meet the regulations and fundamental standards and therefore remains rated ‘Good’ overall.

The service had a registered manager in post who had returned to work in June 2017 after being on maternity leave for the past year. In the registered manager’s absence the service’s deputy manager had been in operational charge of the home. 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 a legal responsibility for meeting the requirements in the Health and Social Care Act and associated Regulations about how the service is run.

When people were nearing the end of their life, they received compassionate and supportive care. However, staff had not received any end of life care training. We discussed this with the registered manager who agreed to arrange for staff to attend this training to help them meet the needs and wishes of people nearing the end of their life. Progress made by the service to achieve this stated aim will be assessed at their next inspection.

People received personalised care that was responsive to their individual needs. Each person had a comprehensive and individualised support plan that encompassed all aspects of their lives. This set out clearly for staff how they should be meeting people's needs and wishes. This meant people were supported by staff who knew them well and understood their personal and health needs, food and drink preferences and social interests. Staff encouraged people to actively participate in meaningful leisure and recreational activities that reflected their social interests and wishes, and maintain relationships with people that mattered to them. In addition, the Eden Alternative Foundation recently accredited Murray House for its innovative work providing older people who lived there with person centred and fulfilling care and support. The Eden Alternative is an internationally recognised Foundation that promotes person centred care, independent living skills and accessing meaningful social activities for older people.

People remained safe at Murray House. There were robust procedures in place to safeguard people from harm and abuse. Staff were familiar with how to recognise and report abuse. The provider assessed and managed risks to people’s safety in a way that considered their individual needs. Although there had been a reduction in staffing levels there continued to be enough staff on duty to keep people safe. Medicines were managed safely and people received them as prescribed.

Staff continued to be suitably trained and received all the support they needed to perform their roles effectively. People were supported to have enough to eat and drink to meet their dietary needs. They also received the support they needed to stay healthy and to access healthcare services.

People continued to be treated with dignity and respect by staff. People’s privacy was maintained particularly when being supported by staff with their personal care needs. People were supported to have maximum choice and control of their lives and staff helped them in the least restrictive way possible.

The registered manager and deputy manager continued to provide good leadership and led by example. The service had an open and transparent culture. People felt comfortable raising any issues they might have about the home with staff. The service had arrangements in place to deal with people’s concerns and complaints appropriately. The provider also routinely gathered feedback from people living in the home, their relatives and staff. This feedback alongside the provider’s own audits and quality checks was used to continually assess, monitor and improve the quality of the service they provided.

Further information is in the detailed findings below.