Merrington Grange

Updated 10 November 2022

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 undertaken by one inspector.

Service and service type

Merrington Grange 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. Merrington Grange 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 service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

Inspection activity started on 15 September 2022 and ended on 23 September 2022. We visited the location’s service on 15 and 16 September 2022.

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 who commission care to 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

We spoke with two people living at the home and four relatives. We also spoke with the regional manager, registered manager, deputy manager and four staff members

We looked at four people’s care records and reviewed three people’s medicine administration records (MARs). We viewed three staff files and recruitment documentation stored electronically. We also viewed training records and audit documentation. We asked the registered manager to send us further evidence regarding building maintenance action plans.

Updated 10 November 2022

About the service

Merrington Grange is a residential care home providing personal care to up to 10 people across three separate buildings. Each building has its own communal areas and kitchen facilities. The service provides support to autistic people and people living with learning disabilities. At the time of our inspection, there were eight people using the service.

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

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

Right Support:

People were supported in an environment where maintenance was required to reduce the risk of spread of infection and make it more appealing for them. People’s pictures had been put up in the home to personalise it and make the environment more stimulating. People were supported to reach their goals and support was focused on their strengths. Staff supported people to access the local community and engage in activities of their choice. Staff communicated with people in a way that met their needs.

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.

Right Care:

People were not always supported by a sufficient number of staff to meet their assessed needs.

People were supported by staff who were kind and caring to them. People’s privacy and dignity was respected by staff. People were supported by staff who had undergone safeguarding training and understood how to keep them safe. People’s care plans reflected their needs and promoted their wellbeing. Risks to people were managed safely and staff enabled people to take positive risks.

Right Culture:

People were supported by a high number of agency staff. The provider tried to keep consistency but sometimes this meant staff turnover was high. People and those important to them were involved in planning and reviewing their care. People were supported by a management team and staff that were focused on achieving their goals and empowering them. Staff placed people’s wishes at the centre of what they did.

Governance systems in place did not always ensure that appropriate checks were in place to check the quality of the service, for example cleaning schedules and daily records.

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

Rating at last inspection

This service was registered with us on 27 July 2020 and this is the first inspection.

The last rating for the service under the previous provider was good, published on 2 June 2018.

Why we inspected

The inspection was prompted in part due to concerns received about staffing levels and governance at the home. A decision was made for us to inspect and examine those risks.

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.

We have found evidence that the provider needs to make improvements. Please see the Safe and Well Led sections of this full report.

Enforcement

We have identified a breach in relation to the governance of the home at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.