Merlin's Barrow

Updated 9 March 2022

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

As part of CQC’s response to the COVID-19 pandemic we are looking at how services manage infection control and visiting arrangements. This was a targeted inspection looking at the infection prevention and control measures the provider had in place. We also asked the provider about any staffing pressures the service was experiencing and whether this was having an impact on the service.

This inspection took place on 24 February 2022 and was announced. We gave the service 24 hours’ notice of the inspection.

Updated 9 March 2022

We undertook this unannounced inspection on 25 June 2018. The last inspection of the service was carried out on 15 January 2016. At that time the service was rated as good.

Merlin’s Barrow is a 'care home'. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The home is part of Innovations Wiltshire Limited and is located in the town of Marlborough. It is registered to provide personal care for up to four people with a learning disability. The home is a detached house situated in a residential area. At the time of the inspection four people were living at the service.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

At our last inspection we rated the service good in all five domains of safe, effective, caring, responsive and well-led. At this inspection we continued to rate the service as good overall. However, the service’s rating for one key question, ‘Is the service safe?’ had deteriorated from good to requires improvement. This is because following a fire safety inspection during November 2017 the provider had received a recommendation that all staff should be trained in the use of fire extinguishers. When we asked for evidence of this, the provider was unable to demonstrate this had taken place. Instead, we were sent confirmation that training had been arranged for July 2018. We asked one member of staff if they knew how to use the extinguishers and they said, “I’ve had fire training, but I’ve never had actual extinguisher training. I know you pull the pin out, but that’s all.” This meant that for a seven month period staff were not trained to use fire extinguishers.

Some areas of the stair carpet were worn and there was a risk these could be a trip hazard. Also, there were worn areas in people’s bedroom carpets caused by fire door safety mechanisms. These issues had been highlighted in the provider’s audits as far back as September 2017. The house manager said the carpets were due to be replaced when people went on holiday, but no holiday dates had been set which meant there was no set date for when this would be completed.

Staff knew how to keep people safe. Risk assessments were in place and care plans contained clear guidance on how to keep people safe whilst maximising their independence.

Medicines were managed safely. People received their medicines as prescribed. Medicines were stored safely.

Incidents and accidents had been reported.

With the exception of extinguisher training, staff were trained to carry out their roles and had regular supervisions with a line manager.

People’s nutritional needs were met and people were involved in meal planning and preparation.

People were supported to access ongoing health care. Examples included doctor, dentist and optician appointments. The service worked closely with the community learning disabilities team.

Consent to care was sought in line with legislation and guidance. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

We saw and heard many positive interactions between people using the service and staff. People told us the staff were “very kind” and “nice.”

Care plans were person centred and people were actively involved in their plans. People and their families were asked for feedback about the service.

There was a complaints procedure in place. This, and other written information provided to people was in an easy read format to aid understanding.

There was a positive open culture at the service. People and relatives spoke highly of the management team. Staff said they felt well supported.