Mercers

Updated 26 February 2019

The inspection

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.

Inspection team: Two inspectors conducted the inspection.

Service and service type:

Mercers is a care home that can accommodate up to seven people who have complex needs including mental health, learning disability and needs related to the Autistic Spectrum. At the time of inspection there were six people living at the service, five people lived in the main building and one person in a separate building across the road. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager registered with the Care Quality Commission. 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.

Notice of inspection:

This inspection was unannounced and took place on 28 November 2018.

What we did:

Before the inspection, we reviewed information we had received about the service since the last inspection. This included details about incidents the provider must let us know about and we sought feedback from the local authority and other professionals involved with the service. We assessed the information that providers send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. We used all this information to plan our inspection.

During our inspection visit, we spoke with 2 people using the service and 5 staff including the provider, registered manager, senior care staff and care staff. We observed the support provided to people. We looked at records in relation to people who use the service including three care plans and five medication records. We looked at records relating to recruitment, training and systems for monitoring quality and safety.

Updated 26 February 2019

About the service: Mercers 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 care home provides care and support to people who have complex needs including mental health, learning disability and needs related to the Autistic Spectrum.

The service had 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. ‘Registering the Right Support’ CQC policy.

People’s experience of using this service:

Staff had a good knowledge of how to keep people safe from avoidable harm and risk assessments were in place for staff to follow.

People were supported to take their medicines in a safe way.

Staff were recruited safely and appropriate checks were carried out before they started work at the service.

Training for staff had not always completed and not all staff had undertaken the Care Certificate where required to ensure they had the skills knowledge and experience to deliver effective care and support to people using the service.

Staff had a good understanding of key pieces of legislation and when they should be applied including the Mental Capacity Act 2005.

Where lessons were learned, feedback was provided to staff to ensure continuous improvement took place throughout the service.

Quality assurance processes did not always effectively identify issues in the service to ensure sufficient oversight of the service. Although audits were undertaken further work was needed to ensure themes and trends were identified and managed. The inspection found improvements had been made but the provider and registered manager need to ensure improvements are sustained and continue to drive improvements forward.

People received care and support based on their individual assessment, needs and preferences.

People were supported by staff who understood the need to ensure person centred care and to respect and listen to people. The registered manager ensured consistency in staffing to enable positive relationships between staff and people.

People were well cared for by staff who treated them with respect and dignity.

Systems were in place for people to raise complaints and concerns.

Staff liaised with other health care professionals to ensure people's safety and meet their health needs.

Staff spoke positively about working for the provider. They felt well supported and could talk to management at any time, feeling confident any concerns would be acted on promptly. More information is in the full report

Rating at last inspection: Inadequate (report published 30 June 2018)

Why we inspected: This was a planned inspection based on the rating at the last inspection. We found improvements had been made since our last inspection.

Follow up:

We previously inspected Mercers on 12 March 2018 where the service was rated ‘Inadequate’ and placed in special measures. This was because there were significant shortfalls in the way the service was led. People's safety and welfare was compromised where the provider did not have robust and effective quality monitoring and assurance processes in place to identify potential risks to people. Risk assessments had not been carried out thoroughly particularly in relation to individual's choking and to risks within the physical environment. Necessary maintenance work and health and safety precautions had not been taken within the home to protect people from risk of harm. The cleanliness of the service had been neglected and improvements were required regarding infection prevention. People were not supported to have maximum choice and control of their live. Risks had not been assessed to ensure that the least restrictive option had been considered and ensure people's freedom was respected. There had been a lack of oversight of the service by the provider and the registered manager to ensure the service delivered was of a good quality, was safe and strived to continuously improve.

This service has been in Special Measures. Services that are in Special Measures are kept under review and inspected again within six months. We expect services to make significant improvements within this timeframe. During this inspection the service demonstrated to us that improvements have been made and is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is now out of Special Measures.

We will continue to monitor all intelligence received about the service to ensure the next planned inspection is scheduled accordingly.