This unannounced inspection took place on 12 and 13 April 2018. At our previous inspection in February 2016 we had no concerns in the quality of care and had rated the service as good. At this inspection we found that the service was still good. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection

Merrington Grange 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. Merrington Grange is registered to provide accommodation and personal care for up to nine people who have learning disabilities. At the time of our inspection eight people were living there.

Merrington Grange 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.

A manager was in post and was resent throughout this inspection. They had recently been appointed by the provider and had yet to register with the Care Quality Commission (CQC). A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People continued to remain safe as staff knew how to recognise and respond to concerns of ill-treatment and abuse. There were enough staff to support people to meet their needs. Staff members followed safe infection prevention and control practices. The provider followed safe recruitment procedures when employing new staff members. The provider learnt from incidents and accidents and worked with people and families to minimise the risk of reoccurrence if things had gone wrong.

People were safely supported with their medicines by competent staff members. People received care and support from staff members who had received training and support to effectively assist them. New staff members received an introduction to their role and were equipped with the skills they needed to work with people.

People continued to receive care that was effective and personalised to their individual needs and preferences. 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. People were able to access areas of their own home and garden.

People received support that continued to be caring and respectful. People were supported by a staff team that was compassionate, thoughtful and kind. People’s privacy and dignity was respected by those providing assistance. People were supported at times of upset and distress.

People, and when needed family or advocates, continued to be involved in developing their own care and support plans. When changes occurred in people’s personal and medical circumstances, these plans were reviewed to reflect these changes. The management team had procedures in place to address people’s care as they approached end of life. People’s individual preferences were known by staff members who supported them as they wished. People and their relatives were encouraged to raise any concerns or complaints. The provider had systems in place to address any issues raised with them.

Merrington Grange continued to be well-led by a management team that people and staff found approachable and supportive. People were involved in decisions about their care and support and their suggestions were valued by the provider. Staff members believed

This inspection was unannounced and took place on 3 February 2016.

Merrington Grange provides accommodation and personal care for up to 10 people who have a learning disability. On the day of our inspection nine people were living there.

The home had a registered manager who was present for the inspection. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons.’ Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People felt safe living in the home and the provider had a written policy in place to ensure staff knew how to protect people from the risk of potential harm. Staff had access to risk assessments that told them how to care and support people safely and there were enough staff on duty to meet people’s needs. People’s prescribed medicines were managed by staff and people received them when needed.

Staff had access to regular training to ensure they had the skills and competence to care for people and they received regular supervision from the manager. People’s human rights were protected because staff were aware of the principles of the Mental Capacity Act and the Deprivation of Liberty Safeguard. People were provided with meals of their choice and staff were aware of their dietary needs. When required people were supported by staff to access healthcare services to promote their health.

Staff were aware of people’s care and support needs and this was provided in a sympathetic and caring manner. People’s privacy and dignity were respected. People were involved in planning their care and care records were available in a format they could understand.

People were encouraged and supported to be involved in their assessment and to live a lifestyle of their choice. Complaints were listened to, taken seriously and acted on to improve the service.

People were involved in running the home and were supported to maintain contact with their local community. There was a structured management team in place and people and staff were aware of who the manager was. The provider had quality assurance audits in place to monitor the quality of service provided.

In this report the name of a registered manager appears who was not in post at the time of the inspection. Their name appears because they were still a Registered Manager on our register at the time.

Although we met six people in the home, most were not able to express their views about the service they received in any detail. However, one person told us that the staff were, "Brilliant".

Everyone we met appeared happy in the home. People were comfortable with the staff and their surroundings.

Staff met people's care and support needs in ways that they preferred and we saw that detailed records gave staff the information they needed to do this. Plans were in place to support people to enjoy their lives and staff were aware of risks, people's rights and their responsibilities.

We saw that the home’s policies had been reproduced in an easy to read format to help people understand and be involved in how the home was run.

We found that care plans were person centred. People and their relatives had been involved in developing their care plans. The plans were regularly reviewed.

We found that appropriate checks were properly carried out on staff before they were allowed to start work, although records were kept at the company’s head office rather than in the home.

The provider had a suitable complaints procedure in place. It had been made available to people’s relatives and representatives and was also available in an easy to read format.

We visited Merrington Grange on 19 April 2012.

This home consisted of four distinct areas with each one being run and staffed separately from the others although the senior member of staff on duty is responsible for the whole home.

We saw that some of the people who lived there could not communicate with us verbally. Those that could often gave us single word answers. Some were able to say two or three words together when talking to us.

When we were not talking with the people who lived in the home we sat with them and observed how they reacted to the staff and other people who lived there.

All of the people that we saw were relaxed and cheerful. They all seemed confident that the staff would be helpful if they approached them. They also appeared to be used to staff approaching them and asking them questions. The questions that the staff asked were about such things as whether or not someone would like a cup of tea or would they like to go out to an activity.

Two of the people that we talked with were able to confirm that staff had talked to them about what things that they liked to do during the day. They were also able to tell us that they liked the home, felt safe living there and would say if anyone was harming them.

We were also able to talk with the relatives of one of the people who lived in the home when they visited their family member. They said they were “Really pleased with the way …. has settled in”.