Merryfields is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. This service does not provide nursing care. Merryfields accommodates up to 20 older people in one adapted building. There were 18 people living in the service when we inspected on 12 March 2018. This was an unannounced comprehensive inspection.

At our last inspection of 21 March 2016, the service was rated Good. At this inspection, we found the evidence continued to support the rating of Good. There was no information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

There was a registered manager in post. 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.

The service continued to provide a safe service to people. This included systems designed to protect people from abuse and avoidable harm. Staff were available when people needed assistance. The recruitment of staff was done safely. The service was clean and hygienic. People received their medicines safely.

The service continued to provide an effective service to people. People were cared for by staff who were trained and supported to meet their needs. 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 received care and support to maintain a healthy diet and good health. People were supported to access health professionals where needed. The environment was suitable for the people living there.

The service continued to provide a caring service to people. People had good relationships with the staff. Staff interacted with people in a caring manner. People were consulted about the care and support that they received.

The service continued to provide a responsive service to people. People received care and support which was assessed, planned and delivered to meet their individual needs. People were supported to participate in meaningful activities that interested them. A complaints procedure was in place. There were systems in place to support people at the end of their life.

The service continued to provide a well-led service to people. The service had a quality assurance system to monitor and assess the service provided to people. These systems assisted the registered manager and provide to identify and address shortfalls promptly. As a result, the quality of the service continued to improve.

Further information is in the detailed findings below.

Merryfields provides accommodation and personal care for up to 20 older people, some living with dementia. There were 18 people in the service when we inspected on 21 March 2016. This was an unannounced inspection.

There was a registered manager in post. 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 received care that was personalised to them and met their needs and wishes. Staff listened to people and acted on what they said. The atmosphere in the service was vibrant and welcoming.

Feedback from people and relatives about the staff and management team was positive.

Procedures were in place which safeguarded the people who used the service from the potential risk of abuse. Staff understood the various types of abuse and knew who to report any concerns to.

Staff knew how to minimise risks and provide people with safe care. Procedures and processes guided staff on how to ensure the safety of the people who used the service.

People were provided with their medicines when they needed them and in a safe manner.

There were sufficient numbers of staff to meet people’s needs. Recruitment processes checked the suitability of staff to work in the service. People were treated with kindness by the staff. Staff respected people’s privacy and dignity and interacted with people in a caring and compassionate manner.

Staff were trained and supported to meet the needs of the people who used the service. The service was up to date with the Deprivation of Liberty Safeguards (DoLS). People’s nutritional needs were assessed and met. People were supported to see, when needed, health and social care professionals to make sure they received appropriate care and treatment.

People were provided with personalised care and support which was planned to meet their individual needs. People, or their representatives, were involved in making decisions about their care and support.

A complaints procedure was in place. People’s comments, concerns and complaints were listened to and addressed in a timely manner.

There was an open and transparent culture in the service. Staff were aware of the values of the service and understood their roles and responsibilities in providing safe and good quality care to the people who used the service. The service had a quality assurance system where shortfalls could be identified and addressed promptly. As a result the quality of the service continued to improve.

Prior to our visit we reviewed all the information we had received from the provider. During the inspection we spoke with people who used the service and one relative and asked them for their views. We also spoke with three care workers, one assistant manager, the deputy manager and the acting manager. The acting manager had applied to become the registered manager with the Care Quality Commission (CQC). A registered manager is a person who has registered with the Care Quality Commission to manage the service and shares the legal responsibility for meeting the requirements of the law with the provider.

We looked at some of the records held in the service including the care files for 10 of the 20 people who used the service. We observed the care and support people who used the service received from staff and carried out a tour of the building.

The summary below describes what people using the service, a relative and the staff told us, what we observed and the records we looked at.

If you want to see the evidence that supports our summary please read the full report.

Is the service safe?

We found people's needs had been assessed and individual care plans drawn up to meet people's needs. These assessments and plans included consideration of risks to the person and how these could be managed to keep the person safe.

The provider had arrangements in place to deal with foreseeable emergencies. We were told by staff members we spoke with that they were able to contact a manager when they needed to.

We found that people were protected from the risk of abuse because the provider had ensured that safeguarding policies and procedures were in place and available to staff. Staff had been trained in safeguarding and knew what to do in the event of abuse being suspected, witnessed or alleged.

People we spoke with told us there were enough staff to meet their needs. We found there were enough staff on duty to meet the needs of the people living at the home.

CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. While no applications have needed to be submitted, proper policies and procedures were in place. Relevant staff had been trained to understand when an application should be made, and how to submit one.

Is the service effective?

People told us they were happy with the care they received and felt their needs had been met. It was clear from what we saw and from speaking with staff that they understood people's care and support needs and that they knew them well.

We saw people being cared for and supported in accordance with their plans. Staff had received training to meet the needs of the people living at the home. A relative we spoke with told us, “Staff work closely with health professionals”.

We found the provider assessed people's capacity to make choices and decisions and ensured peoples' best interests were taken into account.

Is the service caring?

We found people were supported by kind and attentive staff. We saw staff talking with people with kindness and in a respectful manner. We observed staff supporting people to move about the home in accordance with their needs showing patience and consideration.

Staff we spoke with were knowledgeable about the individual needs of people. Staff told us they felt it was important for people to be cared for with kindness. One staff member said, “I think this is a good home, we try to give residents the best care possible”.

People we spoke with told us, "The staff are nice" and, "Staff are very helpful, in the main”. A relative told us they were happy with the way their relative was cared for and supported.

Is the service responsive?

We found people's needs had been assessed before they moved into the home. We found that each person's needs were regularly reviewed with care plans updated if needed. Records showed that people were supported in line with these plans.

People had access to activities that were important to them and had been supported to maintain relationships with their friends and relatives.

Is the service well-led?

We found that quality assurance processes were in place. People's views had been obtained by the provider along with the views of relatives and staff. The provider made changes to improve the service people received as a result of people's views.

We found that staff received training and the provider was able to produce evidence that most of the staff held vocational qualifications relevant to their role.

Staff told us they were clear about their roles and responsibilities. Staff told us they found the manager of the home to be approachable and supportive.

The manager told us the home had achieved the Gold Standard Framework for end of life care. Staff members we spoke with told us they felt working towards this award had helped them improve the quality of care and support provided to people.

People who used the service told us that they were well cared for and enjoyed living in the service. They told us that the staff were kind and helped them with their daily activities of living. One person told us, "I am very settled here." Another person told us, "We go out a lot, I enjoyed the trip to the Camel Sanctuary."

Care plans were up to date and regularly reviewed to ensure that people were given the treatment and care they needed. Risk assessments were made on relevant areas to protect the safety and welfare of people. Staff recruitment and retention policies and practices were in place and records were well maintained. Training was comprehensive; and met the needs of the service and the staff.

The provider used a comprehensive system of audits to ensure that standards were maintained. Regular surveys of people who used the service helped to identify areas for improvement, most survey respondents were full of praise for the service.

We spoke with four people who used the service. They told us they liked living in Merryfields, were happy with their care and the staff treated them well.

People told us they enjoyed the food on offer in the service. One person told us, “There is nice selection. It’s fresh and home cooked.” Another person said, “They (staff) ask you what you want and are happy to make something else if you don’t fancy what is on offer.”

People told us they liked the activities on offer and said there was plenty to do. One person said, “We have plenty to do here or you can choose to stay in your room if you prefer your own company. I do that sometimes when I want to rest.”

People were complementary about the staff and manager. They told us their needs were met and they were well looked after. One person said, “Everyone is here is very kind and caring.”

People said that staff respected their privacy and dignity and helped them to remain as independent as possible. One person said, “They (staff) are very discreet and don’t rush me, I get there eventually ...its just takes time.”

We spoke with five people who lived in the home and they told us they were involved in decisions, their views were listened to and they were treated with dignity and respect. One person said “I can say what I want and they (staff) listen to me”. Another person told us “I was involved in my care plan making sure they know what I like and don’t like”. In relation to privacy one person told us the “staff always knock on peoples’ doors and call out before entering”.

People who used the service told us there was a range of social activities available, they explained that they could choose whether or not to join in or pursue individual interests if they preferred. One person told us “I am happy with my decision to move in here, I can be as independent as much as I want or join the others if I want company”.

People told us they experienced good care and their healthcare needs were met. One person said “staff are very attentive and supportive and take good care of me”.

We received positive comments about the food and drinks in the home. One person who used the service said “I can’t complain about the food, you get plenty of choice – you can have what you want when you want”. They also told us “staff are always coming in checking if you want a drink or something to eat”. Another person said “I like the food here, there is always plenty of choice and they (staff) know what I like and what I don’t like to eat”.

People who used the service told us there was enough staff to support them with their needs. One person said “I get on very well with the staff they are all caring and kind hearted”. Another person said about the manager “they are very friendly, always willing to help and take on board any ideas you have”.

Everyone we spoke with told us they felt safe and secure living at Merryfields with their care workers.