We inspected this service on the 16 May 2018 and it was unannounced. At our last inspection in April 2017, we found four breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2015. We asked the provider to complete an action plan to show what they would do and by when to improve the key questions Safe, Effective, Responsive and Well-led to at least good. At this inspection, we found the service had made all of the required improvements.

Merrydale 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. Merrydale accommodates 15 people in one adapted building. At the time of our inspection there were 13 people living at the service.

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 had individual risk assessments with suitable safety measures in place to keep them safe. There were also comprehensive risk assessments for the environment which had been regularly reviewed.

Medicines were managed safely; we observed medicines administration and observed that staff practice was safe. The medicines administration records were completed in full with no unexplained gaps.

There were sufficient staff available to meet people’s needs. Staff understood their role in keeping people safe and had received training on safeguarding people from harm. The registered manager had carried out the required pre-employment checks before staff started work.

Staff were well trained and had opportunity for regular supervision. They told us they felt well supported and could approach the registered manager at any time. New members of staff had an induction period where they could learn about the job role. There was a clear staff structure and everyone was aware of their responsibilities.

People had sufficient food and drinks. Staff offered the required support to enable people to eat where appropriate. People were involved in planning the menus and always had choice of food and drink.

The premises were kept clean and well maintained. The staff followed effective infection prevention and control practices. The service was a small home that felt very homely.

People were supported by a staff team that knew their needs well. We observed kind and compassionate interactions that demonstrated mutual respect. 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.

Care plans were comprehensive and regularly reviewed. There was a ‘co-worker’ system in place, which meant people were allocated a member of staff to work more closely with. ‘Co-workers’ reviewed care plans and wrote their own monthly reports on people’s needs.

People had been given the opportunity to record their end of life wishes. The service had supported people at the end of their lives with assistance from healthcare professionals.

Activities were varied and provided daily. People had the option to be involved but could also choose to spend time doing their own activity. Visitors were welcomed without restriction.

There were regular meetings for people, relatives and staff and minutes were kept. Surveys were completed so that feedback about the service could be sought. All feedback we saw was positive. People, relatives and healthcare professionals all stated they thought the service was caring, responsive and well-led.

There was a complaints policy in place and an easy read copy was availa

This inspection took place on 4 April 2017 and was unannounced. Merrydale provides accommodation and personal care for up to 16 people, who do not require nursing care. There were 14 people living at the home when we visited.

The home had a registered manager. 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 registered manager was aware of legislation designed to protect people’s rights and freedoms; however, assessments of people’s ability to make some decisions which had been made on their behalf had not been formally assessed or recorded. Applications to the local authority for approval of restrictions on some people’s liberty had not been made where required.

Risk assessments and care plans were not up to date and lacked individual detail as to how people should be cared for. This placed them at risk of not having all their needs met in a consistent and safe way. Although staff had received training they were not always following safe procedures when they assisted people to reposition; nor did they follow care plan instructions as to how a person should be supported with drinks. We discussed these areas with the registered manager who told us they were taking immediate action to address the areas of concern.

Providers are required by law to notify CQC of significant events that occur in registered services. We identified safeguarding incidents and a fall following which a person required hospital treatment which had not been reported to us. Where incidents between people, or falls resulting in an injury, had occurred the registered manager told us they had not provided a written explanation of the event to the person or their relatives although they had spoken with them about the incident.

People received the personal care they required and were supported to access other healthcare services when needed. People received a varied diet and were supported appropriately to eat. The home’s environment was homely, clean and safe for people.

People were protected from the risk of abuse and staff knew how to identify, prevent and report abuse. Staff understood how to keep people safe in an emergency.

People were cared for with kindness and compassion. Staff knew people well, interacted positively and supported them to maintain friendships. People and their relatives were positive about the way staff treated them. People were treated with respect and given choice; their dignity and independence were promoted. People received mental and physical stimulation in the form of organised and ad hoc activities.

There were enough staff to meet people's needs. The recruitment process helped ensure staff were suitable for their role. Staff received appropriate training and were supported in their work. Staff worked well together, which created a relaxed and happy atmosphere that was reflected in people's care.

There was a complaints policy in place and people knew how to raise concerns. Where issues had been raised the provider had acted to the satisfaction of the person raising the concern.

We found four breaches of the Health and Social Care Act 2008 (Regulated activities) Regulations 2014 and one breach of the Care Quality Commission (Registration) Regulations 2009. You can see what action we told the provider to take at the back of the full version of this report.