The comprehensive inspection took place on 1 and 5 November 2018. It was unannounced on the first day and was announced on the second day. The inspection was completed by one adult social care inspector.

Murreyfield Care Centre 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 service can accommodate a maximum of 23 people. At the time of the inspection 16 people were using the service. The property consists of two large houses that have been converted into a care home and has bedrooms and bathroom facilities located across three floors.

Murreyfield Care Centre has been operating for a number of years and had previously been registered with CQC under a different provider. Changes to the ownership of the service mean the service was reregistered with CQC in November 2017 and therefore this was the first inspection of the service under the new providers ownership.

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 the time of the inspection, a manager was in place, however, they had not yet completed an application to register. 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 had been without a registered manager since March 2018.

Staff administered people’s medicines safely and they were stored securely. Audits identified recording errors, but had not found issues with the timing of administering controlled drugs, or the lack of protocols for some when required medicines. The provider had addressed recording issues though we found these continued.

Areas of the service were not always clean or in a good state of repair. The layout of the premises meant people who used the service were often disturbed when watching television. Audits had not identified environmental issues, so issues had not been addressed. You can see what action we have told the provider to take at the back of the full version of the report.

Staff had completed training and further training was booked. However, the provider had not assured themselves that best practice was imbedded and staff had the required skills and knowledge to meet people’s needs, as there was a lack of supervisions and appraisals.

People felt safe and trusted the staff. People were protected from avoidable harm and abuse by staff who were able to identify and report concerns to relevant professionals. Risks to people’s safety and wellbeing were appropriately managed. Recruitment processes helped ensure only suitable people were employed and arrangements were in place to promote continuity of care for people whilst staff were recruited.

People’s health and dietary needs were met and the provider had reviewed meal times and menus; offering people more choice. Staff were kept informed of people’s changing needs by appropriate communication methods.

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 supported to maintain relationships with relatives and friends and had built meaningful relationships with staff. Each person was respected as an individual and their privacy and dignity was maintained and independence was promoted by staff.

Staff were