Merlin Manor Care Centre

At the last inspectionin April 2022,weidentifiedbreaches of regulation in relation to fire safety, staffing and oversight of the service. At this inspectionimprovementshad beenmadeand theservicewas no longer in breach of regulations but improvements were needed to ensure these were fully embedded and sustained.

We completed this inspection as part of our routine programme, and because some concerns had been raised around how people were supported. The registered manager and clinical team demonstrated a strong caring culture. People, relatives and professionals consistently described staff as kind, compassionate and committed. People spoke positively about feeling safe, valued and supported, and we observed respectful interactions where staff took time to reassure people and respond to their preferences. These strengths contributed to people feeling comfortable and supported in their day-to-day lives.

Staff demonstrated strong clinical input and partnership working with health and social care professionals. They followed evidence-based guidance to support people’s health needs. People received appropriate support with nutrition and hydration, and professionals spoke positively about staff knowledge and how well they worked with visiting teams.

However, there were concerns about staffing which impacted the safety, responsiveness and overall quality of care. Feedback from all stakeholder groups, supported by rota analysis and inspection observations, showed staffing levels were often insufficient, particularly at night and on some units. This affected the timeliness of care, supervision, staff visibility and consistency of support. These pressures also impacted staff ability to complete care records and staff wellbeing.

Care planning, risk assessment and medicines management systems were in place but were not always effective in practice. Some records lacked clarity or up-to-date information, and medicines processes did not consistently ensure safe administration. Although management had identified a number of these issues and had taken some action, improvements were not yet fully embedded.

The regional management team had recently come into post and were still getting to know the service and staff. The registered manager was approachable and promoted a supportive culture, and they had a range of governance systems in place. But, the provider’s governance processes had not always resulted in timely or sustained improvement, particularly in relation to staffing, medicines and communication.

While people often experienced kind and compassionate care, risks remained due to staffing pressures, inconsistencies in care delivery and gaps in oversight.