Merchant House

At our last inspection we rated this key question Requires Improvement. At this inspection the rating has changed to Good. This meant the service was consistently managed and well-led. Leaders and the culture they created promoted high-quality, person-centred care.

Promoting a positive culture that is person-centred, open, inclusive and empowering, which achieves good outcomes for people ● People, their relatives and staff expressed confidence in the management team. Comments included, "Yes, it's well managed. I know (name) the registered manager and (name) the deputy.", "It's well organised" and "It's friendly has a happy atmosphere like a big family". ● Staff told us, and we observed morale was high. Staff told us the management team were approachable and supportive. One staff member told us,"(Registered Manager) is absolutely brilliant, I can go to him with anything, he is approachable. He's the best boss I've ever had". ● The registered manager and staff team promoted a person-centred culture to ensure people received personalised care and support. People told us they were happy living at Merchant House, and we saw they were relaxed and happy with staff.

How the provider understands and acts on the duty of candour, which is their legal responsibility to be open and honest with people when something goes wrong ● The CQC sets out specific requirements that providers must follow when things go wrong with care and treatment. This includes informing people and their relatives about the incident, providing reasonable support, providing truthful information and an apology when things go wrong. The provider understood their responsibilities.

Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirements, Continuous learning and improving care ● The registered manager and staff understood their roles and responsibilities and strived to ensure care was delivered in the way people needed and wanted it. ● There were effective communication systems in place along with clear lines of responsibility and accountability across the staff team. ● The service had governance arrangements in place. Both the registered manager and provider recognised the importance of systems being effective to strengthen the quality of the service that people received. ● Regular audits were carried out by the registered manager and the provider. These included audits of care plans, medication and the day to day running of the service. Findings from audits were analysed and actions were taken to drive continuous improvement.

Engaging and involving people using the service, the public and staff, fully considering their equality characteristics ● From our observations and speaking with staff, the provider demonstrated a commitment to providing consideration to people's protected characteristics. ● There was a positive open culture at the service that valued people as individuals and looked for ways to continually improve people's experience. ● Staff told us that they were involved in the development of the service, through discussions at individual supervisions and staff meetings.

Working in partnership with others ● The service worked in partnership and collaboration with a number of key organisations to support care provision, joined-up care and ensure service development. ● Records showed the provider worked closely and in partnership with multidisciplinary teams to support safe care provision. Advice was sought, and referrals were made in a timely manner which ensured there was continuity of care.

The five questions we ask about services and what we found