Merlin Court Care Home's new owners hit back at regulator's 'requires improvement' judgment - Avery Healthcare criticises CQC's criteria
Merlin Court care home at the top of Hyde Lane in Marlborough has been given an overall rating of 'Requires improvement' after an inspection by the Care Quality Commission (CQC).
But Merlin Court's owners, the Avery Healthcare Group have hit back at the CQC's new inspection regime and have pointed to the 'serious consequences' that the overall rating 'requires improvement' is having on public opinion.
Avery's statement complains that the CQC's new inspection 'methodology and criteria' are not in the public domain and that means 'the natural public response is to receive such an assessment as negative, and even damning against the home': "The impact this has on homes throughout the UK can be catastrophic..."
Avery's full statement can be found at the foot of this report.
The judgment on Merlin Court expressed as 'requires improvement' is the same for all five questions the CQC ask during their inspections of care homes: Is the service safe? Is it effective? Is it caring? Is it responsive? And is it well-led?
Merlin Court provides resident nursing and personal care for up to 62 older people. When the CQC made their unannounced inspection (July 22 & 23) there were 50 people at the home.
The ground floor is for people with dementia or those who for some other reason require personal care. Those needing nursing care are on the first floor. Since November 2014 the home has been run by the Avery Healthcare Group.
The CQC's inspection was prompted by a number of 'concerns' they had received about care at the home and about record keeping.
The report says: "Whilst most people and their relatives spoke positively about the care and support they received it was evident throughout the inspection there was a significant divide between the safety and quality of services provided on the first floor and the ground floor."
"We found that whilst care on the ground floor was centred on the person we did not always experience this on the first floor."
The CQC report on Merlin Court includes these judgments: "This service was not always safe": there were not always enough staff on the first floor. "The service was not always caring": people on the first floor 'were not always treated with dignity and respect'.
The report also includes some of the inspectors observations: "At 12.05pm on day two of our inspection, people on the first floor were still waiting to be assisted with their personal care and to be able to get up out of bed. A relative told us: 'I visited at 11.30am one day and (family member) was still in bed."
The shortage of staff on the first floor was the cause for another critical observation that people on the first floor often went for long periods without 'any interactions with staff': "For example, after lunch we saw that most people were sat in the lounge area. One person was constantly shouting out to other people to 'Shut up', which other people found upsetting, however no member of staff came into the lounge to offer people any support for the two hours we sat at the nurse's station."
Inspectors found six breaches of the Health and Social Care Act 2008's 2014 regulations - and have spelled out the actionsAvery Healthcare must take to put these right.
During the CQC inspection in 2013 the CQC found 'the provider satisfied the legal requirements in the areas that we looked at'.
The full report can be read here.
Merlin Court is a renowned quality care home in Marlborough, Wiltshire. The home achieved full compliance with CQC in May 2014 prior to the new regulations coming into force. It is clear that the new CQC methodology is causing much frustration with care providers across the UK, with some taking out injunctions to prevent the publication of those CQC inspection reports.
This is due to the serious consequences that the publication of reports with an overall rating of ‘requires improvement’ is having on public opinion. ‘Requires improvement’ generally applies to administrative improvements, and may not relate to any care risk for residents; however the methodology and criteria of these reports, subject to individual inspector assessment on the day, is not in the public domain.
Without the process being clearly articulated the natural public response is to receive such an assessment as negative, and even damming against the home. The impact this has on homes throughout the UK can be catastrophic, with happy residents being judged for residing in the home, for relatives feeling guilty and confused for potentially choosing the home, and on the morale of the hardworking staff.
Merlin Court has already worked on the recommended actions and Avery are confident that the home is a safe and comfortable place to live with caring and compassionate staff.
CQC statement (September 3) :
"It is surprising that the Avery Healthcare Group appears to think that CQC's new approach to inspections is in any way unclear.
We adopted a new system of inspections last year after a long and public process of consultation, which included the providers themselves. There are full details of how we work and what we are looking for on our website.
Our inspectors will use a standard set of key lines of enquiry that directly relate to the five key questions – are they safe, effective, caring, responsive and well-led? At the heart of what we do are the people using services, their families and carers – asking the questions that matter to them, listening to their views, taking action to protect them when that is necessary and providing them with clear, reliable information.
It is utterly wrong to suggest that the rating Requires Improvement implies that we require merely administrative improvements. In this case, we have specific concerns which must be addressed, for the benefit of the people living in Merlin Court. We have made this perfectly clear to the provider.
As the regulator for health and social care, we make no apology for doing our job, which is to protect people from inadequate care and to encourage care services to improve.
We want to make sure that people using services receive care that is safe, effective, high-quality and compassionate. We are all entitled to that and none of us, or our loved ones, would want to live in a poor care home."