Inspection on 17/06/08 for Merry Hill House

This is the latest available inspection report for this service, carried out on 17th June 2008.

CSCI found this care home to be providing an Good service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Merry Hill House 15/02/07

Merry Hill House 08/06/06

Merry Hill House 15/09/05

Merry Hill House 06/06/05

Merry Hill House 19/10/04

Merry Hill House 10/06/04

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Westmead

Extracts from inspection reports are licensed from CQC, this page was updated on 28/09/2008.

CARE HOMES FOR OLDER PEOPLE Merry Hill House Langley Road Merry Hill Wolverhampton West Midlands WV4 4YT Lead Inspector Bhag Jassal Key Unannounced Inspection 17th June 2008 09:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Merry Hill House DS0000036001.V366275.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Merry Hill House DS0000036001.V366275.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Merry Hill House Address Langley Road Merry Hill Wolverhampton West Midlands WV4 4YT 01902-553397 01902 553397 john.lem@wolverhampton.gov.uk www.wolverhampton.gov.uk Wolverhampton City Council Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mr John Lem Care Home 35 Category(ies) of Old age, not falling within any other category registration, with number (35) of places Merry Hill House DS0000036001.V366275.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 50 years and above Date of last inspection 11th June 2007 Brief Description of the Service: Merry Hill House opened in 1983. It is one of four residential care homes for older people managed directly by Wolverhampton City Council Social Services Department. Merry Hill House is a purpose built, single-storey establishment, registered to provide care to 35 people over the age of 50 years. The building is divided into five separate units and there is a combined sitting/dining room with a small kitchenette facility in each unit and a conservatory provides an additional area for people to relax. All bedrooms are single rooms and have the facility of a wash hand basin, with bathrooms and toilets located nearby. A central area houses an office, kitchen and staff facilities. The Home has equipment such as wheelchairs and hoists to assist people with all aspects of daily living. There is adequate car parking space at the rear of the premises and also garden areas at the rear of the premises, which are accessible for people who use the service. Merry Hill House makes its services known to prospective service users in the Statement of Purpose and Service Users’ Guide. The Inspection Report is mentioned in the statement of purpose and a copy can be obtained from the home upon request. The home is located off a main road on the southwest side of the city in close proximity to shops, a public house and the bus route into the City Centre. All people living at the home are funded by the local authority-the home is not aware of individual fees. Merry Hill House DS0000036001.V366275.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 Star. This means the people who use the service experience good quality outcomes. This report is on a Key Inspection, part of which included an unannounced visit undertaken on 17th June 2008. This unannounced visit started at 09:00 am and lasted 8 hours and 20 minutes. The home had 35 places occupied and two of these service users were recently admitted to hospital. The judgements made within this report are based upon information supplied by the home. This information included the Annual Quality Assurance Assessment (AQAA) completed by the Registered Manager, which supplemented the inspection process, and also from interviews with the Registered Manager, staff and people who use the service. In addition, comments and views were received through surveys from two people using the service and four relatives/friends of people living at Merry Hill House. The content of these surveys is reflected within the relevant outcome groups in the report. During the course of inspection the assessment information and care plans were inspected for 5 people who use the service. Medication administration was checked. Staff records were seen to check staff rotas, recruitment procedures and training. Various documents were seen in order to check compliance with health and safety legislation. A tour of premises was also undertaken and observations of care practices and interaction between staff and people who use the service was completed. Discussions took place with several members of staff on duty, and several people using the service were spoken to throughout the day of inspection. The Registered Manager, Mr John Lem, was present throughout the inspection from 11:30 onwards. Mrs Joan Berg – Acting Assistant Manager was also present throughout the inspection until 15:45. The Standards Development Officer – Ms Auriol Hayes was also present at the conclusion of the inspection. All the information received from the care home was considered and discussed with the Registered Manager. The Inspector wishes to thank the Registered Manager, the staff, people using the service and their relatives for their assistance and co-operation on the day of inspection. Merry Hill House DS0000036001.V366275.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? The home has implemented all the three requirements made in the last key inspection report, but two recommendations still remain under consideration to be addressed appropriately. The home has an experienced Registered Manager in post and he is managing the care home well. Conversations with staff, and people using the service, indicated that the Registered Manager is service user focused, leads and supports an enhanced staff team providing them with improved training and supervision. This style and approach to management aims to pursue future improvements in all aspects of service. One person who lives at the home stated “This place is a lot more peaceful and better organised now”. The home has made some good improvements in their record keeping and care planning. Care Plans seen for people who use the service were informative Merry Hill House DS0000036001.V366275.R01.S.doc Version 5.2 Page 7 and gave some indication of how care is to be delivered for each of them. Medication practices have improved and more staff have received training in safe handling of medication. The home has organised staff training on the Mental Capacity Act 2005. A majority of staff have received training in safe working practice topics, adult protection/safeguarding issues and NVQ Level 2 in direct care that will enable them to expand their knowledge and skills and enhance the care they give to people living at Merry Hill House. The home has increased staffing levels and this has resulted in an improvement in activities and care staff being able to spend little more ‘quality time’ with people who use the service. It was noticeable that there have been many improvements made to the environment of the home. A rolling programme of refurbishment and redecoration of toilets areas has been implemented, and also communal areas and some bedrooms have been redecorated. What they could do better: The social and leisure activities enjoyed by the people who use the service should be consistently recorded, evaluated and incorporated into their individual care plans. Those members of staff who as yet have not received training in safe working practice topics, including Infection Control/COSHH, safe handling of medication, Dementia care, NVQ Level 2, Adult Protection and safeguarding issues must do so as a matter of priority. This training would enable staff to improve further their knowledge, skills and care practices. During the tour of the premises it was seen that the home still had not fitted magnetic closures to the lounge doors and still a number of door wedges were seen around the home. Therefore, the home is strongly recommended to undertake an audit of all areas accessible to people using the service and where it is identified that the current door opening mechanism reduces the service users’ access, then advice should be sought from the local Fire Safety Officer regarding a suitable door closure device. It was also seen that the gardens areas were in need of tidying up and overgrown grass and weed needs cutting down. The trees and bushes were also in need of pruning/cutting down in order to improve the natural light in the bedrooms and communal areas and view of garden areas and their safe use by people living at Merry Hill House. Merry Hill House DS0000036001.V366275.R01.S.doc Version 5.2 Page 8 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Merry Hill House DS0000036001.V366275.R01.S.doc Version 5.2 Page 9 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Merry Hill House DS0000036001.V366275.R01.S.doc Version 5.2 Page 10 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3. Standard 6 is not applicable to this home. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Everyone receives a full assessment prior to admission to the home to make sure that their needs can be met. EVIDENCE: Merry Hill House provides detailed and clear information, in the form of a Service Users’ Guide, to people who will be using the service and their families to enable them to make decisions about whether or not to live at the home. Admissions are not made to the care home until a full assessment of need has been undertaken by the person’s social worker with the staff from the home obtaining additional information at the time of admission. The home is then able to confirm that they can meet the needs of the individual through the service they deliver as detailed in the Statement of Purpose. A discussion with two people using the service who had recently been admitted spoke to their satisfaction with the admission process. Merry Hill House DS0000036001.V366275.R01.S.doc Version 5.2 Page 11 Five files/care plans of people who use the service were inspected, which contained pre- admission assessments of their needs, both from assessments by the home’s senior staff and other relevant professionals, for example, Social Workers. Observations and discussions with people using the service, Registered Manager, and staff on duty indicated that the home continues to meet the needs of older people in a satisfactory and sensitive manner. It was noted from the staff training records that a majority of staff have undertaken their training in safe working practice topics, and adult protection and safeguarding issues. The home does not provide a service for those assessed and referred solely for intermediate care, who require help to maximise their independence and return home. Merry Hill House DS0000036001.V366275.R01.S.doc Version 5.2 Page 12 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ personal, healthcare and social needs are being met and staff are guided well by the home’s care plans. Medication is administered and stored in a manner that safeguards everyone using the service. People who use the service are treated with respect and dignity and their right to privacy is understood and upheld. EVIDENCE: People who use the service undergo an assessment of their needs prior to admission to the care home. A Care Plan is produced, which is based on the assessment of needs. The home operates a good key worker and link worker system, which means that each service user has designated staff that will ensure care plans are implemented and followed. These designated staff work with new service user (carers, relatives or representatives as appropriate) to develop care plans and carry out monthly and annual reviews to ensure that the plan continues to identify and meet needs and choices. This system also Merry Hill House DS0000036001.V366275.R01.S.doc Version 5.2 Page 13 helps to ensure that the recommendations arising from the care plan reviews are implemented. Five Care Plans of people using the service were examined in detail. There was evidence to show that the short-term goals and long-term goals, aims and objectives were clearly identified and appropriate interventions required to meet the individual needs of people who use the service were also identified. The care plans that were read were clearly written and included an element of risk assessment. Information from the initial assessments had been written into plans of care. The care plans are reviewed on a monthly basis by senior staff. Discussion with people who use the service showed that the home involves them in making decisions about all aspects of their life. People who use the service are supported to access health services both within the home and the community. Appointments are planned or arrangements are made for professionals to visit frail people using the service. Whenever possible continuity of care for the service users’ declining state of health is assured. District Nurses are called upon to assist with clinical help, equipment and advice where necessary. The Registered Manager promotes the key worker and link worker system so that relationships between staff and individuals are enhanced. The Registered Manager stated that the requirement made in the last inspection report regarding the use of bed rails in the home has been implemented. There are four service users who use bed rails and the appropriate risk assessments are in place and included in their care plans. The bed rails have been fitted to the appropriate height and width in accordance with the manufacturer’s and MHRA/HSE guidance. The bed rails are checked and maintained by the manufacturer and the designated staff in the home. Visitors are able to meet people using the service in their bedrooms and/or in the lounge area in each Unit. It was observed that people who use the service were being treated with respect and staff were working both professionally and sensitively in meeting individual needs. We spoke at length with several people using the service and all of them commented positively about their care and felt they have everything that they need. Comments from people who use the service included “The carers are very good and kind and they look after us very well” and “The carers are always there to help us”. Generally people who use the service appeared to be content and comfortable. They were complimentary regarding the quality of their lives and care they were receiving at Merry Hill House. The Registered Manager stated that a requirement made in the last key inspection report in regard to “medication including creams must be given as prescribed and all medication must be stored in accordance with Merry Hill House DS0000036001.V366275.R01.S.doc Version 5.2 Page 14 manufacturers’ instructions” has been appropriately implemented. There was evidence to show that this requirement has been fully implemented. There are appropriate policies and procedures in place for the administration of medication. It was noted that the care plans contained a list of current medication. The Registered Manager stated that reviews are carried out on a regular basis of all the care plans to ensure that medication details are up to date. Appropriate records are kept of all medicines ordered, received, administered and leaving the home. Random sample of medication and administration sheets were seen at the inspection and there were no discrepancies. All the medicines are stored in the locked medication room. Daily checks are taken of the temperature of the medicines in the refrigerator. There are controlled drugs used by two people using the service at the care home, which are stored securely and safely in a lockable metal cupboard in the medication room. Medication rounds were observed during the inspection. Senior staff were seen to administer and record when medicines had been given. The Registered Manager stated that all senior staff and carers responsible for administering medication were appropriately trained in safe handling of medication. All staff involved in the administration of medication are regularly monitored to ensure continued competence. A pre-packed monitored dosage system is used and the pharmacist visited every three months to audit arrangements in the home for the safe keeping of medication. Merry Hill House DS0000036001.V366275.R01.S.doc Version 5.2 Page 15 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service are able to exercise choice with regard to social and leisure activities at the home. Activities provided meet the needs of the people using the service. Relatives and friends are encouraged and assisted to maintain contact with the people using the service. The food at the home is of good quality and choices are always available. EVIDENCE: People using the service, who were able to give opinion, were very complimentary about the activities provided, and particularly the external entertainers. People who use the service are enabled to enjoy a full and stimulating life style with a variety of options to choose from. A record of activities participated in is kept via photographs of major events and displayed in the home. Recording of daily activities was inconsistent. Better recording will enable the service to evaluate and monitor participation and assist in future planning. Merry Hill House DS0000036001.V366275.R01.S.doc Version 5.2 Page 16 People using the service were seen sitting in the lounges chatting to staff and in other communal areas within the home. Three people who use the service stated that they preferred to sometimes sit quietly in their bedrooms and the staff respected this. After lunch time a number of people who use the service were engaged in playing different games. The Registered Manager stated that service users are encouraged to become involved in the daily running of the Unit i.e. choosing what’s included on the menu and what sort of activities should be available. Now the designated staff each day are responsible for implementing activities programme. The AQAA completed by the Registered Manager also states that “Our plans for improvement in the next 12 months are to develop the programme of activities to offer a wider range of different activities and events to provide appropriate stimulation and encourage interest; and also to look at community resources and activities as well as in-house”. Several people using the service spoken to stated that they were in regular contact with their family members and friends, and spoke about their visitors’ involvement and interest in their care matters. The visitors’ book kept in the home showed a considerable activity. People who use the service also keep contacts with the local community – for example, church services, pubs, shops and park. Five people who use the service told us that they are happy with the care and social activities offered by the care home. They further added “the home provides a good service and the staff are very caring and they are pleasant”. The home also provides a variety of indoor activities, including festive and birthday parties. The Registered Manager stated that the people who use the service were positively encouraged and helped to exercise their choices, and control over their lives and daily living, subject to risk assessments in terms of safety, security and capacity to make certain decisions. The Registered Manager also stated that a close liaison is maintained with the relatives and representatives, where the people using the service are not able to make certain decisions. The relatives of people using the service and their representatives are informed of the availability of Advocacy Service based at the local Age Concern. The information about the Advocacy Service is included in the home’s Statement of Purpose and Service Users’ Guide. Several people who use the service told us “The home is very good and its peace and quiet here”. “The food was very nice well cooked and tasty”. The consensus of people using the service was the range, quality and choice of food provided was very good and the home catered for those people using the service, who have individual preferences and medical needs. The Registered Manager stated that the menu is changed regularly in consultation with the people who use the service. This is usually done in Merry Hill House DS0000036001.V366275.R01.S.doc Version 5.2 Page 17 accordance with seasonal changes as well. The four weekly menus provide pictorial guidance for people who may experience difficulty communicating their preferences. Throughout the day staff were seen to provide prompt and sensitive assistance to people who needed help with their eating and drinking. The kitchen is well equipped and kept clean and tidy. The catering staff are appropriately trained in food safety and hygiene matters. Merry Hill House DS0000036001.V366275.R01.S.doc Version 5.2 Page 18 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is clear Complaints Procedure in place, a copy of which is made available to people who use the service and their relatives. This should ensure that any complaints made are listened to and acted upon. The home has an Adult Protection policy and procedure in place to protect people who use the service from all forms of abuse or harm. EVIDENCE: The home has a good Complaints Procedure in place, which is referred to in the home’s Service Users’ Guide and in the Statement of purpose. There is a system of recording concerns and complaints. The Commission for Social Care Inspection (CSCI) has not received any complaints about the care home. However, the Registered Manager stated that there was one adult protection/safeguarding referral made during the last 12 months. This matter was dealt with through Wolverhampton’s Adult Protection/Safeguarding Procedure. People told us that they know how to formally make a complaint but they said they would quite happily talk to one of the staff or the manager. The home has policies and procedures in place regarding restraint, dealing with aggressive behaviour and prevention of abuse, which includes whistle-blowing Merry Hill House DS0000036001.V366275.R01.S.doc Version 5.2 Page 19 policy. The Registered Manager stated that adult protection/safeguarding issues are discussed during induction training, supervision and staff meetings. The Registered Manager stated that a majority of staff have received formal training in protection of vulnerable adults and those who as yet have not received this mode of training will do so as a matter of priority. He also confirmed that staff receive training in adults protection and abuse awareness and that the home works within the framework of local area safeguarding adults procedure. Staff on duty spoke confidently about the importance they attach to safeguarding people from the risk of abuse or harm. The AQAA completed by the Registered Manager states that “Two new procedures have been implemented in the last 12 months as part of the Care Services Policy and Procedure manual: Procedure for the use of bed safety measures; and Procedure for Risk Assessment in Care Practice”. The above procedures include forms and directions for assessing and recording how identified risks are responded to and how to assess and use bed safety measures when appropriate to ensure the safety of a service user. Several people who use the service stated they are satisfied with the service provision, feel safe and well supported by staff that have their protection and safety as a priority. Merry Hill House DS0000036001.V366275.R01.S.doc Version 5.2 Page 20 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The standard of the environment is good providing a homely, clean and secure place to live. EVIDENCE: The home offers a comfortable and well-maintained environment to all people who use the service. The home has a rolling programme of redecoration to maintain good standards. The conservatory and patio areas are well maintained. However, the grass in the garden areas is overgrown and in need of cutting and also the overgrown trees and bushes are in need of pruning/cutting down in order to improve natural light in bedrooms and view of garden areas for people living at Merry Hill House. A small garden is located outside of Windsor Unit and the Registered Manager spoke of their intention to develop this area – which might be further enhanced if this area was fully Merry Hill House DS0000036001.V366275.R01.S.doc Version 5.2 Page 21 enclosed and made secure. We have already made a recommendation in this regard in our last key inspection report. The home has provided suitable aids and adaptations in the home to meet the general and specific needs of all the people using the service. There are adequate numbers of bathrooms/showers and WCs in the home. The Registered Manager confirmed that there is an ongoing programme of redecoration and a refurbishment of toilet areas, which has have been an outstanding issue for sometime. This redecoration and refurbishment work is to be completed by the end of June 2008. The bathroom on Stuart Unit also has been refurbished. It was noted during the tour of the premises that the bedrooms are “personalised” by most of the people using the service. During the day of inspection, the home was found to be clean, tidy and free from any unpleasant odour. The home has good policies and procedures in place regarding infection control/COSHH. Information provided by the home indicated that majority of staff have undertaken training in infection control. The Registered Manager stated that those members of staff who as yet have not received this mode of training will do so shortly and as a matter of priority. It was noted from staff records also that all new members of staff received induction training and they are made aware of the dangers of cross-infection. Merry Hill House DS0000036001.V366275.R01.S.doc Version 5.2 Page 22 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Merry Hill House is staffed by well-trained and experienced staff to meet the needs of people who use the service. There are robust recruitment procedures in place to protect people who use the service. There is a good training programme in place that ensures staff are competent to do their jobs. New members of receive structured induction training. EVIDENCE: Information provided by the home and available staff rotas for the month of June 2008 indicated that the home has sufficient care staff to meet the needs of the 33 people using the service at present. There is one assistant manager and six carers on duty throughout the day. Two carers are on wakeful night duty with one assistant manager or the Registered Manager on sleeping duty and available in case of emergency at the premises throughout the week. In addition, there is adequate support staff on duty to cover cleaning, laundry, preparation of meals and maintenance duties. Since the last inspection staffing levels within the home have increased during the day to include between one to two ‘floating members of staff’ who are able to assist in any one of the Units on request. On the day of our inspection this new system appeared to be working well with people using the service confirming that now the activities within the home have improved and that Merry Hill House DS0000036001.V366275.R01.S.doc Version 5.2 Page 23 staff respond to their requests and provide assistance promptly. Staff also spoke how the increase in staffing levels has had a positive impact on the people who use the service. The Registered Manager stated that the home has not appointed any new staff since the last inspection. However, there has been staff redeployment within the Adult Services and Merry Hill House was provided additional staff resource. In addition, two vacant posts of carers (32 hours per week each) are being filled by the end of June 2008. Four staff files were examined in detail in order to check compliance with the recruitment requirements. The Registered Manager stated that the home adheres to the Social Services Department’s policy and procedure in relation to recruitment and selection. Thus the staff job application forms, references and CRB disclosure and other related information is held at the Department’s Human Resources section. The AQAA states that “staff are trained by our in-house Training Unit, all staff have a training profile that highlights their training requirements. Staff training needs were highlighted through Employee Performance Review interviews and regular one to one sessions”. The Registered Manager stated that all staff training have their training profiles held at the Department’s Training Unit and he will ask the Training Unit to provide the home with copies of staff profiles to be available at the care home. He also confirmed that 90 of staff have completed their NVQ Level 2 qualification in direct care and three members of staff have also completed their NVQ Level 3 training. The remaining members of staff who as yet have not received this mode of training will also be nominated to undertake this mode of training shortly. The home does employ Agency staff as and when needed. The staff team is a well-balanced group in terms of age, experience, gender and ethnicity. There is a staff training and development programme in place. In addition to the mandatory training staff also would benefit from training in adult protection/safeguarding issues, Mental Capacity Act 2005, equality and diversity, and physical aggression/challenging behaviours. Staff confirmed that training is provided and there are many opportunities to improve themselves for the benefit of the care of people using the service. All new staff received their induction training in accordance with the Skills for Care standards and specifications. People who use the service commented that they feel safe with staff caring for them and they felt that the home employs people that are capable of carrying out their care duties. Merry Hill House DS0000036001.V366275.R01.S.doc Version 5.2 Page 24 Merry Hill House DS0000036001.V366275.R01.S.doc Version 5.2 Page 25 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36, and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service can be assured that the home is run in their interests. Financial interests of people using the service are safeguarded. The home promotes the health, safety and welfare of people who use the service. EVIDENCE: The Registered Manager – Mr John Lem has considerable experience of caring for older people and has the supportive qualifications and skills to manage the home. Mr Lem has completed his Registered Managers’ Award, D32 and D33 Assessors’ Award and NVQ Level 4 qualifications. He appears to be managing the home well. There are clear lines of accountability within the home and the Merry Hill House DS0000036001.V366275.R01.S.doc Version 5.2 Page 26 Registered Manager is well supported by his line manager. The home has a formal staff supervision system in place, and Mr Lem is implementing the system of supervision of staff and meetings both with staff and people using the service. Observations made and discussions with people who use the service and staff have indicated that the Registered Manager is very approachable and he operates an ‘open door’ policy. People who use the service, who could express themselves, stated that they are happy to approach the manager and staff with any problems they might have and were confident that they would respond to them appropriately. Equality and diversity for people who use the service were seen to be promoted throughout the home within the assessments, care plans and activities. Equality for staff is promoted through the opportunities for training at all levels. It was noted that the home has a Quality Assurance monitoring system in place. Quality Assurance takes place throughout the service in both a formal and informal manner. Meetings and day-to-day contacts all provide records to show that satisfaction is at the heart of the service for people who use the service. Surveys were carried out recently for the year 2008. A report on the result of the feedback from people who use the service and their relatives is to be prepared by mid-July 2008. In addition, stakeholders’ survey was also carried out and their feedback is also to be analysed shortly. Financial records and administrative procedures relating to the handling of the monies of people who use the service were looked at and were found to be well ordered and maintained. The home actively encourages people using the service, where able, to manage their own money. The home keeps records to show that health and safety of people who use the service is promoted and protected. The Registered Manager stated that the hot water supply is checked/tested at the required intervals in all the hot water outlets. However, the records of such tests were not available on the day of our visit for inspection. The Registered Manager stated that this matter will be addressed immediately and as a matter of priority. Likewise the recent test/service certificate (dated 02/05/08) for the gas boiler was not available at the home, because this document was held at the Department’s Assets Management section and this certificate subsequently was made available to the CSCI. The Registered Manager confirmed that a majority of staff have received their mandatory training in safe working practice topics, e.g. moving and handling, food hygiene, first aid, infection control, health and safety and fire safety. The Registered Manager also stated that all those members of staff who as yet have not received this mode of training will do so shortly. They will also Merry Hill House DS0000036001.V366275.R01.S.doc Version 5.2 Page 27 receive training in equality and diversity, Mental Capacity Act 2005, Adult Protection/safe guarding issues, safe handling of medication, NVQ Level 2, and Dementia care. People who use the service spoken with were very complimentary about the Registered Manager and staff in the home. Many of them knew who they were by name and looked at ease in their presence. Merry Hill House DS0000036001.V366275.R01.S.doc Version 5.2 Page 28 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X X 3 X 3 Merry Hill House DS0000036001.V366275.R01.S.doc Version 5.2 Page 29 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP19 Good Practice Recommendations That magnetic door catches are fitted to all doors from the lounges (11/06/07 assessed as not achieved). 17/06/08 - It is strongly recommended that an audit of all areas accessible to people living at the home is undertaken and where it is identified that the current door opening mechanism reduces the person’s access, then advice should be sought from the local Fire Safety Officer regarding a suitable door closure device. 2. OP19 That extra fencing and a gate are provided to create an enclosed garden by Windsor unit. 11/06/07 and 17/06/08 - Not yet achieved but evidence to suggest that attention to this area is under consideration. That the overgrown grass and weed in and around garden Merry Hill House DS0000036001.V366275.R01.S.doc Version 5.2 Page 30 areas should be cut down and tidied up; and also the overgrown trees and bushes at the premises should be pruned and cut down in order to improve the natural light in the bedrooms and view of garden areas by the people living at Merry Hill House. 3. OP12 That the daily activities enjoyed by the people who use the service should be evaluated, consistently recorded and also incorporated into their individual care plans. This consistent approach of monitoring participation in activities will assist the home in future planning. Merry Hill House DS0000036001.V366275.R01.S.doc Version 5.2 Page 31 Commission for Social Care Inspection West Midlands West Midlands Regional Contact Team 3rd Floor 77 Paradise Circus Queensway Birmingham, B1 2DT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Merry Hill House DS0000036001.V366275.R01.S.doc Version 5.2 Page 32 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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