Random inspection report
Care homes for adults (18-65 years)
Name: Address: Merrywick Hall 41 New Road Hedon East Yorkshire HU12 8EW two star good service The quality rating for this care home is: The rating was made on: A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Diane Wilkinson Date: 1 5 0 4 2 0 1 0 Information about the care home
Name of care home: Address: Merrywick Hall 41 New Road Hedon East Yorkshire HU12 8EW 01482899477 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Margaret Rose Scott Type of registration: Number of places registered: Conditions of registration: Category(ies) : Willerfoss Homes care home 27 Number of places (if applicable): Under 65 Over 65 0 learning disability Conditions of registration: Date of last inspection Brief description of the care home 27 Merrywick Hall is a privately owned care home that provides care and accommodation for up to twenty-seven people who have a learning disability. The home is located in the town of Hedon on the border of Hull and the East Riding of Yorkshire. It is close to all local amenities including shops, the post office and public houses, and there is easy access to public transport. The home comprises of a large detached property and a bungalow that has been adapted for residential care use; both are situated within the same well-maintained grounds and there is a considerable amount of interaction between people living within the two properties. Private accommodation consists of fourteen single bedrooms and four shared rooms in
Care Homes for Adults (18-65 years) Page 2 of 11 Brief description of the care home the main house, and the bungalow provides independent living accommodation for up to five people. Communal accommodation consists of two living rooms and a large dining room. Wheelchair users and those with poor mobility living in the main building are accommodated on the ground floor, as there is no passenger or stair lift. Access to and egress from the building are made possible via the provision of ramps. Information about the home is available from the registered manager in the homes statement of purpose and service users guide. Care Homes for Adults (18-65 years) Page 3 of 11 What we found:
We looked at the following outcomes: Choice of Home: We looked at the records for someone who had been admitted to the home for respite care in an emergency situation. A community care assessment and care plan had been obtained from the local authority on the day of the persons admission and the home had started to undertake their own assessment and develop an individual plan of care at the same time. A hazard identification form and a safety management plan had also been completed on the day of admission. We noted that an independent advocate had been involved at the time of the persons admission to the home. Individual Needs and Choices: We received nine completed surveys from staff. They all told us that they are given up to date information about the needs of the people they support and that the ways they share information between staff and managers work well. The person admitted for respite care is now a permanent resident at the home. We checked their plan of care and found it to be thorough and individualised. Areas included in the individual care plan are domestic skills, mobility/manual dexterity, perception, communication, medication, self-help skills, community and leisure skills and social interaction. Each area consists of an assessment, the persons strengths and needs, their long-term objectives, their short term objectives and a strategy/action plan. The person concerned, their key worker and the manager have signed the plan of care to evidence that it has been discussed and agreed. We noted that any specific areas of concern are accompanied by a risk assessment, such as nutrition, sexuality and vulnerability. Appropriate professionals are involved in these assessments to ensure that people have assistance with decision making and responsible risk taking. We saw that there was a separate risk assessment in place for any bed rails in use at the home. These are checked for safety each week by the homes handyman. The home has obtained information from the Medicines and Health Care Regulatory Agency (MHRA) and we advised that they should check their own risk assessment against the one recommended by MHRA to ensure that they are following these guidelines. We saw that monthly reviews of care plans take place and that every person living at the home had a six-monthly review of their care plan during January, February or March; this ensures that care plans are kept up to date and that staff are working with current information. We received nine surveys from people living at the home. They all told us that they can make decisions about what to do each day and that they can do what they want to do
Care Homes for Adults (18-65 years) Page 4 of 11 during the day, in the evening and at the weekend. Lifestyle: At the last key inspection we recommended that people living at the home should have the option of a seven day annual holiday provided within the contract price. We were told that, last year, people chose a variety of holidays. Some people went to Spain, some people stayed in a caravan and some people went on an overnight coach trip. These trips were paid for by service users but the staff who accompanied people on these holidays were paid by the home (as the homes contribution to the total cost). Several people told us in surveys and on the day of the site visit that they enjoyed their holiday to Spain last year and that they are going again this year. One person arrived home from work whilst we were present. They enjoyed telling us about what they had been doing at work and clearly enjoyed this level of responsibility. We did not see the serving of lunch or tea on this occasion but noted that there is a menu on display. We received several comments in surveys telling us that food provision at the home is good. Personal and Healthcare support: The manager told us that she has attended training on personalisation and has already obtained copies of patient passports; they are in the process of developing one for each person living at the home. Patient passports are designed to be taken by people to the hospital to inform medical staff of their personal care needs, nutritional needs and their likes and dislikes, and are especially useful for people who have communication difficulties. On the day of the site visit we checked medication administration records, the storage of medication and details of staff training. Medication is stored safely; none of the people living at the home are currently prescribed controlled drugs but there are storage arrangements in place should this occur. There were no gaps in recording on medication administration record (MAR) sheets; we noted that the amount of medication received from the pharmacist had been recorded and signed for, and that any handwritten entries on MAR sheets are signed by two members of staff to ensure accuracy. We suggested that it would be good practice to have an information sheet stored with each MAR sheet to record a persons medical conditions, current medication prescribed, any allergies and any common side effects. Everyone had a photograph attached to their medication records to assist staff with identification, apart from the person who was newly admitted. At the last inspection we recommended that the home purchase a medication fridge to enable them to store medication at the correct temperature. They had been promised a fridge by the pharmacy but it had not arrived. The manager told us that they only have a small amount of medication that requires storage at a low temperature and they store it in a locked container in the kitchen fridge; this is considered to be a satisfactory arrangement. Staff who administer medication have undertaken appropriate training and we saw
Care Homes for Adults (18-65 years) Page 5 of 11 evidence on the day of the site visit of refresher training that had been arranged; this had been booked for 19/4/10. We also saw a document that was used by the manager to record her observations of staff who administer medication to ensure that they follow the homes policies and procedures; this is good practice. Concerns, Complaints and Protection: All of the people living at the home who returned a survey told us that they know who to speak to if they have any concerns and that they know how to make a formal complaint. Staff who returned a survey told us that they know what to do if anyone expresses concerns about the home. We checked the complaints log and found that complaints made by people living at the home had been recorded and appropriate action taken; people were also informed of the outcome of their complaint. Environment: These standards were not assessed on this occasion but we did check the recommendations that were made at the last key inspection. There is now evidence that the home meets the Water Supply (Water Fittings) Regulations 1999 and washbasins in the laundry room are clearly labelled, i.e. one is used for staff to wash their hands and the other is used for sluicing or for staff to wash by hand. The manager told us that the washing machine also has a sluicing facility. We noted that disinfecting gel is available in the laundry room and throughout the home. Staffing: We checked the recruitment records for a new member of staff. We saw that they had completed an application form that recorded their qualifications, employment history, a criminal conviction declaration and the names of two referees. A Protection of Vulnerable Adults (POVA) first check and two written references had been obtained prior to the person commencing work at the home and their Criminal Records Bureau check had arrived five days after their start date. The new staff member had signed a document to record that they had read a variety of policies and procedures and that they had received the code of conduct issued by the General Social Care Council. They had a performance review and a supervision meeting with the manager approximately one month after their start date, and completed Skills for Care Induction training 3 months after their start date. Records seen at the home evidenced that all but six members of care staff have achieved National Vocational Qualification (NVQ) Level 2 in Care and that five staff are continuing with training by working towards NVQ Level 3 in Care; this is good practice. Conduct and management of the home: The manager told us that she has recently undertaken training on the Deprivation of Liberty and safeguarding adults from abuse (managers awareness). She previously worked as a nurse and has now commenced NVQ Level 4 in Management training. Nine staff returned a completed survey. They told us, the manager is approachable if I have
Care Homes for Adults (18-65 years) Page 6 of 11 any problems. The home is warm and welcoming with a calm and relaxing atmosphere and the manager is approachable and always has a caring attitude towards all residents and staff. The manager said that she meets with the manager of their sister home to discuss policies, procedures and practices at the homes and at recent meetings they have redesigned their quality assurance system. The survey that they use now contains less questions, as it was felt that the previous survey contained too much information and people were reluctant to complete it. Surveys are distributed three times a year and the returned information is collated and recorded on a results sheet; this information is shared at staff and resident meetings. They also plan to produce an annual quality report. We checked a selection of health and safety documentation at the home, including fire safety, the servicing of lifts and hoists, accident reporting and the gas safety certificate; all were found to be satisfactory and up to date. We noted that staff at the home had signed a form to record that they had read the health and safety policies and procedures. What the care home does well: What they could do better:
It would be good practice to include an information sheet with medication administration records that includes a persons medical conditions, current medication, any allergies and common side effects. We suggested that the home could use the MUST nutritional tool in place of the one already used. Care Homes for Adults (18-65 years) Page 7 of 11 We advised the manager to check the risk assessment they currently use to assess the safety of bed rails against the information obtained from the MHRA. This is to ensure that they are meeting current good practice guidelines. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 2. Care Homes for Adults (18-65 years) Page 8 of 11 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements
These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards.
No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 9 of 11 Requirements and recommendations from this inspection:
Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours.
No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set.
No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service.
No Refer to Standard Good Practice Recommendations 1 9 The manager should check that the risk assessment used by the home on the safe use of bed rails is equivalent to the one recommended by MHRA, to ensure that bed rails used at the home are safe. It would be good practice to have an information sheet to accompany MAR sheets that records a persons medical conditions, medication currently prescribed, any allergies and common side effects. 2 20 Care Homes for Adults (18-65 years) Page 10 of 11 Reader Information
Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or got from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for noncommercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. Care Homes for Adults (18-65 years) Page 11 of 11 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!
