Inspection on 08/09/06 for Merlyn House

This inspection was carried out on 8th September 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Merlyn House 27/03/08

Merlyn House 15/12/05

Merlyn House 27/05/05

Merlyn House 03/02/05

Merlyn House 05/11/04

Merlyn House 13/08/03

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOME ADULTS 18-65 Merlyn House West End Road West End Southampton Hampshire SO30 3BT Lead Inspector Nick Morrison Unannounced Inspection 8th September 2006 10:00 Merlyn House DS0000011918.V311179.R01.S.doc Version 5.2 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 Merlyn House DS0000011918.V311179.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 Adults 18-65. 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. Merlyn House DS0000011918.V311179.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Merlyn House Address West End Road West End Southampton Hampshire SO30 3BT 023 8047 3166 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) SCOPE Ms Kim Sutherland Care Home 10 Category(ies) of Physical disability (10) registration, with number of places Merlyn House DS0000011918.V311179.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 15th December 2005 Brief Description of the Service: Merlyn House is a registered home that provides personal care for 10 physically disabled adults. It is owned and run by Scope. The home is situated on the outskirts of Southampton within easy reach of local shops and amenities. The home consists of a two-storey building. The garden is landscaped and is maintained by volunteers. All the homes bedrooms are single. There is a passenger lift. Three of the residents attend social services day services once or twice a week. Other day service provision and activities are arranged by the home. Merlyn House DS0000011918.V311179.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Most of the inspection was done on 8th September but it was completed on 11th September, as the manager was not at the home on the 8th. The Inspector toured the building, spoke to staff, service users and the manager, spent time observing staff supporting and interacting with service users and looked at relevant records. The inspection took seven hours in total. What the service does well: What has improved since the last inspection? What they could do better: 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. Merlyn House DS0000011918.V311179.R01.S.doc Version 5.2 Page 6 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Merlyn House DS0000011918.V311179.R01.S.doc Version 5.2 Page 7 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. This judgement has been made using the available evidence including a visit to the service. Service users benefit from having their needs assessed prior to admission to the home. EVIDENCE: All the service users files contained initial assessments that had been completed prior to admission and updated since. The assessments had been used in devising each person’s care plan. Merlyn House DS0000011918.V311179.R01.S.doc Version 5.2 Page 8 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7 and 9 Quality in this outcome area is adequate. This judgement has been made using the available evidence including a visit to the service. Service users benefited from having their needs detailed in an individual plan and from being involved in making decisions about their own lives. Service users would benefit further from having their risk assessments regularly reviewed. EVIDENCE: Files showed that all service users had individual plans in place. Staff spoken with were clear about the plans for each person and services users understood the planning system. Plans were regularly reviewed with input from service users and Care Managers where appropriate. Staff and service users spoken with were very clear that service users made their own decisions about their own lives and the Inspector observed staff supporting service users to make their own choices. Risk assessments were in place for service users where specific risks had been identified. Staff spoken with understood these. Review dates on the risk assessments demonstrated that they were not all reviewed on a regular basis. Merlyn House DS0000011918.V311179.R01.S.doc Version 5.2 Page 9 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17 Quality in this outcome area is good. This judgement has been made using the available evidence including a visit to the service. Service users benefit from being part of the community and involved in varied activities. They also benefit from regular contact with their friends and families and a healthy diet. EVIDENCE: The home has an activities programme in place for all service users based on their interests. This includes making use of local college activities as well as local day services. The home also employs a day care co-ordinator to plan and lead activities within the home. Service users were able to choose which activities they were involved with or were able to opt out of all activities if they wanted to. A visitors’ policy was in place and service users were encouraged to have visits from friends and families at all times. During the inspection visit the Inspector observed staff interacting with service users and they behaved in a respectful way and were aware of the rights of service users. Service users opened their own mail and staff respected their privacy by knocking and waiting for an Merlyn House DS0000011918.V311179.R01.S.doc Version 5.2 Page 10 answer before entering their rooms. Staff interaction with service users was positive throughout the inspection. Service users spoken with were happy with the food provided in the home. Menus demonstrated that the diet was varied and nutritious. Individual preferences and dietary needs were considered in the writing of menus and staff went around to service users individually and offered them options for their meals for the day. Service users were happy with the food at the home and were supported to eat and make mealtimes a social occasion. Merlyn House DS0000011918.V311179.R01.S.doc Version 5.2 Page 11 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 Quality in this outcome area is good. This judgement has been made using the available evidence including a visit to the service. Service users are protected by the home’s medication policy and practices and benefit from having their health and support needs met appropriately. EVIDENCE: Service users had been involved in their own care planning and were able to comment on how they received care. This also took place when care plans were reviewed. Service users files showed that health needs were monitored on a regular basis, depending on the needs of each person, and that service users were supported to access healthcare services as necessary. The home had an effective medication policy in place and staff were clear about their responsibilities within this. All staff involved in administering medication had received training. Medication records were all up-to-date and medication was appropriately stored. All medication coming into and going out of the home was accounted for. Merlyn House DS0000011918.V311179.R01.S.doc Version 5.2 Page 12 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is adequate. This judgement has been made using the available evidence including a visit to the service. Service users benefit from a clear complaints policy and were generally protected by the home’s abuse policies and practices. They would be further protected by clearer financial record keeping. EVIDENCE: Service users spoken with were clear that staff listened to them and that their concerns were responded to. There was a complaints policy in place which all service users and their families had access to. The policy was clear and service users were encouraged to complain whenever they felt it necessary. A system was in place for recording and responding to complaints. An appropriate abuse policy was in place in the home and service users spoken with said they felt safe within the home. Staff were aware of the abuse policy and had received training in protecting vulnerable adults. The system for managing service users’ finances was unclear and difficult to follow. The staff in the home looked after small amounts of money for each service user and this was kept safe. Records were kept of expenditure, but these were not always clear. Records contained a lot of crossing-out, overwriting and tippex. There were mistakes on the records that had not been fully accounted for. Some mistakes were highlighted as being ‘under investigation’ but there was no record of any investigation or any outcome. Service users had financial risk assessments in place, but these had not been reviewed for two years. It is necessary, where service users’ money is being kept and managed by staff, that accurate and clear records are maintained and a requirement has been made in respect of this. Merlyn House DS0000011918.V311179.R01.S.doc Version 5.2 Page 13 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 Quality in this outcome area is poor. This judgement has been made using the available evidence including a visit to the service. Service users would benefit from the home being cleaner and safer. EVIDENCE: The home is very homely and service users spoken with felt it was comfortable. The building is old and has suffered from some deterioration over the last few years. It was noted, from the manager, that the provider had recognised this and had begun some work on the house and that the kitchen had been replaced. There were also plans in place for further improvements to the house during the year to address the outstanding work needed in the building such as repairing and re-sealing the hall floor, replacing carpets and decorating communal areas. This work needs to be completed in order to bring the home to a safer and more comfortable level. The cleanliness in the home needed considerable improvement. During the inspection, which took place over two separate days, it was noted that the whole building needed to be cleaned thoroughly. Specific issues identified were dirty sanitary bins, a very dirty wooden nailbrush left on a sink in a communal bathroom, dirty sinks and baths, stained carpets, tea or coffee stains over paintwork, dirty pull cord light switches in communal bathrooms and dirty Merlyn House DS0000011918.V311179.R01.S.doc Version 5.2 Page 14 wheelchairs and hoists. The kitchen area was kept clean by the kitchen staff and an up-to-date cleaning schedule was in place. The rest of the building is supposed to be cleaned by the care staff according to the cleaning schedule. None of the staff at the home on either of the two days were able to even find the cleaning schedule. It was clear that the building is not being thoroughly cleaned on a regular basis. Staff spoken with were clear that their primary responsibilities were concerned with ensuring the needs of service users were met and that cleaning the home was of secondary importance compared to this. The home needs an initial thorough clean and a cleaning schedule needs to be in place and referred to on a daily basis. If care staff do not have sufficient time to maintain the cleanliness of the home, employing separate cleaning staff should be considered. Merlyn House DS0000011918.V311179.R01.S.doc Version 5.2 Page 15 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33 and 35 Quality in this outcome area is good. This judgement has been made using the available evidence including a visit to the service. Service users benefit from being supported by competent, trained staff and are protected by the home’s recruitment policies and practices. EVIDENCE: Staff files demonstrated that staff were only appointed once satisfactory checks had been received for them, including references and Criminal Records Bureau checks. The recruitment process was clear and the policy was followed in the home. Staff training records were clear and up-to-date and staff spoken with and observed during the inspection had the skills and training to do their job. Records demonstrated that the training needs of staff were discussed and considered on a regular basis through supervision. Merlyn House DS0000011918.V311179.R01.S.doc Version 5.2 Page 16 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 43 Quality in this outcome area is good. This judgement has been made using the available evidence including a visit to the service. Service users benefit from living in a well run home and they are protected by the home’s Health and Safety policies and practices. Their views are considered within the home’s quality assurance processes. EVIDENCE: The home is well managed around the needs and wishes of service users. The Manager has the necessary skills, experience and qualifications to manage the home and roles and responsibilities within the home are made clear. Service users were able to contribute to the running of the home in a number of ways, including input into their own care plans and reviews, group meetings, private meetings with keyworkers and they all had regular access to the manager. Service plans were clear and related to issues that had been raised by service users. Health and safety within the home was well managed, except where explicitly stated otherwise elsewhere in this report. Up-to-date records were kept of all servicing. Staff training, including their induction, covered health and safety Merlyn House DS0000011918.V311179.R01.S.doc Version 5.2 Page 17 issues and there were good records to support this. Staff spoken with were clear about their health and safety responsibilities. Most workplace risk assessments, except where explicitly stated otherwise elsewhere in this report, were clearly written and kept up to date. Service users and staff spoken with did not highlight any health and safety concerns. Merlyn House DS0000011918.V311179.R01.S.doc Version 5.2 Page 18 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 1 STAFFING Standard No Score 31 X 32 X 33 X 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 2 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Merlyn House DS0000011918.V311179.R01.S.doc Version 5.2 Page 19 No Are there any outstanding requirements from the last inspection? 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. 1 2 3 Standard YA9 YA23 YA30 Regulation 13 17 23 Requirement All risk assessments must be kept under regular review Records of service users’ finances must be kept up to date and be clear. The home must be cleaned thoroughly throughout and a regular cleaning schedule must be implemented. Timescale for action 31/10/06 31/10/06 31/10/06 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 YA24 Good Practice Recommendations The planned improvements to the building should continue until completed Merlyn House DS0000011918.V311179.R01.S.doc Version 5.2 Page 20 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW National Enquiry Line: 0845 015 0120 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 Merlyn House DS0000011918.V311179.R01.S.doc Version 5.2 Page 21 - 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!