Inspection on 20/09/06 for Melrose House

This inspection was carried out on 20th September 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

Melrose House 22/10/09

Melrose House 24/04/09

Melrose House 28/11/07

Melrose House 22/11/05

Melrose House 26/07/05

Melrose House 24/11/04

Melrose House 01/07/04

Melrose House 10/03/04

Similar services:

22 Sandown Road

The Highlands

Dilston College Of Further Education

West View House

Prince Bishop Court

Park View (15)

Craigmore House

1 Lanark Close

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

CARE HOME ADULTS 18-65 Melrose House 25 Beverley Terrace Cullercoats Whitley Bay Tyne & Wear NE30 4NT Lead Inspector Bill Middlemist Key Unannounced Inspection 20th September 2006 1:30 Melrose House DS0000000380.V296127.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 Melrose House DS0000000380.V296127.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. Melrose House DS0000000380.V296127.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Melrose House Address 25 Beverley Terrace Cullercoats Whitley Bay Tyne & Wear NE30 4NT 0191 2513259 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 Stephen Hunter Mrs Linda Hunter Mrs Linda Hunter Care Home 9 Category(ies) of Learning disability (7), Learning disability over registration, with number 65 years of age (2) of places Melrose House DS0000000380.V296127.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 22nd November 2005 Brief Description of the Service: Melrose House is a small home for 9 people who have a learning disability. The home is situated on the sea front in Cullercoats, in between Tynemouth and Whitley Bay, and is close to a number of good amenities and transport services. Melrose House is attractive, well furnished and blends in with the local environment - it is not recognisable as a care home from the outside. This home has excellent views of the sea and coastline. Melrose House is part of the Sovereign Care organisation. Melrose House DS0000000380.V296127.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection lasted for three hours. Care plans were examined to see if they reflected people’s needs and ambitions. A tour of shared areas was made to see if they were safe and clean. All of the people at home during the inspection were asked about their experience of living at Melrose House. Documents about health and safety were inspected. 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. Melrose House DS0000000380.V296127.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 Melrose House DS0000000380.V296127.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 from evidence gathered both during and before the visit to this service. Each person’s needs have been assessed so that the home can carry out detailed plans for each person. EVIDENCE: Each person’s file that was inspected included a recent assessment carried out by a suitably qualified person. Melrose House DS0000000380.V296127.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, 9 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. Each person’s needs and ambitions are recorded in an individual plan so that the service can help people to live the lives they want to. Each person is supported to make decisions so they can make choices. Each person takes risks as part of their lifestyle but work needs to be done to balance rights, risks and safety. EVIDENCE: Care plans remain as previously stated. They are detailed and reflect the individuality of each person with clear guidelines to promote choice, rights, inclusion and independence. Each person has “things I would like to do” recorded and there is evidence that many outcomes have been achieved. Five people said that they are well supported by staff when they need to make any kind of decision. Melrose House DS0000000380.V296127.R01.S.doc Version 5.2 Page 9 Each person has a set number of housekeeping tasks that also promote independence skills. There was no evidence that risk assessment and risk management plans have been done as a result of accidents recorded in the accident book, and for everyday daily living tasks. These need to be done to balance people’s rights, independence and safety. Melrose House DS0000000380.V296127.R01.S.doc Version 5.2 Page 10 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, 17 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. Each person has excellent opportunities to take part in a diverse range of activities, and be part of the local community. Each person is encouraged to continue the relationships that suit them. Each person has a number of responsibilities within the home, these also encourage using independence skills. Meals are enjoyable and people are offered a healthy diet. EVIDENCE: Staff have worked hard to get people a range of activities that they will enjoy. Each person said that they are doing what they want to do, both inside and outside of Melrose House. The activities include going to local clubs, art Melrose House DS0000000380.V296127.R01.S.doc Version 5.2 Page 11 classes, college, day centres, supported work placements and local places of interest. Each person is able to go out and enjoy local pubs, cafes and restaurants. Everyone has had a recent holiday and were still talking about it during this inspection. Staff continue to support each person to keep in touch with the others, such as relatives and friends, who are important to them. People have opportunities to mix with people who do not have disabilities, through the use of what the local community has to offer. Each person is encouraged to learn and use a number of different independent living skills. A relative of one person that he had been “taught to do things he would not do”. Menus are varied and people can make choices in what they eat. One person said, “The food is really nice”, and another said, ”We always have a choice”. Training has been provided in Food Hygiene. Melrose House DS0000000380.V296127.R01.S.doc Version 5.2 Page 12 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, 20 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. Each person is getting the personal support they need in way that suits them. Each person’s physical health needs are being met. Each person benefits from the way the home deals with medication. EVIDENCE: All personal support is provided in private. There are no restrictions regarding times for going to bed and getting up other than for scheduled activities and routines. There was evidence that people are encouraged to choose their own clothes and to take care of their appearance. People’s healthcare needs are met through the home’s systems making sure that they get to the right kind of help at the time that they need it. The home is good at monitoring people’s conditions and making referrals to specialists before potential complications develop. People are reliant on care to staff to administer medication in line with the home’s medication policy and procedure. Records were examined and a spot Melrose House DS0000000380.V296127.R01.S.doc Version 5.2 Page 13 check made on a limited number medications: all those inspected were in order. There was evidence that staff have received the right training in order to deal with medication. All medication was stored in line with pharmacy guidelines. Melrose House DS0000000380.V296127.R01.S.doc Version 5.2 Page 14 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, 23 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. Each person knows who to make a complaint to. Each person is protected from abuse and neglect. EVIDENCE: The home has an effective complaints procedure that details action to be taken in the event of a complaint being made, including timescales, and ensures that people will not be victimised for making a complaint. All six people said they know who to make a complaint to. The home has procedures for the protection of vulnerable adults which includes whistle blowing. The member of staff on duty confirmed that they are familiar with these. There are good guidelines available for staff to meet the needs of people whose behaviour may challenge the service, and evidence that people have benefited from a positive approach to challenging behaviours. The home has an effective system for recording transactions made on resident’s behalf. A sample of three people’s monies was checked. These were in order. Melrose House DS0000000380.V296127.R01.S.doc Version 5.2 Page 15 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, 30 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. Melrose House provides a homely and comfortable place to live. Each person benefits living in a clean and hygienic home. EVIDENCE: Melrose House is homely and comfortable. The kitchen floor is worn and is going to be replaced soon. The lounge, hall and staircase areas are all going to be redecorated. Everywhere was clean and hygienic. Melrose House DS0000000380.V296127.R01.S.doc Version 5.2 Page 16 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, 34, 35 Quality in this outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. Staff demonstrated their competencies, but are covering extra shifts due to staff shortages. The way staff are taken on protects the people who live at Melrose House. It was not possible to assess the staff training schedule and how this affects each person at the home. EVIDENCE: Four people were asked about staffing levels and replied that another member of staff has just left. This leaves a gap in current staffing levels with a small number of staff covering all shifts. There are plans to hold interviews for new staff, but this will still leave a gap until someone suitable is appointed. This means that some aspects of running the home are not up to the standards already set. One member of staff was on duty during this inspection and was observed carrying a number of different tasks. This was for nine residents. The member of staff was enthusiastic about their work. The home’s management Melrose House DS0000000380.V296127.R01.S.doc Version 5.2 Page 17 should consider this level of staffing in relation to people’s safety, and a lone working policy should be developed. Staffing records are satisfactory and comply with the law and Sovereign care’s own policy. It was not possible to assess the staff training programme at this inspection. Melrose House DS0000000380.V296127.R01.S.doc Version 5.2 Page 18 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, 42 Quality in this outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. Each person benefits from living in a well run home but some health and safety matters need more attention. Quality assurance systems are in place but monthly visits from the responsible Individual could be more detailed. EVIDENCE: Every matter about Health and safety that was inspected was satisfactory apart from three points. The Fire Log was not up to date but residents do know what to do if the fire alarm goes off. Water temperatures were too hot at 50°C. Some food was not stored properly. The responsible Individual makes monthly visits as part of Quality Assurance. The visits are documented and identify some shortfalls in recording; the detail Melrose House DS0000000380.V296127.R01.S.doc Version 5.2 Page 19 could be greater to ensure that essential tasks, such as those listed above, are carried out to protect people and staff working in the home. Melrose House DS0000000380.V296127.R01.S.doc Version 5.2 Page 20 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 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 2 33 X 34 3 35 X 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 2 X X 2 X Melrose House DS0000000380.V296127.R01.S.doc Version 5.2 Page 21 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. 1 2 3 Standard YA9 YA33 YA42 Regulation 13 18 13 Timescale for action Develop risk assessment and risk 30/11/06 management plans Review staffing levels 30/11/06 Ensure that the following health and safety matters are dealt with; The Fire Log is kept up to date Water temperatures are regulated to safe standards. Food is stored properly. 20/09/06 Requirement 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 YA40 Good Practice Recommendations Develop a lone working policy. Melrose House DS0000000380.V296127.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Cramlington Area Office Northumbria House Manor Walks Cramlington Northumberland NE23 6UR 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 Melrose House DS0000000380.V296127.R01.S.doc Version 5.2 Page 23 - 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. 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