Inspection on 28/11/07 for Melrose House

This inspection was carried out on 28th November 2007.

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 there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also 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 20/09/06

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 Mary Blake Unannounced Inspection 28 November 2007 09:00 th Melrose House DS0000000380.V333871.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.V333871.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.V333871.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.V333871.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 20th September 2006 Brief Description of the Service: Melrose House is a small home for 9 people who have a learning disability. The home provides care for male and female residents. Situated on the sea front, it provides a central location for access to local facilities. All of the bedrooms are single occupancy with bathrooms/toilets located around the building. There are spacious and comfortable communal lounges and dining area. There were 8 residents at the time of inspection. The service user guide and last inspection report were available at the entrance. The fees range from £359 to £365 per week. Melrose House is part of the Sovereign Care organisation. Melrose House DS0000000380.V333871.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This site visit was unannounced and took place over one day and involved one inspector. A full tour of the premises took place and a sample of records were inspected which included: two care plans, one staff file and other statutory records. Case tracking was carried out where certain residents and staff were spoken to and their records were examined. A questionnaire was also completed by the home before the inspection to provide information. Questionnaires were also sent to residents and other people involved with the home that may be able to comment about the running of the home. One resident’s and one relative’s questionnaires were returned and these gave positive statements on the care provided. There were eight residents staying during the inspection visit. Private discussions took place with two residents, staff and the acting Manager. What the service does well: The service gives good support in preventative health care and enables individuals to have a healthy lifestyle. The service gives good support to enable individuals to maintain and develop personal and family relationships and provides support to help deal with change. The service gives good support to enable individuals to make decisions and participate in the running of the home. It was observed and residents confirmed, that staff were kind, considerate and supportive. There is a complaints procedure and in addition resident views are actively sought. Residents felt their views were listened to and acted upon. Staff were friendly and relaxed with the inspector and were keen to discuss their work and the residents care needs. Melrose House DS0000000380.V333871.R01.S.doc Version 5.2 Page 6 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. The summary of this inspection report can be made available in other formats on request. Melrose House DS0000000380.V333871.R01.S.doc Version 5.2 Page 7 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.V333871.R01.S.doc Version 5.2 Page 8 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. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The home collects enough information about the needs of prospective residents before they move in to help ensure staff are aware of the amount of care and support needs of the resident as they settle in. Residents and their relatives are very welcome to visit the home to assess its suitability. EVIDENCE: Records for two of the residents showed that when they were admitted to the service an assessment of their care needs had been carried out before their admission. The resident and relevant people who knew them were involved in the initial assessment. Residents have the opportunity to visit the home as often as they need in order to decide if they want to stay there. A resident may come for meals, have overnight stays and be introduced to other residents at the home at a pace suitable to the individual. Melrose House DS0000000380.V333871.R01.S.doc Version 5.2 Page 9 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. 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 using available evidence including a visit to this service. There are arrangements in place to ensure that residents’ health and social care needs are met. Staff supports residents and care plans show the amount of care and support that staff are providing to residents. The operation of the home ensures that residents are consulted and involved in the running of their lives. Staff do support residents to take risks as part of independent living but this is not sufficiently reviewed or documented. EVIDENCE: There are detailed assessments in the residents’ care plans. Melrose House DS0000000380.V333871.R01.S.doc Version 5.2 Page 10 Personal support needs are documented and give clear instructions to staff on how to support people in tasks such as washing, bathing, dressing, communicating and carrying out any assessed tasks to help promote the independence of the person. The majority of the residents do not require moving and handling support and technical aids and equipment is available for one resident who requires this support. Residents care records showed that they have access to external health care services. GPs and Community Nurses were regularly consulted for advice and treatment. Residents are asked individually and consulted about decisions involving themselves and the day-to-day running of the home. Staff at the home encourage residents to express their views and to communicate by whatever means so they may become more involved in running their lives and retain some control in decision making. The staff support residents to remain independent and take risks in order to live a more fulfilled lifestyle, however up to date risk assessments were not present in one residents care record. Melrose House DS0000000380.V333871.R01.S.doc Version 5.2 Page 11 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. 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 using available evidence including a visit to this service. Residents are encouraged to take part in age, peer and culturally appropriate activities and use community facilities wherever possible. Residents are encouraged to have appropriate personal and family relationships. Residents’ rights and responsibilities are recognised in their daily lives. Residents are offered healthy diet and a relaxed and social mealtime. EVIDENCE: The residents spoken to confirmed that they are involved in the running of the home and involved in making decisions about their lives. Melrose House DS0000000380.V333871.R01.S.doc Version 5.2 Page 12 Residents care plans and case records detail any family involvement. Conversation with residents and staff provided evidence that residents are encouraged to maintain contact with family and friends, staff providing the necessary levels of support for them to do so. In discussion with the residents, acting manager and staff they confirmed their involvement and choice in relation to visitors. Opportunities to meet people who do not have a disability were available and reviewed within the individual plan was social and relationship opportunities. Residents enjoyed a range of leisure activities. For example art, drama, shopping, music and craft were undertaken. The residents have regular outings and holidays at local and national venues. Residents have the opportunity to increase their social network and staff support residents to maintain existing friendships and social relationships. It was observed staff seeking permission prior to entering individual rooms and interacting well with residents. Residents were observed to move freely around the home and were able to spend time alone. Residents commented on the quality and choice of food available. Fresh fruit was available and residents were observed having breakfast and coffee in a relaxed and social setting. Choice of meals was evident and residents are able to prepare light meals in the kitchen. Melrose House DS0000000380.V333871.R01.S.doc Version 5.2 Page 13 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. 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 using available evidence including a visit to this service. Residents receive personal support in the way they prefer Residents physical and emotional health needs are met. Medicines are generally well managed and in a way that protects residents. EVIDENCE: It was evident from examination of care plans, discussions with acting manager, staff and residents that residents, who require personal support, are given this in a way that protects their dignity and maximises their independence. Residents’ individual health needs are identified and residents are supported to access community health services such as general practitioner, district nurse, dentist, and optician. Residents have an annual health check. Physiotherapist, dietician, psychologist and learning support team provide specialist health support. Two care plans and case records were inspected. The daily records Melrose House DS0000000380.V333871.R01.S.doc Version 5.2 Page 14 detailed the care and support required for different needs. They reflected the changing needs of residents. Staff training has been undertaken to provide awareness and additional support for health related needs. Families are involved as necessary whilst respecting confidentiality. Medication was inspected and the medicines were stored safely with a monitored dosage system was in place. There were controlled drugs and discussion was held about the need for two staff to administer/record. Further advice will be sort from community pharmacist. Staff spoke knowledgably about medication and administration and had recently completed training in this area. Melrose House DS0000000380.V333871.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The complaints procedure was available to remind people coming into the home of their right to complain. Residents are protected from abuse. EVIDENCE: There is a complaints procedure to inform people visiting the home of how they could complain if necessary. Residents have access to a complaints procedure that assists them and supports them to bring any matters to the attention of staff outside of the home in case they felt uncomfortable bringing any complaints or concerns to the attention of staff within their home. Staff were aware of the whistle blowing policy and informing the manager or the Proprietor of any incidents or issues of which there are concerns. It was clear from the training records that staff had completed Protection of Vulnerable Adults training. Staff spoke knowledgably about the protection of the residents and what action they would take if they had cause for concern. Melrose House DS0000000380.V333871.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Residents live in a homely, clean, comfortable and safe environment. There is a good standard of hygiene. EVIDENCE: A tour of the premises was undertaken and all bedrooms viewed. The premises are generally well maintained with plans to address the damaged flooring and replace the stair carpet. Residents have their own bedrooms that are well furnished, decorated and very well personalised according to the wishes and tastes of the individual. There is one domestic staff employed with staff giving additional support to residents to enable them to carry out individual domestic, catering and laundry tasks. A good standard of hygiene was evident in the home. Melrose House DS0000000380.V333871.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34, 35 & 36 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. Systems are in place to ensure residents are in safe hands. There are recruitment policy and practices in place to protect residents. Staff are trained to meet the care needs of residents. EVIDENCE: Examination of staff rotas and discussion with the acting manager, staff team, residents provided evidence that the numbers of staff vary in according to the needs of the residents at any one time. There are enough staff on duty to meet the necessary staffing levels and the current needs of the residents. There has been a turnover of staff this leaves a gap in current staffing levels with a small number of staff covering all shifts. The Provider is currently reviewing staffing levels. In house and external training takes place and with 50 of the staff having NVQ level 2 or above. Changes in staff mean that this training is ongoing. Melrose House DS0000000380.V333871.R01.S.doc Version 5.2 Page 18 Staff said that they would be undertaking or had completed NVQ level 2 or over and spoke of the homes induction and training programme. Staff confirmed that they also receive advice and /or training in other areas, such as challenging behaviour, values and rights of people with learning disabilities. Staff meetings are used to provide additional in-house training. A new staff handbook has been developed. Staff spoken to had a good understanding of individual needs and the principals of promoting independence, choice, respect and dignity. One staff recruitment files was examined and was satisfactory. Staff supervisions had begun and were well structured and documented. Staff stated that they enjoyed working in the home and were observed to be kind, caring and respectful to residents. A very positive, happy rapport was noticeable between the staff on duty and residents. Melrose House DS0000000380.V333871.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39 & 42 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Residents’ benefit from the ethos, leadership and management approach at the home. Quality assurance systems are being established to take into the views of people using the service. The health, safety and welfare of residents are generally promoted and protected. EVIDENCE: The homes current Registered Manager is Mrs Linda Hunter, who is also the proprietor. Whilst actively involved she does not have day-to-day Melrose House DS0000000380.V333871.R01.S.doc Version 5.2 Page 20 management responsibility of the home. Changes to the management are under review and once complete the Provider must submit an application for the acting Manager to become registered with the Commission for Social Care Inspection. Residents and staff said they felt confident with the openness and approachability of the acting Manager. Discussion and observation maintain that she puts the needs of the residents first and promotes an ethos amongst staff of involving staff and residents in decision making within the home. The system for checking resident’s monies was satisfactory. The records examined were secure, up to date and in good order. Staff supervision records showed a comprehensive process and that the timescales of six per year would be met. Health and safety systems are well organised, the building is safe and the management and staff spoke knowledgeably about maintaining and promoting the welfare of the residents. A new Quality assurance system has been introduced and being established across the organisation this system includes audits, surveys, residents and staff meetings and provider visits. Fire testing and maintenance is generally undertaken at the given timescales but there were some gaps in testing, this was being addressed The home is well maintained with services and testing in place. Melrose House DS0000000380.V333871.R01.S.doc Version 5.2 Page 21 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 3 36 3 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 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 x 3 X 3 X X 3 x Melrose House DS0000000380.V333871.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? yes 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 Standard YA33 Regulation 18 Requirement The Registered Person must undertake a review of the number of staff employed and deployed within the home Outstanding as of 30/11/06 2 YA20 13(2) The Registered Person must consult with the community pharmacist about the administration and recording of controlled drugs. The Registered Person must submit an application for the proposed Registered Manager to the CSCI 01/02/08 Timescale for action 01/03/08 3 YA37 8 01/02/08 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 YA6 Good Practice Recommendations To ensure that residents have an annual review involving the resident, family and advocates DS0000000380.V333871.R01.S.doc Version 5.2 Page 23 Melrose House Melrose House DS0000000380.V333871.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection 4th Floor St Nicholas Building St Nicholas Street Newcastle upon Tyne NE1 1NB 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 Melrose House DS0000000380.V333871.R01.S.doc Version 5.2 Page 25 - 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!