Inspection on 11/10/06 for Mercers

This inspection was carried out on 11th October 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

Mercers 27/09/07

Mercers 15/03/06

Mercers 08/12/05

Mercers 26/01/05

Mercers 03/08/04

Mercers 03/03/04

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

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

CARE HOME ADULTS 18-65 Mercers 14 Serpentine Walk Colchester Essex CO1 1XR Lead Inspector Neal Wolton-Harragan Key Unannounced Inspection 11th October 2006 10:00 Mercers DS0000028660.V316838.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 Mercers DS0000028660.V316838.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. Mercers DS0000028660.V316838.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Mercers Address 14 Serpentine Walk Colchester Essex CO1 1XR 01206 570226 01206 570226 gazza.k@lineone.net 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 Pelandapatirage Gemunu Susantha Dias Mr Gary John Kittle, Mrs Kaushali N Kittle Mrs Kaushali N Kittle Care Home 7 Category(ies) of Learning disability (7) registration, with number of places Mercers DS0000028660.V316838.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Persons of either sex, aged 65 or under, who require care by reason of a learning disability (not to exceed 6 persons) One person, under the age of 65 years, who requires care by reason of a learning disability to be accommodated at 16 Cowdray Avenue, Colchester The total number of service users accommodated must not exceed 7 persons 15th March 2006 Date of last inspection Brief Description of the Service: Mercers offers accommodation and care for up to six individuals, with learning disabilities, between the ages of 20 and 40. Registered in 2002, the home is owned by Mr P Dias and Mr and Mrs Kittle, with Mrs Kittle as Registered Manager. All three proprietors are qualified nurses. The premises consist of a two storey, detached property in a residential area within walking distance of Colchester town centre. All bedrooms are single occupancy, two of which are on the ground floor. One of the ground floor rooms, a recent addition off the conservatory, has en suite facilities, although none of the older rooms have such facilities. Communal facilities include a lounge, dining room and conservatory, which had been extended shortly before the inspection. The current weekly fee charged by Mercers for residential care is £980. Mercers DS0000028660.V316838.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report follows a key inspection of Mercers that culminated in an unannounced visit to the service. The judgements made within this report are based upon evidence found on the day of the inspection along with information submitted by the service and feedback from service users, staff and other parties since the previous inspection. Mrs Kaushali Kittle, registered manager of the home, was at Mercers during the inspection visit and took an active role in the inspection process. During this inspection 28 of the 43 standards were looked at; 25 of these were met and three were partially met. During the visit to Mercers, staff and service users were spoken with. All were positive about the home and service users appeared at ease and were happy to talk to the Inspector. Interactions between staff and service users observed during this inspection were positive. The visit to Mercers included a partial tour of the home, discussions with service users, staff and the home manager, as well as the opportunity to look at records of how people living at Mercers were supported and how the staff were recruited and trained. Lisa Nurse (expert by experience) and her supporter from Barking and Dagenham Mencap were at Mercers for part of the inspection. As a service user, Lisa has an expert opinion on what it is like to receive services for people who have a learning disability. Lisa’s comments are included throughout this report. What the service does well: Mercers continued to have a good staff team that worked well to support the people living at the home. The home was well managed and staff had a good understanding of their roles and responsibilities. The home had a positive attitude towards staff training and those working at Mercers were encouraged to attend training and development events. Service user records showed that people living at Mercers were consulted on all areas of life at the home and supported to make decisions about how they would live their lives. The expert by experience said, “I observed a reward system board for clients this encourages them to become part of the daily tasks, they are rewarded with points that can be exchanged for goods, this encouraged them to be part of a rota in daily chores and sharing the daily life of the home.” Mercers DS0000028660.V316838.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. Mercers DS0000028660.V316838.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 Mercers DS0000028660.V316838.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): 1, 2, 4 & 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective service users can expect to have the information they require to make an informed choice about where they live and their needs assessed. Prospective service users could expect to be able to visit and ‘test drive’ the home prior to deciding to move in permanently. Each service user could expect to have an individual contract or statement of terms and conditions with the home. EVIDENCE: The examination of service user records showed that people were offered the opportunity to visit the home prior to moving in and were able to test the service before committing to entering permanently. This was in line with the home’s stated admissions policy and procedure and discussions with service users discussions with service users gave evidence that this was the practice of Mercers. The Statement of Purpose and service user guide had been reviewed since the last inspection to take account of the annexe at 16 Cowdray Avenue and some changes in the make up of the staff team. Service user records showed that the needs and aspirations of prospective service users were assessed by a qualified person, usually the home manager, Mercers DS0000028660.V316838.R01.S.doc Version 5.2 Page 9 to ensure that the home could accommodate the needs of individuals before a placement was offered. Service user records also showed that each person living at Mercers had an individually prepared contract with the home. Mercers DS0000028660.V316838.R01.S.doc Version 5.2 Page 10 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, 8 & 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users can expect their changing needs and personal goals to be reflected in their individual plan and can expect to be consulted on decisions about their lives. Service users can expect to be supported to take risks as part of an independent lifestyle. EVIDENCE: The service user records sampled during the inspection showed that individual needs were assessed and were reflected within individual service user plans. These plans were subject to regular monitoring and review and changes in needs were identified and acted upon. The examination of records and discussions with individual service users gave evidence that service users were central to the decision-making processes within the home as well as playing a primary role within the care review system in place. There were regular service user meetings held at Mercers and minutes of these were available. Mercers DS0000028660.V316838.R01.S.doc Version 5.2 Page 11 Records showed that comprehensive risk assessment had been undertaken and risks were managed and reviewed appropriately. The expert by experience noted: • • • • Clients were able to choose what they wanted to wear. All clients were able to choose when they got up All clients chose when they went to bed All clients get to choose what they want to eat. Clients can make and receive personal phone calls • Mercers DS0000028660.V316838.R01.S.doc Version 5.2 Page 12 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, 14, 15, 16 & 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users can expect to have opportunities for personal development and to take part in age, peer and culturally appropriate activities. Service users can expect to be encouraged to be active members of the local community engage in appropriate leisure activities and be supported to have appropriate opportunities to develop and maintain personal and family relationships. Service users’ can expect to have their rights respected and responsibilities recognised in their daily lives. Service users can expect to be offered a healthy diet and enjoyed their meals and mealtimes. EVIDENCE: The Service user records examined gave evidence that each person living at the home had a detailed weekly programme that included work, education and leisure type activities. Service users spoken with on the day of inspection stated that they used community facilities as part of their daily lives, one had Mercers DS0000028660.V316838.R01.S.doc Version 5.2 Page 13 returned from shopping shortly before the inspection started and another went bowling on the morning of the inspection. Discussion this service users and staff, as well as the examination of records and the direct observation of interactions between staff and service users, showed that service users rights were respected and appropriate personal relationships supported. All service users had keys to their own rooms and some chose to keep their doors locked. Discussions were service users and the examination of records showed that a varied diet was offered to service users with all nutritional needs being met. Mrs Kittle informed the inspector that the weekly menu was compiled jointly and that those living at the home participated in the shopping and meal preparation. One service user was supported to prepare their own lunch on the day of inspection. The expert by experience reported: • • • • • • • All clients had TV in their own room, also TV available in the lounge Clients had their own DVD’S Clients went out shopping with support and those more able without support All clients had keys to their own bedroom, two clients informed me that they would like a front door key. Clients can have friends and family to visit them in the home Weekends were seen as different from the weeks activities, clients were able to watch what they wanted on TV. Clients are encouraged to make their own sandwiches with the support of staff if needed. Mercers DS0000028660.V316838.R01.S.doc Version 5.2 Page 14 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. Service users can expect to receive personal support in the way they prefer and require to ensure their and physical and emotional health needs are met. Service users can expect to be protected by the homes policies and procedures for dealing with medicines. EVIDENCE: Service users spoken with were happy with the way they were supported at Mercers and this was reflected within the care plans examined. Service users had an understanding of the contents of their individual plans and had contributed to their development and review. Care plans identified individual needs, as well as the choices made by individuals as to how these needs were to be met. Care plans were well detailed, regularly monitored and formally reviewed at appropriate intervals depending on individual need. There was an ongoing process of assessment to take account of the changing needs of individuals and the services of healthcare professionals such as community nurses, speech and language therapists or psychologists were accessed as necessary. Mercers DS0000028660.V316838.R01.S.doc Version 5.2 Page 15 While none of the service users took responsibility for storage of his or her own medications, one service user was given their daily medications in the morning to take at the appropriate times through the day. This was appropriately documented and monitored and the service user was managing this system well. The expert by experience noted: • All clients are able to choose whether to have a bath or shower and when they wish to take it. Praise was given to the client that was making her own lunch. One client was being prepared to live independently, and talked of the process of doing more for her. • • Mercers DS0000028660.V316838.R01.S.doc Version 5.2 Page 16 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. Service users can expect that the arrangements in place would help to protect service users from abuse, neglect and self-harm. Service users can expect their views to be listened to and acted upon. EVIDENCE: The Home had a robust complaints procedure. The adult protection policies and procedures were adequate to protect service users from abuse and where service users presented with behaviours likely to cause self-harm, these behaviours were identified within their care plans and management strategies devised. Service users spoken with on the day of inspection said that should they have concerns or complaints they thought these would be taken seriously by the staff and manager of Mercers and appropriate actions would be taken. Mercers DS0000028660.V316838.R01.S.doc Version 5.2 Page 17 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 adequate. This judgement has been made using available evidence including a visit to this service. The service users can expect to live in a generally homely, comfortable and safe environment that is clean and hygienic. EVIDENCE: Areas visited during this inspection were seen to be homely, comfortable and safe. Service users expressed satisfaction with their environment both inside and out. All areas visited on the day of inspection were clean and hygienic although the expert by experience noted a urine smell in one bedroom. The inspector did not note this smell and may have become present between the inspector and the expert by experience visiting this room. The internal décor at Mercers was tired and, although the environment was safe, there were areas, such as the bathroom and first floor corridor, that required attention. Mercers DS0000028660.V316838.R01.S.doc Version 5.2 Page 18 The expert by experience also noted: • The back and front garden was not user friendly; this was due to uneven paving, wholes in the paving and steps. The garden was much unkempt. The wall surrounding the patio area was unsafe. It would have been nice for the clients to become involved in having some responsibility for the care of the garden. The carpet in the hall way was dirty and worn. Clients were in outdoor shoe’s although inside, slippers would be more comfortable. One client had decorated their own room in the colours she had chosen Paintwork in the home was grubby and in need of cleaning One client had a pet in their room that they had sole care of this gave them some responsibility in caring for animals. One of the clients showed me their bedroom. She is very keen on art and had no means of undertaking her activity at a table in her room as this had not been made available to her. Also the room was large enough for a small settee rather than a small chair this would make it more selfcontained for the client. One of the bedrooms I visited smelt strongly of urine, this was due to a soiled pad in the bin that had not been emptied. This made it difficult to sit and talk in a relaxed atmosphere the client was comfortable in. There was a bathroom both up and down stairs. All bedrooms had washbasin facilities. The home had the feeling of being a residential home rather than a home for people to live in (no books on bookcase, no nick knacks or ornaments, no paintings except one by a client (making the environment home from home.) Décor was bland, making a cold feeling Bedrooms did not have wall cupboards for personal items. One room had no valance on the bed and the chest of draws was broken, (giving little ownership of self worth). No personal photos in the room making it the clients own space. • • • • • • • • • • • • • • Mercers DS0000028660.V316838.R01.S.doc Version 5.2 Page 19 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, 33, 34 & 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users can expect to be supported by competent and qualified staff. Service users cannot expect their needs to be met by appropriately trained staff. Service users can be assured that they will be protected by the home’s recruitment policy and practice. EVIDENCE: Examination of staff records, as well as discussions with the registered manager and staff, gave evidence that care staff had a good understanding of their roles and responsibilities and that staff were largely qualified and competent. Staff spoken with on the day of inspection stated that training was regularly made available and the home manager fully supported staff in meeting their training needs. However, not all staff had received adequate induction. Examination of staff rotas showed that staff were employed in sufficient numbers to meet the needs of the service users creating an effective staff team. Examination of staff records showed that all appropriate checks were Mercers DS0000028660.V316838.R01.S.doc Version 5.2 Page 20 undertaken prior to employment of new staff and proper records were maintained. The expert by experience reported: • I observed staff handling a client with care and kindness. Mercers DS0000028660.V316838.R01.S.doc Version 5.2 Page 21 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. The service users can expect to benefit from a well-run home and confident their views are underpinned by self-monitoring, review and development at the home. Service users can be assured that their health, safety and welfare will be fully promoted and protected. EVIDENCE: Examination of records, discussions with staff and discussions with service users and gave evidence that the home was well managed. Mrs Kittle, the registered manager, has appropriate skills, qualifications and experience and supports the development of skills within the team members. Mercers DS0000028660.V316838.R01.S.doc Version 5.2 Page 22 The home had regular service user meetings and these were central to the quality assurance process. Records examined showed that the health, safety and welfare of service users, staff and visitors was protected and promoted. Observation of interactions between the manager and staff, as well as between staff and service users, gave evidence of an open and inclusive management ethos at Mercers and an environment of mutual respect. The expert by experience noted: • • • • • • All clients are invited to meetings within the home to put their points of view across. Clients spoke about staff being very friendly There is a key worker system in place Staff informed my that if they had any problems they could speak to their shift leader for support Clients also spoke about talking to the shift leader if they had a problem, they felt this helped them very much. I observed a reward system board for clients this encourages them to become part of daily task, they are rewarded with points that can be exchanged for goods, this encouraged them to be part of a rota in daily chores and sharing the daily life of the home. Mercers DS0000028660.V316838.R01.S.doc Version 5.2 Page 23 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 3 2 3 3 X 4 3 5 3 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 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 2 33 3 34 3 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 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 3 X X 3 X Mercers DS0000028660.V316838.R01.S.doc Version 5.2 Page 24 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 1. Standard YA24 YA32 YA35 Regulation 23 (2) (d) 18 Requirement The registered person must ensure the décor inside the home is adequately refreshed. The registered person must ensure that all new staff employed at the home receive appropriate induction training within the first 6 weeks of employment commencing. Timescale for action 31/01/07 31/12/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Mercers DS0000028660.V316838.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Colchester Local Office 1st Floor, Fairfax House Causton Road Colchester Essex CO1 1RJ 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 Mercers DS0000028660.V316838.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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