CARE HOME ADULTS 18-65
Mercers 14 Serpentine Walk Colchester Essex CO1 1XR Lead Inspector
Neal Wolton-Harragan Unannounced Inspection 15th March 2006 01:00 Mercers DS0000028660.V286897.R01.S.doc Version 5.1 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.V286897.R01.S.doc Version 5.1 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.V286897.R01.S.doc Version 5.1 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 6 Category(ies) of Learning disability (6) registration, with number of places Mercers DS0000028660.V286897.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: 1. The home may accommodate 6 persons of either sex, aged 65 or under, who only fall within the category of Learning Disability 8th December 2005 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. Mercers DS0000028660.V286897.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This announced inspection took place between 1.15 pm and 4.30 pm, and was assisted by the Manager, Mrs K Kittle, staff, service users and a relative, who was a regular visitor at the home. A number of records were also inspected. This was a positive inspection with 9 out of the 10 Standards inspected being met, and 1 nearly met. For a more complete picture of the home, the report of the unannounced inspection in December 2005 should also be read. What the service does well: What has improved since the last inspection? What they could do better:
Although genuine attempts had been made, since the last inspection, to meet the legal requirements for recruitment, attention to particular details is needed to maximise protection for service users. Mercers DS0000028660.V286897.R01.S.doc Version 5.1 Page 6 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. Mercers DS0000028660.V286897.R01.S.doc Version 5.1 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.V286897.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 5 Service users or their representatives had agreed contracts with the home. EVIDENCE: A contract / statement of terms and conditions was sampled for one service user. It contained all the elements set out in National Minimum Standard 5 and had been agreed by the person’s advocate. Mercers DS0000028660.V286897.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6 and 7 Service users were involved in planning for their lives. EVIDENCE: A sample of care plans showed that service users had been involved in planning and determining risk management strategies. One person’s key worker took time to talk with them and their relative, who was visiting. The manager and staff were conversant with the detail of service users’ needs. It was evident from care plans and discussion with the manager that individual progress was measured and goals were changed accordingly. For example, one person had moved from Mercers into a more independent living situation and there were plans for another’s changing needs to be met by a different arrangement within Mercers. During the inspection it was evident that staff were helping one service user to plan an activity holiday in line with their particular interest. Mercers DS0000028660.V286897.R01.S.doc Version 5.1 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): 14 and 16 Service users were supported and encouraged to engage in appropriate leisure activities and be responsible in ways that promoted their independence. EVIDENCE: During the inspection, discussion took place between staff and a service user about how they could be supported to attend a holiday they had chosen. It was reported that, previously, service users had taken holidays together or had separate days out; this year, they were being helped to plan individually tailored holidays. A trial reward system had been introduced to encourage service users to undertake household chores, cooking and shopping, with a view to developing their independent living skills and encouraging everyone, as far as possible, to have some part in their home’s operations. Staff and service users were positive about the project, but indicated that it was to soon to say how well it would work. The outings, proposed as the reward, were to be in addition to each individual’s planned outings and activities. During the inspection, staff respected one service user’s need to sit aside and be quiet, whilst showing
Mercers DS0000028660.V286897.R01.S.doc Version 5.1 Page 11 they were available if needed. One service user said they could bring friends home, if they checked with staff first. Mercers DS0000028660.V286897.R01.S.doc Version 5.1 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): None of these Standards were inspected. EVIDENCE: Mercers DS0000028660.V286897.R01.S.doc Version 5.1 Page 13 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): 23 Appropriate arrangements were in place to help protect service users from abuse. EVIDENCE: Immediately, following the inspection, the manager took action to protect residents from a situation, where they were potentially at risk. Her handling of the matter concerned was robust and transparent. Two other examples of the manager giving priority to the safety and well being of service users were highlighted during this inspection. Mercers DS0000028660.V286897.R01.S.doc Version 5.1 Page 14 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): None of these Standards were inspected. EVIDENCE: Mercers DS0000028660.V286897.R01.S.doc Version 5.1 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 34 Service users were benefiting from the competence and effectiveness of the staff supporting them. Although genuine attempts had been made to meet the legal requirements for recruitment, attention to particular details is needed to maximise protection for service users. EVIDENCE: Mercers was operating with a minimum of 3 staff throughout the day. Contingency arrangements were made during the inspection to enable one service user to go to college, as usual, whilst ensuring sufficient staff were available to meet the needs of service users remaining in the home. Discussion with the manager and staff showed that due care was exercised in using agency staff, when this was necessary to maintain staffing ratios, and that, where possible, they used the same people to provide continuity. Sustained and appropriate interaction was observed between staff and service users. Service users showed that they felt comfortable approaching staff on matters of importance to them. One member of staff on duty was communicating effectively with a service user using Makaton. It was evident from discussion that service users were involved in staff recruitment. One service user said they were given opportunity to question a candidate and give their opinion of them.
Mercers DS0000028660.V286897.R01.S.doc Version 5.1 Page 16 Staff recruitment was inspected in discussion with the manager and from examination of staff records. The manager was advised that one Criminal Records Bureau (CRB) disclosure needed to be updated because the person concerned had experienced a break in their employment. One person had been employed on the strength of a POVA First disclosure, whilst the full CRB disclosure was awaited. The manager explained the exceptional circumstances for this decision and had taken appropriate action in relation to other aspects of recruitment and to safeguard service users; however, a copy of the person’s birth certificate and passport (if any) were not with the other records. Letters on the files inspected showed that new contracts had just been issued to staff and that signed copies for their files were awaited. Mercers DS0000028660.V286897.R01.S.doc Version 5.1 Page 17 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 Service users were benefiting from a well run home. EVIDENCE: All evidence pointed to Mercers being a well run home with positive outcomes for service users. Comments from staff about training opportunities and from service users about user participation were very encouraging. The manager had also shown sound professional judgement in response to difficult situations that had arisen and, in each case, taken the line that best served the interests of service users. Mercers DS0000028660.V286897.R01.S.doc Version 5.1 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 X 3 X 4 X 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 X 23 3 ENVIRONMENT Standard No Score 24 X 25 X 26 X 27 X 28 X 29 X 30 X STAFFING Standard No Score 31 X 32 3 33 3 34 2 35 X 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X X X LIFESTYLES Standard No Score 11 X 12 X 13 X 14 3 15 X 16 3 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X X X X 3 X X X X X X Mercers DS0000028660.V286897.R01.S.doc Version 5.1 Page 19 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 YA34 Regulation 19 Schedule 2 Timescale for action The registered person must 31/03/06 ensure that all pre-employment checks are undertaken and the appropriate documentation is maintained. This is a repeat requirement but the matter was being addressed at the time of inspection. 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. Refer to Standard Good Practice Recommendations Mercers DS0000028660.V286897.R01.S.doc Version 5.1 Page 20 Commission for Social Care Inspection Colchester Local Office 1st Floor, Fairfax House Causton Road Colchester Essex CO1 1RJ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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