Inspection on 27/09/07 for Mercers

This inspection was carried out on 27th September 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 no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Mercers 11/10/06

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 27th September 2007 11:30 Mercers DS0000028660.V352165.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.V352165.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.V352165.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 k.kittle@tiscali.co.uk 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.V352165.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 11th October 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.V352165.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 included an unannounced visit to the service on September 27th 2007 as well as subsequent fieldwork. The judgements made within this report are based upon evidence found on the inspection visit along with information submitted by the service and feedback from service users, staff and other parties since the previous inspection. Mrs Kaushali Kittle, the Registered Manager and co-proprietor of Mercers was available throughout the inspection visit and contributed fully to the inspection process. During this inspection, 30 of the 43 applicable standards were looked at, 29 of which were met and 1 was nearly met resulting in 1 statutory requirement. During the visit to Mercers, people living at the home and staff were spoken with. All were positive about the home and the people living there appeared at ease and were happy to talk to the Inspector. Interactions between staff and the people living at Mercers observed during this inspection were positive. An environmental tour of the home was made. Discussions were held with people living at the home, 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. What the service does well: What has improved since the last inspection? Since the last inspection, many areas within Mercers have been redecorated and new flooring has been laid in all bedrooms, the lounge and dining rooms and the main hallway. Mercers DS0000028660.V352165.R01.S.doc Version 5.2 Page 6 The induction programme for new staff at Mercers has been improved and all staff now receive appropriate induction training within the first six weeks of working at the home. 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.V352165.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.V352165.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, 4 and 5 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Comprehensive needs assessments are completed before a person moves into Mercers and people can ‘test drive’ the home to be certain it will be able to meet their needs. Prospective service users can expect to be issued with an individual contract for living at the home. EVIDENCE: There had been two new admissions to the home since the previous inspection. Individual care records showed that thorough assessments were undertaken to ascertain all the needs of individuals before a place was offered to them at Mercers. These comprehensive assessments included input from the service user, care manager, relatives and other services (either residential or day care), forming the basis of the individuals initial care plan and contributing to the on-going process of assessment within the home. Individual care records also contained care package summaries and contracts of residence. Mercers DS0000028660.V352165.R01.S.doc Version 5.2 Page 9 Discussions with care staff and the Manager, as well as the examination of service user records, gave evidence that prospective service users were given the opportunity to visit the home before they made the decision to stay and were able to have a phased introduction to Mercers that involved short daytime visits to meet the staff and other people living at the home before moving onto longer visits and overnight stays. Mercers DS0000028660.V352165.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 and 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care planning is robust, showing evidence of contributions by individuals through discussions at reviews. People were supported to take risks as part of an independent lifestyle. People living at the home were consulted on all aspects of life at the home through regular discussions. EVIDENCE: The individual plans and care records examined as part of this inspection showed that those living at Mercers contributed to their construction and to their ongoing review. The care plans reflected the individuality of the person and the uniqueness of each person’s needs. Conversations with carers showed that there was an understanding of the issues within the individual plans of care and that these were followed. There were regular meaningful entries in daily records that showed needs were being met. Mercers DS0000028660.V352165.R01.S.doc Version 5.2 Page 11 Care plans were regularly monitored to ensure their effectiveness and people living at the home had their needs and aspirations reassessed at appropriate intervals to ensure their individual plans reflected the true needs. Discussions were people at the home showed there was a process of active and responsive consultation in relation to the day-to-day running of the home. There were records of discussions held between individuals and their keyworkers regarding a range of subjects including activities, trips and menus and these discussions formed the basis for planning and developments at Mercers. There were comprehensive risk assessments conducted for each person living at Mercers along with clear risk management plans to ensure individuals were supported to take risks as part of an independent lifestyle. These included environmental risks for both inside and outside the home as well as risks that may be encountered while undertaking planned activities. Mercers DS0000028660.V352165.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): 11, 12, 13, 14, 15, 16 and 17 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. People living at Mercers were able to take part in a wide range of activities tailored to their individual needs and preferences and were active members of their local community. Rights of individuals were respected and relationships were positive for those living at Mercers. EVIDENCE: Individual care records sampled showed that each person had a detailed weekly programme of activities both inside and outside of the home based upon their own needs and choices. These activities included work, education and leisure type activities. Activity programmes were clearly displayed outside the office in pictures to enable people to easily see what they were doing and when. People spoken with on the day of inspection used community facilities as part of their daily lives and enjoyed the activities on offer. Mercers DS0000028660.V352165.R01.S.doc Version 5.2 Page 13 Discussion with people living and working at Mercers, as well as the examination of records, showed that peoples rights were respected and appropriate personal relationships supported. The observation of interactions between those living at the home and care staff showed evidence of relationships that were built on mutual respect and trust. Staff were seen to knock on doors before entering a persons private room and the way people talked to each other showed that dignity and respect was upheld. Visitors were welcome at the home at any time and people living at Mercers were able to receive guests in private if they wished. The examination of records and discussions with the home’s manager provided evidence of those living at Mercers receiving a healthy diet. Menus were developed through discussions with service users and people living at homes took it in turns to choose the weekly menu. People living at the Mercers were encouraged to take part in meal preparation and in shopping for foodstuffs. Lunch on the day of inspection was seen to be unhurried and an opportunity for people to socialise and discuss their day. Mercers DS0000028660.V352165.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 and 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users received personal support in the way they preferred and required and physical and emotional health needs were met. People were not always protected by the home’s medication policies and procedures. EVIDENCE: People spoken with were happy with the way they were supported and this was reflected within the care plans examined. Care plans identified individual needs as well as the person’s preferences for how these needs could be met. Care plans were well detailed and are regularly monitored and formal reviews held at appropriate intervals. As noted at previous inspections, care records showed an ongoing process of assessment, to take account of the changing needs of individuals. The services of healthcare professionals, for example community nurses, speech and language therapists and psychologists were accessed as necessary. Mercers DS0000028660.V352165.R01.S.doc Version 5.2 Page 15 One person living at Mercers currently receives their medications weekly and takes responsibility for their storage and administration. This process is well documented with appropriate risk assessments conducted and includes routine and ad hoc monitoring to ensure adequate protection. A second person at the home is preparing to move on to a monitored self-administration process and has started by taking any lunchtime medications with them on days when they will be out at that time. Although there were good recording processes around those people selfadministering their medication, there were a significant number of gaps in medication records for the remainder of people living at Mercers. On all Medication Administration Record (MAR) Sheets, on a number of days, there were times when medications had not been signed as being given or a code letter entered to show reason for non-administration. Mercers DS0000028660.V352165.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 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living at Mercers could expect their views to be listened to and acted upon. There were robust arrangements in place to afford protection for those living at the home from abuse, neglect and self-harm. EVIDENCE: The home had a robust complaints procedure and this was also presented in a manner that was easy for service users to understand. One person had the complaints procedure in symbol format in their bedroom. 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. Discussions with people living at the home showed evidence of a feeling that if a person had a concern it would be listened to and acted upon. People living at Mercers were very positive about the approachability of the staff and management and this was also shown by there interactions. There have been no formal complaints about the services at Mercers since the last inspection. Mercers DS0000028660.V352165.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 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Mercers is a clean, comfortable, homely and safe place to live in. EVIDENCE: An environmental tour of the home showed that service users lived in a homely, comfortable and safe environment and that individual bedrooms suited service users’ needs and lifestyles and promoted independence. A number of areas had been redecorated since the last inspection including the hallway, stairs and landing, the bathroom and the lounge and dining rooms. New flooring had been laid in the lounge, the main hallway and in all bedrooms. The Manager informed the inspector that there are plans for the kitchen to be refurbished although this will not be until spring 2008. Mercers DS0000028660.V352165.R01.S.doc Version 5.2 Page 18 Externally, the gardens were tidy and well maintained offering outside seating for people living at the home. All areas of Mercers were clean and hygienic. Mercers DS0000028660.V352165.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 and 36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Carers at Mercers were appropriately trained and skilled to meet the individual and group needs of those living at the home. Staff recruitment practices afforded support and protection to those living at Mercers and people living at the home benefited from supported and supervised staff. EVIDENCE: Examination of staff records, as well as discussions with the Registered Manager and staff, gave evidence that care staff were qualified and competent. Records showed that all required pre-employment checks were undertaken and documentation was collected to ensure the protection of those living at Mercers. Staff were employed in sufficient numbers to meet the needs of the service users and were well trained with access to induction and regular on going development opportunities. Staff spoken with on the day of inspection stated that training was regularly made available and the home’s Manager fully supported staff in meeting their training needs. Mercers DS0000028660.V352165.R01.S.doc Version 5.2 Page 20 The examination of staff records showed that care staff received regular formal support and supervision. Staff were observed as caring and professional and interactions between carers and those living at Mercers were positive, encouraging independence for the individual. Observation of interactions showed carers worked as an effective staff team, meeting the individual and collective needs of those living at Mercers. Mercers DS0000028660.V352165.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, 38, 39 and 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living at Mercers benefited from the management approach at the home and could feel confident that their views underpinned developments. The health, safety and welfare of people living and working at Mercers were promoted and protected. EVIDENCE: People spoken with on the day of this inspection visit were positive about the management style adopted in the home and staff felt able to raise concerns with, or make requests to, the Manager. Mrs Kaushali Kittle, co-proprietor and Registered Manager of the home, demonstrated appropriate skills, qualifications and experience and operated the home in an open and inclusive manner. Mercers DS0000028660.V352165.R01.S.doc Version 5.2 Page 22 There were records of regular staff meetings where management and care issues were discussed and within these was evidence of staff contributing to the smooth running of the home and that their suggestions were given due discussion and consideration. There were records of regular discussions with those living at Mercers to offer the opportunity to be able to contribute to how the home was run on a day-today basis and a formal quality assurance process was in place that sought the views and opinions of those living at the home, relatives, staff and visiting professionals. Maintenance and routine inspection records examined showed that the health, safety and welfare of service users, staff and visitors was protected and promoted and there were regular checks of the fire alarm system and records of routine gas and electrical safety checks. Mercers DS0000028660.V352165.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 X 2 4 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 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 3 36 3 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 4 12 4 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 3 3 3 X X 3 X Mercers DS0000028660.V352165.R01.S.doc Version 5.2 Page 24 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 Standard YA20 Regulation 13(2) Requirement The home must ensure that records for the administration of medications are appropriately maintained, with signatures of staff giving the medication or codes entered to denote reason for non-administration, to ensure the safety and well-being of people living at the home and to protect against mishandling of medications. Timescale for action 31/10/07 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.V352165.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.V352165.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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