Inspection on 10/10/05 for Merchiston House

This inspection was carried out on 10th October 2005.

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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Merchiston House 20/02/07

Merchiston House 27/06/05

Merchiston House 27/09/04

Merchiston House 24/05/04

Merchiston House 19/01/04

Merchiston House 01/10/03

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

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

CARE HOME ADULTS 18-65 Merchiston House 1 Colham Road Hillingdon Middlesex UB8 3RD Lead Inspector Mrs Rekha Bhardwa Unannounced Inspection 12:20p 10 and 25th October 2005 th Merchiston House DS0000032543.V257025.R01.S.doc Version 5.0 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 Merchiston House DS0000032543.V257025.R01.S.doc Version 5.0 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. Merchiston House DS0000032543.V257025.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Merchiston House Address 1 Colham Road Hillingdon Middlesex UB8 3RD 01895 235920 01895 232797 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) London Borough of Hillingdon Mr Timothy Green Care Home 4 Category(ies) of Learning disability (4) registration, with number of places Merchiston House DS0000032543.V257025.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The carpet in the front hallway and corridor must be replaced by 31 July 2003. Care Homes Regulations 2001. Reg 23(2)(d). The kitchen must be refurbished by 31 July 2003. Care Homes Regulations 2001. Reg 23(2)(b). 29th June 2005 Date of last inspection Brief Description of the Service: Merchiston House is a spacious five bedroom house standing in its own grounds in Hillingdon. The accommodation comprises of four bedrooms for service users and one for staff. There is a bathroom on the first floor and a toilet on the ground floor.The home is owned by Hillingdon Health Authority and managed by the Social Services Department. The home is located in Colham Road, near Hillingdon hospital and is a short walk away from local shops and amenities. Merchiston House provides a home for four service users with severe learning difficulties who present a challenge to the service. At the time of the inspection only two service users were being accommodated at the home. Merchiston House DS0000032543.V257025.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection undertaken by Mrs Rekha Bhardwa. The focus of this inspection was to follow up the requirements from the inspection in June 2005 and to assess the remaining National Minimum Standards for Younger Adults. A total of 4 hours were spent on the inspection process. The Inspector undertook a tour of the premises; spoke with three members of staff, the Registered Manager and one service user. Service users records, staff records and medication administration records were viewed. At the time of the inspection there were two service users accommodated at the home. It is recommended that the reader this report in conjunction with the inspection report dated 29th June 2005. What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Merchiston House DS0000032543.V257025.R01.S.doc Version 5.0 Page 6 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Merchiston House DS0000032543.V257025.R01.S.doc Version 5.0 Page 7 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,3 & 4 The service users in the home are provided with information about the home and the services provided, so as to be clear about the services the home provides to meet their needs. Service users are assessed prior to admission to ensure that the home can meet their needs. Prospective service users and/ or their representatives are encouraged to visit the home in order to allow them to make an informed choice. EVIDENCE: The Statement of Purpose had been reviewed and a copy of the updated Statement of Purpose had been sent to the Commission. At the time of the inspection there was one vacancy and the Registered Manager was in the process of negotiating a trial visit for a prospective service user to meet the other service user and the staff. A needs led assessment had been obtained and the home had undertaken their own assessment. This standard will be examined in detail at the next inspection. Merchiston House DS0000032543.V257025.R01.S.doc Version 5.0 Page 8 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,8,9 & 10 There is a clear care planning system in place, which provides the staff with the information they need to meet the needs of the service users. The home has good risk management systems in place, which protects the safety of the service users. Records are stored securely and policies on confidentiality are in place thus safeguarding the service users. EVIDENCE: Two service user plans were viewed. These were comprehensive and detailed the assessed needs of the service users. Both had been reviewed and were up to date. Review records were available. Details on how the service user behaviour is managed were detailed in the care plans viewed. Daily recordings are completed on each shift. Individual risk management plans are also in place for individual service users. Care plans are discussed with the service user and their representative. Merchiston House DS0000032543.V257025.R01.S.doc Version 5.0 Page 9 The level of participation of the service users is limited, due to the level of their learning disability and their short attention and concentration span. Where possible the service users work alongside staff in undertaking light household chores, examples given were dusting and polishing. All risk assessments have been reviewed by the Registered Manager, behavioural management plans are in place and individual risk assessments for each service user were available. A missing persons procedure was available. At the time of the inspection none of the service users were able to go out unaccompanied. Service users records are kept in a locked filing cabinet. The home follows the London Borough of Hillingdon’s confidentiality policy. Information is shared with other professionals on a need to know basis. Merchiston House DS0000032543.V257025.R01.S.doc Version 5.0 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): 16 & 17 Service users rights are respected by the staff and this enables the service users to have responsibilities within their capabilities. Dietary needs of service users are well catered for with food choices provided and food available that meets service users preferences. EVIDENCE: Service users do not have a key to their bedrooms or the front door. This is clearly recorded in the service users plan. The laundry and kitchen are kept locked and service users can only access this area when accompanied by a staff member. Merchiston House DS0000032543.V257025.R01.S.doc Version 5.0 Page 11 The Registered Manager informed the Inspector that service users are involved in developing the menu for the week. The focus is on healthy eating. Menus were not viewed at this inspection. Service users weight gain and weight loss is monitored by the individual link workers. The kitchen was viewed and found to be clean and well ordered; fridge/freezer temperatures were being recorded daily. Merchiston House DS0000032543.V257025.R01.S.doc Version 5.0 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): 19,20 & 21 Service users physical and emotional health needs were identified and being met by the staff. The systems for the management of medication were in place and well managed and therefore safeguarding service users. Service users changing needs are identified and met, thus ensuring appropriate care is provided. EVIDENCE: The Registered Manager stated that all moving and handling needs of service users has been assessed. Records viewed indicated that service users health needs were being met. This included visits to the GP, Consultant Psychiatrist, hospital visits and other health care professionals. At the time of the inspection none of the service users were able to manage their own medication. The Boots Monitored Dosage System is used by the home. Medication Administration Records were viewed and found to be satisfactorily recorded. The storage of medication was appropriate and only senior staff administer medication. Merchiston House DS0000032543.V257025.R01.S.doc Version 5.0 Page 13 The changing needs of service users are addressed and appropriate support is provided within the home and other professional advice is sought as required. The Registered Manager informed the Inspector that the changing needs are discussed with the service users Merchiston House DS0000032543.V257025.R01.S.doc Version 5.0 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 The home has a clear complaints procedure in place to address any concerns raised by service users and their visitors. Systems are in place for the protection of vulnerable adults so as to protect them from possible risk of harm or abuse. EVIDENCE: A complaints procedure was in place. This was also available in pictorial form for the service users. The Registered Manager said that home had not received any complaints since the last inspection. There have been no Protection of Vulnerable Adults (POVA) issues reported. Merchiston House DS0000032543.V257025.R01.S.doc Version 5.0 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27 & 28 The home was clean and tidy and the environment, bathroom, toilet and communal areas are safe for service users to use. EVIDENCE: A brief tour of the premises was undertaken. The home was well maintained and fixtures and furnishings were of a good standard. Each service user has a washbasin in their bedroom. There is one bathroom with a toilet, and a separate toilet on the first floor. There is also a separate toilet on the ground floor. The lino in the first floor toilet was due to be replaced. The work had been authorised and the Registered Manager was waiting for a date for the work to commence. The communal spaces are the lounge, quiet room, the dining room and the large garden at the rear of the house. The furniture in the dining room is minimal and is functional. The staff keep no ornaments, pictures or paintings in the communal areas. Merchiston House DS0000032543.V257025.R01.S.doc Version 5.0 Page 16 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,34 & 35 The staffing provision was appropriate to the meet the needs of the service users, thus providing them with appropriate care. A plan for staff training is in place in order to provide the staff with the skills to address the needs of service users. EVIDENCE: The Registered Manager works alongside staff in caring for service users. All staff have a job description and only senior staff administer medication. The Registered Manager reported that due to the home only accommodating only two service users there had been a change to the staffing levels. The staffing provision on the days of the inspection met the assessed needs of the service users. No new staff had been recruited since the last inspection. The Registered Manager was aware of the records required prior to staff being employed. This standard will be examined in detail at the next inspection. Progress had been made in ensuring that staff training records were available for inspection. Training needs are discussed in individual supervision and at Merchiston House DS0000032543.V257025.R01.S.doc Version 5.0 Page 17 team meetings. A training assessment had been undertaken by the Registered Manager, where shortfalls have been identified a training plan had been formulated. Merchiston House DS0000032543.V257025.R01.S.doc Version 5.0 Page 18 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 39,40,41,42 & 43 Meeting the service users needs is a priority for the staff team. Up to date records were available and this protects the service users and enables efficient running of the home. Health and safety systems are in place and this protects the service users. EVIDENCE: A business plan for Merchiston House was available and had been reviewed by the Registered Manager. Copies of the Regulation 26 Visit reports had been sent to the Commission. The Registered Manager stated that in house policies are reviewed periodically. Corporate policies and procedures when reviewed updated versions are then sent to the home. Merchiston House DS0000032543.V257025.R01.S.doc Version 5.0 Page 19 Overall the records viewed in the home were well maintained, systematic and easily accessible. Individual and generic risk assessments were in place. The last recorded fire drill practice was dated 3/10/05 and 10/10/05. A sample of servicing records were viewed at random and found to be satisfactory. Moving and handling assessments were available in the service users files viewed. Merchiston House DS0000032543.V257025.R01.S.doc Version 5.0 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 x 3 3 x Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 x 3 3 3 Standard No 24 25 26 27 28 29 30 STAFFING Score x x x 3 3 x x LIFESTYLES Standard No Score 11 x 12 x 13 x 14 x 15 x 16 3 17 Standard No 31 32 33 34 35 36 Score 3 x 3 3 3 x CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Merchiston House Score x 3 3 3 Standard No 37 38 39 40 41 42 43 Score x x 3 3 3 3 3 DS0000032543.V257025.R01.S.doc Version 5.0 Page 21 No 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. Standard Regulation Requirement Timescale for action 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 Merchiston House DS0000032543.V257025.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection West London Area Office 58 Uxbridge Road Ealing London W5 2ST National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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