Inspection on 17/01/08 for Mere Hall View

This inspection was carried out on 17th January 2008.

CSCI found this care home to be providing an Excellent service.

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

Mere Hall View 13/06/06

Mere Hall View 03/12/05

Mere Hall View 18/04/05

Mere Hall View 02/09/04

Mere Hall View 20/04/04

Mere Hall View 21/10/03

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SignHealth

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

CARE HOME ADULTS 18-65 Mere Hall View 7 Mere Hall Street Bolton BL1 2QT Lead Inspector Mike Murphy Unannounced Inspection 17th January 2008 09:30 Mere Hall View DS0000030291.V356638.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 Mere Hall View DS0000030291.V356638.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. Mere Hall View DS0000030291.V356638.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Mere Hall View Address 7 Mere Hall Street Bolton BL1 2QT 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) 01204 337098 01204 337099 amanda.allwood@bolton.gov.uk Bolton Metropolitan Borough Council Adriana Dodds Care Home 7 Category(ies) of Learning disability (7), Physical disability (7), registration, with number Sensory impairment (7) of places Mere Hall View DS0000030291.V356638.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum of 7 service users, to include: up to 7 service users in the category of LD (Learning Disabilities under 65 years of age); up to 7 service users in the category of PD (Physical Disabilities under 65 years of age); up to 7 service users in the category of SI (Sensory Impairment under 65 years of age). The service should employ a suitably qualified and experienced Manager who is registered with the Commission for Social Care Inspection. 13th June 2006 2. Date of last inspection Brief Description of the Service: Mere Hall View is part of Bolton Social Services provision for people with learning, physical and sensory disabilities. It provides a short-term break service for up to seven people. The building is in a residential area, half a mile from Bolton town centre. Bus routes and several amenities are within easy reach. Accommodation is on two floors with a lounge on each. All bedrooms are single and have a washbasin. The ground floor bathrooms have showers. One of the two bathrooms on the first floor has a bath. Mere Hall View DS0000030291.V356638.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 3 stars. This means the people who use this service experience excellent quality outcomes. This key inspection, which included a site that the home did not know was going to happen, was undertaken on the 17th of January 2008 over a period of seven hours. The inspection included talking to people using the service, their relatives, the manager and her staff, inspection of records kept at the home and a tour of the premises. Before the inspection, we also asked the manager of the home to complete a form called an Annual Quality Assurance Assessment (AQAA) to tell us what they felt they did well, and what they needed to do better. This helps us to determine if the management of the home view the service they provide the same way that we see the service. We felt this form was completed in great detail and that a lot of time and effort had been given to filling it in. What the service does well: What has improved since the last inspection? The requirements made at the last key inspection in June 2006 and the random inspection of August 2006 have been complied with. There have been improvements in the environment (and future improvements are planned) and there has been an increase in the aids and adaptations within the home to maximise the independence and meet the care and support needs of people who use the service. There has also been an expansion in the service to be provided to people who experience physical disabilities. Mere Hall View DS0000030291.V356638.R01.S.doc Version 5.2 Page 6 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. Mere Hall View DS0000030291.V356638.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 Mere Hall View DS0000030291.V356638.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. All people are appropriately assessed before using the service provided. EVIDENCE: The statement of purpose provides details the admission criteria and states that referrals are made through care management arrangements. A Short Term Care Forum meeting takes place approximately once a month. Inspection of care files, discussion with relatives of people who use the service and the manager of the service reveal that a detailed process of assessment is undertaken before the service is used. The assessment process also includes a period where the individual visits the service to see if it is suitable for them. The length of the introductory process is determined by individual need. Mere Hall View DS0000030291.V356638.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7 and 9. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. People who use the service are supported and enabled to make choices and live as independently as possible. EVIDENCE: The care records of three people who use the service were inspected. The care plans detailed care and support needs and it was evident from discussion with people using the service, their relatives and responses in pre inspection surveys their views are central to the care planning process. Care plans were informative and reflected people’s cultural needs. Care records also contained the assessments conducted prior to the service commencing (referred to earlier in this report). Care records were detailed and regularly reviewed. They contained important information relating to support agencies, contacts and social worker details, a contract, a care plan covering living arrangements, personal support, income, cultural and religious needs, education, training and occupation, family and social contact, detailed risk assessments and management and physical and mental health needs. Risk assessments conducted seek to enable people using the service to live as Mere Hall View DS0000030291.V356638.R01.S.doc Version 5.2 Page 10 independently as possible whilst ensuring they are as safe as possible. Risk management continues to be assessed using appropriate guidance, and there were examples of environmental risks being properly addressed, including liaison with health professionals such as the Occupational Therapists to identify solutions. Personal risks and related strategies are clearly documented and agreed with the individual, their family, and with other professionals involved. Mere Hall View DS0000030291.V356638.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16 and 17. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. People using the service are enabled and encouraged to develop personally and adopt a lifestyle that is fulfilling. EVIDENCE: People using the service, their relatives and staff working in the home indicate a wide range of individual social and leisure activities are provided. Because there can only be a maximum of seven people staying individual preferences in this important area can be readily catered for. Staff numbers are planned to meet the support needs of people using the service and this includes the needs to engage in activities within and outside the home. Themed stays, such as ‘Ladies weekend’ and ‘Young Male Weekend’ demonstrate how the interests of particular groups are addressed in a creative way. Discussion with people using the service and staff revealed that activities are pursued in the local community and further wider. Mere Hall View DS0000030291.V356638.R01.S.doc Version 5.2 Page 12 There are open visiting arrangements and visitors say there is always a friendly and welcoming atmosphere. Every effort is made to ensure compatibility between prospective and current people using the service and friendships are promoted in the group. People using the service are actively encouraged to exercise choice in their daily lives. Staff seek to promote the health and wellbeing of people who use the service by providing nutritious, varied and balanced meals in a pleasant setting at flexible times. The small number of people using the service enable a wide choice to be available to all. Discussion with people using the service and responses in pre-inspection surveys that were returned indicates that choice is provided, that their likes and dislikes are respected. Discussion with the manager and staff indicate that in respect of food people’s cultural and religious requirements are met. Mere Hall View DS0000030291.V356638.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 and 20. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The personal support, health and medication needs of people using the service are being met. EVIDENCE: Discussion with people using the service and staff responses in completed preinspection surveys indicate the home provides highly personalised, sensitive and flexible personal support and seeks to maximise people’s privacy, dignity, independence and control over their lives. Personal preferences and normal routines of individual people are detailed in care records – which since the last inspection all support staff can now access. Although the service provided is for relatively short periods, care records and discussion revealed the physical and emotional health needs of people are met. The home can readily access the support of medical and other health care professionals. During the inspection the manager and staff were observed to deal with a medical emergency calmly, quickly and effectively. Training is provided to enable staff to support the health needs of people using the service. Medication arrangements were well managed and documented. The requirements made in respect of medication at the August 2006 inspection had Mere Hall View DS0000030291.V356638.R01.S.doc Version 5.2 Page 14 been complied with. However to comply with recent changes (2007) in legislation it is now required that an appropriate metal cupboard is provided for the storage of ‘controlled’ medication that comply with the change in legislation. Mere Hall View DS0000030291.V356638.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The views of people who use the service are listened to and acted upon and they are protected from abuse, neglect and self-harm. EVIDENCE: Discussion with people using the service, their relatives and responses in preinspection surveys indicates that people know how to make a complaint if necessary. However it was clear that the vast majority of issues raised by people are listened to and acted upon quickly before they become formal complaints. There is a clear and accessible complaints procedure (available in different formats) and it was clear people are supported appropriately when complaints are made. A record of complaints is kept. This details the nature of the complaint, how it has been investigated and the outcome of the investigation. Those recorded appeared to have been managed appropriately. No complaints have been made to the CSCI about the service since the last key inspection in June 2006. A record of compliments received at the home is also kept. These are numerous and clearly reflect the very high degree of satisfaction with the service provided. The safeguarding processes operated by the home protect people who use the service. There are clear safeguarding policies in operation – including the interagency safeguarding policy in operation in Bolton. Discussion with staff and inspection of training records show that all staff are provided with regularly updated safeguarding training. Also staff are trained in how to manage challenging behaviour appropriately. All staff are trained in Mere Hall View DS0000030291.V356638.R01.S.doc Version 5.2 Page 16 Bolton’s agreed physical intervention strategy, ‘Studio 3’. Staff are also aware of the recording and notifying procedures if physical intervention is used. Mere Hall View DS0000030291.V356638.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): 24,25,26,27,28,29 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use this service are provided with a pleasant and suitable environment in which to stay. EVIDENCE: The home provides accommodation for up to seven people to use the service. All bedrooms provide single occupancy. A programme of refurbishment is clearly being operated. For example bedrooms have been redecorated and refurbished since the last inspection and there are plans to install a passenger lift to enable people who use the service with physical disabilities to be able to use the bedrooms on the 1st floor of the building. There are also advanced plans in place to provide a sensory garden area for the benefit of people using the service. The security of the home is enhanced by an electronic system that enables staff to monitor entry to the home. The lounge areas were comfortably and appropriately furnished and the home was well lit, heated and ventilated throughout. Bedrooms were well decorated and furnished and have been and are in the process of being provided with specialised adjustable beds and ‘tracking’ hoisting equipment has also been fitted – clearly this makes the Mere Hall View DS0000030291.V356638.R01.S.doc Version 5.2 Page 18 moving and handling needs of people using the service much easier to meet safely. People are also actively encouraged to personalise their rooms during their stay and it was evident during the inspection they do so. Toilets, bathing and showering provision is suitably equipped and adapted to provide privacy. There is ample and suitable specialist equipment to enable people using the service to maximise their independence. Staff are provided with appropriate training to enable them to safely use this equipment. There is a dedicated laundry room that is suitably equipped. The kitchen, situated adjacent to the main lounge was clean and suitably fitted and equipped. The home was found to be very clean and free of malodour at the time of this unannounced inspection. Discussion with people who use the service and staff and responses in pre-inspection surveys indicates that people are of the view the environment of the home is of a high standard. Mere Hall View DS0000030291.V356638.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): 32,34 and 35. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. People who use the service are well supported by competent, appropriately trained and suitably supervised staff. EVIDENCE: Both day and night staffing levels at the home are determined by the support and care needs of people using the service and not the needs of the service. This flexibility in staffing enables a wide range of social and leisure activities to be enjoyed by people using the service as part of a small group or individually. Discussion with the manager, individual staff and inspection of training records indicate staff are provided with regular and appropriate training. All staff spoken to (working on the day of inspection) and responses from staff in completed pre-inspection surveys indicate staff are valued and their views are important. The manager and her staff certainly appear to enjoy an excellent rapport with people using the service and their supporters. The local authority Social Services Department conducts staff recruitment centrally. This process was inspected by the CSCI in July 2007. At that inspection areas of good practice were noted. Two areas that needed to be improved were also identified and two requirements made. The CSCI have been informed both requirements have been complied with. Mere Hall View DS0000030291.V356638.R01.S.doc Version 5.2 Page 20 Once recruited staff undergo a programme of induction and other relevant training (including NVQ training) is updated regularly. Discussion with people using the service, their relatives, staff, and responses in pre-inspection surveys and information in care records indicate that the individual and group needs of people using the service are being met appropriately. Mere Hall View DS0000030291.V356638.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 and 42. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home is conducted and managed in a way that the needs of the people who use the service are met appropriately and safely. EVIDENCE: A new registered manager has been appointed since the last CSCI inspection. This person is very experienced and suitably qualified to manage this service. The manager also undertakes regular training and development to update her knowledge, skills and competence to manage the home. The manager uses a variety of methods to measure how effective the service provided is, including - Open days, questionnaires and surveys, home visits, Fair Access to Care reviews, multi-disciplinary meetings, planning with the individual, complying with relevant legislation, conducting relevant risk assessments, implementing and monitoring appropriate policies and procedures. As stated previously at the time of this inspection the views of people using the service and their Mere Hall View DS0000030291.V356638.R01.S.doc Version 5.2 Page 22 carers reflect high levels of satisfaction. Information submitted by the manager in respect of how quality at the home is monitored included; • Internal Audit is completed on at least an annual basis. This includes the auditing of individual files to ensure that all the necessary documentation is in place, up to date and pertinent. The regularity of supervisions is as per council policy all the necessary policies and procedures are in place and accessible, that the recording and monitoring systems for food regulations, health and safety and medication are correct. • The results of questionnaires have been collated and have been shared with the commissioners at the annual ‘contract monitoring reviews’. The questionnaires also feed into our own internal quality assurance systems to ensure continual development. • Annual ‘contract monitoring review’ includes the presence of commissioning, review officer registered manager and service managers. • Each service user has an annual review. Staff who act as key workers for individuals attend the review and where necessary feed back on behalf of the individual, outcomes that have been achieved and what future targets the individual wishes to achieve. • Referrals for advocacy and health and social care professionals are made by staff from the service to ensure that the required support is in place as and when necessary. • Close liaison between services, professionals and carers is encouraged to ensure that the service provision is the most appropriate possible for individuals. The health, safety and welfare of people using the service (and others) are promoted and protected. Information provided by the home indicates that equipment (including the utilities provided) are regularly maintained and inspected. Staff are all trained in moving and handling techniques – including the use of relevant equipment. A fire risk assessment and ‘fire log book’ is maintained. Other risk assessments regarding individual people who use the service, practices within the home and in relation to the building that seek to maximise the health, safety and wellbeing of all are also in place. Mere Hall View DS0000030291.V356638.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 X 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 4 23 4 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 X 32 4 33 x 34 4 35 4 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 4 X 4 x LIFESTYLES Standard No Score 11 x 12 4 13 4 14 X 15 4 16 4 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 4 3 x 4 X 4 X X 4 x Mere Hall View DS0000030291.V356638.R01.S.doc Version 5.2 Page 24 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. 1 Standard YA20 Regulation 13(2) Requirement To comply with Misuse of Drugs (safe custody) Regulations 1973 (amended 2007) it is now required that an appropriate metal cupboard is provided for the storage of ‘controlled’ medication to comply with the change in legislation. Timescale for action 30/04/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Mere Hall View DS0000030291.V356638.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Manchester Local office 11th Floor West Point 501 Chester Road Manchester M16 9HU 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 Mere Hall View DS0000030291.V356638.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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