Inspection on 18/04/05 for Mere Hall View

This inspection was carried out on 18th April 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Mere Hall View 17/01/08

Mere Hall View 13/06/06

Mere Hall View 03/12/05

Mere Hall View 02/09/04

Mere Hall View 20/04/04

Mere Hall View 21/10/03

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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 Lancashire BL1 2QT Lead Inspector Rukhsana Yates Announced 18 April 2005 09:30 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 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 Stationary 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 F56 F06 S30291 Mere Hall View V213007 180405 Stage 4.doc Version 1.20 Page 3 SERVICE INFORMATION Name of service Mere Hall View Address 7 Mere Hall Street Bolton Lancashire BL1 2QT 01204 337098 01204 337099 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Bolton Metropolitan Borough Council Amanda Allwood CRH Care Home 8 Category(ies) of LD Learning Disability 8 Places registration, with number PD Physical Disability 8 Places of places SI Sensory Impairment 8 Places Mere Hall View F56 F06 S30291 Mere Hall View V213007 180405 Stage 4.doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: Within the maximum of 8 there can be up to 8 LD, up to 8 PD and up to 8 SI. The additional registered place to be used solely for emergency placements. The service should employ a suitably qualified and experienced Manager who is registered with the Commission for Social Care Inspection. Date of last inspection 02 September 2004 Brief Description of the Service: Mere Hall View is part of Bolton Social Services provision for people with learning disabilities. It provides a short term break service for up to seven people whose primary need for support is due to learning disabilities. The building is in a residential area, half a mile from Bolton town centre. Bus routes and several amenities are within easy reach. Accomodation 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 F56 F06 S30291 Mere Hall View V213007 180405 Stage 4.doc Version 1.20 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was announced and took place over 8 hours. Most of the day was spent in discussions with the manager, three staff members, two service users and two relatives, and in observing practice. Key records were examined and a tour of the premises undertaken. Completed questionnaires were received from 4 service users and 6 relatives of service users. What the service does well: What has improved since the last inspection? Management cover has improved, with staff feeling better supported. There are now more staff on duty at certain times so that people having a short stay can get involved in more of the activities they like. Two staff members described feeling better motivated and enthusiastic. They talked about getting out and about more, and communicating better with families. A lot of work has been done to improve the experiences of people coming to stay. Themed weekends have brought together people of similar ages with similar interests, and the staff have worked hard to make these positive and enjoyable. Mere Hall View F56 F06 S30291 Mere Hall View V213007 180405 Stage 4.doc Version 1.20 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Mere Hall View F56 F06 S30291 Mere Hall View V213007 180405 Stage 4.doc Version 1.20 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 Standards Statutory Requirements Identified During the Inspection Mere Hall View F56 F06 S30291 Mere Hall View V213007 180405 Stage 4.doc Version 1.20 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 standard(s) 2 Each person considering using Mere Hall View has their needs assessed, and is provided with information about what the service can offer. The admission process ensures that the service is suitable, and individual needs properly understood, before regular short stays are arranged. EVIDENCE: A ‘Short Term Care Forum’ meeting takes place once a month, where three short stay providers are represented. Here, assessment information from care managers is used to decide upon the service most suitable for meeting each individual’s needs. Minutes of the monthly meetings show good and meaningful consideration of suitability and individualised introductions to the chosen service. For example, it is clear that the pace of introduction visits varies for different people, and sometimes a decision is made to look at alternative services. Service users and relatives consulted expressed confidence in the suitability of the service, and staff knowledge of their needs before admission. Since the last inspection, the manager has become more assertive about the information to be provided by care managers on referral. As a result the manager and staff know, and are therefore better placed to meet, the expectations of prospective service users and their families. Mere Hall View F56 F06 S30291 Mere Hall View V213007 180405 Stage 4.doc Version 1.20 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 standard(s) 6, 8 and 9 Very good progress has been made in updating care plans in recent months in consultation with service users and their families. As a result the changing needs, choices and risks for each person are known and used to plan appropriate support. Accessible policies and procedures are needed so that service users are involved in, and understand, service developments. EVIDENCE: The care plan format covers a wide range of assessment topics. Staff at Mere Hall View have been allocated as keyworkers to named people, and take responsibility for meeting with service users and their representatives to ensure that the care plan is accurately completed. Staff interviewed felt that their involvement has led to positive outcomes. There is better communication with families, more time to spend with service users to find out what they want, and service users are being supported in their choices. This improvement was also identified in discussions with two visiting relatives. Risks and related strategies are clearly documented and agreed with the individual, their family, and with other professionals involved. This guidance gives staff the confidence to support people in their preferred activities and to maximise their independence while keeping them safe. Mere Hall View F56 F06 S30291 Mere Hall View V213007 180405 Stage 4.doc Version 1.20 Page 10 There is a need for Mere Hall View to have key policies and procedures in a form that service users and their families understand. These must be specific to this service and cover, for example, new initiatives such as ‘themed weekends’, the way in which bookings are prioritised, and how and when people can expect to be consulted. A parent / carer meeting takes place twice a year as one way of informing people. Written information in different languages and in pictorial form will ensure increased participation of service users and their representatives in how the service is run. Mere Hall View F56 F06 S30291 Mere Hall View V213007 180405 Stage 4.doc Version 1.20 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12 and 16 Significant initiatives in terms of staffing and support have resulted in service users taking part in a good range of fulfilling activities. Care practices ensure that service users’ rights are upheld. EVIDENCE: Service users, relatives and staff members consulted described an increase in the number of activities taking place since the last inspection. Staffing levels are higher and rotas flexible so that support is available when it is most needed. The introduction of themed stays, such as ‘Ladies weekend’ and ‘Young Male Weekend’ show a good consideration of compatibility and interests to enhance service users’ short break experiences. Staff members interviewed said they felt motivated, enthusiastic and better about their role now that they have time to “plan activities people like and get out and about”. The service has achieved a better focus on its stated purpose since the last inspection. This means staff are rightly spending their time with those having a short break, rather than using some of that time providing an ‘outreach’ service. Introduction visits are better managed so that new service users have Mere Hall View F56 F06 S30291 Mere Hall View V213007 180405 Stage 4.doc Version 1.20 Page 12 the opportunity to see the facilities and talk to staff during less busy times of the day. Individual files show that a range of indoor and community activities are taking place, although the details of these are better recorded in some daily reports than in others at present. The manager is working with staff to ensure consistency in the quality of recording so that there is clear information to inform future review and planning around activities. Mere Hall View F56 F06 S30291 Mere Hall View V213007 180405 Stage 4.doc Version 1.20 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18 and 19 Service users have their health and personal support needs met in the way that they prefer and require. EVIDENCE: The manager described developments in working closely with people who have particular communication needs. These developments include training courses for staff, the use of speech therapy services, and the introduction of aids such as individualised communication books. These ensure that staff have a better understanding of how service users expect their personal care needs to be met. A health profile is being compiled for each service user. There is evidence of liaison with a range of health professionals with the aim of promoting and safeguarding health. One example shows that the service has obtained clear guidelines on managing epilepsy from a specialist nurse. The two relatives interviewed said that staff are very good at asking for and “taking on board” the information given about how needs should be met. One said “They follow guidelines and ask questions to make sure they’re doing things right”. Mere Hall View F56 F06 S30291 Mere Hall View V213007 180405 Stage 4.doc Version 1.20 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 standard(s) 22 and 23 Service users and their relatives feel they are listened to and their views acted upon. However, the complaints procedure needs to be accessible in different languages and formats to be sure that everyone using the service knows how to raise issues and how the service will respond. Protection policies and practices ensure the safety of service users. EVIDENCE: The Mere Hall View welcome pack contains a lot of useful information about the service, including details of how to complain. At the time of the last inspection, the service was to make this information available in different languages, but this has not yet happened. The manager is involved in a working group looking at developing an accessible complaints procedure. The service employs an Asian worker who can communicate with families that have Urdu or Gujerati as their first language. This provides one way in which views can be heard, but their right to an accessible complaints procedure needs to be addressed. This would encourage people to make their views known, and help the service to identify unmet needs. For example, one parent said that she has offered to show the cook how to prepare Indian dishes as her son, and other service users she knows, want similar food to the meals they have at home. She said that some parents did not get a proper break because they felt they should prepare and bring meals in to their son or daughter during his or her stay. The cook is accepting the offer of help, but this example, of one person speaking for others, highlights a need to make sure everyone has the individual means to make their views known directly to the service. Mere Hall View F56 F06 S30291 Mere Hall View V213007 180405 Stage 4.doc Version 1.20 Page 15 The manager and staff at Mere Hall View are clearly keen to listen, to respond to issues raised and want to develop the service in a way that reflects the community it serves. They were described as approachable and helpful by service users and relatives. There are written procedures for the protection of adults and for whistleblowing. Staff members understood these, having covered this topic in training courses. Mere Hall View F56 F06 S30291 Mere Hall View V213007 180405 Stage 4.doc Version 1.20 Page 16 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 standard(s) 24 and 30 Mere Hall View provides a safe, clean, comfortable environment for service users. Improvements to the grounds to increase privacy are being considered. EVIDENCE: Mere Hall View has three bedrooms on the ground floor and four bedrooms on the first floor. There is a lounge on each floor, providing a choice of communal space for service users. Each room has basic furniture, a washbasin and a television. Service users and visitors were happy with the environment, describing it as pleasant and clean. Since the last inspection, new leather sofas have replaced the old ones in the lounge. These are more comfortable, easy to clean, and have made the lounge area more pleasant to spend time in and for receiving visitors. The railings securing the grounds do not ensure privacy for service users in the garden. The manager suggested a benefit in service users being able to talk to neighbours, but this benefit cannot be assumed for all the people having short breaks. The manager is considering the use of plants to cover the railings. Mere Hall View F56 F06 S30291 Mere Hall View V213007 180405 Stage 4.doc Version 1.20 Page 17 There is evidence that Mere Hall View may be used to provide a service to young people with autistic spectrum disorders in the near future, and some changes to the building may be needed. The benefits of making the garden less exposed to strangers and to external, unpredictable distractions therefore become an important consideration in creating the right environment. For this reason the recommendation for privacy issues to be addressed made at the last two inspections remains outstanding. Mere Hall View F56 F06 S30291 Mere Hall View V213007 180405 Stage 4.doc Version 1.20 Page 18 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33 and 36 Since the last inspection, the staff team has become more effective and motivated in meeting service users’ personal and social care needs. Although staff feel well supported, there is a need for regular, individual supervision to ensure personal development needs are identified and met. EVIDENCE: Visiting relatives spoke very highly of all the staff at Mere Hall View, and two service users said “they are brilliant”. Staff described a more stable staff team, and the benefits this brings in terms of consistency for service users and good team working. They confirmed that staffing levels are increased at peak times of activity to ensure individual service users’ needs can be met. There has been no use of agency staff since Christmas. Staff within the department’s learning disability services, familiar with Mere Hall View, cover shifts if necessary. The manager is currently looking at changing shift patterns in order to provide more flexible support. The manager and staff said that supervision takes place informally on a day to day basis, and regular and recorded individual meetings have not taken place. Staff support different service users each week, and the range of needs they are expected to meet are varied and complex. There must be arrangements in place for each staff member to have regular, recorded supervision meetings to evaluate practice and training and development needs. Mere Hall View F56 F06 S30291 Mere Hall View V213007 180405 Stage 4.doc Version 1.20 Page 19 Standard 35 is to be assessed at the next inspection. Supervision should therefore be used to develop individual training profiles. There should be evidence that the specialist needs of future service users inform training plans, and that training includes race and cultural awareness. Mere Hall View F56 F06 S30291 Mere Hall View V213007 180405 Stage 4.doc Version 1.20 Page 20 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37 and 39 Management cover has improved since the last inspection, resulting in positive experiences for service users, and a commitment to improving quality. A development plan is needed that will show service users and others how their views are being used to develop the service, and the provider needs to assess quality regularly. The manager’s job description should be updated to reflect her duties. EVIDENCE: Since the last inspection, arrangements have been made for the manager to work full time at Mere Hall View, although her job description does not reflect her responsibilities. Staff members described a range of improvements due to the clearer direction and support they receive, including a better understanding of what they are trying to achieve, good organisation and communication, and the resources and autonomy to plan with individual service users. Mere Hall View F56 F06 S30291 Mere Hall View V213007 180405 Stage 4.doc Version 1.20 Page 21 Service users and relatives expressed great confidence in the manager and the staff in terms of their understanding, enthusiasm, willingness to listen and to act upon guidance and advice to ensure service users enjoy their stay. These comments, and the progress made since the last inspection, show that quality matters in this service. However there was no development plan to reflect service users’ experiences and their contributions to future plans. The quality development plan must be in accessible formats and languages so they can see how their views underpin the improvement process. The registered provider must also ensure that quality assurance visits are carried out at least monthly, and to record the findings as another way of demonstrating continuous improvement. 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. Where there is no score against a standard it has not been looked at during this inspection. 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 x 3 x x x Standard No 22 23 ENVIRONMENT Score 2 3 INDIVIDUAL NEEDS AND CHOICES Standard No Mere Hall View Score Standard No 24 25 26 27 Score 3 x x x Version 1.20 Page 22 F56 F06 S30291 Mere Hall View V213007 180405 Stage 4.doc 6 7 8 9 10 LIFESTYLES 3 x 2 3 x Score 28 29 30 STAFFING x x 3 Standard No 11 12 13 14 15 16 17 x 3 x x x 3 x Standard No 31 32 33 34 35 36 Score x x 3 x x 2 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 x x Standard No 37 38 39 40 41 42 43 Score 3 x 2 x x x x Mere Hall View F56 F06 S30291 Mere Hall View V213007 180405 Stage 4.doc Version 1.20 Page 23 yes 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 8, 22 Regulation 4, 6, 22 Requirement Policies and procedures for the home must cover the areas listed in Schedule 1. Summaries of the procedures, including the complaints procedure, must be produced in an accessible format and in languages required by service users and their families. All staff must receive regular, recorded supervision. (Previous timescale of 1.12.04 not met) Quality monitoring results must be used to form an annual development plan, based on service users views. The provider must assess and report monthly on the quality of the service provided.(Previous timescale of 1.3.05 not met) Timescale for action 01 November 2005 2. 3. 36 39 18 24, 26 06 June 2005 06 June 2005 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard 24 37 Good Practice Recommendations The lack of privacy in the grounds should be addressed. The managers job description should be revised to F56 F06 S30291 Mere Hall View V213007 180405 Stage 4.doc Version 1.20 Page 24 Mere Hall View accurately reflect the role and responsibilities. Mere Hall View F56 F06 S30291 Mere Hall View V213007 180405 Stage 4.doc Version 1.20 Page 25 Commission for Social Care Inspection Turton Suite, Paragon Business Park Chorley New Road Bolton BL6 6HG 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. Extracts may not be used or reproduced without the express permission of CSCI Mere Hall View F56 F06 S30291 Mere Hall View V213007 180405 Stage 4.doc Version 1.20 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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