CARE HOME ADULTS 18-65
Mere Lodge 93 Mere Road Leicester LE5 5GQ Lead Inspector
Chris Wroe Unannounced Inspection 30th May 2006 2:15 Mere Lodge DS0000064385.V296181.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 Lodge DS0000064385.V296181.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 Lodge DS0000064385.V296181.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Mere Lodge Address 93 Mere Road Leicester LE5 5GQ 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) 0116 2515203 Mere Lodge Healthcare Ltd Miss Tracy Jayne Johnson Care Home 4 Category(ies) of Learning disability (4) registration, with number of places Mere Lodge DS0000064385.V296181.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. No additional conditions of registration apply. Date of last inspection 4th November 2005 Brief Description of the Service: Mere Lodge is a converted 2 storey, 4 bedded terraced property in the Highfields area of the city of Leicester. It is situated adjacant to Spinney Hill park and close to many shops and local amenities. The home consists of 2 lounges, a dining kitchen, and large bathroom with whirlpool bath to the ground floor; all 4 bedrooms, toilet with shower enclosure, and office are on the first floor; access to which is by the main staircase. Fees charged range from £1000 to £1700 per week. Mere Lodge DS0000064385.V296181.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This key inspection included a visit to the service. The inspector visited the home on 30th May 2006. The visit started at 2.15pm and lasted for five hours. Three residents were at home during the inspection. All three residents chose to speak to the inspector. The main method of inspection used was ‘case tracking’. This means looking at the care given to residents in different ways. The ways this was done are: • talking to the residents • talking to staff and the manager • watching how residents are given support • looking at written records. All the residents were happy about the care given by staff. They felt they got good support. They felt the home was comfortable and they had what they need. All the key standards were checked during this inspection. The information below is based only on those aspects checked in this inspection. Only four residents live in the home, so a lot of individual detail has been kept out of the report, to make sure it is kept confidential. What the service does well:
The manager finds out about people before they come to live in the home. She asks people about what they need and the things they like and don’t like. People who want to come and live in the home can visit and stay to see if they like it. There are care plans in the home for each person who lives in the home. Care plans tell about what is important for each person living in the home. Staff know what each person who lives in the home needs, and about the things they like and don’t like. Staff make sure other people, like social workers, keep in contact with people living in the home and know about what is happening. People who live in the home can choose things that they want to do. There are risk assessments in the home for each person. Risk assessments tell about
Mere Lodge DS0000064385.V296181.R01.S.doc Version 5.2 Page 6 how people who live in the home can be helped to do the things they want to do and be kept safe. People who live in the home can do different things they want to do. Staff help each person who lives in the home to see people they want to see. There are some policies in the home, which tell staff about how to give good support to people who live in the home. Care staff cook meals for people who live in the home. Care plans have information about what people like to eat, and what they cannot eat. Staff know about the different cultural needs of people who live in the home. Staff help people who live in the home to look after themselves. There is a policy in the home which tells staff about how to give out medication safely to people who live in the home. Staff have had training to show them how to give out medicine. People who live in the home said that they could talk to the manager if they had a problem. They felt they would be listened to. There is a policy, which tells people how they can make a complaint if they want to. Staff have had training about how to make sure people are kept safe from harm. There is a policy in the home, which tells staff about what they need to do if anyone is in any danger. People living in the home have their own things in their bedrooms. They can choose what colour they want their bedrooms to be. The home is mostly comfortable for people who live in it. Staff make sure they check the home is safe for people who live in it. All rooms in the home were mostly clean and safe. There is a staff rota in the home to show how many people are working in the home and who they are. There are always two or more people working in the home. Staff are given training to show them how to do their job well. They get support from the manager and can talk about how things are going. Staff feel that they get good support. There are different ways that people who live in the home can say what they think about the home. The people who own the home have got plans about how to make the home better for people living in it and how to keep checking things are good. Mere Lodge DS0000064385.V296181.R01.S.doc Version 5.2 Page 7 There are policies in the home, which tell staff about how to work safely. Some staff have had training in first aid so they can help people in an emergency. Staff do checks to make sure that equipment in the home is safe. What has improved since the last inspection? What they could do better:
It would be good if staff made a policy about the rights of people who live in the home to have sexual relationships if they want to and if they understand about them. It would be good if staff looked at how to keep people safe if they want to have relationships. It would be good if staff could help people who live in the home to have regular appointments at the dentist, and help people who need dentures to get them. It would be good if the staff asked the GP to sign for each person living in the home what extra ‘homely’ medicines it is safe for them to take. Staff said the floors in the bathroom and kitchen can be slippery when they get wet – it would be good if the floors were made safe. In the downstairs bathroom there are no grab rails or aids to help people to get in and out of the bath, so it could be unsafe for people who live in the
Mere Lodge DS0000064385.V296181.R01.S.doc Version 5.2 Page 8 home. It would be good if it was made safe for people to get in and out of the bath. The temperature of water in the downstairs bathroom sink had been tested, and was very hot. It is important that this is made cooler to be safe for people who live in the home. Checks of electrical things in the home have not been done, and it would be safer if they were done. In the toilet upstairs there is a problem with the floor. The floor lets water through and is not clean or safe for people who live in the home. It would be good if the floor in the upstairs toilet is made safe for people who live in the home. There are some problems drying clothes because there are too many to dry in the tumble dryer and there is no clothes line. Staff have used radiators to dry clothes making the home feel too hot sometimes. It would be good if staff could sort out a proper way to dry clothes. 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. Mere Lodge DS0000064385.V296181.R01.S.doc Version 5.2 Page 9 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 Lodge DS0000064385.V296181.R01.S.doc Version 5.2 Page 10 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): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ needs and aspirations continue to be assessed so that staff can support them in the way they need. EVIDENCE: Before people come to live in the home, the manager finds out about what they need and the things they like and don’t like. People who live in the home were told about the home before they came to live in it. They were able to come and visit and stay for a while to see if they liked the home. Mere Lodge DS0000064385.V296181.R01.S.doc Version 5.2 Page 11 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, 7, 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are enabled to fulfil their own needs and choices. EVIDENCE: There are care plans in the home for each person who lives in the home. Care plans tell about what is important for each person living in the home. Staff know what each person who lives in the home needs, and about the things they like and don’t like. Staff make sure other people, like social workers, keep in contact with people living in the home and know about what is happening. People who live in the home can choose things that they want to do. There are risk assessments in the home for each person. Risk assessments tell about how people who live in the home can be helped to do the things they want to do and be kept safe. Mere Lodge DS0000064385.V296181.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16, 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents generally benefit from a good lifestyle in the home. EVIDENCE: People who live in the home can do different things they want to do. The people who live in the home told the inspector about the different things they like. They like to do things like go shopping, go for walks, go to Wesley Hall (community centre), read books, watch television. Three people who live in the home talked about friends and family that they keep in touch with. Staff help each person who lives in the home to see people they want to see. There are some policies in the home, which tell staff about how to give good support to people who live in the home. It would be good if staff made a policy about the rights of people who live in the home to have sexual relationships if they want to and if they understand about them. It would be good if staff looked at how to keep people safe if they want to have relationships. Mere Lodge DS0000064385.V296181.R01.S.doc Version 5.2 Page 13 One person living in the home has an advocate, who gives support. Staff also make sure that people living in the home have support from social workers and other people. Care staff cook meals for people who live in the home. Care plans have information about what people like to eat, and what they cannot eat. Staff know about the different cultural needs of people who live in the home. For one person living in the home this means that there are some special ways some foods need to be prepared, and staff make sure this is done. There are menus in the home, which show the different foods that are cooked. Staff keep a check on how healthy people who live in the home are. Mere Lodge DS0000064385.V296181.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from mostly good staff attention to health and medical care needs. EVIDENCE: Staff help people who live in the home to look after themselves. If people feel poorly they can see a local GP. It would be good if staff could help people who live in the home to have regular appointments at the dentist, to make sure they stay healthy. There is a policy in the home, which tells staff about how to give out medication safely to people who live in the home. Staff have had training to show them how to give out medicine. There is information about medication in the care plans. Staff can read about the different medicines to make sure people living in the home are kept safe and well. Staff write down if they have to give some extra medicine to help someone who is having a difficult time. It would be good if the staff asked the GP to sign for each person living in the home about what extra ‘homely’ medicines it is safe for them to take. Mere Lodge DS0000064385.V296181.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are protected from harm by policies in the home and awareness of staff. EVIDENCE: People who live in the home said that they could talk to the manager if they had a problem. They felt they would be listened to. There is a policy, which tells people how they can make a complaint if they want to. Staff have had training about how to make sure people are kept safe from harm. There is a policy in the home, which tells staff about what they need to do if anyone is in any danger. Staff have shown that they follow this properly. Mere Lodge DS0000064385.V296181.R01.S.doc Version 5.2 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 the following standard(s): 24, 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents benefit from living in a generally clean and comfortable home, but some attention could be paid to improvements, to ensure residents’ safety. EVIDENCE: The inspector looked round the home, and saw the different rooms that people who live in the home use. People living in the home have their own things in their bedrooms. They can choose what colour they want their bedrooms to be. The home is mostly comfortable for people who live in it. Staff make sure they check the home is safe for people who live in it. There are some things that could be better: Staff said the floors in the bathroom and kitchen can be slippery when they get wet – it would be good if the floors were made safe. In the downstairs bathroom there are no grab rails or aids to help people to get in and out of the bath, so it could be unsafe for people who live in the home. It would be good if it was made safe for people to get in and out of the bath.
Mere Lodge DS0000064385.V296181.R01.S.doc Version 5.2 Page 17 The temperature of water in the downstairs bathroom sink had been tested, and was very hot. It is important that this is made cooler to be safe for people who live in the home. Checks of electrical equipment in the home have not been done, and it would be safer if they were done. All rooms in the home were mostly clean and safe. In the toilet upstairs there is a problem with the floor. The floor lets water through and is not clean or safe for people who live in the home. It would be good if the floor in the upstairs toilet is made safe for people who live in the home. The washing machine/tumble dryer is in the kitchen. There are some problems drying clothes because there are too many to dry in the tumble dryer and there is no clothes line. Staff have used radiators to dry clothes making the home feel too hot sometimes. It would be good if staff could sort out a proper way to dry clothes. Mere Lodge DS0000064385.V296181.R01.S.doc Version 5.2 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 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from supportive staff. EVIDENCE: There is a staff rota in the home to show how many people are working in the home and who they are. There are always two or more people working in the home. Staff are chosen to work in the home who are safe and able to support people well. Staff are given training to show them how to do their job well. They get support from the manager and can talk about how things are going. Staff feel that they get good support. Mere Lodge DS0000064385.V296181.R01.S.doc Version 5.2 Page 19 Conduct and Management of the Home
The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are kept generally safe by management systems in the home. EVIDENCE: The manager is spending some time at another home to help staff there. Staff can contact her on the telephone if the need her. The manager comes to the home to check everything is running properly. There are different ways that people who live in the home can say what they think about the home. There are residents meetings in the home. Keyworkers talk to people who live in the home about the things they like and don’t like. Care plans talk about how people can be asked what they think about the home. The people who own the home have got plans about how to make the home better for people living in it and how to keep checking things are good. There are policies in the home, which tell staff about how to work safely. Some staff have had training in first aid so they can help people in an emergency. Staff do checks to make sure that equipment in the home is safe.
Mere Lodge DS0000064385.V296181.R01.S.doc Version 5.2 Page 20 Mere Lodge DS0000064385.V296181.R01.S.doc Version 5.2 Page 21 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 3 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 3 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 2 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 2 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 2 2 X 3 X 3 X X 3 X Mere Lodge DS0000064385.V296181.R01.S.doc Version 5.2 Page 22 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. 1. 2. 3. Refer to Standard YA15 YA19 YA20 Good Practice Recommendations It is recommended that a policy is developed relating to sexual relationships between residents, and that where risk to safety is identified risk assessments are prepared. It is recommended that residents are supported to have regular dental care, to ensure continuing health. It is recommended that residents’ GPs are asked to sign for each person living in the home what extra ‘homely’ medicines it is safe for them to take. It is recommended that the floors in the bathroom and kitchen are made safe so as not to be a slip hazard for residents. It is recommended that proper aids/adaptations are provided to enable residents to climb safely in and out of the bath. It is recommended that action is taken to make water a safe temperature for residents when an excessively high temperature is identified in tests of equipment.
DS0000064385.V296181.R01.S.doc Version 5.2 Page 23 4. 5. 6. YA24 YA24 YA24 Mere Lodge 7. 8. YA24 YA30 It is recommended that safety checks of electrical equipment are carried out. It is recommended that the floor in the upstairs toilet is repaired so that it is impermeable and prevented from being a safety hazard to residents. Mere Lodge DS0000064385.V296181.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Leicester Office The Pavilions, 5 Smith Way Grove Park Enderby Leicester LE19 1SX National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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