Inspection on 23/10/06 for Meridan House

This inspection was carried out on 23rd October 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Meridan House 16/03/09

Meridan House 03/01/06

Meridan House 30/08/05

Meridan House 21/02/05

Meridan House 12/07/04

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

CARE HOME ADULTS 18-65 Meridan House 1 Stonecrop Close Colindale Avenue Colindale London NW9 5RG Lead Inspector Daniel Lim Key Unannounced Inspection 23rd October 2006 09:00 Meridan House DS0000010548.V313351.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 Meridan House DS0000010548.V313351.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. Meridan House DS0000010548.V313351.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Meridan House Address 1 Stonecrop Close Colindale Avenue Colindale London NW9 5RG 020 8205 4048 020 8205 2986 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) Richmond Fellowship Gloria Achiekwelu Care Home 12 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (12) of places Meridan House DS0000010548.V313351.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Foxlands and Meridan will have one registered manager and a designated deputy manager in each home. There is one female service user at Meridan House over the age of 65 (D.O.B 30/11/1937). The CSCI must be informed when this service user no longer receives care at the home. The homes Meridan House and Foxlands House will function separately with their own registration and independent staff group to provide personal care only. 3rd January 2006 3. Date of last inspection Brief Description of the Service: Meridan is a care home registered to provide personal care for a maximum of twelve younger adults with mental disorders. Most of the residents were previously patients at Napsbury Hospital in Hertfordshire. The home is operated by a charity called The Richmond Fellowship which also operates several other care homes for people with mental health problems in London. The stated aim of the home is to provide a home where residents can be cared for with dignity and where they can lead as independent a life as possible. The home is a modern, detached two storey house which was opened in 1998. It has twelve single bedrooms. All bedrooms have ensuite facilities. The staff office, kitchen, diner and two large lounges are on the ground floor. The bedrooms and two smaller lounges are on the first floor. There are two communal bathrooms on the ground floor and one communal toilet on each floor. There is a small front garden and an attractive larger back garden which is partly paved and accessible to service users. The home is within walking distance of Colindale Hospital and about a mile away from Edgware Hospital. It is also close to shops, restaurants and public transport facilities along the Edgware Road. The fees charged by the home are based on a block contract with the local health authority (£1158 per person week). Meridan House DS0000010548.V313351.R01.S.doc Version 5.2 Page 5 The provider must make information about the service available (including reports) to service users and other stakeholders. Meridan House DS0000010548.V313351.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was carried out on 23 October 2006 and took a total of three and a half hours to complete. The inspector found that the overall quality of care provided was of a high standard. During this inspection, the inspector was accompanied by the home manager (Gloria Achiekwelu). The inspector was able to interview four residents. The feedback received from them indicated that they were satisfied with the care provided. Statutory records were examined. These included three residents’ case records, the maintenance records, accident records, complaints’ record and fire records of the home. The premises including bedrooms, bathrooms, activities room, resource room, treatment room, laundry, kitchen, gardens and communal areas were inspected. Three staff on duty were interviewed on a range of topics associated with their work. Staff records, including supervision records, evidence of CRB disclosures, references and training records were examined. The minutes of staff and residents’ meeting were also examined. In addition, completed questionnaires were received from two healthcare professionals, three relatives and four residents. These were positive and indicated that the respondents were satified with the care provided at the home. What the service does well: The case records of residents were comprehensive and plans of care were structured and up to date. The premises were clean and homely. The garden was attractive and well maintained. Effort had been made to ensure that residents are mentally stimulated and have access to a range of activities. Residents were satisfied with the care provided and they stated that staff had treated them with respect and dignity. Meridan House DS0000010548.V313351.R01.S.doc Version 5.2 Page 7 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. Meridan House DS0000010548.V313351.R01.S.doc Version 5.2 Page 8 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 Meridan House DS0000010548.V313351.R01.S.doc Version 5.2 Page 9 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, 3 The quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. Arrangements were in place to ensure that residents’ aspirations and needs are assessed. This ensures that their needs can be identified and met at the home. EVIDENCE: The four residents who were interviewed indicated that their care needs had been met at the home and they were happy with the care provided. Comments made included, “well treated” and “I am feeling better now”. A sample of three residents’ case records which were examined, contained comprehensive assessments, plans of care and details of how residents needs had been met. The inspector observed that residents in the home were clean, appropriately dressed and appeared well cared for. Feedback received from those who returned their completed questionnaires indicated that the needs of residents had been met. Meridan House DS0000010548.V313351.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8, 9 The quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. Arrangements were in place to ensure that residents are able to make decisions about their lives and remain as independent as possible. EVIDENCE: Residents who were interviewed indicated that they had been consulted regarding their care and had been encouraged to be as independent as possible. Residents stated that they had been involved in household chores such as tidying their bedrooms, doing their laundry and food preparation. The inspector noted that residents could go out and return freely. One of the residents stated that she was attending a course. She further informed the inspector that staff had treated her well and she now felt settled in the home. Meridan House DS0000010548.V313351.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 14, 15, 16, 17 The quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. The daily life and routines of residents were well organised and individually tailored to meet the needs of residents. This ensures that residents felt valued and are able to exercise choice and control over their lives. EVIDENCE: The home had a varied activities programme for residents. This included music and relaxation sessions, health & beauty sessions, video, gardening and outings to places of interest. There was evidence in the case records that they had been kept active and stimulated. Residents informed the inspector that they had enjoyed a week’s holiday at Butlins during the summer. Meetings had been organised and residents had been consulted regarding the management of the home. The minutes of these meetings were available for inspection. Meridan House DS0000010548.V313351.R01.S.doc Version 5.2 Page 12 Resident interviewed indicated that they were satisfied with the meals served. The menus examined appeared varied and balanced. One resident informed the inspector that she was able to cook her own meals. The inspector noted that two rooms had been set aside for promoting the personal development of residents. One was a resource room where reference books and magazines and a computer were provided for residents. The other room was now an activities room with a treadmill, exercise bike and a selection of art and crafts items. The manager also provided evidence of ornaments, paintings and pictures done by service users. In addition, a resident was able to confirm that she had opportunity to learn embroidery and had managed to develop her skills in arts and crafts and assisted other residents in this area. The inspector was informed by the manager that residents had taken part in their area sports day and had won a trophy. Evidence of this was provided. Residents interviewed stated that they had been in contact with their relatives. This was also confirmed by a relative who spoke to the inspector over the telephone prior to the inspection. Meridan House DS0000010548.V313351.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 The quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. The arrangements for healthcare and personal care were on the whole, satisfactory. This ensures that residents’ holistics needs are being met at the home. Improvement is required in the storage of medication. EVIDENCE: The four residents interviewed stated that they had been attended to by healthcare professionals including their CPN and psychiatrist. The medication records were well maintained and residents stated that they had been given their medication. The temperature of the room where the medicines cupboard was located had been monitored daily. The inspector noted that there were occasions when the temperature was noted to be 26C). The inspector was reassured by the manager that an air conditioner was in the process of being purchased for the room. Meridan House DS0000010548.V313351.R01.S.doc Version 5.2 Page 14 The sample of three case records contained comprehensive plans of care which addressed the holistic needs of residents. There was evidence in the records to indicate that plans prepared had been carried out. These plans were reviewed regularly. The sample of three residents’ case records contained appropriate care plans and assessments. Plans of care had been signed by residents’ concerned and these had been regularly reviewed. The care and plans of care of a resident who had exhibited challenging behaviour was examined and discussed in detail. The inspector noted that the risk assessments and care plans were appropriate and comprehensive and the manager was aware of the care and support to be provided. The inspector noted that this resident who had challenging behaviour had made significant improvement as a result of care provided and a behaviour modification programme. Meridan House DS0000010548.V313351.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 The quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. The arrangements for responding to complaints and for adult protection were satisfactory. This ensures that residents feel listened to and are protected from abuse and harm. EVIDENCE: The complaints book was examined. The inspector noted that one complaint had been recorded since the last inspection. There was documented evidence that this complaint had been responded to appropriately. Residents interviewed stated that they were well treated by staff and no allegations of abuse were received by the inspector. Meridan House DS0000010548.V313351.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, 25, 26, 27, 28, 29, 30 The quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. The home was clean, well equipped and furnished to a high standard, therefore providing a nice environment to live in. EVIDENCE: The premises were clean and well equipped. The communal areas were well decorated and adequately furnished. The garden was attractive and colourful. The inspector was informed that residents had been involved in maintaining the gardens. The required maintenance and safety certificates were seen by the inspector. These included safety inspection certificates for the portable appliances, electrical installations and gas equipment. The laundry was inspected. Linen which had been washed were examined. These were found to be clean. Lockable facilities had been provided in bedrooms inspected. Meridan House DS0000010548.V313351.R01.S.doc Version 5.2 Page 17 Meridan House DS0000010548.V313351.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): 31, 32, 33, 34, 35, 36 The quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. The recruitment process and staffing arrangements were satisfactory. This ensured that residents’ needs were met by an appropriate and capable group of staff. EVIDENCE: The four residents who were interviewed indicated that staff were responsive and had treated them with respect and dignity. The duty rota was examined. It indicated that in addition to the manager, there was normally at least three staff during the morning shift, 2 staff during the afternoon and evening shifts and one staff on sleeping duty during the night shifts. The two staff who were on duty were interviewed on a range of topics associated with their work (such as health and safety, adult protection, fire procedures and the mental healthcare care of residents). They were noted to be knowledgeable regarding their roles and responsibilities. Meridan House DS0000010548.V313351.R01.S.doc Version 5.2 Page 19 There was documented evidence that staff had been provided with essential training. This included the management of residents with challenging behaviour, mental healthcare, care documentation, first aid, medication and health and safety. The staff records examined indicated that the required recruitment standards and procedures (including obtaining satisfactory CRB disclosures and references) had been followed. Staff further stated that there was a good team spirit. There was documented evidence of formal staff supervision. Meridan House DS0000010548.V313351.R01.S.doc Version 5.2 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 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, 38, 39, 41, 42 The quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. The home was run in the best interest of residents and arrangements were in place to ensure the safety and welfare of residents in the home. EVIDENCE: The manager was found to be knowledgeable regarding her role and responsibilities. There was evidence that staff and residents were consulted regarding the management of the home. Monthly residents’ meetings had been held. There was evidence that residents preferences regarding holidays and meals provided were responded to. All four residents interviewed expressed satisfaction at the way the home was managed. Meridan House DS0000010548.V313351.R01.S.doc Version 5.2 Page 21 Weekly fire alarm checks, fire door checks, fire drills and fire training had been documented. The emergency lighting had been tested weekly. The fire risk assessment had been updated. The hot water had been checked weekly and the temperature was noted to be satisfactory (no higher than 43 C). All windows inspected had been fitted with window restrictors. These were engaged. The issue of equalities and valuing diversity was discussed. The manager provided the inspector with documented evidence that staff had been provided witgh training in this area and the home had a statement promoting equalities and valuing diversity. Residents interviewed confirmed that they had been treated with respect and dignity and staff were polite to them. No negative remarks were made by any of those interviewed. The home had a system of quality assurance and this included a consumer questionnaire. Meridan House DS0000010548.V313351.R01.S.doc Version 5.2 Page 22 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 3 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 3 25 3 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 X 3 3 X LIFESTYLES Standard No Score 11 4 12 3 13 3 14 3 15 3 16 4 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 3 3 4 3 X 3 X 3 Meridan House DS0000010548.V313351.R01.S.doc Version 5.2 Page 23 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 Timescale for action 01/12/06 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 Meridan House DS0000010548.V313351.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Southgate Area Office Solar House, 1st Floor 282 Chase Road Southgate London N14 6HA 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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