Inspection on 30/08/05 for Meridan House

This inspection was carried out on 30th August 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Meridan House 16/03/09

Meridan House 23/10/06

Meridan House 03/01/06

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 Unannounced 30 August 2005 @ 09.30 am 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. Meridan House 20050830 Meridan House X00022 UN Stage 4 S10548 V240624 G59.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Meridan House Address 1 Stonecrop Close, Colindale Avenue, Colindale, London NW9 5RG 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) 020 8205 4048 020 8205 2986 Nigel Pink for Richmond Fellowship Gloria Achiekwelu PC Care Home only 12 beds Category(ies) of MD Mental Disorder registration, with number of places Meridan House 20050830 Meridan House X00022 UN Stage 4 S10548 V240624 G59.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. Foxlands and Meridan will have one registered manager and a designated deputy manager in each home. 2. 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. 3. The homes (Meridan House and Foxlands House) will function seperately with their own registration and independent staff group to provide personal care only. Date of last inspection 21 February 2005 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 nursing 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.It has 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. Meridan House 20050830 Meridan House X00022 UN Stage 4 S10548 V240624 G59.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out on 30 August 2005 and took three hours to complete. The inspector found that many of the National Minimum Standards had been met and the overall quality of care provided was good. During this inspection, the inspector was accompanied by the deputy manager (Paul Britte) and manager of the home (Ms Gloria Achiekwelu). The inspector was able to interview three residents. The feedback received was positive and residents indicated that they were well cared for. Completed questionnaires were also received from nine residents, a healthcare professional, three placement officers / care manager and three relatives. These indicated that all the respondents were satisfied with the care provided at the home. Three residents case records were examined in detail. The premises including bedrooms and the gardens were inspected and the maintenance records were examined. Staff on duty were interviewed on a range of topics associated with their work and a sample of staff records were examined. Minutes of staff meetings and residents’ meetings were also examined. What the service does well: The care documentation examined was comprehensive and up to date. The premises were clean and well furnished. The gardens were attractive. Residents had been consulted and their preferences regarding activities organised had been responded to. Meridan House 20050830 Meridan House X00022 UN Stage 4 S10548 V240624 G59.doc Version 1.40 Page 6 Staff were knowledgeable regarding the care to be provided for residents. What has improved since the last inspection? What they could do better: Improvements are needed in the storage of medication. The registered person must ensure that medication is stored at the required temperature of no higher that 25 C. Improvements are also needed in the area of Health and Safety. The registered person must ensure that weekly checks of the emergency lighting are carried out and to ensure that the fire safety arrangements are adequate, a request must be made for a fire safety inspection to be carried out by the LFEPA. A requirement has also been made for the registered person to arrange for the placement and care of the resident identified in standard 3 to be reviewed with professionals involved to ensure that her needs are met. Meridan House 20050830 Meridan House X00022 UN Stage 4 S10548 V240624 G59.doc Version 1.40 Page 7 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 20050830 Meridan House X00022 UN Stage 4 S10548 V240624 G59.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Meridan House 20050830 Meridan House X00022 UN Stage 4 S10548 V240624 G59.doc Version 1.40 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 standard(s) 2,3 The manager, deputy manager and her staff had a good understanding of the needs of residents and were able to ensure that most of their needs were met. Action is required to ensure that the placement of a resident identified to the manager is appropriate and she is receiving the care required. EVIDENCE: The inspector interviewed three residents. The feedback received indicated that their care needs had been met. Comments received included,“well cared for”, “staff treat me well”, “alright here”. Three case records examined contained assessments and plans of care. These were up to date and comprehensive. The inspector observed the physical condition of residents. They were noted to be clean and appropriately dressed. The inspector however, noted that a resident had been unco-operative with her care and treatment. This was also documented in her case records. This was Meridan House 20050830 Meridan House X00022 UN Stage 4 S10548 V240624 G59.doc Version 1.40 Page 10 discussed with the manager and deputy manager and a requirement is made for the care and placement of this resident to be reviewed. Meridan House 20050830 Meridan House X00022 UN Stage 4 S10548 V240624 G59.doc Version 1.40 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 standard(s) 6,7,8,9 There was evidence that staff had enabled residents to make decisions about their lives and encouraged them to remain as independent as possible. EVIDENCE: Residents who were interviewed were able to confirm that staff listened to them and suggestions made by them had been acted upon. This included holidays and outings organised. The minutes of residents’ meetings were examined. These contained evidence that residents’ preferences had been responded to. The sample of residents’ case records contained evidence that residents had been encouraged to be as independent as possible. This included taking part in household chores such as tidying their bedrooms, assisting with cooking, going on outings and watering the flowers. Meridan House 20050830 Meridan House X00022 UN Stage 4 S10548 V240624 G59.doc Version 1.40 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 standard(s) 11,12,13,14,15,16,17 Residents had opportunity to engage in various activities aimed at their personal development. The arrangements for the provision of meals was found to be satisfactory. EVIDENCE: The inspector noted that the daily life and routines of residents were well organised. The home had a varied activities programme for residents. This was seen by the inspector. There was evidence in the case records that they had been kept active and stimulated. The daily programme and case records examined indicated that residents had been encouraged to assist in household chores such as shopping and tidying of their bedrooms. Meridan House 20050830 Meridan House X00022 UN Stage 4 S10548 V240624 G59.doc Version 1.40 Page 13 Meetings had been organised and residents had been consulted regarding the management of the home and outings orrganised. Resident interviewed indicated that they were satisfied with the meals served. The menu examined appeared varied and balanced. Meridan House 20050830 Meridan House X00022 UN Stage 4 S10548 V240624 G59.doc Version 1.40 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 standard(s) 18,19,20, The personal and healthcare needs of most of the residents had been met at the home. Improvements are needed in the care of a resident (identified to the manager and deputy manager) and in the storage of medication. EVIDENCE: The visiting community psychiatric nurse was interviewed by the inspector. He informed the inspector that staff maintained close liaison with him and his guidance and instructions had been followed. The three residents interviewed stated that they had been attended to by healthcare staff. The medication records were well kept and residents had been given their medication. The temperature of the medicines cupboard was at times higher than 25 degrees centigrade. The manager must ensure that the temperature is kept below 25 degrees centigrade to ensure the potency of medication and as advised by the CSCI pharmacy adviser. Meridan House 20050830 Meridan House X00022 UN Stage 4 S10548 V240624 G59.doc Version 1.40 Page 15 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 and residents’ personal and healthcare needs had been met. The inspector however, noted that a resident was unco-operative with her care and treatment and her behaviour had been a cause for concern for staff. This was discussed with the manager. A requirement is made for the care and placement of this resident to be reviewed. Meridan House 20050830 Meridan House X00022 UN Stage 4 S10548 V240624 G59.doc Version 1.40 Page 16 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) 22,23 There was evidence that the residents were listened to and protected from abuse and neglect. EVIDENCE: The staff records contained evidence that staff had been provided with adult protection training. The complaints book was examined and complaints made had been promptly responded to The three residents interviewed stated that they were well treated by staff. Meridan House 20050830 Meridan House X00022 UN Stage 4 S10548 V240624 G59.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24,25,26,27,28,29,30 The home was well furnished and well equipped, therefore providing a pleasant environment to live in. EVIDENCE: The premises were inspected and found to be clean and well furnished. The hot water in bedrooms was tested and found to be within the required safe temperature range of no higher than 43 C. The gardens were attractive and seating had been provided. The inspector was informed by the manager that some residents had assisted in watering the flowers in the garden. The communal areas were well furnished and appeared cosy. The required maintenance records and safety certificates were seen by the inspector. These included safety inspection certificates for the gas and electrical installations, portable appliances and fire safety equipment. Meridan House 20050830 Meridan House X00022 UN Stage 4 S10548 V240624 G59.doc Version 1.40 Page 18 Meridan House 20050830 Meridan House X00022 UN Stage 4 S10548 V240624 G59.doc Version 1.40 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,33,34,35,36 The recruitment process in place ensured that residents needs were met by an appropriate group of staff. Staff were supported and closely supervised by their managers EVIDENCE: Staff were interviewed and noted to be knowledgeable regarding their role and the care to be provided. The three residents who were interviewed indicated that they were well treated. The staff rota was examined and staffing arrangements examined in detail. This was noted to be adequate. The training records examined, indicated that staff had been provided with essential training. This included training in the care of residents who have challenging behaviour, adult protection, administration of medicines and fire safety. Meridan House 20050830 Meridan House X00022 UN Stage 4 S10548 V240624 G59.doc Version 1.40 Page 20 There was evidence in the staff records to indicate that staff were closely supervised. Meridan House 20050830 Meridan House X00022 UN Stage 4 S10548 V240624 G59.doc Version 1.40 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 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) 37,38,39,42 Systems were in place to ensure that the rights and interests of residents were safeguarded. Two requirements are made to further improvements to health and safety within the home. EVIDENCE: Meridan House 20050830 Meridan House X00022 UN Stage 4 S10548 V240624 G59.doc Version 1.40 Page 22 When interviewed on a range of topics associated with the care of residents and staff management, the manager and her deputy were found to be knowledgeable. Residents and staff interviewed expressed confidence in the way the home was managed. The fire logbook examined indicated that fire drills and weekly checks of the fire alarm had been carried out. A fire risk assessment was in place. Fire training had been arranged for staff. When questioned, staff were knowledgeable regarding the fire procedures. However, the home had not been inspected by the fire authorities during the past two years. To ensure that the fire safety arrangements are adequate, the registered manager must request that a fire safety inspection be carried out by the LFEPA. The inspector noted that the home did not have a record of weekly checks of the emergency lighting. This is required for safety reasons. Meridan House 20050830 Meridan House X00022 UN Stage 4 S10548 V240624 G59.doc Version 1.40 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 2 x x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 3 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score 3 3 3 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Meridan House Score 3 2 2 x Standard No 37 38 39 40 41 42 43 Score 3 3 3 x x 2 x 20050830 Meridan House X00022 UN Stage 4 S10548 V240624 G59.doc Version 1.40 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 3, 19 Regulation 23(2)(b) Requirement The registered person must arrange for the placement and care of the resident identified in standard 3 to be reviewed with professionals involved to ensure that her needs are met. The registered person must ensure that medication is stored at the required temperature of no higher that 25 C The registered person must ensure that weekly checks of the emergency lighting are carried out and documented. The registered person must request that a fire safety inspection of the home be carried out by the LFEPA. Timescale for action 30/9/05 2. 20 13(2) 30/9/05 3. 42 13(4) 13/10/05 4. 42 23(4) 1/11/05 5. 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. Meridan House 20050830 Meridan House X00022 UN Stage 4 S10548 V240624 G59.doc Version 1.40 Page 25 Refer to Standard Good Practice Recommendations Commission for Social Care Inspection 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. Extracts may not be used or reproduced without the express permission of CSCI Meridan House 20050830 Meridan House X00022 UN Stage 4 S10548 V240624 G59.doc Version 1.40 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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