Inspection on 14/09/05 for Merlewood

This inspection was carried out on 14th September 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 no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Merlewood 08/09/09

Merlewood 16/08/07

Merlewood 05/10/06

Merlewood 02/03/06

Merlewood 14/12/04

Merlewood 19/07/04

Similar services:

Clover House

Parkside

Park Lodge

Mere Hall View

St Bonaventures

Hudson Road

Whitewalls

Home Farm

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

CARE HOME ADULTS 18-65 Merlewood 52 Park Lane Great Harwood Lancashire BB6 7RF Lead Inspector Mrs Lynn Mitton Announced Inspection 14th September 2005 10:00 Merlewood DS0000009586.V251969.R01.S.doc Version 5.0 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 Merlewood DS0000009586.V251969.R01.S.doc Version 5.0 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. Merlewood DS0000009586.V251969.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Merlewood Address 52 Park Lane Great Harwood Lancashire BB6 7RF 01254 885355 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) National Autistic Society Mrs Sharon Clough Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Merlewood DS0000009586.V251969.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 14th December 2004 Brief Description of the Service: Merlewood is registered with the Commission for Social Care Inspection to provide personal and social care for up to 6 adults with a learning disability aged over 18 years. At the time of the inspection there were six people accommodated. The home is part of the Hyndburn National Autistic Society Scheme, which has two other residential care homes and a domiciliary support agency, and is a charitable organisation specialising in caring for those diagnosed with Autistic Specific Disorders. Merlewood is a detached property located on a busy main road in a popular residential area, within walking distance of local shops and bus routes. Parking is available at the front of the home. Merlewood had been decorated and furnished to meet the needs of service users, being mindful of the specific needs of those with Autistic Spectrum Disorder. A range of communal ground floor space was available. All service users had their own bedroom, but share bathing facilities. At the rear of Merlewood was a large secure garden and a games room. At the time of the inspection some of the out buildings could not be used due to dry rot. Merlewood DS0000009586.V251969.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was announced and lasted approximately 6 hours. There were 6 service users accommodated at this time. A tour of the home and grounds took place. Over the course of the inspection 6 of the staff on duty, plus the registered manager and deputy were spoken to, and interaction between the service users and staff members were observed. Throughout the report there are references to the “tracking process”, this is a method whereby the inspector focuses on a small representative group of service users. Records regarding these people were inspected. Policies and practices were also read. Four service users relatives had completed the Commission’s comment card, and these indicated that overall they were pleased with the level of service received at Merlewood. What the service does well: One service user’s relative commented, “We are always pleased with the effort and trouble that staff go to making us feel that we are still out son’s parents” Many of the care staff team had considerable experience in caring for people with autism, and were well established at Merlewood ensuring continuity for service users. Written information was in place for each service user regarding their care and health needs and how they were to be met. Any identified risks and how they were to be managed was also recorded. Regular activity programmes for each service user ensured that each person had opportunities to lead a valued and fulfilling life. Good practice was in place with regards to the administration, safekeeping, storage and disposal of medication. There were clear policies and practices in place about making a complaint. Care staff were routinely involved in the development of care plans and how care was delivered to service users. Procedures for recruitment of staff and checks to safeguard service users were in place. The attitude of the staff and management is to run the home with the needs and wishes of the service users as the highest priority. Service users and their families were regularly consulted. Merlewood DS0000009586.V251969.R01.S.doc Version 5.0 Page 6 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. Merlewood DS0000009586.V251969.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Merlewood DS0000009586.V251969.R01.S.doc Version 5.0 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 the following standard(s): YA1 Written information provided in the statement of purpose and service user guide provided a clear picture of the homes facilities and services, enabling prospective service users to decide if the home was right for them. EVIDENCE: The statement of purpose and service user guide had been updated since the last inspection. These documents now contained the information needed for a prospective service user to understand how the home was run and what facilities were offered. The service user guide had also been completed pictorially. Merlewood DS0000009586.V251969.R01.S.doc Version 5.0 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 the following standard(s): YA6, YA7, YA8, YA9 & YA10 The care needs of service users were identified and documented. Service users individual needs were know by staff. Regular reviews of care plans and risk assessments ensured that any changes were regularly documented and that any action needed was taken. Service users and their families were consulted about the service they received. The risk assessment and management framework supported service users to take responsible risks. The service users documentation and policies should be written in a format that is appropriate to their ability. EVIDENCE: Service users had a comprehensive care plan in place that included a plan of action of how to address service users specific needs and included information such as a personal profile, behaviour support plan and positive intervention strategies. One care plan was examined in detail during the inspection. It gave a good account of that persons specific needs and how the care staff team should meet these. Daily records seen gave a good account of events and activities undertaken during each day. Merlewood DS0000009586.V251969.R01.S.doc Version 5.0 Page 10 Whenever possible, service users were given information and options to help them make positive decisions about their own lives. Service users were consulted about the day to day running of the home in a way that was meaningful to them on a day-to-day basis. A service user questionnaire had last been completed in April 2005. The service users family and next of kin had also participated in this process. Risk assessments were an integral element of the service users care plan and a number had been completed. The care plan and risk assessments had been recently reviewed. Some of the documentation and policies still had not been written in a format that would be understood by some of the service users. The inspector was advised that it was hoped that this would be remedied in the near future. Merlewood DS0000009586.V251969.R01.S.doc Version 5.0 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): YA12, YA13, YA14, & YA15 The home was run to make sure the service users enjoyed their life and had opportunities to fulfil their potential. Service users had regular access to their local community, and had opportunities to maintain family links. EVIDENCE: Each service user had an individual programme, which included communitybased activities. These were small group (2-3) or one to one. Merlewood care staff support the service users during these activities. The inspector was satisfied that these were based on meaningful and valued activities, which endeavoured to ensure service users had opportunities to fulfil their potential socially, emotionally, and maintain their independent living skills. At the time of the inspection a small group of service users went on a ramble, taking a packed lunch. Service users also attended the NAS day centres on a sessional basis. All service users had had a holiday or a number of “quality” days out. More were planned for October. The National Autistic Society’s policy was to contribute £250 per service user per year towards the cost of their holiday. Merlewood DS0000009586.V251969.R01.S.doc Version 5.0 Page 12 The inspector advised that service users in long term placement should have as part of their basic contract price, the option of a minimum 7 day holiday or days out. Most service users have regular contact with their families. One service user’s relative commented, “We are always pleased with the effort and trouble that staff go to making us feel that we are still out son’s parents” Merlewood DS0000009586.V251969.R01.S.doc Version 5.0 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): YA 20 Good practice was in place with regards to the administration, safekeeping, storage and disposal of service user’s medication. EVIDENCE: Policies and practices for managing and administering medication were in place. Medication was administered using the Boots Monitored Dosage System. All service users had their medication administered by care staff. Information giving consent to medication being administered by staff was in place on the care plan case tracked. The care staff team had completed basic Boots medication system training, however, accredited training for staff regarding the safe administration of medication had not yet taken place. Administration records were completed correctly. Good practice such as patient information leaflets and an initial register were in place. Medication not suitable for the MDS was stored in plastic boxes named for each service user. There was no overstocking of medication, and records of unused drugs returned to the pharmacy were in good order. Merlewood DS0000009586.V251969.R01.S.doc Version 5.0 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 the following standard(s): YA22 There were clear complaints policies and practices in place. Staff spoken to had a good understanding how to deal with informal and formal complaints. EVIDENCE: One service user said, “If I’m not happy with something I go to tell staff”. There had been no complaints since the last inspection. The complaints procedure was now available in a pictorial/symbol format, which was more appropriate for some service users living at Merlewood. Staff spoken to were able to describe the complaints procedure and how they would deal with someone making a complaint. A book was in place to promote good communication between the home and service users families and visitors. Care staff were provided with identity cards, and most staff on duty had theirs with them. Staff were also issued with cards to be given to the public explaining who they work for and their role, in case of an inappropriate behaviour incident whilst in the community. The inspector advised that this was good practice. Merlewood DS0000009586.V251969.R01.S.doc Version 5.0 Page 15 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): YA24 The standard of cleanliness and hygiene in the home was satisfactory. Further improvements as identified below would improve the standard of the home. EVIDENCE: The home was clean and odour free. The inspector and registered manager toured the home and grounds. It was noted that the carpet at the entrance and staircase of the home was well worn in areas and possibly unsafe. There were bath aids in place for one service user. The front garden was unkempt and there was litter in the garden/car park area. The inspector was advised that it was planned that the windows throughout the home were due to be replaced, and other works were to be undertaken when the service users go on holiday in October. These included new valves fit to the central heating system and improvements to the shower room. An alarmed box had been fitted around a fire extinguisher to manage one service user’s behaviour. In the back garden, a tree had been removed and an oil storage tank fenced off. Merlewood DS0000009586.V251969.R01.S.doc Version 5.0 Page 16 Plans were still being considered regarding the re-development of the out buildings, which would increase the space available within the home. The inspector and registered manager discussed this issue at length. One service users family member commented, “The Games room is unavailable for service users and needs the building work doing and re-opening as soon as possible”. Merlewood DS0000009586.V251969.R01.S.doc Version 5.0 Page 17 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): YA 32, YA 34, YA35 & YA36 Staff spoken to and observed by the inspector demonstrated a very good understanding of the needs of the service users. Staff should continue to complete their NVQ training to enable them to better meet the needs of service users. Care staff were routinely involved in the development of care plans and how care was delivered to service users. Procedures for recruitment of staff and checks to safeguard residents were in place. EVIDENCE: The inspector noted that 7 out of 20 care staff members had obtained their NVQ level 3; a further 5 were awaiting verification of their NVQ 3. 7 care staff had recently started their NVQ 3 training. All induction and foundation training was Learning Disability Award Framework accredited. Care staff told the inspector that house team meetings were held every 4 – 6 weeks. Key worker meetings were held weekly. These include contributing and reviewing care plans and day to day planning for things such as appointments. Merlewood DS0000009586.V251969.R01.S.doc Version 5.0 Page 18 Each member of staff had a training profile and training needs were regularly reviewed through the management support & development and appraisal process. These meetings take place every 3- 4 months. One staff member said “We do have an open house policy – any problems or queries we talk about without waiting for a meeting” A staff questionnaire has very recently been sent out to staff. One or two responses had been received. The inspector observed a staff handover, this gave good evidence that the care staff team know the service users and their needs extremely well. There was also evidence of how service users were treat with respect and dignity. The inspector observed service users being supported by competent and experienced staff. There were at least 4 care staff on duty during the waking day. The inspector case tracked two staff member’s employment files. These contained the information required to demonstrate that all checks had been taken to ensure that service users were safeguarded. Merlewood DS0000009586.V251969.R01.S.doc Version 5.0 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): YA 37, YA39, YA41, & YA43 The registered manager should complete her NVQ 4 training at the earliest opportunity. The attitude of the staff and management is to run the home with the needs and wishes of the service users as the highest priority. Service users and their families were regularly consulted. Information was available about the National Autistic Society. EVIDENCE: The registered manager was in the process of completing the NVQ 4 in Management training qualification. It was anticipated that this would be completed by Spring 2006. Reports on behalf of the registered person were being regularly received. Service users were consulted about the day to day running of the home in a way that was meaningful to them on a day-to-day basis. A service user questionnaire had last been completed in April 2005. Merlewood DS0000009586.V251969.R01.S.doc Version 5.0 Page 20 Outstanding from the last inspection report, a policy which had been developed in pictoral format advising service users of their right to access their personal records was in need of slight amendment. There was an up to date business, service development and financial plan in place for the national service, the Hyndburn service and for Merlewood. A copy of this document was supplied to the Commission. Merlewood DS0000009586.V251969.R01.S.doc Version 5.0 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 X X X X Standard No 22 23 Score 3 X ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 X 3 3 2 Standard No 24 25 26 27 28 29 30 STAFFING Score 2 X X X X X X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 2 15 3 16 X 17 Standard No 31 32 33 34 35 36 Score X 2 X 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Merlewood Score X X 2 X Standard No 37 38 39 40 41 42 43 Score 2 X 3 X 2 X 3 DS0000009586.V251969.R01.S.doc Version 5.0 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. 1 Standard YA20 Regulation 13(2) Requirement Timescale for action 31/12/05 2 YA24 23(2) To ensure the health and safety of service users, accredited training for the safe administration of medicines must be in place for all staff administering medication. The homes premises must be 31/12/05 suitable for their stated purpose and safe and well maintained. 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 Good Practice Recommendations Standard 1 YA6 The care plan should be made available in formats that are easily understood by the service users. 2 YA10 Ensure the homes policies are available to the service users in an appropriate format. 3 YA14 Service users in long-term placement should have as part of their basic contract price, the option of a minimum 7day holiday outside the home. 4 YA32 Sufficient numbers of staff should be engaged in training to ensure compliance with this standard by 2005. 5 YA37 The registered manager should obtain the NVQ 4 in care and management by 2005. 5 YA41 Amend Merlewood’s policy advising service users of their right to access their personal records. 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