Inspection on 02/03/06 for Merlewood

This inspection was carried out on 2nd March 2006.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 4 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 14/09/05

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 Unannounced Inspection 2nd March 2006 10:00 Merlewood DS0000009586.V281551.R01.S.doc Version 5.1 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.V281551.R01.S.doc Version 5.1 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.V281551.R01.S.doc Version 5.1 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) Vanessahalfacre@nas.org.uk National Autistic Society Mrs Sharon Clough Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Merlewood DS0000009586.V281551.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 14th September 2005 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 day care facilities, 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 is 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.V281551.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and lasted approximately 6 hours. There were 6 service users accommodated at this time. A tour of the communal areas of the home took place. Over the course of the inspection 2 of the staff on duty, plus deputy manager 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. What the service does well: Service users were only admitted to the service once information about their care needs was obtained. This meant that care staff had a clear understanding of what they needed to do to care for them. Policies and practices enabled service users to make decisions about their lives. Interaction between care staff and service users was observed to be very positive and respectful and service users wishes and personal choices were respected, and whenever possible acted upon. Personal support was offered to service users in a way that promoted empowerment, choice, dignity, respect and autonomy. Service users care and health needs were known and being met. Staff spoken to had a good understanding of adult protection issues and how to deal with complaints made by service users. The standard of cleanliness and hygiene in the home was satisfactory. The care staff valued staff training. Merlewood DS0000009586.V281551.R01.S.doc Version 5.1 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.V281551.R01.S.doc Version 5.1 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.V281551.R01.S.doc Version 5.1 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): YA2 Service users were only admitted to the service following completion of an assessment. This ensured that all information about their care needs was obtained before they arrived, and for staff to have a clear understanding of what they needed to do for them. EVIDENCE: There had been a new admission to the home since the last inspection; the inspector saw that assessment documents had been completed prior to the new person’s admission to the scheme. Merlewood DS0000009586.V281551.R01.S.doc Version 5.1 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): YA7 & YA10 Policies and practices enabled service users to make decisions about their lives. This information was conveyed to the service users in a meaningful way. EVIDENCE: Observations were made by the inspector of care staff demonstrating a number of ways in which service users were supported in making decisions about their daily lives, for example, there were a number of minor variations to the menu to accommodate everyone’s personal tastes to the lunch served on the day of the inspection. Service users were seen to be empowered and spoken to with dignity and respect by the care staff. Since the previous inspection, a number of pertinent policies and practices had been implemented in a pictorial format. This meant that some of the service users may be able to understand them. Merlewood DS0000009586.V281551.R01.S.doc Version 5.1 Page 10 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): YA14, YA16 & YA17 The home was run to make sure the service users enjoyed their life and had opportunities to fulfil their potential. The policy of contributing £250 towards service users holiday should be reviewed. Interaction between care staff and service users was observed to be very positive and respectful and service users wishes and personal choices were respected, and whenever possible acted upon in a sensitive and caring manner. EVIDENCE: The National Autistic Society’s policy continued to be to contribute £250 per service user per year towards the cost of their holiday. 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. By observation of the care staff interacting with the service users, the inspector noted that the homes daily routines promoted independence, individual choice and were in accordance with each persons care plan. Care staff and service users interaction was observed to be very positive and Merlewood DS0000009586.V281551.R01.S.doc Version 5.1 Page 11 respectful and service users wishes and personal choices were respected whenever possible acted upon. The inspector ate lunch with the service users and care staff on the day of the inspection, and observed interaction between service users and care staff. Records were made on each person’s daily records of meals eaten. The inspector noted some omissions on these records, and given that at least three service users had difficulties in eating their meals in a conventional manner, how this was being managed was discussed at length with the deputy manager. The inspector advised that very careful food intake records must be kept for all service users. Service users were observed being supported in a very sensitive and caring manner. Merlewood DS0000009586.V281551.R01.S.doc Version 5.1 Page 12 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): YA18, YA19 & YA20 Personal support was offered to service users in a way that promoted empowerment, choice, dignity, respect and autonomy. Service users health needs were known and being met. Accredited medication training would ensure best practice was in place with regards to the administration, safekeeping, storage and disposal of service user’s medication. EVIDENCE: Following observations the inspector was satisfied that sensitive and flexible personal support was offered to service users living at Merlewood. Some service users required verbal prompts, guidance and support, to maintain appropriate boundaries and timeframes. There was an intimate care policy in place. A key worker system was in place. The inspector noted on the care plan case tracked that a health plan was in place. This was dated January 2006. There was detailed information regarding meeting all the service users health needs. This included regular weight checks and records of all optical, dental GP, chiropody and psychiatry appointments. Merlewood DS0000009586.V281551.R01.S.doc Version 5.1 Page 13 Outstanding from numerous previous inspections, care staff administering medication had completed basic Boots medication system training, however, accredited training for staff regarding the safe administration of medication had not yet taken place. The inspector advised that the 4 day Boots medication training was considered by the Commission to be “accredited”. Merlewood DS0000009586.V281551.R01.S.doc Version 5.1 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): YA23 The homes policies should be regularly reviewed, to ensure that the contents are up to date and still relevant. Staff spoken to had a good understanding of adult protection issues and how to deal with complaints made by service users. EVIDENCE: The inspector examined the prevention of vulnerable adults policy. This was dated February 2004, and there was no evidence that this document had been reviewed since this date. Staff spoken to were able to give definitions of different types of abuse and were clear about how they would act if they witnessed abuse of any kind. Merlewood DS0000009586.V281551.R01.S.doc Version 5.1 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 & YA30 Some tasks to ensure maintenance and upkeep of the home had been completed. Further improvements as identified below would improve the standard of the home and ensure it was fit for its purpose. The standard of cleanliness and hygiene in the home was satisfactory. EVIDENCE: The inspector was advised that since the last inspection the windows throughout the home had been replaced, and other works including new valves fit to the central heating system and improvements to the shower room had been undertaken when the service users went on holiday in October. A new stairs carpet had also been fitted. The front garden had been tidied, and cleared of litter and new bushes planted. The inspector was advised that plans to build an extension to the home had been put on hold due to budgeting constraints. This meant that the homes out buildings, which included a games room for service users, continued to be out of commission. Merlewood DS0000009586.V281551.R01.S.doc Version 5.1 Page 16 The inspector advised that staff sleeping in facilities, which also doubled up as the homes office, were not suitable for their purpose. There were no facilities within the home to conduct private discussions, or private staff changing facilities. The home was clean, tidy, warm, and free from offensive odours. The dishwasher was awaiting repair at the time of the inspection. Merlewood DS0000009586.V281551.R01.S.doc Version 5.1 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): YA32 Some staff were trained to NVQ level 3 standard. Staff training was ongoing which would ensure that the care staff team could competently care for the service users. EVIDENCE: The inspector was advised that six out of the 18 care staff had achieved NVQ3 Qualification. A further 2 out of 18 had completed this training and were awaiting verification. 6 care staff were in the process of completing this training. The care staff team also received specialist training about meeting the needs of service users with autism. One staff member who had recently completed induction and foundation training told the inspector; “this is the best training I’ve ever received in any job”. Merlewood DS0000009586.V281551.R01.S.doc Version 5.1 Page 18 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): YA37, YA41 &YA42 The registered manager should complete her NVQ 4 training at the earliest opportunity. All care staff must complete staff training and follow procedures to ensure the health and safety of the service users. EVIDENCE: The inspector was advised that the registered manager’s NVQ 4 qualification training had been completed and was awaiting verification. The Registered Manager’s Award had been almost completed and expected to be done by the end of March 2006. Since the previous inspection Merlewood’s policy advising service users of their right to access their personal records had been developed pictorially and in a language that service users at the home may understand. The inspector noted the care staff training matrix which indicated that most staff had completed 1st Aid training, all care staff had completed basic health and safety training and basic food hygiene (although two were overdue), it was Merlewood DS0000009586.V281551.R01.S.doc Version 5.1 Page 19 agreed that moving and handling training was not needed at the time of the inspection. However, no care staff had completed infection control training, and the homes fire training and records had not been kept up to date. The fire alarm had not been tested since 17th February 2006, one fire door closure was not working correctly, no staff had signed to say they had read and understood the fire/evacuation procedures since April 2005. The fire doors test had not been completed for over one month. The inspector and deputy manager discussed this issue and the recording format could be improved to ensure that the risk of errors was reduced. Merlewood DS0000009586.V281551.R01.S.doc Version 5.1 Page 20 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 X 23 2 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 3 30 X STAFFING Standard No Score 31 X 32 2 33 X 34 X 35 X 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score X 3 X X 3 LIFESTYLES Standard No Score 11 X 12 X 13 X 14 2 15 X 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 2 X X X 3 2 X Merlewood DS0000009586.V281551.R01.S.doc Version 5.1 Page 21 Are there any outstanding requirements from the last inspection? Yes 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 1. YA20 13(2) To ensure the health and safety 30/06/06 of service users accredited training for the safe administration of medicines must be in place for all staff administering medication. 2. YA23 17(3) The registered person must 30/06/06 ensure that policies and practices are kept up to date and regularly reviewed. 3. YA24 23(2)(3) The homes premises must be 30/06/06 suitable for their stated purpose and safe and well maintained. 4. YA42 23 (4) 13 The registered person must take 10/04/06 (4) adequate precautions against the risk of fire. Unnecessary risks to the health and safety of residents are identified and as far as is possible, eliminated. 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. 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. 2. YA32 50 of care staff should of completed training to ensure compliance with this standard by 2005. 3. YA37 The registered manager should obtain the NVQ 4 Merlewood DS0000009586.V281551.R01.S.doc Version 5.1 Page 22 qualification in care and management by 2005. Merlewood DS0000009586.V281551.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection East Lancashire Area Office 1st Floor, Unit 4 Petre Road Clayton Business Park Accrington BB5 5JB 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 Merlewood DS0000009586.V281551.R01.S.doc Version 5.1 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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