Inspection on 10/11/06 for Merok House Rest And Convalescent Home

This inspection was carried out on 10th November 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 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

Merok House Rest And... 06/06/07

Merok House Rest And... 28/09/05

Merok House Rest And... 13/10/04

Merok House Rest And... 21/04/04

Merok House Rest And... 13/06/03

Merok House Rest And... 17/09/02

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

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

CARE HOMES FOR OLDER PEOPLE Merok House Rest And Convalescent Home 46 New Brighton Road Emsworth Hampshire PO10 7QR Lead Inspector Mrs Michelle Presdee Unannounced Inspection 10th November 2006 09:30 X10015.doc Version 1.40 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 Merok House Rest And Convalescent Home DS0000012208.V313689.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 Older People. 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. Merok House Rest And Convalescent Home DS0000012208.V313689.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Merok House Rest And Convalescent Home Address 46 New Brighton Road Emsworth Hampshire PO10 7QR 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) 01243 372 155 Mr Hemraj Chumun Mr Hemraj Chumun Care Home 22 Category(ies) of Dementia (22), Dementia - over 65 years of age registration, with number (22), Mental Disorder, excluding learning of places disability or dementia - over 65 years of age (22), Old age, not falling within any other category (22) Merok House Rest And Convalescent Home DS0000012208.V313689.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 28/09/05 Brief Description of the Service: Merok House is a detached property in the suburban area of Emsworth. There is a car park at the front of the house. The rear of the house has a wellmaintained garden, with flower borders, trees, vegetable patches, furniture and a summerhouse. Residents are encouraged to grow plants and vegetables in the garden. The home offers personal care and accommodation for up to 22 service users within the categories of old age mental disorder and dementia, over the age of 65 years. The fees for the home range from £385.00 to £500.00 per week. Merok House Rest And Convalescent Home DS0000012208.V313689.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. During this unannounced inspection, which lasted over six hours the majority of service users were seen and spoken with. Two health professionals who visited the home on the day of the inspection, a hairdresser and two family visitors were spoken with, all had praise for the home and the way it was run. During the inspection Mr and Mrs Chumun assisted the inspector. A tour of the building was undertaken with five bedrooms randomly chosen to view. A range of paperwork was viewed including staff records, assessments, care plans, policies, procedures and safety records. Information was received from the registered provider prior to the inspection, which has helped form some of the judgements. On the visit it was noted for one member of staff the home did not have the necessary paperwork to employ this person; as a result they were suspended from duty. What the service does well: What has improved since the last inspection? The home continues to improve the physical environment of the home. Since the last inspection six service users bedrooms have been re-carpeted. Merok House Rest And Convalescent Home DS0000012208.V313689.R01.S.doc Version 5.2 Page 6 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. Merok House Rest And Convalescent Home DS0000012208.V313689.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Merok House Rest And Convalescent Home DS0000012208.V313689.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3,6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Assessments clearly identify service users needs prior to admission, ensuring their needs can be met. EVIDENCE: The assessments of the last two service users to enter the home were viewed. It was found these contained good information, recording a service users needs at that time. Assessments had been gained from other professionals involved in the service users care. The inspector was advised no service user would be admitted to the home unless until they had had carried out an assessment on the service user. Service users spoken to and visitors to the home both professional and non-professional felt the home did a very good job at caring for serving users and meeting their needs. The home does not provide intermediate care. Merok House Rest And Convalescent Home DS0000012208.V313689.R01.S.doc Version 5.2 Page 9 Merok House Rest And Convalescent Home DS0000012208.V313689.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans provide adequate information, to care staff, which ensures service users needs are met. Health care needs are well met with a range of services available to meet service users needs. Medication is well managed in the home and offers appropriate protection for service users. The core values of privacy and choice are promoted in the home. EVIDENCE: The care plans of the two service users assessments viewed were looked at. It was found these gave a clear account of service users needs and abilities. The care plans gave clear information to enable staff to meet service users needs. Risk assessments had been completed. Care plans viewed had been reviewed on a monthly basis and in one viewed; a family member had signed the review. The inspector was advised family members are invited to reviews. No photographs were available on the two care plans seen, but the inspector was advised the photographs were stored in the camera and would be printed soon. Merok House Rest And Convalescent Home DS0000012208.V313689.R01.S.doc Version 5.2 Page 11 Care plans also demonstrated the home has good links with health professionals. The home has a visiting optician, dentist and chiropodist. The inspector was advised if possible service users would be taken to these services in the community if they were able. Whilst in the home the inspector heard Mr Chumun making arrangements to take one service user to a hospital appointment, which he explained he and another member of staff would take the service user as this would cause them less distress. A consultant psychiatrist was visiting the home on the day of the inspection and stated he felt the home coped and cared very well for the service users in the home. He felt the home always called him and community psychiatric nurses appropriately. The home has a medication policy. Only staff that have received training and feel competent to do the drugs are involved in the administration of medication. Twelve members of staff did medication training last year. The home is just going to change from using the nomad system to a new system, which it hopes will reduce the room for error. The inspector checked the medication and records of two service users and found these to be accurate. All medication including controlled medication was being stored and recorded appropriately. The inspector witnessed medication being dispensed at lunchtime and noted the policy was followed. From observations and discussions on the day it appeared service users were treated in a manner, which respects their privacy and dignity. It was noticed when the representatives from the health service visited service users were seen in private in their bedrooms. All toilets and bathrooms had appropriate locks. Visitor spoken to confirmed their relative always had her own clothes on, which were always clean. All double rooms had screens. Merok House Rest And Convalescent Home DS0000012208.V313689.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Social activities are arranged in the home, but they need to be more specific for the client group. Visitors are made welcome to the home and they can see service users in private. A varied menu is available and good quality food is served to service users. EVIDENCE: It was difficult to establish if service users felt the home offered adequate social activities due to limited communication abilities. One service user explained he enjoyed reading and stated there was always a selection of books. The inspector was advised he could be taken to the local library if he wished to choose books on a regular basis. A visitor calls into the home on a regular basis and plays the piano. Care staff in the afternoons will give service users manicures and help with make up and facials. Service users spoken to enjoyed having their nails painted. Outings are arranged in the summer months and service users enjoy the enclosed garden. On the day of the inspection several service uses went out for a walk around the garden. Several Merok House Rest And Convalescent Home DS0000012208.V313689.R01.S.doc Version 5.2 Page 13 religious services are offered in the home to meet service users needs. The inspector was advised all service users have visitors and most go out with family members. Two visitors advised the inspector they can visit at any time and can always see their relative in private. However Mr Chumun explained visitors usually see all service users as the home has a communal feel. Discussions were held on providing activities, which are specifically designed for service users with dementia. Mr Chumun agreed this would be of benefit to service users and agreed to contact several agencies to see if they would provide training or information packs for his staff. It was clear service users had choice in activities of daily living. Service users had access to all parts of the home and could access the garden independently. Service user had brought items of their furniture into the home. The inspector was sent details of a four-week rotating menu. Menus demonstrated meals are varied and well balanced. A choice at lunchtime is always available. On the day of the inspection corned beef hash, carrots and two seasonal vegetables were served; the choice was vegetable pasty. For pudding rhubarb and custard was served. The cook was aware of service users likes and dislikes. A diabetic diet was also followed for two service users. The cook reported the food was of a good quality and there were no restrictions on the budget. Fresh vegetables are served on a daily basis and most cakes are home baked. The inspector watched meals being given out and assistance being given to one service user. It was noted this was done in a dignified manner, which tried to promote the service users independence. Two service users later commented the meals were good and a choice was available. Merok House Rest And Convalescent Home DS0000012208.V313689.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home has a complaints procedure, which visitors felt they would be able to use. Staff do not have adequate knowledge on dealing with suspected abuse and the procedures they should take; which could put service users at risk. EVIDENCE: The home has a complaints procedure, which details all the necessary information including names, address, telephone numbers and timescales. Details of the complaints procedure are given to service users and their visitors in the service user guide. Visitors spoken to felt they would be able to complain and explained they would speak to Mr Chumun first and felt the complaint would be dealt with. Mr Chumun stated he had not received any complaints since the last inspection. The home has information and policies and procedures relating to abuse and adult protection. The home has had no allegations of abuse and has not referred any staff to the Protection Of Vulnerable Adults (POVA) list. The inspector was advised no service users are physically aggressive and no restraint is used in the home. No formal training on adult protection has taken place in the home and staff spoken to were unsure about what steps should be taken if abuse was suspected in the home. This was brought to Mr Chumun Merok House Rest And Convalescent Home DS0000012208.V313689.R01.S.doc Version 5.2 Page 15 attention who agreed to look into providing some formal training for staff members. Merok House Rest And Convalescent Home DS0000012208.V313689.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides a clean, safe, pleasant and well-maintained environment for the enjoyment of service users. EVIDENCE: All areas of the home were clean, safe, warm and well maintained. Whilst walking around the home no unpleasant odours were detected. The home has a dining room and a lounge. Five bedrooms seen which were chosen at random, were clean and decorated to a reasonable standard; some service users had brought their own furniture to decorate the rooms. Double bedrooms had screens. It was noted in one bathroom the pull cord of the alarm call system had broken; Mr Chumun reported that was due to be fixed next week. The home has a laundry room, which has an industrial washing machine with a Merok House Rest And Convalescent Home DS0000012208.V313689.R01.S.doc Version 5.2 Page 17 sluice programme and an industrial dryer. The home has a lift, which was serviced in August. Merok House Rest And Convalescent Home DS0000012208.V313689.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home has good staffing levels ensuring service users needs can be met. Training in the core areas has been arranged to ensure staff members have the knowledge and skills to improve their practice. The lack of good recruitment procedures could put service users at risk. EVIDENCE: The home has a written duty rota, which confirms who, works what hours. The duty rota for the week including the day of the inspection was displayed. This accurately reflected the staff on duty. The home has three members of staff on duty all day and has two waking staff at night time. Mr and Mrs Chumun also work in the home on a daily basis as extra to the duty rota. The home also employs a cook and a cleaner. From observations on the day it would appear the staffing levels are adequate to meet the needs of service users. Service users were helped in an unhurried manner and service users and visitors stated there was always adequate staff on duty. Mr Chumun reported he encourages all staff to complete a National Vocational Qualification (NVQ) Level 2. Information provided to the Commission by Mr Chumun states eight members of staff currently have N.V.Q. Level2 and three Merok House Rest And Convalescent Home DS0000012208.V313689.R01.S.doc Version 5.2 Page 19 more staff are currently studying for N.V.Q. Level 2 and one member of staff is undertaking N.V.Q. Level 4. The records of the last three members of staff to join the home were looked at. It was found these were inconsistent with not all necessary checks and references being undertaken. Discussions were held on the need to ensure all checks, references, visa and photo evidence is seen and recorded. Discussions were also held on the need to undertake references and not accept references an applicant may bring with them. For one staff file looked at no photo evidence or visa could be evidenced; only one reference was on file, which was not on letter headed paper and it was not signed. This member of staff was suspended. Discussions were held on how this could put service users at risk and on how the responsibility lay with the registered persons to ensure all paperwork is correct before someone works in the home. Training is offered in the home. Four members of staff have completed training on dementia and six members of staff are due to start on this course in June 2007. Three members of staff are currently finishing an induction programme. Twelve members of staff are doing a first aid course in January 2007. All staff will have had updated training on manual handling by March 2007 and six members of staff are due to start food hygiene in April 2007. The cook has an in date food hygiene certificate. Merok House Rest And Convalescent Home DS0000012208.V313689.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 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, 33, 35, 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home is well managed. Service user and visitors views contribute in the development of the home. Service users finances are protected and the health and safety procedures in the home ensure service users are protected. EVIDENCE: Mr Chumun has many years experience and many qualifications in working with service users who have dementia. He has recently completed his Registered Managers Award. All visitors spoken to were full of praise for Mr Chumun feeling he was a very caring manager who was very approachable and knowledgeable. It was clear he had a good relationship with service users who Merok House Rest And Convalescent Home DS0000012208.V313689.R01.S.doc Version 5.2 Page 21 responded well with him. The failure to follow recruitment procedures for all care staff is an issue, which questions the management of the home. It was clear from observations on the day and discussions with service users, visitors and staff members the home is run in the interests of service users. One visitor stated, “nothing is too much trouble for the staff, they will do anything”. The home has started seeking the views of service users and visitors to the home. Questionnaires have been sent out; some of the returned forms were looked at and it was noted all comments were good. The home does not manage any service users finances. For two service users who came to the home in November, the home is managing the personal allowance for these service users. The inspector looked at the records held and found these to be accurate and gave an account of all monies in and out. No obvious hazards to health and safety were observed and staff felt the home was a good environment to work in. Staff working in the home had protective clothing and were aware all substances harmful to health had to be locked away. Relevant COSHH sheets were available for chemicals used in the home. The inspector was shown a range of service records, which demonstrated equipment in the home is regularly serviced. Care staff had received two sessions on fire training by an outside trainer. All necessary checks were being carried out in the fire equipment. The cook was aware of good food and hygiene practices in the kitchen. The temperature of the fridge and freezers were recorded daily. A probe thermometer was used to test the temperature of the cooked protein and recorded daily. All food in the fridge was covered and dated. Merok House Rest And Convalescent Home DS0000012208.V313689.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 Older People 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 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 N/A 18 2 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 1 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 3 X X 3 Merok House Rest And Convalescent Home DS0000012208.V313689.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? No 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 OP29 Regulation 19 Requirement The registered persons must ensure that all checks as per Schedule 2 including written references, CRB, POVA checks and work permits where necessary are undertaken for all care staff, prior to employment. A record of these checks must be available for inspection at all times. Timescale for action 20/01/07 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 Refer to Standard OP12 Good Practice Recommendations Social activities especially for services user with dementia should be provided in the home. Merok House Rest And Convalescent Home DS0000012208.V313689.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 Merok House Rest And Convalescent Home DS0000012208.V313689.R01.S.doc Version 5.2 Page 25 - 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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