Inspection on 15/05/06 for Merok Park Nursing Home

This inspection was carried out on 15th May 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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 but made no statutory requirements on the home.

Other inspections for this house

Merok Park Nursing Home 15/03/10

Merok Park Nursing Home 08/12/09

Merok Park Nursing Home 30/06/09

Merok Park Nursing Home 10/07/07

Merok Park Nursing Home 17/01/06

Merok Park Nursing Home 15/04/05

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Merok Park Nursing Home Merok Park Nursing Home Park Road Banstead Surrey SM7 3EF Lead Inspector Megan McHugh Key Unannounced Inspection 15th May 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 Park Nursing Home DS0000062507.V294871.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 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 Park Nursing Home DS0000062507.V294871.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Merok Park Nursing Home Address Merok Park Nursing Home Park Road Banstead Surrey SM7 3EF 0208 652 7702 0208 652 7702 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) Mr Soondressen Cooppen Mrs Maleenee Coopen To be confirmed Care Home 29 Category(ies) of Dementia - over 65 years of age (20), Old age, registration, with number not falling within any other category (29) of places Merok Park Nursing Home DS0000062507.V294871.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 2 beds may be used for respite care Of the 29 older persons accommodated, up to 20 may be in the category DE(E) (Older people suffering from dementia) 17th January 2006 Date of last inspection Brief Description of the Service: Merok Park is a large detached property located within a five-minute drive or fifteen minute walk of Banstead town centre and its amenities. The home currently provides accommodation and nursing care to twenty seven service users who are elderly and some of whom suffer from dementia. The home has been extended and has twenty five single and two double bedrooms. Fourteen of the single rooms have an en-suite toilet and washing facility and all other rooms have a hand wash basin. The rooms are arranged over two floors and the first floor can be reached by staircase or passenger lift. There are three toilets, a bath and a shower on the ground floor and three toilets, a bath and a shower on the first floor. The toilets and bathrooms are located in such a way that all bedrooms have a toilet and bathing facilities nearby. There are two lounges and two dining rooms on the ground floor and a large kitchen. The home stands in its own large well maintained gardens and has parking to the front of the building. Merok Park Nursing Home DS0000062507.V294871.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection carried out by Megan McHugh, regulation inspector. The inspection was carried out over a period of six hours and fifteen minutes and was the first inspection in the Commission for Social Care Inspection (CSCI) for the new inspection year. The registered provider of the home Mr Cooppen was present along with the registered nurses in charge of the shifts. Four staff members, twelve service users and six visitors were spoken with during this inspection. A tour of the premises was undertaken and records relating to the care of service users and the staffing and management of the home were examined. The Commission want to thank the management, staff and service users for their courtesy and co-operation throughout the inspection. What the service does well: The home was observed to be functioning well during the inspection and there was a calm and relaxed atmosphere throughout. Service users were observed to be well groomed and appropriately dressed, and were engaged in activities with staff and each other. Staff members were seen to interact in a positive and respectful manner with service users. Service users spoken with were complimentary about the care and services provided in the home and made comments such as the staff are kind and they treat me well, I like living here, staff come when we call them. All spoken with said the food was nice and they could choose what they had to eat. The home provides a good range of activities both inside and outside the home and an occupational therapist is employed to organise and carry out the timetable. A visitor stated that there are lots of social events now which their relative enjoys taking part in. A number of visitors were seen in the home during the course of the inspection and all gave positive feedback about the care provided to the service users. Two visitors stated that they had noted improvements in the home since the new management had taken over. Another visitor stated that they never see staff rushing the service users; they always take time with the older people. A number of visitors stated that the manager and owner are very approachable and keep them up to date with their relative’s care needs. Merok Park Nursing Home DS0000062507.V294871.R01.S.doc Version 5.1 Page 6 What has improved since the last inspection? What they could do better: Two immediate requirements were made at the site visit. One was to keep the door leading down to the staff room and store rooms locked at all times. This poses a serious risk to any service user who could open the door and fall down the flight of stairs. The second immediate requirement was in relation to the second dining area. All service users who use this dining room must be risk assessed to be safe to eat unattended for short periods of time, be able to call for help should the need arise or alternatively the staff member must not be allowed to leave the room while service users are eating. The new manager is in the process of reviewing and rewriting individual plans of care for service users, these will include action plans for identified risks. Those files sampled did contain some action plans, however these were not seen to be individual to the specific service user. An example of the new plan of care was viewed and found to be individualised and well written, covering more aspects of the persons care. However these could be more holistic and incorporate a whole view of the service users needs and wants. All admission forms are completed as fully as possible and notes about outstanding information is clearly written onto the paperwork. It is recommended that all care plans are reviewed with the service user and their representatives annually and that the care plans are then rewritten following that review. Please contact the provider for advice of actions taken in response to this Merok Park Nursing Home DS0000062507.V294871.R01.S.doc Version 5.1 Page 7 inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Merok Park Nursing Home DS0000062507.V294871.R01.S.doc Version 5.1 Page 8 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 Park Nursing Home DS0000062507.V294871.R01.S.doc Version 5.1 Page 9 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): 6 The provider stated that intermediate care is not provided at the home. EVIDENCE: Merok Park Nursing Home DS0000062507.V294871.R01.S.doc Version 5.1 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 and 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Individual plans of care were available although these are not holistic and need to incorporate the identified risks. Service users health care needs were met and medication was appropriately handled and administered by staff. Service users are supported with dignity and their privacy is respected. EVIDENCE: The manager is in the process of updating and rewriting the plans of care and evidence of these new plans was seen. They were more personalised to the individual service user and incorporated the identified risks and action plans to minimise these. However these plans need to be more holistic and include all aspects of health, personal and social care needs as well as minimising the identified risks. Therefore the previous requirement remains although the inspector acknowledges that the home has been working towards meeting it. All service users are registered with a local GP of their choice and access specialist healthcare professionals through the GP practice. A chiropodist visits the home every six to eight weeks. Merok Park Nursing Home DS0000062507.V294871.R01.S.doc Version 5.1 Page 11 A staff member discussed the home’s method of administration of medication and this was in line with policy. There were no gaps noted on the administration charts and a second staff member is checking and signing any medication that needs to be handwritten onto the administration records. The as required medication is better noted on the administration records and staff stated they are aware of what to do for all service users with as required medication. The controlled drugs were counted and all tallied with the register. Service users were seen to be treated with dignity and spoken to in a respectful manner. Personal support and care was given discreetly and with service users’ privacy maintained. A visitor to the home stated that staff never rush the service users and always seem to take as much time as the service user needs to get up or walk etc. Other visitors to the home stated that staff treat the service users with kindness and they never hear anyone shouting at the service users. Merok Park Nursing Home DS0000062507.V294871.R01.S.doc Version 5.1 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 and 15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users have a lifestyle in the home that reflects their individual needs and preferences and satisfies their cultural and religious needs. The home assists services users to maintain contact with relatives and friends. Service users are encouraged to make choices. The meals served are of a high standard and are specifically prepared to meet the service users’ needs. There was a safety issue identified by service users using the second dining room and being left alone during the mealtime. EVIDENCE: The home employs an occupational therapist who is responsible for organising leisure activities for the service users. A timetable of activities is in place that has been devised in consultation with the service users and records are kept of each individual’s participation in the activities. Religious services are held at the home and details of how the home aims to meet service users’ cultural and religious needs are contained in the home’s statement of purpose. Service users spoken with said they enjoyed taking part in activities and stated that they had had trips out to the pub, cinema and local shops recently as well as taking part in arts and crafts, bingo and quizzes in the home. A visitor to Merok Park Nursing Home DS0000062507.V294871.R01.S.doc Version 5.1 Page 13 the home stated that there are lots of social events now and their relative enjoys taking part in these. Service users stated that staff always ask them what they want to do and help them choose their outfits everyday as sometimes they are not sure of the weather. Staff were overheard asking service users where they would like to sit, what they would like to eat, if they had eaten enough lunch, where would they like to go after lunch and more. Some service users are unable to communicate verbally and staff stated that they watch the individual’s nonverbal responses to indicate if they are happy or not. The kitchen was clean and appropriately stocked. The chef discussed the menus and the choices provided with the inspection team. Only positive comments were made in regard to the food provided, service users stated that they liked the choices, variety of the menu and the quality and quantity of food. A visitor to the home stated that they had only seen well presented and appropriate food being served. An immediate requirement was made in relation to service users who eat in the dining room that is down the corridor, away from the kitchen and lounge area. All service users who use this dining room must be risk assessed to be safe to eat unattended for short periods of time, be able to call for help should the need arise or alternatively the staff member must not be allowed to leave the room while service users are eating. Merok Park Nursing Home DS0000062507.V294871.R01.S.doc Version 5.1 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 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users concerns and complaints are listened to and acted upon by the home and they are protected from abuse. EVIDENCE: The home has a policy and procedure for dealing with complaints. All members of staff and service users are given a copy of the procedure. Records are kept of all complaints and the outcome. The home has received no complaints since the last visit on 17th January 2006. However the Commission has received a complaint in relation to the service, which was looked into as part of this inspection process. Service users spoken with said they knew how to raise any concerns they had. Some visitors to the home had knowledge of the complaints procedure and some did not, however all stated that if they had any issues they would talk to the manager or the provider. A visitor stated that any small issues that they had brought to the attention of the staff was rectified immediately therefore removing the need to make any formal complaints, however they had been given information on how to make a complaint should they need to. All staff members have a copy of the home’s adult protection policy and have received training in house on the different types of abuse and procedures to follow. The home has a copy of the Surrey Multi-Agency Procedures (February 2005) for safeguarding adults. Service users stated that staff never shout at them or treat them badly. All comments received were positive comments Merok Park Nursing Home DS0000062507.V294871.R01.S.doc Version 5.1 Page 15 about staff being kind, gentle, giving service users time to walk/eat etc and service users stated they liked living in the home. Merok Park Nursing Home DS0000062507.V294871.R01.S.doc Version 5.1 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 and 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users live in a safe well-maintained environment that is clean, pleasant and hygienic. EVIDENCE: The home is clean and tidy throughout with no unpleasant odour. New carpets have been fitted in many communal areas of the home, with the remainder to be replaced in time. New armchairs and dining room furniture have also been purchased increasing the comfort for service users and making the lounge area more pleasant to relax in. The door that opens onto stairs leading down to the store rooms and staff room was unlocked and this posed a risk to service users, as someone could find the door unlocked and fall down the stairs. The provider stated that the lock on the door was broken and that the maintenance person was due to visit the home in the morning to fix it. An immediate requirement was made. Merok Park Nursing Home DS0000062507.V294871.R01.S.doc Version 5.1 Page 17 The front of the building has been tidied up and made to look more attractive with flowers and shrubs being planted and turf laid and further improvements are planned. The owner is to be commended for his commitment to raising the standard of the environment of the home, however there are still areas that need to be addressed. The provider stated that there are plans in place for maintenance work and redecoration to take place but they had been awaiting the summer months to begin the work so that they can use natural ventilation to air the home and minimise any unpleasant odours that could affect service users. The provider has agreed to provide the commission with a copy of his development plan for the home for the coming year. Merok Park Nursing Home DS0000062507.V294871.R01.S.doc Version 5.1 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 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The numbers and skill mix of staff meets Service users’ needs and staff are trained to do their jobs. EVIDENCE: On the day of the inspection the home was staffed according to the staffing rota and comments received from service users and visitors to the home indicated that the home was sufficiently staffed through out the day. Many visitors stated that the service users are well cared for and that staff take time with the service users and do not rush them through tasks. Members of staff spoken with confirmed that they receive training and were able to identify training courses attended or due to attend since the last inspection such as fire safety and moving and handling. Staff spoke about their induction training and what this consisted of. Staff mentioned that their training records and certificates are held on their files, however as the manager was not on duty, these were not seen by the inspector. The manager has provided the Commission with a copy of the training schedule for the year, as part of the pre-inspection questionnaire information and this linked up with the training staff had informed the inspector they had or were due to have. Merok Park Nursing Home DS0000062507.V294871.R01.S.doc Version 5.1 Page 19 The manager was not available at the time of the inspection and therefore recruitment records could not be viewed. Merok Park Nursing Home DS0000062507.V294871.R01.S.doc Version 5.1 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, 34, 35 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well run by a newly appointed manager. Members of staff are supervised, although no documented evidence was seen. The home is run in the best interests of service users and their financial interests are protected. The health, safety and welfare of service users and staff are promoted and protected. EVIDENCE: The Home has appointed a manager in the last few months. The manager is in the process of applying to the Commission to become registered and under the new registration processes is awaiting the return of their CRB before sending his application into the CSCI Local Office. The manager has made some changes to the home and is in the process of updating and reviewing all care plans and other documentation in the home. All visitors to the home had Merok Park Nursing Home DS0000062507.V294871.R01.S.doc Version 5.1 Page 21 positive comments in relation to the new manager and many stated that the home and the manager are open, approachable and ensure they have all information they require about the care of their relative. The home is not involved in service users finances and any services or purchases not included in the fees are invoiced directly to the service user or a representative. The home has robust procedures in place for the accounting of such expenditure with individual records maintained for all service users and copies kept of all receipts. It was pleasing to hear that supervision is taking place however it could not be evidenced that it was meeting the required six sessions a year. A further requirement has been made. All procedures have been updated and staff have been informed of these. The new staff discussed their induction and stated that they had been made aware of the policies and procedures for the home. Merok Park Nursing Home DS0000062507.V294871.R01.S.doc Version 5.1 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 X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 X 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X X 3 2 X X 3 Merok Park Nursing Home DS0000062507.V294871.R01.S.doc Version 5.1 Page 23 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. 1. Standard OP7 Regulation 14(2) 15(1)(2) Requirement Timescale for action 26/06/06 2. OP15 3. 4. 5. OP19 OP31 OP36 The service user’s plan sets out in detail the action which needs to be taken by care staff to ensure that all aspects of the health, personal and social care needs of the service user are met. All care plans need to be reviewed and incorporate all aspects of care. 13(4) The registered person must review the arrangement for staffing the second dining room and all service users who use this room must be risk assessed to do so. 13(4)(a)(c The door leading down to the ) staff room must be kept locked at all times. 8 (1) (a) The manager must submit an (b) application for registration to the Commission. 18 (2) (a) All staff must receive formal supervision at least six times in a twelve month period and this must be recorded. An action plan must be submitted to the Commission outlining how the home plans to meet this requirement. DS0000062507.V294871.R01.S.doc 18/05/06 15/05/06 30/07/06 20/06/06 Merok Park Nursing Home Version 5.1 Page 24 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 OP7 Good Practice Recommendations It is recommended that the home reviews and rewrites the plans of care for all service users annually. Merok Park Nursing Home DS0000062507.V294871.R01.S.doc Version 5.1 Page 25 Commission for Social Care Inspection Surrey Area Office The Wharf Abbey Mill Business Park Eashing Surrey GU7 2QN 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 Park Nursing Home DS0000062507.V294871.R01.S.doc Version 5.1 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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