Inspection on 18/07/07 for Merrie Meade

This inspection was carried out on 18th July 2007.

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 but made no statutory requirements on the home.

Other inspections for this house

Merrie Meade 15/12/09

Merrie Meade 13/10/09

Merrie Meade 02/07/09

Merrie Meade 09/07/08

Merrie Meade 16/06/06

Merrie Meade 20/10/05

Merrie Meade 05/04/05

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

CARE HOMES FOR OLDER PEOPLE Merrie Meade 3 Watergate Road Newport Isle Of Wight PO30 1XN Lead Inspector Janet Ktomi Unannounced Inspection 18th July 2007 10:00 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 Merrie Meade DS0000060991.V341444.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. Merrie Meade DS0000060991.V341444.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Merrie Meade Address 3 Watergate Road Newport Isle Of Wight PO30 1XN 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) 01983 520299 01983 520299 merrymeade@btconnect.com Merrie Meade Residential Home Ltd Janice Gibson Care Home 31 Category(ies) of Dementia - over 65 years of age (14), Mental registration, with number disorder, excluding learning disability or of places dementia (14), Mental Disorder, excluding learning disability or dementia - over 65 years of age (3) Merrie Meade DS0000060991.V341444.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home can accommodate one named individual in the OP category Date of last inspection 16th June 2006 Brief Description of the Service: Merrie Meade is a large detached two-storey property with a two-storey extension, set in reasonable sized grounds with a summerhouse and two storage sheds available for use by service users. The home is located on the outskirts of Newport within walking distance of the town centre shops and amenities. There is off road car parking to the front. Residents’ accommodation is provided on both floors. The home provides long stay care of older people with mental frailty and illness associated with dementia and long-term care/support for younger adults with mental health problems. The older people are cared for in the purpose built extension, which provides a suitable environment for their care needs. There is a lift in the extension to provide access to the first floor. There is also ramped access into the garden leading from a side entrance of the ground floor. The younger residents have been accommodated in the main building, which suits their needs. The home is owned by Merrie Mead Residential Home Ltd and managed by Ms Janice Gibson. Weekly Fees: £354.90-£435.05. Merrie Meade DS0000060991.V341444.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report follows the second key inspection of the service that included an unannounced site visit to the home undertaken by one inspector over a period of one day lasting eight and a half hours. The inspector spent time with the people who live at the home, staff on duty and the registered manager as well as viewing documents and the home. This report also contains information received prior to the site visit from the home in their Annual Quality Assurance Assessment. Service user and carer/relative questionnaires were sent to the home prior to the inspectors visit and a total of fourteen were returned, information from which is included in this report. The inspector telephoned care managers following the inspection visit. People who live at the home stated they were happy living there and that staff were nice. Care and other records and documentation identified in the report were viewed. What the service does well: What has improved since the last inspection? The home has complied with many of the requirements made following the previous inspection. Individual contracts now state the fees payable each month. The home continues to invest in the environment and now only has one twin bedroom, has redecorated and re-carpeted some bedrooms and has provided a new patio area outside the younger adults part of the home. Improvements have been made to infection control with liquid soap and paper hand towel dispensers provided in all communal WC’s. Sanitising systems are Merrie Meade DS0000060991.V341444.R01.S.doc Version 5.2 Page 6 being incorporated into the laundry and new cleaning equipment to sanitise rooms has been purchased. A cleaner has been employed. The home has identified that it needs to increase the staffing levels in the younger adults part of the home and has commenced recruitment of new staff. This will increase opportunities for younger adults to be supported to attend health and other appointments and to have activities and outings with staff. All substances potentially dangerous to health are now stored securely. Window opening restrictors are now fitted to first floor windows. What they could do better: The following requirements are made following this inspection: More specific details as to how individual peoples personal care needs should be met must be included in care plans. These should state exactly what level of support people require and what they can do for themselves. All medication, including that which must be stored in a fridge, must be stored securely. Medication administration records must be fully completed with no gaps left. The registered person must ensure that the home has a training and development programme, which ensures that all staff complete mandatory and specialist training to enable them to meet the needs of people living at the home. The provider must ensure that the manager has information about budgets and access to money and finances. Care staff must receive formal supervision at least six times per year. This was previously required following the last inspection undertaken in June 2006. The proprietor must ensure that the manager is able to access funds. Merrie Meade DS0000060991.V341444.R01.S.doc Version 5.2 Page 7 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Merrie Meade DS0000060991.V341444.R01.S.doc Version 5.2 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 Merrie Meade DS0000060991.V341444.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4 and 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides appropriate information and contracts for people. The home would only admit people whose needs it could meet. Standard 6 is not applicable, as the home does not provide intermediate care. EVIDENCE: The inspector viewed pre-admission assessments, spoke with people and staff at the home, received a copy of the service users guide, discussed the preadmission process with the manager, viewed contracts and received information in completed surveys. The home has a statement of purpose and service users guide, a copy of which was provided to the inspector. This had been revised in June 2007. This Merrie Meade DS0000060991.V341444.R01.S.doc Version 5.2 Page 10 document, provided in a typed English format, would be appropriate for people living at the home at the time of the inspectors visit. The statement of purpose and service users guide provides relevant information about the home to prospective people or their relatives. Surveys returned by people living at the service indicated that seven of the nine had received enough information about the home before they moved in. Eight of the nine people who completed surveys stated that they had received a contract. The service users guide contained a sample contract and the inspector viewed completed contracts in people’s files. These were seen to include the fees payable monthly as required following the previous inspection. The inspector viewed pre-admission assessments for two older people and two younger adults and discussed the homes admission process with the manager and people living in the younger adults part of the home. The pre-admission assessment had been undertaken by the manager for all new admissions and provided comprehensive information and included a statement as to whether the persons needs could be met at the home. Information from care managers and health professionals was also seen with pre-admission information. Discussions with the manager indicated that admissions to the younger adults part of the home involved several visits to the home, providing the opportunity for prospective people to meet existing people and vice versa. Younger people the inspector spoke with confirmed this. For older people the opportunity to visit is also there however this is not always practical and the manager stated that it is more often that relatives visit the home and view available rooms. Discussions with the manager indicated that she was clear about the level of need the home could accommodate. Merrie Meade DS0000060991.V341444.R01.S.doc Version 5.2 Page 11 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. 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. The health and personal care needs are met however care plans must contain more individual detail as to how each persons needs should be met. Medication administration records must be fully completed with no gaps and all medication must be stored securely. EVIDENCE: Care plans for people living in both sections of the home were seen. The inspector discussed care plans with people living in the younger adults part of the home who were aware of their care plans and stated that they had been involved in their production and reviews. Care plans for all people contained relevant risk assessments. The manager identified in the homes Annual Quality Assurance Assessment completed prior to the inspectors visit that the home could improve care plans by providing more details in care plans and the inspector would agree. Care plans for older people lacked specific detail or Merrie Meade DS0000060991.V341444.R01.S.doc Version 5.2 Page 12 sufficient information as to how individual personal care needs should be met or what people can do for themselves. This was further discussed with the manager during the inspectors visit. There was evidence that care plans are reviewed regularly. Of the nine surveys received six stated that their care needs are always met and three that their needs are usually met. There was evidence that people are registered with a GP of their choice. Seven of the surveys received from people stated that they always receive the medical support they need with the remaining two stating they usually do. Information in care plan folders listed medical appointments and discussions with people indicated that optician and dental appointments and treatments were organised by the home. The registered manager is a registered nurse and is aware of conditions of older people as well as those experienced by the younger adults. The inspector spoke with community health workers who regularly visit the home. They confirmed that the home meets people’s health needs however staff have not been available to support younger adults to attend appointments. The home has the necessary equipment to support people who may have moving and handling needs as well as other needs associated with older age. The home is increasing the staffing levels in the younger adults part of the home and the manager stated that the home and will soon be providing two staff at all times (except night). This will increase opportunities for staff to support people to attend appointments outside the home and to provide any support at the time people require it. This has previously been an issue when there were no staff to attend hospital appointments with people as identified by people who live at the home and community health workers. The inspector viewed the medication storage arrangements and records in both parts of the home. Within the younger adults section records were well maintained, however one person who self-administers medication had not had a risk assessment undertaken to demonstrate competency. This must be carried out for this person and any others who wish to self medicated and reviewed with care plan reviews. Within the older persons section of the home medication was stored appropriately however there were a number of gaps in the medication records where it was not clear if medication had been administered as prescribed. Medication administration records must be fully completed with no gaps left. The inspector asked about the storage arrangements for medication that must be kept cool. The home does not have a specific medications fridge and medications are stored in an unlocked container in the homes main food fridge. The younger adults may access the kitchen and as such the home must ensure that all medication, including that which must be stored in a fridge is stored securely. With the exception of one twin bedroom all rooms are for single occupancy. People confirmed that their rights to privacy and dignity are fully maintained. The inspector spoke with the two people who share a bedroom and they Merrie Meade DS0000060991.V341444.R01.S.doc Version 5.2 Page 13 confirmed that they are happy with this and that their right to privacy is not compromised. Merrie Meade DS0000060991.V341444.R01.S.doc Version 5.2 Page 14 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. 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. People are provided with choice about aspects of their lives, visitors are welcome and an appropriate diet is provided. The home must consider how more varied activities can be provided. EVIDENCE: Seven of the nine surveys returned by people living at the home stated that the home sometimes provides activities, one never and one always. The inspector discussed activities with the manager, staff and people living in both the younger adults and older persons part of the home. On the day of the inspectors visit a slide show was being enjoyed by people in the older persons part of the home who had been joined by a number of the younger adults. The manager stated that this was the only regular visiting entertainment and that when care staff have time they will undertake some in house activities. Discussions with the younger adults indicated that they are able to organise their own activities but would like care staff to be able to Merrie Meade DS0000060991.V341444.R01.S.doc Version 5.2 Page 15 accompany them sometimes or that day trips can be organised. Activities, or lack of, were the main concern of the younger adults in their discussion with the inspector. The manager stated that staffing levels in the younger adults part of the home is in the process of being increased from one to two throughout the day. Care staff confirmed that increased staffing levels would enable them to support the younger adults in their activities. A requirement is therefore not made in respect of this. Some younger adults showed the inspector their bedrooms that were seen to contain a range of home entertainment equipment. Some of the younger adults attend external day services. People in both parts of the home confirmed that they are able to have visitors whenever they wish and the inspector met a number of visitors during her day at the home. The inspector observed the lunchtime meal and discussed meals and menus with people, staff and the chef. Six of the nine surveys returned stated that people always like the meals and three that they sometimes like the meals. Discussions with people confirmed that they are provided with choice and the inspector observed people having alternatives to the main meal at lunchtime. The younger adults confirmed that they are able to have meals saved or are provided with food if they are not at home when meals are served. The chef stated that he has consulted with people and aims to provide more traditional meals for the older people and will provide meals such as pastas and curries for the younger people as requested by them. Therapeutic or cultural diets would be catered appropriately for. People confirmed that they have access to fresh fruit when they want this and can have hot or cold drinks as and when they wish. Merrie Meade DS0000060991.V341444.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People have access to a robust, efficient complaints procedure and are generally protected from abuse however not all care staff have attended relevant training. EVIDENCE: Six surveys were returned by relatives, five of who stated that they were aware of how to make a complaint and that the home had always responded appropriately if they had raised any concerns. Eight of the nine surveys from people who live at the home confirmed they were aware of how to make a complaint. The inspector spoke with people living in both parts of the home and they confirmed that they would raise any concerns or complaints if they had any. The previous report identified that some of the younger people felt their concerns had not been listened too. On this occasion they felt that they were listened too and that the increase in staffing numbers would resolve some of their issues re staff not being able to accompany them on appointments or outings. Discussions with people indicted that there were occasions in the younger adults part of the home where people were anxious about the behaviour of Merrie Meade DS0000060991.V341444.R01.S.doc Version 5.2 Page 17 other people. They stated that staff were supportive and that they felt staff would protect them. Obviously the planned increases in staffing levels would improve safety for people although there have not been any incidents when people living at the home have been assaulted by other people living at the home. Discussions with staff indicated that some had attended safeguarding adults training and were generally aware of the action they should take if they were concerned that a person living at the home was being, or had been, abused. However not all staff have attended safeguarding adult training or training in respect of mental health awareness, dementia or dealing with violence and aggression. Discussions with external professionals indicated that some people may require more support with managing their personal finances as they are at risk of financial abuse from situations or people outside the home. Merrie Meade DS0000060991.V341444.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People live in a safe, well maintained environment suitable for their individual and collective needs. EVIDENCE: The proprietor continues to invest in the environment and evidence of ongoing improvements was seen during the inspectors visit. The home consists of an older building in which the younger adults live and a new extension which is occupied by the older people. The extension has a large lounge/dining room with access to the rear garden. Seating and soft furnishings are appropriate for the people with sufficient dining room table and chairs for all people should they wish to sit to table for meals. All bedrooms in the extension are single Merrie Meade DS0000060991.V341444.R01.S.doc Version 5.2 Page 19 with ensuite facilities. Appropriate bathing facilities are provided and a passenger lift affords access to the first floor. The younger adults occupy the older part of the home. This has a lounge, quiet sitting room and separate dining room. The home is converting one twin room to provide two single bedrooms. There is one remaining twin bedroom that is situated between the older and newer section of the home. The manager stated that the proprietor is planning to convert one of the bathrooms in the older part of the home into two shower rooms which would seem appropriate for the needs of the people living in this part of the home. Parts of the older part of the home are in need of redecoration and some carpets in the lounge and hallway are showing signs of the high wear they receive. The manager stated that the proprietor is planning on redecorating these areas once the room conversions are completed. Therefore a requirement is not made in respect of this. People living in both parts of the home stated they were happy with both the communal and their private accommodation. Some of the younger adults showed the inspector their private accommodation. One bedroom in the older part of the home, identified to the manager, appeared to have some problems with damp and had a musty aroma. The manager stated the proprietor was aware and had plans to investigate and resolve this problem. The home has a large, private garden to the rear of the home, which is accessible by everyone, and a patio garden outside the lounge of the younger adults part of the home was being completed at the time of the inspectors visit. The builder stated that he is to provide suitable handrails for the three steps from the lounge to the patio once the patio is completed. Previous requirements were made in respect of the absences of liquid soap and paper towel dispensers in bathrooms and WC’s. These were noted to be in place on this inspection visit. The inspector was shown the new OTEX sanitising system that has recently been purchased by the home. The home has also recently installed a new macerator and is to have a OTEX sanitising system installed in the laundry room which will enable clothing to be laundered including disinfection at lower temperatures reducing the risk of clothing being damaged. The manager stated that the home has recently recruited a new cleaner whom the inspector met during her visit to the home. There were no unpleasant odours noted during the visit to the home. Merrie Meade DS0000060991.V341444.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 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 identified a need to increase staffing numbers, staff are appropriately recruited but have not received the necessary training to complete all aspects of their roles. EVIDENCE: The inspector viewed staffing rotas, spoke with care staff and people who live at the home. Surveys from people who live at the home and their relatives are also considered. Seven of the nine people who live at the home who completed a questionnaire stated that staff listen and act on what they say and that staff are always available when they need them. Discussions with people and relatives stated that staff are pleasant and friendly. External professional were positive about staff however they identified that staffing levels in the younger adults section of the home are insufficient to enable people to be supported to attend health appointments or social/leisure activities/outings. At the time of the inspectors visit one person usually staffed the younger adults section although on the day of the inspectors visit a new staff member on induction was also on duty. The inspector discussed staffing levels with the Merrie Meade DS0000060991.V341444.R01.S.doc Version 5.2 Page 21 manager who showed the inspector proposed new duty rotas for the younger adults section of the home. The manager stated that the home aims to provide two staff in the younger adults section once new staff have been recruited. Considering the number and needs of people living in this part of the home two staff would be necessary to meet peoples needs including providing support to attend health and social appointments and opportunities to develop life skills. The older persons section of the home has three staff and a cleaner during the day and two at night. The manager is also based in the older persons part of the home. Staffing levels in the older persons part of the home are appropriate for the number and needs of the people accommodated there. The manager provided information about NVQ qualifications of care staff. Of the twenty-two care staff employed at the home seven have an NVQ of at least level 2, seven are doing the NVQ level 2 and five are waiting to commence NVQ once funding has been obtained. Three staff do not wish to do their NVQ. At present the home does not meet the required Fifty per cent NVQ trained staff however a requirement is not made as further staff are undertaking training. The inspector identified that nine care staff are now in need of manual handling training, fifteen need infection control training and any staff who have been employed for less than one year will require safeguarding adult and health and safety training. Staff have not undertaken training specific to the needs of people who live at the home such as dementia awareness, three staff working with the younger adults need mental health awareness training and all staff need managing violence and aggression training. Staff who administer medication have mainly completed in house training although some have attended external medications training. The manager was unable to provide a training programme for the coming year and stated that she does not have a training budget. In the past the manager has accessed a variety of free training however she stated that this is no longer available for the majority of staff. The inspector viewed recruitment files for new staff and discussed the recruitment process used in the home. The homes recruitment procedures include all the required pre-employment checks and staff undergo an in house induction programme. The inspector spoke with one new member of staff who confirmed that pre-employment checks were undertaken. The inspector discussed recruitment of new staff with some of the younger adults. They stated that if they were at home they would meet potential staff however it was not clear how peoples views of potential staff were used in determining if they were employed. Merrie Meade DS0000060991.V341444.R01.S.doc Version 5.2 Page 22 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36, 37 and 38. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The registered manager is not able to effectively manage, staff are not yet receiving regular formal supervision and people may be at risk of staff not having had the necessary training to meet their needs. EVIDENCE: The manager is a qualified nurse who has managed the home for two years. The manager stated that she is to commence the registered managers award via the local college, however she has had to fund this herself as the home does not have a training budget. The manager is aware of issues relating to the care of older people and younger adults with mental health needs. Merrie Meade DS0000060991.V341444.R01.S.doc Version 5.2 Page 23 Discussions with the manager indicted that she is aware of how to access specialists when required. The manager and proprietor share an office in the older persons part of the home. This means that the manager does not have a private area in which to conduct interviews or staff supervisions. The inspector discussed how the provider and manager divide their responsibilities. The manager does not have budget control or access to money. On the day of the inspectors visit the proprietor was not in the home for the week and the manager had used all the petty cash to give the people living in the older part of the home their allowances and had therefore needed to use her own money to send a member of care staff to the shop as more butter was needed. The proprietor must ensure that the manager is able to access funds. The manager informed the inspector of the quality assurance processes used in the home. The manager stated that there are service user meetings for people living in the younger adults part of the home and issues resulting from these had been addressed. These included the range of food provided to the younger adults, that the home would be getting a free view box and that eligible people would be supported to get free bus passes. The manager stated that she has provided questionnaires to people who live at the home, visitors and external professionals such as care managers. These have yet to be fully audited however the manager stated that she has undertaken a quick audit and is addressing issues raised. The inspector saw completed surveys. The manager explained the procedures in place for services in addition to fees for the people living in the older peoples part of the home. The inspector viewed records in relation to these and the arrangements would seem appropriate. People living in the younger adults part of the home confirmed that they are able to spend their money as they wish. The manager explained that the majority of people living in the younger peoples part of the home manage their own money however it does provide some support for some people, however some people may require more support. The annual quality assurance assessment was well completed by the manager and identified areas that the home could improve upon. Following the previous inspection a requirement was made that staff receive formal supervision at least six times per year. Staff confirmed that this is not yet happening. The manager stated that she is now commencing supervision, however this has not yet happened for all staff. This requirement has therefore not been met and is repeated. Overall records within the home are well completed and appropriately stored. It has been identified that care plans must contain more detail, medication administration records must be fully completed and risk assessments must be completed for people who wish to self-administer. Following the previous inspection a requirement was made that restrictors be fitted to windows on the first floor. These were seen in place and therefore this Merrie Meade DS0000060991.V341444.R01.S.doc Version 5.2 Page 24 requirement is considered to have been met. The environment is generally safe for people, however staff must have infection control training as well as other training specified in the staffing section and any additional training required to ensure people’s needs are met. Merrie Meade DS0000060991.V341444.R01.S.doc Version 5.2 Page 25 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 3 3 3 3 3 X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 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 X 18 2 3 X X X X X X 3 STAFFING Standard No Score 27 2 28 2 29 3 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 X 2 2 2 2 Merrie Meade DS0000060991.V341444.R01.S.doc Version 5.2 Page 26 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 15 (1) Requirement The registered person must ensure that care plans must contain specific information as to how an individuals personal care needs should be met. The registered person must ensure that medication administration records are fully completed with no gaps left. The registered person must ensure that all medication, including that which must be stored at cooler temperatures, is stored securely. Timescale for action 30/09/07 2. OP9 !3 (2) 01/09/07 3. OP9 13 (2) 01/09/07 4. OP30 18 (1)(a) 5. OP31 12(1)(a) The registered person must 01/10/07 ensure that the home has a training and development programme that ensures that all staff undertake mandatory and specialist training to enable them to meet the needs of people living at the home. The proprietor must ensure that 01/09/07 the manager is able to access funds. Merrie Meade DS0000060991.V341444.R01.S.doc Version 5.2 Page 27 6. OP36 18 (2) You are required to commence with the formal supervision of staff, which should be undertaken at least six times a year. This was previously required following the inspection undertaken in June 2006. 30/09/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Merrie Meade DS0000060991.V341444.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 - 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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