Inspection on 20/10/05 for Merrie Meade

This inspection was carried out on 20th October 2005.

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

The inspector 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

Merrie Meade 15/12/09

Merrie Meade 13/10/09

Merrie Meade 02/07/09

Merrie Meade 09/07/08

Merrie Meade 18/07/07

Merrie Meade 16/06/06

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 Neil Kingman Unannounced Inspection 20th October 2005 10:00 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 Merrie Meade DS0000060991.V249018.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for 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.V249018.R01.S.doc Version 5.0 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 Merrie Meade Residential Home Ltd Mrs Victoria Annette Emsley Care Home 31 Category(ies) of Dementia - over 65 years of age (19), Mental registration, with number disorder, excluding learning disability or of places dementia (10), Mental Disorder, excluding learning disability or dementia - over 65 years of age (2) Merrie Meade DS0000060991.V249018.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 5 April 2005 Brief Description of the Service: Merrie Meade is a large detached 2 storey property 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 in the main part of the building for older people with mental frailty and illness associated with dementia. The environment in this area is not currently suitable for people with mobility difficulties owing to the absence of a passenger lift and ramps to facilitate access to communal and private space. However, plans are in place to develop the accommodation extensively in order to meet relevant minimum standards. Since the last inspection a two storey extension has been completed to provide long term care/support for younger adults with mental health problems. This service is separate from the main building but can be accessed either externally or from the main building via a platform lift. Merrie Meade DS0000060991.V249018.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over a day and a half. Since the last inspection a new ten-bedded extension has been brought into service providing accommodation for younger adults with mental health problems. This service was developed as a result of a crisis situation when service users were relocated to Merrie Meade from another home. In light of these circumstances the inspector considered it important to gauge the impact that the whole process has had on service users and staff in both parts of the building. The report is based on the inspector’s observations during a tour of the building, conversations with service users and staff, and the examination of various records. A total of nine satisfaction questionnaires were received from residents and visitors to the home. What the service does well: What has improved since the last inspection? What they could do better: There were three issues identified during the inspection: • The home’s statement of purpose needs updating to reflect the new mental health service for younger adults. Merrie Meade DS0000060991.V249018.R01.S.doc Version 5.0 Page 6 • • New care staff must not commence work before appropriate clearance has been obtained, even though criminal record checks have been sent off as required. The home needs to forward to the CSCI a timescale for the commencement of work to the bedrooms where shortfalls were identified during the inspection. 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. Merrie Meade DS0000060991.V249018.R01.S.doc Version 5.0 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 Merrie Meade DS0000060991.V249018.R01.S.doc Version 5.0 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): 1, 3 and 6 The home has produced a statement of purpose, which is clearly laid out with the information required to meet the standard. However, it does not contain information about the recently developed service for younger adults with mental health problems. The manager ensures that the support and care needs of the people who live at Merrie Meade will be met by undertaking a proper assessment prior them moving into the home. Merrie Meade does not provide dedicated accommodation for short-term intermediate care or specialised facilities for rehabilitation. EVIDENCE: The home’s statement of purpose incorporates a service user guide with terms and conditions of residency. While it has been updated in the last year it describes the service provided for older people with mental frailty and illnesses associated with dementia. Merrie Meade DS0000060991.V249018.R01.S.doc Version 5.0 Page 9 In April 2005 the new extension was completed and the home varied its registration to accommodate younger adults with mental health problems. The statement of purpose needs to be updated to reflect the changes. At the last inspection the recording of pre-admission assessments was not consistent and without that evidence there was no assurance that care needs would be met. However, since that time a new pre-admission assessment record has been developed. The inspector looked at the service user plan for the most recent admission to the home. It contained a comprehensive assessment recorded by the manager. The manager confirmed that this resident had visited the home prior to making the decision to stay. Most residents at Merrie Meade are long term. The home does not provide dedicated accommodation for short-term intermediate care or specialised facilities for rehabilitation. Respite care is offered when accommodation is available. There was no evidence that the provision of this service has a negative impact on the resident group. The inspector had an opportunity to speak with a resident who had just reached the end of a respite stay. While looking forward to returning home he was quite positive about his experience at Merrie Meade. Merrie Meade DS0000060991.V249018.R01.S.doc Version 5.0 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, 9 and 10 The home develops a comprehensive plan for each resident, which describes how individual health, social and personal needs will be met. Medicines are stored in appropriate locked facilities. The home ensures that staff respect residents’ privacy and dignity at all times and responds to issues as and when they are raised. EVIDENCE: At the last inspection there were shortfalls identified in respect of individual care plans and the storage of controlled drugs. These standards were reassessed. The new manager has since developed the home’s care planning system. The inspector looked at a selection of plans for those with mental health problems, including the most recent admission to the home. They contained relevant information about activities for daily living, rights, choices and risks. Current assessments were in place and there was evidence of recent reviews. Merrie Meade DS0000060991.V249018.R01.S.doc Version 5.0 Page 11 Controlled drugs are appropriately stored in a secure metal cabinet and residents’ medication that is not in blister packs is separated and labelled individually. There was evidence that the manager had undertaken a thorough audit of the medication system. The respect for privacy and dignity forms part of the induction for new staff. During the inspection it was noted that the manager and staff would knock before entering residents’ rooms. Staff would typically address residents by their preferred name and speak to them in a respectful manner. The manager said she was in the process of building on the subject of respect for residents by introducing a behaviours framework, aimed at improving staff attitudes to each other. Care plans emphasise the resident’s right to choose a male/female member of staff for personal care. There are two pay phones available for residents’ use and a private installation can be installed in a room on request. The inspector noted privacy screens in the two shared rooms that were viewed. Residents spoken with were very clear that staff at all times treated them with respect and kindness. Several residents were seen to lock their rooms as they left them and it was clear they could come and go as they pleased. Merrie Meade DS0000060991.V249018.R01.S.doc Version 5.0 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 and 13 Residents are encouraged to maintain their independence with flexible routines within the home. They are encouraged to take part in a range of activities away from the home and outside support will be brought in where appropriate. The home will support residents to maintain family links and friendships. Visitors are welcome at all reasonable times and are able to meet with residents in private. EVIDENCE: The home has introduced residents’ meetings from which issues raised are addressed. One resident said that the choice of food was an issue when he arrived. However, when he raised it at the residents’ meeting the chef took note and the outcome was to his liking. There was evidence of three different support workers accompanying residents during excursions away from the home. The manager said that such arrangements had been in place for residents before they moved to Merrie Meade and were encouraged to continue. The inspector noted examples of the home’s support workers accompanying residents on walks, to leisure activities, cafes, shops and to day services. This support was particularly evident with a new resident who was exploring new activities and needed items for his room. Records showed that residents go out alone if they wish, subject to agreed restrictions in their Merrie Meade DS0000060991.V249018.R01.S.doc Version 5.0 Page 13 individual plan. The manager and staff said that they are currently developing a range of indoor games to be available in the lounge for the younger adults. Residents’ family, relatives and friends are encouraged to visit regularly and maintain contact by letter or telephone. The home’s service user guide contains information on visiting arrangements, which are generally unrestricted. Residents can receive visitors in their own rooms, the lounge or the newly installed and heated summerhouse. One resident felt that quiet areas for privacy were limited and the manager agreed to explore this further. Merrie Meade DS0000060991.V249018.R01.S.doc Version 5.0 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): 18 The home’s policies, procedures and practices ensure that residents are safeguarded from abuse. Procedures for responding to suspicion or evidence of abuse are robust. EVIDENCE: The home uses the adult protection policy guidance provided by Isle of Wight social services. Staff spoken with during the inspection showed an understanding of how to recognise abuse and were very clear about reporting issues of concern without delay. Merrie Meade DS0000060991.V249018.R01.S.doc Version 5.0 Page 15 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): 24 While many of the rooms occupied by residents are furnished and equipped to assure comfort and privacy, several were identified as being in need of refurbishment. EVIDENCE: The inspector toured the building with the manager and looked at eighteen rooms. Rooms in the new extension are carpeted, furnished and equipped to a good standard. All have en-suite facilities. Two residents spoken with in their rooms expressed satisfaction with the facilities. In the older building it was clear that improvements have been made. Furniture has been replaced and rooms decorated in line with the maintenance and redecoration programme. At the time of the inspection one ground floor room was being refurbished. However, five rooms were of an unacceptable standard. Areas for attention were pointed out to the manager and included old and tired decoration, a hole in a wall, peeling wallpaper, stained sanitary ware and torn and lifting vinyl floor covering. Merrie Meade DS0000060991.V249018.R01.S.doc Version 5.0 Page 16 Merrie Meade DS0000060991.V249018.R01.S.doc Version 5.0 Page 17 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): 28 and 29 To ensure residents are in safe hands the home ensures that staff undertake NVQ training. While the procedures for the recruitment of staff are generally robust safety checks (POVA First checks) must be carried out before new staff commence work, to ensure the proper safeguards that offer protection to people living in the home. EVIDENCE: At the time of the inspection 44 of care staff had achieved the NVQ at level 2. The home is taking steps to meet the minimum standard of 50 through ongoing training and assessment. Of the sixteen staff employed at the home all are either undertaking the training or are qualified at NVQ level 2 or above. The manager is in the process of developing staff training profiles together with a matrix of staff training needs and achievements. The inspector saw evidence of this task being well under way. While staff recruitment was assessed at the last inspection the inspector noted that two new care staff had been recruited during the summer without POVA clearance before they commenced work in the home. While it is recognised that a full criminal records check can take time the home must not allow staff to commence work with vulnerable adults without a POVA First check being Merrie Meade DS0000060991.V249018.R01.S.doc Version 5.0 Page 18 carried out. Other records in respect of this recruitment process were found to be in order. Merrie Meade DS0000060991.V249018.R01.S.doc Version 5.0 Page 19 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 and 36 The manager is new to the home since the last inspection and has yet to complete the process for registration. The home has now developed effective quality assurance systems for measuring its performance based on seeking the views of residents. Staff are appropriately supervised. EVIDENCE: The manager Ms Gibson was appointed in April 2005 and has almost completed the process for registration. She has a Diploma of Higher Education in Nursing Studies and has several years experience of working in residential homes for older people. The manager has developed, but not yet implemented a range of service user satisfaction surveys to obtain the views of residents, parents, relatives, Merrie Meade DS0000060991.V249018.R01.S.doc Version 5.0 Page 20 advocates, professionals and purchasing services. Residents’ meetings provide an opportunity for views to be aired as a group, with issues raised addressed by management. The conduct of the home is independently audited each month and a report forwarded to the Commission. The manager and staff said that documented formal staff supervision takes place, covering work practice, philosophy of care and development needs. The manager has developed a new method of recording the sessions and is currently developing a new method of staff appraisal. Informal supervision of staff takes place on a daily basis by the manager and/or the proprietor. The inspector saw evidence of the recent documented supervision. Merrie Meade DS0000060991.V249018.R01.S.doc Version 5.0 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for 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 2 x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 x 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 x COMPLAINTS AND PROTECTION Standard No Score 16 x 17 x 18 3 x x x x x 2 x x STAFFING Standard No Score 27 x 28 2 29 2 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 x 2 x x 3 x x Merrie Meade DS0000060991.V249018.R01.S.doc Version 5.0 Page 22 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 OP1 Regulation 4 Requirement To update the home’s statement of purpose to include the new service for younger adults with mental health problems. To ensure that no person commences work in a care position in the home without the POVA First list having been checked. To submit to the Commission a written timescale for work to be carried out to residents’ rooms identified to the manager during the inspection. Timescale for action 18/11/05 2 OP29 19 Sch 2 05/11/05 3 OP24 23 18/11/05 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.V249018.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Southampton, Portsmouth and Isle of Wight Ground Floor Mill Court Furrlongs Newport, IOW PO30 2AA 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 Merrie Meade DS0000060991.V249018.R01.S.doc Version 5.0 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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