Inspection on 05/04/05 for Merrie Meade

This inspection was carried out on 5th April 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 20/10/05

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 5 April 2005 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 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 H55_H04_S60991_Merrie Meade_V218004_050405_Stage 4.doc Version 1.20 Page 3 SERVICE INFORMATION Name of service Merrie Meade Address 2 Watergate Road, Newport, Isle of Wight, PO30 1XN Telephone number Fax number Email 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 Emsley CRH 31 Category(ies) of 31 DE(E) registration, with number of places Merrie Meade H55_H04_S60991_Merrie Meade_V218004_050405_Stage 4.doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 28 October 2005 Brief Description of the Service: Merrie Meade is a large detached two storey property set in reasonable sized grounds with a rear garden, which at the time of the inspection was planned to be landscaped following the completion of a large extension. There is off road car parking to the front. Accommodation for service users is provided on both floors. The home provides long stay care for older people with mental frailty and illness associated with dementia. While it has a comfortable homely feel the older building 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. At the time of the inspection the second of three phases of building work had been completed. A two storey extension provides good quality accomodation and is accessed from the main building via a platform lift. Merrie Meade H55_H04_S60991_Merrie Meade_V218004_050405_Stage 4.doc Version 1.20 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place unannounced over six hours. Only two residents have the cognitive ability to give informed views about the service and both were very complimentary about all aspects of life in the home. There were opportunities during the day to speak with several visitors. One family made reference to the kindness and patience of staff. Another visitor, with experience of a different residential care home, was very clear that Merrie Meade was more able to meet their mother’s needs. The atmosphere was relaxed and friendly and staff were cheerful and attentive to residents throughout the day. What the service does well: What has improved since the last inspection? The home has completed the second stage of a three stage development programme to bring the home up to standard. While the older part of the building still has areas in need of redecoration work is progressing. New carpets have been laid in the two lounges and two further bedrooms have been redecorated. The home had just appointed a new manager at the time of the inspection to enable the managing proprietor to devote more time to the development of the home. Merrie Meade H55_H04_S60991_Merrie Meade_V218004_050405_Stage 4.doc Version 1.20 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Merrie Meade H55_H04_S60991_Merrie Meade_V218004_050405_Stage 4.doc Version 1.20 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 Standards Statutory Requirements Identified During the Inspection Merrie Meade H55_H04_S60991_Merrie Meade_V218004_050405_Stage 4.doc Version 1.20 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 standard(s) 3 and 4 To ensure that the home is able to meet residents’ needs the manager undertakes a pre-admission assessment of prospective residents before they move into the home. However, records of pre-admission assessments are not consistent. Without clear evidence of assessments there is no assurance that care needs will be met. Merrie Meade provides a service for people with mental frailty and illness associated with dementia. Dementia awareness forms part of the training for staff working in the home. EVIDENCE: Each resident has an individual care plan. In general terms the plans are comprehensive but those relating to two recently admitted residents lacked information in key areas. Only one of the two plans contained a pre-admission assessment. It was clear from conversations with the manager that preadmission assessments took place on both occasions but the home needs to ensure that records evidence the fact. Senior staff in the home are long standing and have experience of meeting the needs of people with dementia. Dementia awareness is a feature of the home’s staff training programme. Records showed that specialist services are Merrie Meade H55_H04_S60991_Merrie Meade_V218004_050405_Stage 4.doc Version 1.20 Page 9 accessed as and when required. One resident and a visiting family spoken with were very clear that the home is able to meet residents’ needs. Merrie Meade H55_H04_S60991_Merrie Meade_V218004_050405_Stage 4.doc Version 1.20 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 standard(s) 7, 8 and 9 While the home’s care planning system is generally comprehensive there were shortfalls in the plans of two recently admitted residents. The home must ensure that care plans are developed more quickly than at present. Assessments must identify risks and provide guidance for staff on the actions required to minimise those risks. There was evidence that residents’ health care needs are being met with good pressure area and continence management, and access to health care services as and when required. EVIDENCE: The newest admission to the home had no structured care plan, merely a collection of loose-leaf records. There was no pre-admission assessment or evidence of a review and the risk assessment lacked detail. A potential risk that had been identified had not been recorded. The home provides a secure facility for storing medication and records of administration were seen to be appropriate. It is recommended that controlled drugs are stored in a metal cabinet. Additionally, the home is advised to group each resident’s medication, which is not in blister packs, together within the cupboard, either in rows or in separate containers. Merrie Meade H55_H04_S60991_Merrie Meade_V218004_050405_Stage 4.doc Version 1.20 Page 11 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 standard(s) 14 and 15 Although residents would be encouraged to manage their own financial affairs they all lack the capacity to do so and have relatives to assist. The home has appointed a new chef since the last inspection. Meals are varied, nutritious and reflect what the chef knows residents like. EVIDENCE: The manager confirmed that arrangements are in hand to access the advocacy service for one resident while others had family to assist. The chef said he had a good understanding of residents’ preferences for meals and while changes are made to what is essentially a three week menu he prepared meals that he knew they enjoyed. Stocks of food were low at the time of the inspection but the chef said that a ‘cash and carry’ run was due the following day. Most residents eat in the dining room with staff available to assist them where needed. Staff were seen to be attentive and sensitive to the difficulties experienced by residents at the meal table. They can, and do, have meals on a tray in their room if they wish. A family visiting one of the residents expressed satisfaction with the food. Merrie Meade H55_H04_S60991_Merrie Meade_V218004_050405_Stage 4.doc Version 1.20 Page 12 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 standard(s) 16 Merrie Meade has a complaints policy, details of which are included in the home’s statement of purpose. Arrangements are in place to ensure staff treat residents’/representatives’ complaints seriously and deal with them appropriately. However, attention should be paid to ensuring complainants are given written feedback following investigations. EVIDENCE: The home keeps a record of complaints, which gives details of issues raised. However, recent records lacked details of the investigation outcome and evidence of feedback having been given to the complainant. Merrie Meade H55_H04_S60991_Merrie Meade_V218004_050405_Stage 4.doc Version 1.20 Page 13 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 standard(s) 19 and 26 There is an ongoing programme of redecoration and refurbishment. Rooms are gradually being upgraded to provide a more modern and comfortable living space for residents. On the day of the inspection the home was clean, hygienic and there were no unpleasant odours. EVIDENCE: Since the last inspection new carpets have been laid in the main and quiet lounges. Two residents’ rooms have been decorated and one has a new carpet. A family visiting one resident recognised that the bedroom was badly in need of redecoration as wallpaper was peeling in several areas. However, they had concerns about the impact of the upheaval on the resident and had discussed this with the manager. In recent years major work has been carried out on the home with a new kitchen and a ten-bedded extension completed. The old part of the building has yet to be fully refurbished to meet residents’ needs but it is recognised that it will be the third stage of a planned three stage project. During the inspection arrangements were being made to landscape the rear garden following completion of the new build. Merrie Meade H55_H04_S60991_Merrie Meade_V218004_050405_Stage 4.doc Version 1.20 Page 14 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 28, 29 and 30 The home generally operates a robust system of recruitment, which provides the safeguards to offer protection to people living in the home. Staffing levels are adequate to meet residents’ needs. New staff are inducted to TOPSS England specifications and all staff are scheduled to receive statutory and dementia awareness training. Some staff with the NVQ at level 2 have left the home since the last inspection leaving only 7 currently qualified. EVIDENCE: Staff rotas showed that a minimum of three care staff are on duty at all times during the day. Two staff are on duty overnight. With nineteen residents in the home the levels were seen to be adequate to meet their needs. The home employs additional domestic, catering and maintenance staff. Four new care staff and a chef have been recruited since the last inspection. Recruitment records in respect of four were seen to be in good order. There was only one reference in place for one member of staff and the manager gave an explanation for the shortfall. It is important when verbal telephone references are taken that a record is kept of the date and time, the person spoken with and what was said. The home currently falls well short of the standard of 50 NVQ trained care staff and the manager explained that it was in the most part due to trained staff leaving the home. However, it was confirmed that three staff are currently working towards the NVQ 3 and four working towards the NVQ 2. Merrie Meade H55_H04_S60991_Merrie Meade_V218004_050405_Stage 4.doc Version 1.20 Page 15 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33, 35 and 38 Following recommendations at previous inspections little progress has been made towards meeting the standard relating to quality assurance. Quality assurance monitoring based on seeking the views of service users is key to measuring the home’s performance in meeting its aims and objectives. The home provides a sound system to ensure residents’ finances are safeguarded. Policies, procedures and staff training are in place to ensure so far as is reasonably practicable the health, safety and welfare of residents and staff. EVIDENCE: The home has introduced a comments section to its visitors’ book, which invites visitors to make comments about the service. A quality assurance questionnaire and quality audit form have been developed, but have yet to be implemented. The manager said surveys had been tried in the past but had been met with a poor response. It is recognised that only a minority of residents have the cognitive ability to give informed views about the service. This places additional importance on seeking the views of visitors, relatives, Merrie Meade H55_H04_S60991_Merrie Meade_V218004_050405_Stage 4.doc Version 1.20 Page 16 healthcare professionals and others capable of providing constructive feedback about the home’s performance. The home’s system of administering residents’ finances was checked and found to be in good order. Staff receive training in health and safety, infection control, first aid, moving and handling training and medication. A selection of records relating to the compliance of relevant legislation was checked and found to be in order. The issue of appropriate risk assessments for residents has been dealt with in Standard 7. Merrie Meade H55_H04_S60991_Merrie Meade_V218004_050405_Stage 4.doc Version 1.20 Page 17 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. Where there is no score against a standard it has not been looked at during this inspection. 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 2 3 x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 3 15 3 COMPLAINTS AND PROTECTION 2 x x x x x x 3 STAFFING Standard No Score 27 3 28 2 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 2 x x x x x x 3 x x 2 Merrie Meade H55_H04_S60991_Merrie Meade_V218004_050405_Stage 4.doc Version 1.20 Page 18 NO Are there any outstanding requirements from the last inspection? 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 3 Regulation 14 Requirement All new admissions to the home, so far as practicable must be accompanied by a pre-admission assessment of needs, a copy of which should be available for inspection. A care plan must be generated from a comprehensive assessment to form the basis of the care to be delivered, and reviewed by care staff at least once a month The care plan must include a risk assessment, fully completed, which identifies the risk and sets out the measures to be taken to minimise the risk of harm to the service user. To review the current arrangements for quality assurance to seek ways in which this standard could be fully met. Timescale for action 5/4/05 Immediate requiremen t notice served. 5/4/05 Immediate requiremen t notice served. 5/4/05 Immediate requiremen t notice served. 31/5/05 2. 7 15 3. 7 13 4. 33 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. Refer to Good Practice Recommendations H55_H04_S60991_Merrie Meade_V218004_050405_Stage 4.doc Version 1.20 Page 19 Merrie Meade 1. 2. 3. 4. Standard 9 9 16 29 Controlled drugs to be stored in a metal cabinet. To group each resident’s medication, which is not in blister packs, together within the cupboard, either in rows or in separate containers To record the outcome of a complaint investigation and to provide written feedback to the complainant. Where verbal telephone references are taken a record should be kept of the date, time, who was spoken with and what was said. Merrie Meade H55_H04_S60991_Merrie Meade_V218004_050405_Stage 4.doc Version 1.20 Page 20 Commission for Social Care Inspection Mill Court Furrlongs Newport Isle of Wight, 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 H55_H04_S60991_Merrie Meade_V218004_050405_Stage 4.doc Version 1.20 Page 21 - 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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