Inspection on 14/08/07 for Merrill House

This inspection was carried out on 14th August 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

Merrill House 09/10/06

Merrill House 24/01/06

Merrill House 20/09/05

Merrill House 02/11/04

Merrill House 16/06/04

Merrill House 16/03/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE Merrill House Merrill House Queensferry Gardens Shelton Lock Derby Derbyshire DE24 9JR Lead Inspector Claire Williams Key Unannounced Inspection 09:00 14th August 2007 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 Merrill House DS0000035949.V340680.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. Merrill House DS0000035949.V340680.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Merrill House Address Merrill House Queensferry Gardens Shelton Lock Derby Derbyshire DE24 9JR 01332 718400 F/P 01332 718400 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) Derby.gov.uk Derby City Council Christine Ann Flower Care Home 40 Category(ies) of Old age, not falling within any other category registration, with number (40) of places Merrill House DS0000035949.V340680.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 9th October 2006 Brief Description of the Service: Merrill House provides personal care and support for up to forty older persons, both male and female. It is located in a busy residential area in the South of Derby, close to shops, local amenities and bus routes. The building is purpose built and the accommodation is provided over two floors, and access is gained via the passenger lift, chairlift and stairs. There are three wings, each providing a lounge and dining area, and toilets are located close by along a corridor. There are forty single rooms, although none of these have en-suite facilities. There are suitably adapted bathroom facilities located on each wing and each floor, and a shower room is also available. The building provides level access and is therefore accessible throughout to assist those people with mobility problems. There are emergency call systems located in all private and communal areas accessed by people who live at the home. There is a patio and lawned area surrounding the building with seating areas provided. The home has a smoking room, which is located on the first floor. A copy of the most recent inspection report is available in the lounge areas, along with the Statement of purpose and Service user guide. The fees currently are £318.00 per week per person, but each person would have a financial assessment and would be consulted about this fees. Merrill House DS0000035949.V340680.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection report is based on all the information we have received about the service over the last 12 months. This includes the previous key inspection report the completed Annual quality assurance questionnaire, notifications, and the unannounced site visit for the purposes of this inspection. All key standards identified by the CSCI were assessed during this visit. Case tracking was used as part of the methodology. This involved the random sampling of four people whose care and service provision was examined more closely. Discussions were held with those individuals (in accordance with their given capacities) and where possible their representatives and also the staff involved in their care. Individual’s care and associated records was examined and their private and communal accommodation inspected. The Registered manager has moved to another service and an acting manager is currently covering the position, but she was not on duty on the day of this visit. We were supported by the relief and deputy manager on duty, and contact was made with the acting manager after the visit to discuss the outcome of the inspection. At the time of this inspection visit, there was thirty eight people accommodated receiving personal care and support. What the service does well: People have access to information and have an assessment undertaken so that they know the home is able to meet their needs. People liked living in this home and said that they feel safe here. They spoke positively about the staff team and made the following comments: “the staff delivered good care, and work very hard”, “they are friendly and caring”, “They care for me with utmost respect and dignity”. People felt confident to raise any concerns and felt listened to by the staff and management team. Letters of commendation had been sent to the home, comments made included: “Thanking the staff team for their care, sympathy and support, which was second to none, and their professionalism and cheerfulness. “Thanking staff for providing such good care and support to people” Merrill House DS0000035949.V340680.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Information about the home needs to be updated so that it clearly reflects the current management arrangements. It would be good practice for the acting manager to undertake a pre-admission assessment to enable her to meet people before they move into the home. Each person who lives in the home must have a detailed person centred care plan to enable the staff team to provide support and care that meets their individualised needs. Risk assessments must also be undertaken in order to assess any potential risks to individuals and action to be taken to minimise these. This is to ensure individuals receive planned care, which is provided in a safe way. The information in place must then be kept under review so that it reflects the person’s current needs. A medication fridge was in use at the home, but the temperature was not monitored to ensure the fridge was maintaining the correct storage temperature for the medication stored within. The staffing levels need to be reviewed, as staff support was not always available to people when they needed it. Some people require emotional support and assistance and the current staffing levels mean this may not always be provided. Due to the staffing levels people do not have access to planned activities, as the staff priorities are to ensure peoples personal care needs are met. Information was received following the visit, to support that an assessment had already been undertaken of peoples dependency needs, and strategies have been implemented to assist with the staffing situation. The fire risk assessment needs to be reviewed so it includes reference to oxygen that is currently stored in the building. This is to ensure any potential risks can be identified and minimised. A delegate of the provider needs to undertake monthly visits to the service to check on the standards maintained and complete a report of their findings. This is in accordance with their legal obligations. Merrill House DS0000035949.V340680.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. Merrill House DS0000035949.V340680.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 Merrill House DS0000035949.V340680.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): Standards 1, and 3 (standard 6 not applicable) Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People have the information they need to be able to choose a home and are assessed prior to moving into this service so that they can be confident that the home is able to meet their needs EVIDENCE: At this inspection, discussions were held with those people who care was case tracked and also the family of two people, concerning the arrangements for their admission and their care needs. The feedback received was mixed as the people living in the home stated they have received information about the home, but the relatives stated that they had not been given any information either when they visited to look around or when their relative had moved in. There are copies of the Statement of purpose and Service user guide available in the folders located in all three lounge areas. These documents however need to be updated due to the recent changes to the manager’s position, to ensure they reflect the current situation in the home. Information about the home is Merrill House DS0000035949.V340680.R01.S.doc Version 5.2 Page 10 provided in standard print format, although it can be made available in large print. Many people spoken to stated that they or their family came to visit before a decision was made about moving in. There was evidence in the three files examined to support that their respective Care manager had undertaken a needs assessment. However there was no information to support that the manager of this service had undertaken an assessment, which is good practice, as this enables the manager to make an informed decision about whether the home is able to meet their assessed needs. There was evidence to support that a letter confirming the placement had been sent based on the information provided by the Care manager. Merrill House DS0000035949.V340680.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): Standards 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. People do not receive support in a manner, which promotes and safeguards their health and wellbeing, as person centred care plans were not in place to inform the delivery of their care. EVIDENCE: Discussions with people and the visiting relatives confirmed that the staff team work very hard to ensure that people’s needs are met. People spoke positively about the staff team and the way they receive support, which they confirmed, was always delivered “with the utmost dignity and respect”. People felt that the staff team supported them in accordance with their preferences and choices and “did there best based on the resources available”. We examined four care files for people who were the most recent admissions to the service. Only one file contained a care plan that had been completed in sufficient detail to support the delivery of their care. One file contained a care plan that had sections incomplete, and in the other two files majority of the documents were blank with very little information provided apart from the Care manager’s initial assessment. Merrill House DS0000035949.V340680.R01.S.doc Version 5.2 Page 12 Information concerning individuals preferences and preferred routines was not available which means people do not receive person centred care in accordance with their wishes. The care staff are responsible for the completion of the care plans but due to issues with the staffing levels, (please see standard 17) they have not had time to undertake these tasks, and have instead prioritised their time focusing on supporting the people in the home. Although the required documentation was not in place for these people, discussions with individuals confirmed that in their opinion they felt “well looked after”. Staff spoken with was enthusiastic and motivated and demonstrated that they had a good knowledge of peoples needs even though this was not supported by written documentation. Care files did not contain completed risk assessments in the areas of falls, nutrition, and moving and handling. Two files did have a tissue viability assessment completed but these were not reviewed as the guidance stated based on the outcome of the assessment. Oral risk assessments had been undertaken for two people, but no outcome was recorded following this assessment as to what, if any action should be taken. There was no evidence to support that monthly reviews were being facilitated, but one family did confirm that they had been invited to an annual review. Information was received following the inspection to confirm that falls assessments had been completed and tele-care equipment obtained in order to support people with the prevention of falls, and with their mobility. The arrangements for the management and administration of medicines was examined and these appeared to be satisfactory. The relief manager stated that all managers have or are in the process of completing training in medication. They are completing a unit that is part of a National Vocational Qualification (NVQ) so therefore it includes observations and an assessment of their competency undertaking medication tasks. There was two people who self-administer their medication, and a signed declaration was in their files, and lockable storage was provided in their rooms. However a medication risk assessment was not available in these people’s files. A medication fridge was being used, but the temperature of the fridge was not being monitored. Merrill House DS0000035949.V340680.R01.S.doc Version 5.2 Page 13 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): Standards 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. Although people are satisfied with the meals provided, they do not have access to social, cultural and recreational activities that meet their expectations, due to limitations of staff resources. EVIDENCE: As mentioned previously the service is experiencing difficulties with the staffing levels. This has had an impact on the availability of activities, as the staff priorities are to support individuals with their daily living needs. There is one staff member allocated to each wing therefore the staff members have little time to facilitate activities due to the dependency needs of the people living in the home. In discussions with the staff members they did state that they try to “fit in activities were possible”, but this depends on the day and how busy they are. There are posters detailing the activities available, which consisted of a variety of board games, singing and beauty treatments, and there are rooms available with the specific function for the provision of these activities. There is also a designated hairdressing room, which is a provision people stated they “really enjoy and look forward to”. People did state that they do go out on trips and spoke about a trip that was planned, but had to be cancelled due to the weather. People also stated that they sometimes go to the local pub for a drink Merrill House DS0000035949.V340680.R01.S.doc Version 5.2 Page 14 and a meal, but this is dependent upon staff resources. Staff members spoken with stated that they try to book outings but this can be difficult as this often means staff working in their own time so it is dependent upon their availability. In discussions with people living in the home they stated that there is “little to do during the day as the staff are busy, but try there best” Observations supported that when time allowed staff did interact positively with people when they could. For majority of the day people were observed sitting in there chairs sleeping or watching the TV. There was many relatives visiting throughout the day, so for some people they spent quality time in private with their family members. People stated that they were satisfied with the meals that were provided and confirmed that alternatives to the menu were available on request. Menus are based on an eight weekly cycle and were varied and nutritious. People had access to drinks and snacks throughout the day. Catering staff confirmed that they are informed on a verbal basis of people’s dietary requirements. There was no evidence of written documentation in relation to people’s preferences in respect of their food intake but people did state that they had what they needed. A menu was displayed in the dinning area of one lounge, however a relative stated “don’t take any notice of that its been there for ages”. The menu stated that is was the options for week 4 but if this has been displayed for a period of time, then it may confuse people about what meals are available for that respective week. Merrill House DS0000035949.V340680.R01.S.doc Version 5.2 Page 15 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): Standards 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are confident they are listened to, and are safeguarded by the procedures and training provided for the staff. EVIDENCE: During discussions with people they confirmed that they would not hesitate to raise any concerns they had with the staff team. People commented on how supportive and approachable the staff were. Relatives also confirmed that any issues raised have been dealt with. People have access to the complaints procedures as it is displayed in several areas and in the Service user guide. There were no recorded complaints about the home since the last key inspection. Staff spoken with was conversant with the procedures in place for the action required in the event of witnessing a potential abusive situation, and they confirmed access to training in this area. There have been no referrals made since the last inspection. Merrill House DS0000035949.V340680.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 19, 21, 23, and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are satisfied with their surroundings, which are homely, safe and generally well maintained. EVIDENCE: People spoken with stated that they were happy with the cleanliness of the home, and one person said, “it’s always like this, the domestic staff do a very good job”. Relatives also confirmed that during visits they have not smelt any odours and the home was well maintained and clean. People commented on how they liked their rooms, and those visited were personalised with their belongings. People confirmed that they had access to aids and adaptations in order to assist them in daily living tasks. People have access to a wellmaintained garden area where sitting is provided. One of the toilets located on a wing of the building had a rusty radiator located within it, and the paint in this toilet, and the adjourning toilet had started to peel and did not look homely. Merrill House DS0000035949.V340680.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 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. People benefit from being supported by a competent and committed staff team but staffing levels in place may compromise the delivery of care. EVIDENCE: People spoke highly of the staff team and were confident in the staff’s abilities; relatives also spoke positively about their interactions with staff members and stated how informative they were. The home has three wings and one staff member is allocated to each wing, there is currently 12 people accommodated on two wings and 16 on the third. The dependency needs of the people in the home are varied but some individuals on each wing do have high support needs. This seemed more apparent on the wing where 16 people are supported. Time was spent in this area and observations supported that the staffing levels should be reviewed as the staff member occasionally had to leave the lounge area for periods of time to undertake other duties, which resulted in people being left unsupervised. At times some individuals with dementia had to be supported by their peers due to the staff support not always being available. During the afternoon period an incident occurred and people in the home had to notify the staff, as they were not in the area at that time. Merrill House DS0000035949.V340680.R01.S.doc Version 5.2 Page 18 Due to the staff shortages, which is a result of sickness and annual leave, agency staff, are used to provide staff cover. Two agency staff members was working the afternoon shift and was allocated to support people on a certain wing each. Confirmation was received to support that all agencies workers are vetted and trained to ensure they can fulfil their role and safeguard the people in the home. In discussions with the staff members they commented about the difficulties faced by working alone on a wing, and how on occasions they have to support agency staff and work together covering two wings at one time. Although staff felt that they did deliver a good standard of care they often did feel rushed and would like to spend more time with people especially during the morning when supporting individuals to get ready for the day. Issues with the staffing levels have been raised in previous reports and there is no evidence to support that any action has been taken to resolve these issues. Staff confirmed that arrangements for their training and support was very good and they confirmed details of training undertaken by them over the last twelve months. This covered all of the mandatory areas and service specific areas such as dementia. The service operates an equal opportunities policy and staff receive training with regard to equality and diversity. All new staff undertake an induction, which encompasses the skills for care induction standards. The annual Quality Assurance Assessment stated that 16 of the 23 permanent care staff have achieved at least NVQ level 2 or above, which demonstrates a positive commitment to training by the staff team and provider. There is limited documentation held at the home of the recruitment checks undertaken, as these are kept at the human resources department. Evidence of these checks was sent for three staff members and supported that all of the required checks had been undertaken. Merrill House DS0000035949.V340680.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 31, 33, 35, and 38. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People felt that the home was managed in their best interests, but the health and safety systems in place do not ensure their safety is promoted. EVIDENCE: The service has recently been appointed a new manager as the previously manager has moved to another service within the local authority. The current manager worked in this capacity at her previous home so therefore has the skills, knowledge and training to fulfil the role. The manager has not yet processed her application to register but stated that she intends to complete this soon. The manager has been at the home since July 2007 so she is still settling in, and getting to know the people, staff and the systems in place. Merrill House DS0000035949.V340680.R01.S.doc Version 5.2 Page 20 People thought the service was generally well managed and felt consulted about some aspects of the service. Some people stated that although they have not yet spoken to the new manager they have been introduced and look forward to getting to know her. The staff team felt that she was supportive and approachable and felt that she would be a benefit to the service. The manager was not on duty during this visit but contact was made following this visit to provide feedback. The manager confirmed that she was aware of the issues identified in respect of the documentation not being in place for people and the staff shortages. She also confirmed that she is in the process of auditing all systems so that she has a base line to work from. Systems and arrangements for the management and safekeeping of people’s finances were examined and these were satisfactory. Those individuals that are able to, sign for receipt of their money, or two staff members usually sign all transactions. There are suitable safekeeping and administrative records with regard to money held. Regular meetings are held with people and records were in place to support this. This enables people to be consulted about future plans and trips they would like to attend and any other issues they may feel like discussing. A quality assurance survey has recently been sent out and the manager is now waiting for the response, which will be analysed, and a report completed of the findings. There was limited evidence to support that a delegate of the provider visits on a monthly basis in order to assess and monitor the ongoing standards and to gain feedback from people. This issue was raised in the previous report and there is no evidence to support that any progress has been made in this area. The health and safety systems were sampled in accordance with the annual Quality assurance assessment and appeared satisfactory. The fire risk assessment was examined and although this had been reviewed earlier in this year, the information provided was incorrect. Oxygen is now located on the premises, but the location of this was not included in the assessment and the storage of oxygen does present a risk in the event of a fire therefore this must be included in the fire risk assessment. Merrill House DS0000035949.V340680.R01.S.doc Version 5.2 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 3 X 3 X X N/a HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 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 3 3 X 2 X 3 X X 3 STAFFING Standard No Score 27 2 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 3 X X 2 Merrill House DS0000035949.V340680.R01.S.doc Version 5.2 Page 22 Yes 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 OP7 Regulation 15 (1) Requirement All people using the service must have an up to date, detailed person centred care plan. This must direct staff on the delivery of care in accordance with the persons assessed needs. This will ensure that people receive person centred support that meets their needs. All people must have a risk assessment completed in the required areas to support their health care needs. This is to ensure any risks identified can be minimised and monitored. The temperature of the medication fridge must be monitored to ensure medication is being stored as required. People who self-administer their medication must have a medication risk assessment undertaken to support them in undertaking this task safely. The staffing levels must be reviewed in accordance with the dependency needs of the people to ensure there is adequate staff DS0000035949.V340680.R01.S.doc Timescale for action 01/11/07 2. OP8 14 (2) 01/11/07 3. OP9 13 (2) 01/11/07 4 OP9 13 (2) 01/11/07 5 OP27 18 (1) (a) 01/11/07 Merrill House Version 5.2 Page 23 on duty to meet peoples needs. (Repeated from the inspection report dated 16 March 2004 and 24 January 06 and 9th October 06 were it was a recommendation) The manager must apply to register with the CSCI. So that she can be registered as the manager for this service. A delegate of the provider must undertake their legal obligations and visit the service on a monthly basis and complete a report of there findings. This is to ensure that the standards the service are maintained and monitored. The fire risk assessment must be reviewed to include reference to the oxygen being stored in the building. This is to ensure any risk can be minimised and recorded. 6 OP31 8 01/12/07 7 OP31 26 01/12/07 8 OP38 23 (4) (a) and (v) 01/12/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 4 5 Refer to Standard OP1 OP3 OP7 OP7 OP8 Good Practice Recommendations The Statement of purpose and Service user guide should be updated to reflect the current management arrangements. The manager should complete a pre- admission assessment of all people who may move into the home. People should have their care plan reviewed in consultation with them on a monthly basis. Peoples preferences and routines should be recorded in their care plan in order to inform the delivery of their care. All risk assessments should be reviewed on a regular basis, or when a person needs change. DS0000035949.V340680.R01.S.doc Version 5.2 Page 24 Merrill House 6 7 OP12 OP15 8 OP15 People should be consulted and supported to access recreational activities that meet their preferences. If a menu is to displayed, this should be in accordance with the options the catering staff will be providing for that respective week. All other menus should be removed as to not confuse people on what options are available. Information should be recorded in relation to peoples preferences, likes and dislikes in respect of their food and drink intake. Merrill House DS0000035949.V340680.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Lincoln Area Office Unity House, The Point Weaver Road Off Whisby Road Lincoln LN6 3QN 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 Merrill House DS0000035949.V340680.R01.S.doc Version 5.2 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. 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!