Inspection on 28/09/07 for Merrimans, 3 (Adult Respite)

This inspection was carried out on 28th September 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. These are things the inspector asked to be changed, but found they had not done. The inspector also made 10 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Merrimans, 3 (Adult Respite) 26/04/06

Merrimans, 3 (Adult Respite) 30/11/05

Merrimans, 3 (Adult Respite) 25/05/05

Merrimans, 3 (Adult Respite) 02/09/04

Merrimans, 3 (Adult Respite) 26/04/04

Merrimans, 3 (Adult Respite) 20/10/03

Merrimans, 3 (Adult Respite) 16/07/03

Merrimans, 3 (Adult Respite) 16/12/02

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

CARE HOME ADULTS 18-65 Merrimans, 3 (Adult Respite) West Drayton Road Hillingdon Middlesex UB8 1JZ Lead Inspector Ms Pauline Griffin Key Unannounced Inspection 28 September & 2nd October 2007 11:30 th Merrimans, 3 (Adult Respite) DS0000032534.V342200.R01.S.doc Version 5.2 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 Merrimans, 3 (Adult Respite) DS0000032534.V342200.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 Adults 18-65. 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. Merrimans, 3 (Adult Respite) DS0000032534.V342200.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Merrimans, 3 (Adult Respite) Address West Drayton Road Hillingdon Middlesex UB8 1JZ 01895 259324 01895 813757 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) London Borough of Hillingdon Ms Jannette Angelia Thomas Care Home 9 Category(ies) of Learning disability (9), Physical disability (2), registration, with number Sensory impairment (9) of places Merrimans, 3 (Adult Respite) DS0000032534.V342200.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 26th April 2006 Brief Description of the Service: Merrimans is a purpose built home constructed in the 1970’s and is situated on a busy road close to Hillingdon Hospital and public transport links. Following an extensive modernisation programme carried out over the past year, the home can now offer accommodation in two separate units and this means that people can be cared for in groups that are compatible with their needs. The home provides respite care for up to nine people with learning disabilities, physical disabilities and/or sensory disabilities. There are nine bedrooms, four on the first floor and five on the ground floor. The ground floor bedrooms are most suitable for people with physical disabilities. One of the bedrooms on the first floor is used by Hillingdon Social Services Department as an emergency bed for people with learning disabilities. Most of the bedrooms have en suite facilities and in total the home has four standard bathrooms, two assisted showers and one assisted bathroom. There are also two separate toilets on each floor. There are communal rooms on both floors and these are large, airy and have been refurbished to a high standard. There is a kitchen and dining room on each floor. The ground floor activity room is part of the conservatory area which leads out into the large enclosed garden with lawns and spacious patio areas. There is a passenger lift connecting the ground and first floors. People staying in the home continue to attend their day centres, colleges and clubs whilst staying at Merrimans. They remain with their registered General Practitioners. Referrals come from within the boundaries of the London Borough of Hillingdon with only a few exceptions. There are parent/carer’s meetings that include staff held bi monthly. There are approximately 76 people on the current list who come for regular respite care. The staff complement is currently supported by about 20 agency staff but has also begun recruiting permanent staff to support the team. The home accepts emergency placements both from their existing wait list and others referred by Hillingdon Social Services for whom there is often no background information. The majority of these placements are for people with challenging behaviour who have high needs. Merrimans, 3 (Adult Respite) DS0000032534.V342200.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection carried out over two days for a total of 8 hours. Two members of the senior staff, and two care workers were interviewed and one resident was spoken to. Two staff files and two of the residents’ files were chosen at random and examined. Recording systems, policies, staff rostas and maintenance certificates for domestic services and safety equipment were checked. Two telephone calls were made to the parents of people who use the service. Extensive building work has now been completed to modernise the home that now offers two separate units over the two floors. The refurbishment has been carried out to a high standard throughout the home. However, there were some areas that had not been completed to a satisfactory level and these were in the areas of the ‘child locks’ not being sufficiently secure, the front door safety lock not being secure, the outside fire escape having no safety gate, hot taps in the kitchen/laundry have no safety valves and repairs are required to the only assisted Arjo bath. Some of these issues were being addressed on the second day of the inspection. The home is still reliant on about 20 agency staff and carries a 50 vacancy on the permanent staff team. The Shift Leader said that the permanent vacancies were in the process of being filled through a recruitment drive being carried out by the Local Authority. What the service does well: The two senior members of staff who assisted with the inspection were part of the small number of the team who have worked in the home for long periods of time. They were able to demonstrate their knowledge of the needs and wishes of the people who use the serviced and their commitment to their care. Staff are provided with up to date mandatory and specialist training by the Local Authority. Senior staff have achieved an NVQ level 3 and the Registered Manager has completed the Registered Manager’s Award. Merrimans, 3 (Adult Respite) DS0000032534.V342200.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: 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. Merrimans, 3 (Adult Respite) DS0000032534.V342200.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Merrimans, 3 (Adult Respite) DS0000032534.V342200.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2 & 3. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The Statement of Purpose/Service User Guide must be reviewed and brought up to date so that people who use the service have sufficient details of the service they can expect to receive. Assessments must ensure that full information on the individual has been obtained to ensure their needs can be met. EVIDENCE: The Statement of Purpose and Service User’s information must be reviewed to include the changes to the facilities that can be offered to them. Information must also be included regarding the management structure and management details. Staff shortfalls must be included in the details of the staff group. The description of ‘emergency admissions’ must be reviewed. The complaints procedure must give up to date details of The Care Standards Commission (CSCI) and include the telephone number. Reference to Registration and Inspection on page 24 must be re-worded to reflect that inspections are carried out by the CSCI who make requirements and Merrimans, 3 (Adult Respite) DS0000032534.V342200.R01.S.doc Version 5.2 Page 9 recommendations from unannounced inspections carried out annually or more frequently if the situation requires it. The Statement of Purpose should include all the elements of Standard 1 of the National Minimum Standards. People who use the service and their representatives must be provided with a copy of the Statement of Purpose and Service User Guide and have access to the latest inspection report by the CSCI. People must only be admitted on the basis of a full assessment. This must include all available information from professional sources. Placements and emergency placements must only be accepted when risk assessments and the care management assessments indicate that the placement does not compromise the needs of other people who use the service and ascertain that staff levels and specialist requirements can be met. Merrimans, 3 (Adult Respite) DS0000032534.V342200.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7 & 9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service have up to date care plans that detail all the aspects of their care needs and respect their wishes. EVIDENCE: Two files were chosen at random and examined. Both files contained up to date comprehensive information to ensure that the individuals using the service are provided with a personalised service. Each individual is supported by a named link worker. Likes, dislikes and medical needs were recorded in respect of food, mealtimes, activities, clothes and hairstyles. Choice of the gender of the member of staff providing a personal care service must be respected. Evidence that this has been carried out must be recorded. Merrimans, 3 (Adult Respite) DS0000032534.V342200.R01.S.doc Version 5.2 Page 11 People who use the service are facilitated to make decisions about their lives with assistance as needed. Rights are only limited by the assessment of risk process and recorded in the care plan of the individual. Merrimans, 3 (Adult Respite) DS0000032534.V342200.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15,16 & 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are offered a care/service and their preferred routines are respected. The home ensures that peoples’ needs and wishes are met. EVIDENCE: The home encourages the residents to assist with house keeping tasks and they are also actively involved in the menu make up within dietary constraints. Residents follow their usual routine and attend their usual day centre and clubs when they stay at the home. The home has not organised activities for the residents in the past but now offer choices of things like a pub meal, cinema, car boot sales and shopping. Emergency placement residents have the opportunity to visit the hairdresser and purchase clothes. Merrimans, 3 (Adult Respite) DS0000032534.V342200.R01.S.doc Version 5.2 Page 13 The home keeps close links with the family and representatives of the people who use the service. Regular meetings for the family and representatives are held with the staff and the minutes of these were examined during the course of the inspection. People are offered the key to their bedrooms and those who decline have this recorded in their care plan. The home has a ‘knock and wait’ policy which staff were observed to adhere to. Staff were observed to treat the residents who were staying in the home when the inspections were carried out with consideration and respect. The Inspector observed the evening meals being prepared in each of the two units. The member of staff responsible for the meal on the first floor had prepared a fish pie with a cheese and potato topping. This meal was seen to be being enjoyed by the group who ate it ‘family style’ around the dining table With the member of staff. A dessert of rice pudding was chosen by the group for dessert. On the ground floor a meal of beef burgers, chips and salad had been prepared for the two residents. However, following this observation, it was noted by the Inspector that one of the two residents had ‘no beef’ marked clearly on his/her care plan. The senior on duty said that she would investigate this error. The menu was studied and found to include a very good selection of foods designed to suite all tastes and dietary needs. It is the practice of the home to provide a menu to the prospective resident and their representatives in advance of the respite stay so that they can mark down their preferences and make special requests. Both kitchens were clean and hygienic and there were good stocks of both fresh and frozen products. Merrimans, 3 (Adult Respite) DS0000032534.V342200.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 & 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Personal care is provided by a key worker who is familiar with the relevant information to ensure that needs and wishes are observed. EVIDENCE: The home takes into account the needs and wishes of the people who use the service but is not able to confirm that personal care can always be performed by care workers of the same sex as the residents. This must be included in the written information provided by the home to prospective residents and their representatives. The preferred choice of the gender and culture of those providing the personal care must be recorded in the care plan of each resident. This was an issue with some of the parents/carers interviewed in the previous inspection. Residents using the home receive a service from their own GP and the home ensures that all hospital and medical appointments are kept in the usual way. Records inspected confirmed that healthcare is monitored and recorded. Merrimans, 3 (Adult Respite) DS0000032534.V342200.R01.S.doc Version 5.2 Page 15 Senior staff in the home are trained in specialist health care needs like the administration of rectal diazepam and PEG (percutaneous endoscopic gastrostomy) feeding. The home has a satisfactory medication policy and system for the administration of medication. It was noted, however, that the medication policy in use was due for review in 2005. People coming into the home bring their medication with them in pre-dosed or original containers. Only senior staff members administer medication or those who have received training. Medication is kept in a locked cabinet. The medication records were satisfactorily maintained and there had been no medication errors recorded since the last inspection. There have been several discrepancies in medication administration and an action plan has been put into place to minimise further errors. All staff (including agency staff) must receive the London Borough of Hillingdon’s medication training and be deemed competent. Merrimans, 3 (Adult Respite) DS0000032534.V342200.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home’s complaints procedure is designed to ensure that people who use their service and their representatives feel confident that making a complaint or raising a query will not result in any form of reprisal. Staff are provided with up to date training in the protection of vulnerable adults provided by the Local Authority to ensure that the people who use the service are protected from abuse and the different forms it can take. EVIDENCE: The home has received two complaints this year and these had been dealt with in a satisfactory manner. The home regularly receives compliments and these are also recorded. The complaints procedure is to be discussed at the next bi monthly meeting for people who use the service and their representatives. All staff have received training in the protection of vulnerable adults in 2006 and the home has robust procedures for dealing with suspicion of abuse. Four staff have recently received training on dealing with unpredictable behaviour. Staff also receive training on the de-escalation of aggression. Risk assessments are made to manage aggressive behaviour displayed by residents. Merrimans, 3 (Adult Respite) DS0000032534.V342200.R01.S.doc Version 5.2 Page 17 The home has a satisfactory procedure in keeping individual resident’s cash. Cash floats are held in a locked safe in separate containers and transactions are recorded. All policies are produced by the London Borough of Hillingdon and are used in induction training and in supervision of the staff. Merrimans, 3 (Adult Respite) DS0000032534.V342200.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home offers a homely, comfortable, clean and safe environment. EVIDENCE: The home has received extensive re-modernisation and re-furbishment. The furnishing and fitments are of a high quality and the rooms are decorated in light colours and look very attractive. Most of the bedrooms have en suite facilities and in total, the home has four standard bathrooms, two assisted showers and one assisted bathroom. There are also two separate toilets on each floor. There are communal rooms on both floors and these are large, airy and have been refurbished to a high standard. There is an activity room, kitchen and dining room on each floor. The activity room on the ground floor in the conservatory area leads out into the large enclosed garden with lawns and spacious patio areas. There is a passenger lift connecting the ground and first floors. Merrimans, 3 (Adult Respite) DS0000032534.V342200.R01.S.doc Version 5.2 Page 19 At the time of the inspection, the assisted bath on the ground floor was not broken and was awaiting replacement. This is the only assisted bath in the home. Safety issues identified were as follows: • The new front door lock could be opened by turning the key and was easy to open. The shift leader said that an alarm was due to be fitted to with the next few days to the front door to ensure security. The fire door leading out into the garden was very easily opened and although the spring has been intended of easy exit, it means that residents can easily spring the bar and go out into the garden unnoticed. The garden wall could easily be climbed over by a resident who was determined to leave the premises. It was noted that there was a bench chair against the wall which would make it even easier to navigate the wall. There is a very bust road adjacent to the home. • • Merrimans, 3 (Adult Respite) DS0000032534.V342200.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34 & 35. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service are supported by staff who are qualified and competent. The agency staff used by the home have not always been able to provide the excellent service provided by the permanent staff team. EVIDENCE: The home is carrying a 50 staff vacancy and is managing to maintain the service by always using a senior staff member on duty to lead the agency staff used on each shift. The senior staff confirmed that the majority of the agency staff used were regular ones who were familiar with the home and many of the residents. Two staff files were chosen at random to examine and these were found to be satisfactory. The home uses the recruitment procedure of the Local Authority and the files contained all the necessary checks and declarations. The team leaders said that the Local Authority had a recruitment campaign in progress to fill the vacancies with permanent staff. Merrimans, 3 (Adult Respite) DS0000032534.V342200.R01.S.doc Version 5.2 Page 21 Staff receive mandatory and other specialist training arranged by the Local Authority in subjects like, medication, equalities, POVA, food hygiene, infection control, first aid, fire and moving and handling. All the permanent staff have attained an NVQ at either level 2 or 3. The Registered Manager has completed the Registered Manager’s Award. All staff receive one to one formal supervision and an annual performance development meeting to assess their training needs. Merrimans, 3 (Adult Respite) DS0000032534.V342200.R01.S.doc Version 5.2 Page 22 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 39 & 42. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home has policies and guidance and train staff in safe working practice to protect the people who use the service. EVIDENCE: The quality assurance system used by the home still requires development and this has been a requirement of the previous two inspections. Input from stakeholders of the home and professionals might be included as well as the information taken from logs and questionnaires. An overview of this should be collated and action taken as a result of the outcomes. This should be made available to the people who use the service and their representatives and the a copy of this sent to the CSCI each year. Merrimans, 3 (Adult Respite) DS0000032534.V342200.R01.S.doc Version 5.2 Page 23 The home receives a monitoring visit from a senior manager each month and copies of this are provided to the CSCI. The home uses the health and safety policies of the Local Authority to protect the welfare and safety of the people who use the service and the staff. Staff receive training in mandatory safety subjects and have annual moving and handling training and regular fire safety training and fire drills. Water temperatures in the ground floor kitchen and the laundry were scalding hot. Although there were warning signs to remind staff that the water was very hot, the water temperature must be assessed by the Registered Manager to consider what measures must be taken to ensure the safety of staff. Merrimans, 3 (Adult Respite) DS0000032534.V342200.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 2 3 3 3 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 1 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 DS0000032534.V342200.R01.S.doc 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 2 Score PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Merrimans, 3 (Adult Respite) Score 2 3 2 X X X 2 X X 2 X Version 5.2 Page 25 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 YA1 Regulation 5(1)(a to f) (2) & 6 Requirement The Statement of Purpose and Service User information must be updated and include all the information listed in Reg. 5(1) and Standard 1 of the Care Homes Regulations 2001. Service Users and/or their representatives must be provided with copies of this information or have accesss to it. This was a requirement of previous inspections. Timescales given 30/09/05, 01/03/06 & 02/10/06. Not Met. 2. YA17 13(6) 16(2)(i) 18(1)(a) Staff preparing meals for residents must familiarise themselves with their required diet and restrictions due health or cultural needs. 11/11/07 Timescale for action 07/01/08 Merrimans, 3 (Adult Respite) DS0000032534.V342200.R01.S.doc Version 5.2 Page 26 3. YA18 12 (2) & (4) People who use the service 11/11/07 must be given the choice of the gender of the care worker who performs personal care tasks for them. Any restrictions on this choice must be clearly detailed in the Statement of Purpose/ Service User Guide or other written information provided to them. 4. YA20 37 5. YA24 Medication errors must be notified to the CSCI on a Regulation 37 form. Regulation 37 reports must be sent to the CSCU that concern • any serious injury • illness • death • infectious outbreak • theft • misconduct by staff and any other event that adversely affects the wellbeing or safety person in the home. 13 (4)(a)(c) Arrangements must be made to & make the lock on the front door tamperproof to ensure that no 23 (2)(a)(b)(o) residents can leave the premises unnoticed. 11/11/07 11/11/07 6. YA24 13 (4)(a)(c) & 23 (2)(a)(b)(o) The fire doors must be assessed to make sure that the release Mechanism is more tamperproof to ensure that no residents can leave the premises unnoticed. 11/11/07 7. YA24 13 (4)(a)(c) & 23 (2)(a)(b)(o) The outside fire escape staircase must be made safe to ensure that residents cannot sustain injuries if they gain access to it unnoticed. DS0000032534.V342200.R01.S.doc 11/11/07 Merrimans, 3 (Adult Respite) Version 5.2 Page 27 8. YA24 13 (4)(a)(c) & 23 (2)(a)(b)(o) Access over the garden wall 11/11/07 must be assessed for security to ensure that residents using the garden cannot gain access to the busy road adjacent to the premises and are safe within the grounds of the home. The quality monitoring system must be developed to include more feedback than the questionnaires. Feedback seeking the views and input of other professionals and stakeholders as well as monitoring complaints/compliments, accidents and staff retention etc. A copy of the annual overview must be produced for Service Users/representative(s) and sent to the CSCI. This was a requirement oF previous inspections. Timescales: 01/03/06 & 02/10/07. Not Met. 07/01/08 9. YA39 24 10. YA42 23(2)© The very high hot water temperatures in the kitchen and laundry must be risk assessed to consider the safety of the staff using it. 11/11/07 Merrimans, 3 (Adult Respite) DS0000032534.V342200.R01.S.doc Version 5.2 Page 28 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA2 Good Practice Recommendations People admitted to the home (including emergency placements) should only take place after as much information has been obtained as possible. Emergency placements should only be accepted when risk assessments and care management assessments have been carried out. Assessments should include consideration that placements may have by compromising the safety of other people and the staff. Due to the high reliance on agency staff in the home, the need to train agency workers who administer medication in the Local Authority’s own medication policy and practice guidance must be adhered to. 2. YA20 Merrimans, 3 (Adult Respite) DS0000032534.V342200.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection West London Local Office 11th Floor, West Wing 26-28 Hammersmith Grove London W6 7SE 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 Merrimans, 3 (Adult Respite) DS0000032534.V342200.R01.S.doc Version 5.2 Page 30 - 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!