Inspection on 28/07/05 for Merrimore House

This inspection was carried out on 28th July 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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

Merrimore House 04/10/06

Merrimore House 08/02/06

Merrimore House 28/02/05

Merrimore House 21/12/04

Merrimore House 04/03/04

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

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

CARE HOME ADULTS 18-65 MERRIMORE HOUSE 39 Avenue Road Hunstanton Norfolk PE36 5HW Lead Inspector Roger Andrews Announced 28 July 2005 13:00 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address 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 Stationary 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. MERRIMORE HOUSE I55 S27612 Merrimore House V233983 280705 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Merrimore House Address 39 Avenue Road, Hunstanton, Norfolk, PE36 5HW 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) 01485 535299 01485 535299 Mr John Turner Care Home 3 Category(ies) of LD Learning disability registration, with number of places MERRIMORE HOUSE I55 S27612 Merrimore House V233983 280705 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 28 February 2005 Brief Description of the Service: Merrimore House is a care home for three adults with learning difficulties. It is a large terraced house situated in a small road near to the shops and the sea front in Hunstanton.The owners are Mr. and Mrs. Turner who live and run the business as a family home.The property has been adapted in many areas to meet the needs of the residents that includes a large flat floor shower bathroom and a private lounge.The bedrooms are for single occupancy which are on the first and second floor There are two lounges on the ground floor, the second one for all to share with the proprietors.The meals are eaten around a large farmhouse type table in the kitchen. MERRIMORE HOUSE I55 S27612 Merrimore House V233983 280705 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was announced. Not all of the National Minimum Standards were looked at. As Merrimore House is a care home which the Commission does not receive complaints about only the key standards, (the ones the Commission thinks must be inspected each year), were looked at. Some standards will be looked at in the next inspection, which will be unannounced. Based on this and previous inspections the Commission thinks that Merrimore House provides a good standard of care for its residents. What the service does well: 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. MERRIMORE HOUSE I55 S27612 Merrimore House V233983 280705 Stage 4.doc Version 1.30 Page 6 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 Standards Statutory Requirements Identified During the Inspection MERRIMORE HOUSE I55 S27612 Merrimore House V233983 280705 Stage 4.doc Version 1.30 Page 7 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1 & 2 Residents and their families have access to up to date information about the service available in the home. Proper information is gathered before an admission to try and ensure the home can meet the needs of any new resident. EVIDENCE: The Statement of Purpose and Service User Guide have been updated. They are written in plain English and also contain a range of relevant pictures to aid residents. The most recent admission to Merrimore House took place approximately two months ago. The file for this resident was viewed. It contained relevant preadmission reports from the Social Worker and a psychology report. One visit was made by the resident prior to coming to Merrimore giving existing residents the opportunity to meet the prospective resident even though the admission was on the urgent side. Mrs Turner made several visits to see the resident prior to his admission as well as meeting with the Psychologist and the Specialist Behavioural Nurse. MERRIMORE HOUSE I55 S27612 Merrimore House V233983 280705 Stage 4.doc Version 1.30 Page 8 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 7 and 9 Care plans show the areas where residents need help so their needs can be met. Residents are able to take assessed risks in aspects of daily living such as going out alone. EVIDENCE: The care plans of two residents were viewed. These contained a good level of detail and gave a good impression of areas where residents were capable of meeting their own needs such as personal care, and areas where they needed help or, more often, prompting and encouragement. Communication, activities and medical needs are examples of areas covered in care plan files. Care plans also contain goal-setting objectives such as “being able to wash his own hair without assistance”. Care plans contained a photograph of the resident, review sheets and personal details of family and other involved professionals. Risk assessments are on file. These cover areas such as road safety, key holding, managing finances and a fire risk assessment in relation to each resident. One resident said he was able to go out on his own. He regularly goes MERRIMORE HOUSE I55 S27612 Merrimore House V233983 280705 Stage 4.doc Version 1.30 Page 9 to the local library. There was documentary evidence of residents being encouraged to be more independent. MERRIMORE HOUSE I55 S27612 Merrimore House V233983 280705 Stage 4.doc Version 1.30 Page 10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 13, 14, 15 & 17 Residents have full lifestyles, can maintain contact with friends and family and enjoy a varied selection of food. EVIDENCE: Residents have fairly active work and social lifestyles. They attend work centres in King’s Lynn Monday to Friday. Social activities include discos, visiting family and various outings. The residents recently went to see the ‘tall ships’ at Lowestoft. One resident said he liked Merrimore House because “we do a lot of things”. This resident also said he went to the local library regularly where he used the Internet. He also had a computer in his bedroom, which he appeared to be very adept at using. Residents help in keeping their rooms clean and doing laundry. The house is very near the centre of the town and within easy walking distance of shops, local amenities and the beach. Residents can visit friends and receive visitors. From discussion with Mr and Mrs Turner it is clear that where potential relationships may develop they are MERRIMORE HOUSE I55 S27612 Merrimore House V233983 280705 Stage 4.doc Version 1.30 Page 11 conscious of the need for supervision and monitoring depending on the circumstances. The menu is publicised in the kitchen and reflects a varied selection of meals including takeaways such as fish and chips. Residents participate in deciding what meals will be on the menu. Residents said that they liked the food. MERRIMORE HOUSE I55 S27612 Merrimore House V233983 280705 Stage 4.doc Version 1.30 Page 12 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18 & 20 Residents are encouraged to manage their own personal care as far as possible. Medication is securely stored. EVIDENCE: Residents require prompting and reminding with personal care tasks rather than direct help in carrying them out. This is reflected in care plans. Residents can make their own choices, for example, about which clothes they wear and spending time in their rooms. To varying degrees they are involved in day to day activities as the environment at Merrimore House aims at providing a family type experience. At present none of the residents look after their own medication. Medication is stored in a locked cupboard in the kitchen and is in a monitored dosage system package. The MAR sheets were viewed and were up to date. Mrs Turner has undertaken the Boots medication training course. MERRIMORE HOUSE I55 S27612 Merrimore House V233983 280705 Stage 4.doc Version 1.30 Page 13 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 21 & 22 Residents know who to talk to if they have concerns and Proper procedures are in place to deal with any issues that may arise. EVIDENCE: The residents have a complaints procedure and all have a copy. One resident said he found Mr and Mrs Turner easy to talk to. In their survey responses residents reported that they know who to talk to if they had any concerns. No complaints have been received by the home and the Commission has received no complaints about this service. From observations the residents appeared relaxed and at ease in the company of Mr and Mrs Turner. There is also an adult protection policy and ‘protection of vulnerable adults’ training has been undertaken. Mr and Mrs Turner are aware of the protocols for adult abuse as developed by the police and social services. MERRIMORE HOUSE I55 S27612 Merrimore House V233983 280705 Stage 4.doc Version 1.30 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24 & 30 Residents live in a comfortable and clean environment EVIDENCE: The residents have their own lounge on the ground floor, which has comfortable furniture and a television. There is a large kitchen/dining room where communal meals are taken round a large farmhouse type table. This seems to be very much the hub of the building. The house has a warm and homely feel to it and the décor and furnishings throughout the building are in a good state of repair and domestic in style. All areas, including toilets and bathrooms, looked appropriately clean. MERRIMORE HOUSE I55 S27612 Merrimore House V233983 280705 Stage 4.doc Version 1.30 Page 15 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 34 & 35 Mr and Mrs Turner maintain a good training portfolio. This helps provide a more professional and informed level of service to residents. EVIDENCE: Mr and Mrs Turner do not employ any additional staff. However, they are aware of the checks that need to be undertaken if they do employ someone in the future. Mrs Turner has completed her NVQ 4 training. Both she and Mr Turner have undertaken other training. Examples of courses attended include challenging behaviour, Human Rights Act, promoting independence, aspects of autism and the care of people with epilepsy. These examples are not exhaustive. MERRIMORE HOUSE I55 S27612 Merrimore House V233983 280705 Stage 4.doc Version 1.30 Page 16 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 39 & 42 A simple quality monitoring process is required which will be able to report briefly on the progress made over the course of a year in terms of aspects such as training, environment and care standards. Appropriate health and safety practices are in place to help protect residents. EVIDENCE: Discussion took place about establishing an effective quality monitoring process. Some aspects of this have been covered during NVQ training, but any system needs to be realistically manageable given the small size of the service and the domestic environment. Some ideas were discussed which Mr and Mrs Turner are going to develop further. See recommendation. A tour of the house was made. No obvious hazards were identified. There is a cellar where residents occasionally play pool. The stairs to this are quite steep. However, the residents only use this area under supervision. MERRIMORE HOUSE I55 S27612 Merrimore House V233983 280705 Stage 4.doc Version 1.30 Page 17 The fire records were checked. They are up to date and a qualified engineer checks the fire system. The last check was carried out in March 2005. Discussion and agreement was reached on the frequency of testing the smoke alarm points, which will be on a weekly basis. Fire drills are held on a monthly basis and are documented. PAT testing of electrical equipment is carried out on an annual basis. The gas system was checked in Jan 2005. The electrical system was replaced in May 2004. MERRIMORE HOUSE I55 S27612 Merrimore House V233983 280705 Stage 4.doc Version 1.30 Page 18 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 x x x Standard No 22 23 ENVIRONMENT Score x x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score x x x x x x x Standard No 11 12 13 14 15 16 17 x x x x x x x Standard No 31 32 33 34 35 36 Score x x x 3 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 MERRIMORE HOUSE Score x x x x Standard No 37 38 39 40 41 42 43 Score x x x x x x x I55 S27612 Merrimore House V233983 280705 Stage 4.doc Version 1.30 Page 19 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 Regulation None Requirement Timescale for action 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 39 Good Practice Recommendations It is recommended that a simple qulaity monitoring process be developed. MERRIMORE HOUSE I55 S27612 Merrimore House V233983 280705 Stage 4.doc Version 1.30 Page 20 Commission for Social Care Inspection 3rd Floor Cavell House St Crispins Road Norwich NR3 1YF 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 MERRIMORE HOUSE I55 S27612 Merrimore House V233983 280705 Stage 4.doc Version 1.30 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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