Inspection on 24/03/09 for Merrington Grange

This inspection was carried out on 24th March 2009.

CSCI found this care home to be providing an Excellent service.

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

Merrington Grange 11/04/07

Similar services:

Polesworth Group Friary Road

Polesworth Group Pooley Heights

Polesworth Group 32 Station Road

Polesworth Group 70 Long Street

Breme

Polesworth Group 64 Long Street

Polesworth Group 68 Long Street

10 Whitfield Avenue

Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Merrington Grange Merrington Grange Merrington Bomere Heath Shrewsbury SY4 3QJ     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Michael Moloney     Date: 2 4 0 3 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 26 Information about the care home Name of care home: Address: Merrington Grange Merrington Grange Merrington Bomere Heath Shrewsbury SY4 3QJ 01939235163 01939291410 alan@adelphicareservices.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Adelphi Care Services Limited care home 9 Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: 9 1 The registered person may provide the following category of service only: Care Home Only (Code PC) to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Learning Disability (LD) 9 The maximum number of service users to be accommodated is 9. The registered Provider may provide accommodation to service users aged 16 & 17. Date of last inspection Brief description of the care home Merrington Grange is a home for up to 9 people with learning disabilities in the small village of Merrington in Shropshire. Owned by Adelphi Care Services Ltd it is managed by Kim Walshaw. The building is in two separate parts with the larger of the two areas having a downstairs area to one side of the home which has all of the amenities of a self contained flat whilst still allowing easy access to the main living areas. Care Homes for Adults (18-65 years) Page 4 of 26 Brief description of the care home The second main area is a ground floor annex which can accommodate two people. This contains its own lounge, kitchen/ diner, bathroom as well as a laundry area and there is no indoor access to the rest of the house. The home has parking for a number of cars as well as a secure garden area. There are also extensive views of the surrounding countryside, particularly to the north. Further information is available in the homes service user guide. Care Homes for Adults (18-65 years) Page 5 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: A range of evidence was used to make judgements about this service. This includes: information from the provider which included a self assessment document that they are required by law to complete, records kept in the home, medication records, discussions with the staff team, a tour of the premises, previous inspection reports and watching how people reacted to their surroundings and the people looking after their needs as, due to the nature of the disability of a number of the people living in this home, it was not easy for them to communicate what they feel about living there. Care Homes for Adults (18-65 years) Page 6 of 26 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 7 of 26 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 8 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who may want to live in this home have their needs assessed and a written agreement which clearly tells them about the service the will receive. Evidence: The home was seen to have a Service User Guide that contained the information that people may want if they are thinking about arranging for someone to live there. The records of a person who had come to live at the home since the last inspection were looked at and these showed that a full assessment of his needs had been carried out before the home manager had decided that it would be a suitable place for him to live. Care Homes for Adults (18-65 years) Page 9 of 26 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live in this home are involved in decisions about their lives and play an active role in planning the care and support they receive. Evidence: Looking at the records of two of the people who live in this home showed that their care plans were reviewed by the staff on a regular basis. Talking to the manager and the staff on duty at the time of the inspection confirmed this. The care plans were seen to cover a variety of areas of need ranging from self help skills to interests. The manager and the staff confirmed that the information had been gained by watching the reactions of those concerned as well as talking with their families. Records of the staff observations could be seen in the learning logs. The staff were seen and heard talking with the people who live in the home in a clear, friendly and professional manner throughout the inspection. Care Homes for Adults (18-65 years) Page 10 of 26 Evidence: Looking at the way that bedrooms had been decorated showed that some of the interests had been identified and recorded correctly. One room contained pictures of aircraft. Risk assessments and behavioural management programmes were seen to have been developed for a number of the activities so that people could take part in them in as safe a manner as possible. Care Homes for Adults (18-65 years) Page 11 of 26 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live in this home are able to make choices about their life style and are supported to develop their life skills. Social, educational, cultural and recreational activities meet individuals expectations. Evidence: The records of two of the people who live at the home were looked at. Both were seen to have detailed care plans which had been developed with the individual in a way that puts their needs first. Talking to the staff and the manager confirmed that these had been developed by talking with the person concerned, watching which activities the person liked or disliked or asking other people such as friends or relatives for their views. On the day of the inspection one person was seen sitting quietly on a bench in the garden and occasionally get up to go and look at the view before going to sit down again. This activity was consistent with that persons written goals. Another person was Care Homes for Adults (18-65 years) Page 12 of 26 Evidence: seen calmly watching favourite videos on his own in a quiet part of the home. Asked if the videos were good he smiled. Another person went out with two staff as the visit started. A variety of activities were seen to have been arranged for people with some attending college courses going swimming and suchlike. People are supported to take part in these activities on at least a one to one and often two to one basis by staff from the home. Records of the meals that had been prepared and eaten in the home were seen and these showed that people are offered a varied and nutritious diet although the the choice had been limited by either the persons preferences, medical needs or food related behaviours. The records looked at showed that these behaviours were very specific to each individual. The records also said what name each person liked to be known by. Throughout the inspection staff were seen to treat everyone with dignity and respect and explained what they were doing when they did it. The way people reacted gave the impression that they were used to this and expected it. The home was seen to have a vehicle that was available to transport people to the activities or appointments that had been arranged for them. Care Homes for Adults (18-65 years) Page 13 of 26 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The health and personal care that people receive is based on their individual needs. The principles of respect, dignity and privacy are put into practice. Evidence: Looking at the records of the people who live in the home identified that a number of them had issues around eating. These were mostly around the persons reluctance to eat or medical issues around how they could eat. Behaviours that involved only eating certain foods, eating in a particular way or order, eating food prepared in a certain way as well as straight forward refusal to eat had been identified and all of which affect the long term health of the individual concerned. Behaviour management plans for each of these issues had been drawn up and looking at the records and talking to the staff identified that some progress had been made in helping to overcome them. Given the nature of some of these issues watching people at meal times during this visit would have been inappropriate and possibly distressing for them. Therefore direct observation of the behaviour management plans being carried out did not take place. Looking at the records that had been maintained and Care Homes for Adults (18-65 years) Page 14 of 26 Evidence: talking with the manager and the staff confirmed that the programmes were followed. Where appropriate clinical advice had been sought in the development of the programmes and a regular record of peoples weights maintained so that the success of any of the individual programmes could be monitored. The records looked at also showed when each person had either visited or been visited by a healthcare professional, what for and what the outcome was showing that they have access to appropriate health care when they needed it. The arrangements for the storage and administration of peoples medication were looked at. Storage was seen to be secure and well organised with medication records correctly maintained so that it would be easy to check who had been given what medication and when. Each area of the home had its own storage and records thereby reducing the possibility of individuals medication being confused. No controlled drugs were found to be kept at the home. Staff said that they receive training in the safe handling of medication before they are allowed to give them to people and their records confirmed this. Care Homes for Adults (18-65 years) Page 15 of 26 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who live in this home are able to express their concerns and have access to a robust, effective complaints procedure, are protected from abuse and have their rights protected. Evidence: A copy of the homes complaints procedure was seen and this contained the information someone would need if they wished to raise a problem with the home or its owners. Looking at the records of the complaints received showed that they had been managed in an appropriate manner. The manager also confirmed that one issue had been referred into the local procedures that are designed to protect vulnerable adults. Although the level of some of the disabilities of the service users means that they are unlikely to be able to access these formal policies, observation of the staff talking with them and each other indicated that they, the staff, would be aware of any dissatisfaction expressed and it was seen that a whistle blowing policy is available to be used. The manager also explained that some of the service users monies are managed by the home. Full records were seen to be kept outlining any transactions. Care Homes for Adults (18-65 years) Page 16 of 26 Care Homes for Adults (18-65 years) Page 17 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The physical design and layout of the home enables people who use the service to live in a safe, well maintained and comfortable environment, which encourages independence. Evidence: The home is in four separate, but adjoining parts allowing smaller groups of people with similar interests, preferences and needs to share facilities. One area has all of the amenities of a self contained flat for one person. Another area is a ground floor annex which can accommodate two people. This contains its own lounge, kitchen/ diner, bathroom as well as a laundry area and there is no indoor access to the rest of the house. The remainder of the home is on two floors and is divided into two with three people living in each half. Each of these six people has their bedroom on the first floor. The home has parking for a number of cars as well as a secure garden area. There are also extensive views of the surrounding countryside, particularly to the north. Care Homes for Adults (18-65 years) Page 18 of 26 Evidence: There are two laundry areas both of which are appropriately equipped. Within the grounds of the home there are two other small buildings one of which contains the Company head-quarters and the other a training/meeting area. Care Homes for Adults (18-65 years) Page 19 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff in the home are trained, skilled and in sufficient numbers to support the people who use the service, in line with their terms and conditions and to support the smooth running of the service. Evidence: During this visit the staffing rotas were looked at. These showed that during the day there was at least one member of staff on duty for every person living in the home and if one of those people needed to go out two staff would often go with them depending on what was identified in their care plans . Talking to the staff as well as looking at what happened on the day of the inspection confirmed that this is what happens. Looking at the records as well as talking with some recently recruited staff showed that the home has a safe and transparent recruitment procedure which includes all of the background checks that identify whether or not someone is suitable to work with vulnerable people. One member of staff was able describe what training she had been offered and undertaken. This included her induction as well as foundation training and the mandatory safety training that is necessary for someone working in this type of Care Homes for Adults (18-65 years) Page 20 of 26 Evidence: establishment. All of the staff spoken to said that they have access to a good range of professional training that is chosen to meet the identified needs of the people who live in the home. This was confirmed by looking at the training records. By talking with the staff and looking at their records it was also possible to establish that over 50 of the staff team had achieved at least National Vocational Qualification level 2. Care Homes for Adults (18-65 years) Page 21 of 26 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The management and administration of the home is based on openness and respect, has effective quality assurance systems developed by a qualified, competent manager. Evidence: The manager confirmed that she has gained the Registered Managers Award and National Vocational Qualification 4 in care which are appropriate qualifications for someone running a facility such as this. Part of the support that she receives is the regular completion of the monthly visits by the provider that are required by law which look at a range of issues that may affect how the needs of the service users are met. Records were seen that confirmed that these visits take place at appropriate intervals. Equality and diversity for the service users were seen to be promoted throughout the home within the assessments, care plans and activities. A variety of records were seen that showed that safety issues are constantly Care Homes for Adults (18-65 years) Page 22 of 26 Evidence: monitored. Records of such things as fridge freezer temperatures, fire equipment tests, gas safety tests, hot water temperatures and portable appliance testing were seen to have been maintained. Accident records were looked at and these showed that such incidents were monitored by the senior management and action taken to reduce hazards when necessary. Hazardous materials were seen to have been stored in a locked cupboard so that people who do not realise that they may be dangerous do not have access to them. Staff records also showed that the mandatory training that is necessary to keep the service users safe has been taking place. This includes training in such things as food hygiene and fire prevention. Staff spoken to confirmed that these records were accurate. Care Homes for Adults (18-65 years) Page 23 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 24 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 25 of 26 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 26 of 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!