Inspection on 15/02/07 for Merry Hill House

This inspection was carried out on 15th February 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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

Merry Hill House 11/06/07

Merry Hill House 08/06/06

Merry Hill House 15/09/05

Merry Hill House 06/06/05

Merry Hill House 19/10/04

Merry Hill House 10/06/04

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Westmead

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

CARE HOMES FOR OLDER PEOPLE Merry Hill House Langley Road Merry Hill Wolverhampton West Midlands WV4 4YT Lead Inspector Mr Ian Harris Key Unannounced Inspection 15th February 2007 08:00 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 Merry Hill House DS0000036001.V330449.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. Merry Hill House DS0000036001.V330449.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Merry Hill House Address Langley Road Merry Hill Wolverhampton West Midlands WV4 4YT 01902-553397 01902-553397 john.lem@wolverhampton.gov.uk www.wolverhampton.gov.uk Wolverhampton City Council 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) Mr John Lem Care Home 35 Category(ies) of Old age, not falling within any other category registration, with number (35) of places Merry Hill House DS0000036001.V330449.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 50 years and above Date of last inspection 8th June 2006 Brief Description of the Service: Merry Hill House opened in 1983; it is one of four residential homes for the elderly managed directly by Wolverhampton City Council Social Services Department. Merry Hill House is a purpose built, single-storey establishment, the home can accommodate up to 35 Older people over 65 years of age in single bedrooms. The building is divided into five separate units There is a combined sitting/dining room with a small kitchenette facility in each unit. A central area houses an office, kitchen and staff facilities. A conservatory has been added to the rear of the building. The Home has equipment such as wheelchairs and hoists to assist service users in all aspects of daily living. The home is located off a main road on the southwest side of the city in close proximity to shops, a public house and the bus route into the City. Merry Hill House DS0000036001.V330449.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was an unannounced key inspection and took place over 5. hours. During the inspection a tour of the premises took place and staff and care records were inspected. Also staff rotas and general records regarding the maintenance of the home were checked. 5 members of staff and 6 residents were spoken to. It was noted that the fees are set following an individual financial assessment undertaken by he Social service department. On the day of inspection the atmosphere within the home was found to be warm, friendly and comfortable with contented residents. All the residents spoken to who could express themselves in a meaning full way expressed their satisfaction with the care they received and there were comments as follows “ the food is good here” “The staff are very kind” “ I’m very settled and I like my room, this is a very nice home.” “I like the company”. What the service does well: What has improved since the last inspection? Considerable amount of internal re-decoration has taken place since the last inspection. The hall, reception area, 2 offices and 8 bedrooms have been redecorated. Merry Hill House DS0000036001.V330449.R01.S.doc Version 5.2 Page 6 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. Merry Hill House DS0000036001.V330449.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Merry Hill House DS0000036001.V330449.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 6 The quality in these outcome areas is good. This judgement has been made using available evidence including a visit to this service. The home has a good admissions procedure ensuring the individual needs of the residents are fully met. The home does not provide intermediate care but does provide short stay and introductory stays when the home has a vacancy. EVIDENCE: There is evidence on the files that all the residents who are funded by the Local Authority undergo a full multi-disciplinary assessment prior to admission. The residents, who are self funding are assessed by the Care Manager, using the home’s assessment forms. All the residents are permanent. The home does not provide intermediate care. Merry Hill House DS0000036001.V330449.R01.S.doc Version 5.2 Page 9 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): 7, 8, 9, and 10, the quality in these outcome areas is good. This judgement has been made using available evidence including a visit to this service. Each resident has an individual care plan that is reviewed on a monthly basis. The home has good contact with local G.P. s. local hospitals and paramedical services, which ensures that resident’s health needs are met. The systems for the administration of medication are good with clear and comprehensive recording arrangements being in place to ensure resident’s medication needs are met. EVIDENCE: The home provides a comprehensive Care Plan for each individual resident based on the initial assessment. The Care Plans are drawn up by the Care Staff in consultation with the resident and their family. There was evidence on the files to show the care Plans are being carried out and reviewed on a monthly basis. Merry Hill House DS0000036001.V330449.R01.S.doc Version 5.2 Page 10 The home is well supported by local G. P. s. and all of the paramedical services. Wherever possible, the residents are encouraged to retain their own G. P s, Opticians, and Dentists. It was noted that if the resident has moved out of their area the Care Manager ensures that, these services are provided by local practitioners. The records indicate that resident’s medical needs are being met. Medication is administered by means of a monitored dosage system. The system appears to be working very well. The home receives good support from the local pharmacist who does a three monthly audit of the homes medication. All care Staff have been trained to use the system before they are allowed to administer medication. The home has good draft policies and procedures, which have recently been updated and are used as an integral part of the care staff induction programme. All the residents have single rooms with a wash-hand basin. No personal care interventions take place in communal areas. Observed practice on the day of inspection was appropriate and showed respect for the residents. Two of the residents who could express themselves in a meaning full way said that the staff were very helpful and kind. Consultation with health care and social care professionals is carried out within the resident’s bedrooms. Visitors are able to meet residents in their bedrooms, conservatory or in one of the lounges. Merry Hill House DS0000036001.V330449.R01.S.doc Version 5.2 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, and 15 the quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home provides a programme of social activities within the home which are designed to meet the resident’s capabilities, which, the staff encourage residents to pursue. The Care Manager and staff encourage family and friends to maintain good contact with their relatives at the home. The meals in the home are good offering both choice and variety, also catering for special dietary needs. EVIDENCE: The home lost the Staff member designated to organise social and leisure activities and who identified interests that the residents wish to pursue. This and the shortage of care staff has meant that there is very little on offer in the way of stimulating activities. Also it was noted the lack of shopping trips or outings outside of the home. The observations made, examination of menus and the comments received from the residents confirmed that there is a good choice at meal times and particular attention is given to the residents’ individual preferences Merry Hill House DS0000036001.V330449.R01.S.doc Version 5.2 Page 12 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 the quality in these outcome areas is good. This judgement has been made using available evidence including a visit to this service. The home has a satisfactory complaints procedure and there is evidence that residents’ and their families feel that their views are listened to and acted upon The home has good policies and procedures regarding protection from abuse, which includes a whistle blowing policy. EVIDENCE: The home has a good comprehensive complaints procedure. The residents and relatives are made aware of the procedure through the statement of their terms and conditions of residence, the service users guide, of which a copy is placed in the reception hall. The home has a complaints book in which all complaints are recorded. It was noted that the home has not received any formal complaints since the last inspection all minor complaints are dealt with appropriately and quickly. The home has good policies and procedures regarding Restraint, dealing with Aggressive Behaviour and Prevention of Abuse, which, includes a WhistleBlowing policy. These issues are also covered in external and N.V.Q. training, which all care Staff have undergone. Merry Hill House DS0000036001.V330449.R01.S.doc Version 5.2 Page 13 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 the quality in these outcome areas is good. This judgement has been made using available evidence including a visit to this service. The standard of the environment within the home and the garden is good providing the residents with a very attractive, comfortable, homely and safe place to live. The home was found to be clean tidy and free of unpleasant odour. However the toilets need refurbishment. EVIDENCE: The home is long established and was purpose built in order to provide appropriate accommodation for older people. The home is maintained to a high standard, and provides a very comfortable homely and safe atmosphere. There has been considerable work carried out in the home since the last inspection, which includes the redecoration of the hall, reception area, 2 offices and 8 bedrooms. However it was also noted that the toilet on Stuart, Windsor and Hanover units have still not been refurbished. Merry Hill House DS0000036001.V330449.R01.S.doc Version 5.2 Page 14 The fencing that has been erected outside Windsor unit has cut out the residents view. Consideration should be give to planting climbing plant to cover the fence, or hanging baskets to improve the outlook. The provision of extra fencing with a gate to form an enclosed garden in this area would enable the residents’ use of this area. Merry Hill House DS0000036001.V330449.R01.S.doc Version 5.2 Page 15 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): 27, 28,29, and 30 the quality in these outcome areas is poor. This judgement has been made using available evidence including a visit to this service. The The The The home is under staffed with numbers and skill mix of staff. staff have a very good understanding of the residents support needs. home has good policies and procedures regarding the recruitment of staff. home has a very good staff-training programme. EVIDENCE: Inspection of staff rotas and discussions with staff indicated that the home is understaffed at times and does not always meet the needs of the residents. There has been a high turnover of care staff, which has meant that agency staff are being used for cover. The rota indicates that there are only 5 care staff on duty to cover 5 units which means that the units have only 1 member of staff covering it. This is a particular concern given the high dependency of a number of residents and the responsibility to use 2 staff members to administer medication. This creates a situation when units are left uncovered by care staff. The staffing levels within the home should be reviewed as a matter of urgency. The staffing should be increased to ensure a minimum of 2 care staff to each unit and I floating member of staff to concentrate on the administration of medication. The home operates an efficient recruitment procedure and the local Authority has registered in order to complete the appropriate checks on staff. There was Merry Hill House DS0000036001.V330449.R01.S.doc Version 5.2 Page 16 evidence within the home that all the checks are being carried out. However it is noted that the process is very lengthy and causes long delays before a newly recruited staff member can start work. Merry Hill House DS0000036001.V330449.R01.S.doc Version 5.2 Page 17 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): 31, 33, 35 and 38 The quality in these outcome areas is adequate. This judgement has been made using available evidence including a visit to this service The home is well managed by a competent registered manager. The home has good policies and procedures regarding Health and safety and meets the requirements of the Fire Officer and Environmental Health Officer, promoting EVIDENCE: The Care Manager has the Registered Manager’s Award and considerable experience in caring for older people. There are clear lines of accountability within the home and the manager is very supportive of both staff and residents. Observations made and discussions with residents’ relatives and staff indicated that the Care Manager is very approachable and operates an open door policy. Merry Hill House DS0000036001.V330449.R01.S.doc Version 5.2 Page 18 The staff and residents who could express themselves stated that they are happy to approach the Care Manager and staff with any problems they might have and were confident that they would be responded to. There is a good staff supervision system in place and there is evidence that the staff have regular supervision meetings. It was also noted that the home has a Quality Assurance system in place, which includes questionnaires to residents, visitors, other professionals and relatives to obtain feedback on the quality of service. The feedback from the last issue was very positive regarding the improvements made since the last inspection with all feedback stating they are satisfied with the care they are receiving. An action plan has been produced to address issues raised. The routines and activities within the home are flexible and built around the needs of the residents. All the Financial records and administrative procedures within the home that were inspected were found to be well ordered and maintained. It was noted that the provision of a computer would be a great advantage, which would improve communication with outside agencies and would save time releasing the care manager from administration tasks. The home has a good heath and safety policy and all staff are aware of their responsibilities regarding these issues and a number of staff have received training on these issues. All recommendations and requirements made at the last inspections of the Fire Prevention Officer and Environmental Health Officer have been actioned. All safety equipment is regularly checked and well maintained. Merry Hill House DS0000036001.V330449.R01.S.doc Version 5.2 Page 19 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 X X 3 X X 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 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 X X X X X 3 STAFFING Standard No Score 27 1 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 X X 2 Merry Hill House DS0000036001.V330449.R01.S.doc Version 5.2 Page 20 Are there any outstanding requirements from the last inspection? YES 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 OP21 Regulation 23 (2) b Requirement The registered person must ensure the refurbishment of toilets on Hanover, Windsor and Stuart Units must take place (Times scale not met 01/08/05 The registered person must ensure that the care staff hours are increased in order to provide a minimum of 2 care staff on duty in each unit throughout the working day and in addition 1 floating care staff throughout the day to assist in the unit as required (Timescale not met 08/06/06) The registered person must ensure that a programme of social activities within and outside the home is provided. Timescale for action 01/04/07 2. OP27 18 (1) a 01/04/07 3 OP12 16 (2) (m) 01/04/07 Merry Hill House DS0000036001.V330449.R01.S.doc Version 5.2 Page 21 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. Refer to Standard OP19 OP19 Good Practice Recommendations That magnetic door catches are fitted to all doors from the lounges That extra fencing and a gate are provided to create an enclosed garden by Windsor unit. Merry Hill House DS0000036001.V330449.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Shrewsbury Local Office 1st Floor, Chapter House South Abbey Lawn Abbey Foregate SHREWSBURY SY2 5DE 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 Merry Hill House DS0000036001.V330449.R01.S.doc Version 5.2 Page 23 - 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!