Inspection on 19/02/08 for Merrydale

This inspection was carried out on 19th February 2008.

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

Merrydale 12/02/07

Merrydale 23/11/05

Merrydale 28/04/05

Merrydale 25/01/05

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

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

CARE HOMES FOR OLDER PEOPLE Merrydale Spencer Road Ryde Isle of Wight PO33 3AL Lead Inspector Neil Kingman Unannounced Inspection 19 February 2008 10:05 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 Merrydale DS0000062066.V355491.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. Merrydale DS0000062066.V355491.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Merrydale Address Spencer Road Ryde Isle of Wight PO33 3AL 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) 01983 563017 Mr K Pryer Mrs E Pryer Mrs Patricia Lynn Cluett Care Home 16 Category(ies) of Old age, not falling within any other category registration, with number (16) of places Merrydale DS0000062066.V355491.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 12th February 2007 Brief Description of the Service: Merrydale is a residential care home providing care and accommodation for up to 16 people over the age of 65 years. Mrs Patricia Cluett manages the service on behalf of the proprietors Mr and Mrs Pryer who bought the home in August 2004. The home is a detached two-storey property situated in a quiet, private road in a residential area on the western outskirts of Ryde. It is close to the main bus route between Ryde and Newport, and the shops and amenities of Ryde town centre are approximately a half-mile away. The building is very well maintained and includes single room accommodation, most with en-suite facilities. The accommodation is arranged over two floors. However, there is no lift to the first floor where rooms on that level would not be suitable for people with mobility difficulties. There are well-tended and accessible gardens on all sides with seating areas. A small hard standing at the front allows for some off road parking. The home offers a day care facility for local people over the age of 65 years. The day care is provided in a purpose built extension to the property and has a separate entrance. All activities provided for day care users are also available to the people who live in the home. The home provides 24 hours staffing. Weekly fees range between £386 and £508. The manager states that a copy of the home’s service user’s guide is provided to all residents or their representatives where applicable. Merrydale DS0000062066.V355491.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report details the results of an evaluation of the quality of the service provided by Merrydale and brings together accumulated evidence of activity in the home since the last key inspection on 12 February 2007. Part of the process has been to consult with people who use the service. To this end we have received written responses to several surveys, i.e., seven from people who live in the home, nine from visiting relatives and one from a healthcare professional. Included in this inspection was an unannounced site visit to the home by an inspector on 19 February 2008. The registered manager Mrs Cluett and the proprietor Mr Pryer were available throughout the day. At the visit we had an opportunity to tour the building, and speak with staff on duty, several residents and relatives who were visiting residents on the day. We also looked at a selection of records. Prior to the site visit the manager sent to the Commission a selection of information about the service including an Annual Quality Assurance Assessment (referred to as ‘the assessment’ during the report), which has been used with other information to inform the various judgements made about the service. What the service does well: The home provides a homely, comfortable, and safe environment for the people who live there. The rooms are spacious, well decorated and personalised, and people enjoy occupying them. Staff are well trained and provide a good standard of care for people, most of whom are independently mobile. The interactions between the staff and the residents are warm and friendly and staff pay a good deal of attention to respecting peoples’ dignity and privacy. Visitors are made very welcome and there are no restrictions. On the day of the site visit relatives and friends were visiting throughout the day. It was very clear that they have a good relationship with the home, which is reflected in the comments they made. The home’s assessment highlights aspects of the service, which the management consider they do well, key areas being: • We continue to promote training to all staff, which provides the numbers DS0000062066.V355491.R01.S.doc Version 5.2 Page 6 Merrydale • • and skills mix. We retain staff and have appropriate seniors on shift at all times. New staff are rigorously selected, trained and supervised until they meet the homes high standards. Comments in the responses to the surveys tell us what people like about the service: “It is a warm and caring home. My mother feels safe and well looked after.” “The manager achieves a nice balance in the difficult area of needs and wants.” “Very caring staff, good physical care, an environment where residents feel ‘at home’.” “A very comfortable, well-managed and ‘homely’ establishment, with dedicated staff and high standards.” “The staff are very caring and friendly, as is the manager. The food is of good quality and variety. The home is well decorated and the garden is well maintained with areas for residents to sit.” “The manager and her team are professional and passionate about the care and service they provide.” “I am satisfied with all aspects of the care.” What has improved since the last inspection? What they could do better: Most of the comments from people who use the service were very positive. However, recommendations for improvements were made: “Could improve with greater regulatory and variety of entertainment of people in their care.” Merrydale DS0000062066.V355491.R01.S.doc Version 5.2 Page 7 “Aspects of financial administration could be improved (errors in invoicing etc).” “The evening meal could be a bit more imaginative.” “They would benefit if a member of staff could take residents out for a short walk each day.” All comments were fed back to the manager. Reports by the provider on the outcome of visits to monitor the conduct of the home should contain more detail about the quality of the service being provided. 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. Merrydale DS0000062066.V355491.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Merrydale DS0000062066.V355491.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 6 - People who use the 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 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. The home does not provide dedicated accommodation for short-term intermediate care or specialised facilities for rehabilitation. EVIDENCE: Pre-admission assessment People should know that their needs will be met when they move into a home. An important part of ensuring this happens is the pre-admission assessment process. Merrydale DS0000062066.V355491.R01.S.doc Version 5.2 Page 10 The manager confirmed that currently all residents in the home are privately funded. She said that typically referrals come by way of a telephone call from someone who has had the home recommended to them. She herself or her deputy visits the person who may want to use the service either at their home address or another place where applicable. Emergency admissions are avoided and assessments are always carried out before an individual decides to more into the home. The person most recently admitted came to Merrydale for short term respite care from another residential home on the Island. The manager visited this home to carry out an assessment of needs. A range of information was gathered during the process and recorded on a form designed for the purpose. A copy of the pre-admission assessment was available on this person’s file and was used to form the basis of a plan of care. On the day of the site visit we spoke with one of the residents who was admitted to the home from the mainland. She said that her pre-admission assessment had been very thorough, having had a personal visit from one of the proprietors followed by a telephone conversation with the manager. The manager showed a good understanding of the importance of a thorough pre-admission assessment in the process of choosing the right home. Intermediate care People who live at Merrydale tend to be long term. The home does not provide an intermediate care facility or specialised facilities for rehabilitation. However, a room is set aside for short term respite care if requested. Provider’s Annual Quality Assurance Assessment The assessment identified what the service does in this area: • • • • We do a new client pre-assessment visit; encourage new clients to come to the home for a day. Care planning, risk assessment and if needed professional advice to ensure we meet their needs. Care plans have been updated. We have two clients who have been able to return to their home after a crisis or illness after long-term respite. We have a structured work plan around supervisions trainings and meetings. Merrydale DS0000062066.V355491.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 - People who use the 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 health and personal care that people receive is based on their individual needs. The principles of respect, dignity and privacy are put into practice. 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. EVIDENCE: Care planning – The home has a system of care planning with an individual personal plan for each resident. We looked at a sample of three plans. The intention was to look at the outcomes for people who use the service in general by assessing all areas of care for those sampled. The sample included a person with high care needs, the newest admission to the home and a person who had lived at the home for over two years. Merrydale DS0000062066.V355491.R01.S.doc Version 5.2 Page 12 Plans are clear, simple and person centred, with guidance for staff on how residents’ needs and wants are to be met. Each resident’s plan includes key information: • • • • • • • • • • Photograph Admission information Social history Risk assessments Individual care plan, which identifies care needs and objectives Medication profile Various charts relevant to the needs of the individual Healthcare visits Daily recording of relevant information Regular reviews Care plans have the action plan written in a person centred way, paying particular attention to how the person wishes to be treated. They refer to promoting independence, choice and wellbeing. There was a mixed reaction from residents when asked about their individual care plans. Responses varied from those who were unsure about the existence of such a document to a minority who were well aware of their care plan. In discussions with a family visiting one of the residents it was clear that they and the resident were fully involved in decisions relating to information in the care plan. Health and access to care services The manager confirmed, and records evidenced the regular contact with GPs, optician, dentist and chiropodist. People spoken with said that the home always contacted a doctor if they needed one. A visiting family member commented, “They always let us know if a doctor has been called out for any reason.” Records showed and discussions with the manager and care staff confirmed that the risk of pressure sores was currently low. The manager made the point that staff are always vigilant and at the first sign of a problem the Community Nurse is always contacted. They were very clear about what was required to ensure that pressure sores did not develop, i.e., suitable equipment, good liaison with the Community Nurse and care practices. The manager said that people are able to choose their GP since the home receives a service from all four surgeries in the Ryde area. The residents currently use dental surgeries in Ryde and Wootten. Other healthcare professionals visit the home when called upon as and when required. In the response to the healthcare professionals survey it was commented, “This home Merrydale DS0000062066.V355491.R01.S.doc Version 5.2 Page 13 is very well run. No negative comments can be made from a GP’s point of view.” Six of the seven responses to the residents survey indicated they are always given the care and support they need and one indicated usually. All indicated staff listen and act on what they say, and all indicated they always receive the medical support they need. Five of the nine responses to the visiting relatives survey indicated the home always meets the needs of their relative and four indicated usually. Five indicated the home always gives the support or care to their relative that they expected and four indicated usually. Comments made in the surveys included: “It is a warm and caring home. My mother feels safe and well looked after.” “My wife is well care for and is very happy in this care home.” “The manager achieves a nice balance in the difficult area of needs and wants.” “The manager and her team are professional and passionate about the care and service they provide.” Medication Medication is given to the residents by means of a monitored dosage (blister pack) system, which is hygienic and designed to simplify the procedure. The manager said that only staff she deems competent who have completed medication training are permitted to give out medication. The home has a policy and system to ensure residents’ medication is stored, administered and recorded safely. During the site visit we looked at the arrangements in place and noted medicines were stored under secure conditions in a purpose built metal cabinet and accurate records of receipt, administration and disposal of medicines maintained. One resident administers her own medication and has a risk assessment on her file, which covers the procedure. Privacy, dignity and respect The importance of treating people who use the service with dignity and respect is covered in the induction training for new staff. Merrydale DS0000062066.V355491.R01.S.doc Version 5.2 Page 14 On the day of the site visit we toured the building and spent time with residents in the communal areas. There were opportunities to observe staff at work. Staff spoke kindly to people and the interactions between them were warm and friendly. People spoken with were full of praise for the staff and their approach to care and support. In discussions with the visiting relatives they had no hesitation in praising the care staff and how they treat people. Staff address people by the names that they prefer, which are noted in their care plan. They knock on doors and wait for an answer before entering rooms. All residents have locks on their room doors and can come and go as they please. Residents can use the facility of the home’s portable telephone to make and receive calls, in private if they wish. We noted that some people had private installations in bedrooms, with large number phones for those with site impairments. The response to the healthcare professionals survey indicated that individual’s health care needs are always met by the home and that the home always respects individual’s privacy and dignity. Provider’s Annual Quality Assurance Assessment The assessment identified what the service does in this area: • • • • We allow residents the choice to self medicate, putting in place risk assessments. Monthly reviews done by key worker, supervised by senior staff. Staff are trained and supervised to ensure privacy and rights are upheld. More staff have done and are doing City and Guilds medication training. Merrydale DS0000062066.V355491.R01.S.doc Version 5.2 Page 15 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, 14 and 15 - People who use the 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 use the service are able to make choices about their life style and activities are offered to suit their individual needs and expectations. The care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. People are able to keep in touch with family; friends and representatives who are made to feel welcome and can visit at any time. People have healthy, well-presented meals and snacks, at a time and place to suit them. EVIDENCE: Routines and activities – The home’s assessment showed and the manager confirmed that residents are encouraged and supported to exercise choice and control in their lives. Routines for residents are kept as flexible as possible, e.g., they have choice over where and when they have their food served, what time they like to be woken and the time they like to retire, where and when they like their breakfast served etc. This was evident on the day of the site visit when we spoke with individual residents and their visitors. Merrydale DS0000062066.V355491.R01.S.doc Version 5.2 Page 16 The home engages outside entertainers to provide a range of activities for residents and day care users throughout five days of the week. People can come and go as they please, join in with the activities if they wish, or not as the case may be. The aim is for people to carry on with existing hobbies, pursuits and relationships that they enjoyed before moving into the home. On the day of the visit there was musical entertainment in one of the communal areas attended by day care users and several of the residents. Others spent time in their rooms. A mobile hairdresser visited the home during the site visit and several residents chose to use this service. The home produces a monthly activities calendar, which includes: • • • • • • • Arts and crafts Several kinds of musical entertainment Quizzes Karaoke Reminiscence/nostalgia Trips out from the home in the summer months Exercises Merrydale will cater for peoples’ religious needs details of which are recorded in their care plans. The manager said that individuals would be supported to attend church if they wanted to and currently one individual is actively involved with a church group. There are local clergy who visit the home to take communion for those who wish it. Written feedback from the residents indicated there are always activities arranged by the home that they can take part in. Visiting arrangements – Details of visiting arrangements can be found in the statement of purpose and are unrestricted. Residents and their families are encouraged to treat the home as their own. People can receive visitors in their own rooms or any of the communal areas. The visiting relatives spoken with said they were always made welcome by staff. Personal autonomy and choice – Residents were spoken with individually in the lounge and in private. They said they were given choices regarding routines in the home, e.g., times of rising, going to bed, activities, meals, personal care, going out etc. Merrydale DS0000062066.V355491.R01.S.doc Version 5.2 Page 17 The manager confirmed that all residents have a power of attorney to support them independently of the home. People are encouraged to bring with them pictures, ornaments and personal items for their room. During the tour of the building it was noted that nearly all of the rooms were very well personalised, according to peoples’ individual tastes and preferences. The management of residents’ finances is covered later in the report but in a general sense they are encouraged, with support from family or a representative, to handle their own financial affairs for as long as they are able. Meals and mealtimes – We had an opportunity to sit with the residents over lunch. The atmosphere in the dining room was very sociable and friendly and staff were available to assist residents if they needed it. Food served looked appetising and was well presented. The main meal consisted of a meat dish with fresh vegetables. The cook confirmed that an alternative would be provided for those who do not want the main meal. All residents spoken with made very complimentary remarks about the lunch and confirmed that the standard of food was consistently high. People generally take their meals together in the dining area, although a small minority prefer to take meals in their room. Menus are arranged over a four-week cycle and show food to be varied, appealing and well balanced. The cook said that she uses fresh produce and meals are freshly prepared on a daily basis. She has worked in the home for several years and has a good understanding of their likes, dislikes and special dietary needs. Records are maintained of what residents are actually served on a daily basis. We noted that drinks and light snacks were offered through the day between meals. All responses to the residents survey indicated they always or usually liked the meals at the home. Provider’s Annual Quality Assurance Assessment The assessment identified what the service does in this area: We do • • • • the following well: Social activities. Ensure contact with family and friends. Balanced diet. We encourage residents to take control of their lives. DS0000062066.V355491.R01.S.doc Version 5.2 Page 18 Merrydale • • Family, friends, religious needs are met. We have continued to ensure we provide a good service involving all clients’ families and friends. Merrydale DS0000062066.V355491.R01.S.doc Version 5.2 Page 19 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 - People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. 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. EVIDENCE: Complaints – The home has a complaints policy and procedure, summarised in the statement of purpose, which is given to all residents or their representatives. Information on how to make a complaint is prominently displayed in the hall and also in the manager’s office. People spoken with on the day of the site visit were not familiar with the detail of the complaints procedure, but were very confident about raising any concerns with the manager. All responses to the residents and relatives surveys indicated they knew how to make a complaint. All the residents indicated they always knew who to speak to if they are not happy. Merrydale DS0000062066.V355491.R01.S.doc Version 5.2 Page 20 The home’s assessment showed that no complaints had been made about the service since it was last inspected. The home’s complaints register was available for inspection. Safeguarding adults – The home has a Safeguarding Adults Policy and Procedure in place, which follows local authority guidance. The manager said that safeguarding adults training is provided by the College. This was confirmed in discussions with the care staff. The deputy manager has completed a ‘train the trainer’ course in this subject. In discussions with staff they showed an understanding of how to recognise abuse and were very clear about the importance of reporting issues of concern without delay. They also were aware of the home’s “ whistle-blowing” procedures. Since the last inspection there have been no safeguarding adults issues of concern at the home. Provider’s Annual Quality Assurance Assessment The assessment identified what the service does in this area: • • • We have a clear visible complaints policy in the hallway, and in the service users guide. We have an adult abuse policy, which staff are aware of. It is the foremost training we do. We have had no complaints and no adult protection issues this year. Merrydale DS0000062066.V355491.R01.S.doc Version 5.2 Page 21 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 - People who use the 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 stay in a safe and well-maintained home that is clean, comfortable, pleasant and hygienic. There is enough space, and facilities for them meet their needs. The home makes sure people have the right specialist equipment that encourages and promotes their independence. Their rooms are comfortable and they feel safe when they use them. People have enough privacy when using toilets and bathrooms. EVIDENCE: Environment Merrydale has been a residential care home for older people in Ryde for many years and was purpose built at the time of its construction. It has been extended in recent years to include a day care facility for older people in the locality. It is considered suitable for its stated purpose of providing a safe, manageable and comfortable environment for the people who live there. The Merrydale DS0000062066.V355491.R01.S.doc Version 5.2 Page 22 home is located in Spencer Road and is only a half-mile or so from the town shops, seafront and connections to the mainland. All areas of the building are accessible to the people who use the service. Those occupying the three bedrooms on the first floor are able to use the stairs without difficulty. The home is surrounded by well-tended gardens with seating areas for residents use, especially during the fine weather. The home is generally comfortable, well furnished and decorated. Communal areas are bright and airy. There was evidence of continued improvements with ongoing redecoration, the fitting of new curtains and replacement of carpets where needed. Assisted bathing and toilet facilities are adequate for the needs of people who use the service given that twelve rooms have an en-suite facility. Cleanliness All areas of the home were found to be clean and free from unpleasant odours. As mentioned later in the report the home employs domestic staff to ensure the standard of hygiene is maintained. There is a laundry sited on the ground floor with a machine capable of washing articles at the right temperatures. The home’s assessment confirms it has policies and procedures for preventing infection, managing infection control and soiled waste disposal. During the tour of the building it was noted that all bathrooms and WCs were equipped with liquid soap and disposable towels. All responses to the residents survey indicated the home was always or usually fresh and clean. Provider’s Annual Quality Assurance Assessment The assessment identified what the service does in this area: • • • • • We continue to maintain a clean, pleasant and hygienic home, which is in a safe well maintained environment. Soft furnishings, new carpets and decorating have been improved. General updating refreshing of painting. All decking and railings and benches have been treated. Trees overhanging have been removed by professionals. Merrydale DS0000062066.V355491.R01.S.doc Version 5.2 Page 23 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 - People who use the 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 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. EVIDENCE: Staffing levelsThe home employs fourteen care staff. There are two main shifts throughout the day and evening when a minimum of three care staff are on duty at all times. Four staff work during the morning to meet peoples’ needs at this time. Staff rotas showed that the levels remained constant. The home employs additional catering, domestic and maintenance staff. Overnight there are one waking and one sleep-in night staff. The manager works flexibly each day with the deputy manager. On the day of the site visit Merrydale DS0000062066.V355491.R01.S.doc Version 5.2 Page 24 we noted the atmosphere generally to be relaxed with staff available at all times to support the residents as well as those attending the day care service. In discussions with people on the day of the site visit there were no concerns raised about staffing levels. Six of the seven responses to the residents survey indicated there are always staff available when they need them and one indicated usually. National Vocational Qualification (NVQ) training – Records showed and the manager confirmed that currently ten (71 ) of the fourteen care staff have achieved the National Vocational Qualification (NVQ) at level 2. This is an improvement on the position at the last inspection. Three of the care staff are currently undertaking the training to achieve the qualification at level 3. Recruitment The manager was very clear that Merrydale operates a thorough recruitment procedure, with nobody commencing work in the home before the right checks have been carried out. This is to ensure as far as possible that people considered unsuitable to work with vulnerable people are not employed. Records showed that four new staff had been recruited since the last inspection. The home’s recruitment procedures include: • • • • • • An application form Two written references Proof of identification Evidence of Criminal record (CRB) and Protection of Vulnerable Adults (POVA) checks. Job description Contract of employment We looked at all four recruitment records and found them to be in good order. Staff training – The home continues to move forward with training opportunities for staff in order to give them the skills to meet peoples’ particular needs. Records show that the training for mandatory subjects has been scheduled throughout the year. Staff training records were available to evidence training achievements and showed training to include: Merrydale DS0000062066.V355491.R01.S.doc Version 5.2 Page 25 Manual handling Food hygiene First aid Health and safety Dementia awareness Medication (B/Tec) Safeguarding vulnerable adults Fire training Infection control The manager and staff spoken with confirmed that the home has a very good attitude towards training, which is provided by the Isle of Wight College. On the day of the site visit dementia awareness training was being provided for the care staff. The home provides an induction/foundation training programme for new staff, which follows the ‘Common Induction Standards’ required by Skills for Care. The induction workbooks were available for inspection. Provider’s Annual Quality Assurance Assessment The assessment identified what the service does in this area: • • • • We continue to promote training to all staff, which provide the numbers and skills mix. We retain staff and we have appropriate seniors on shift at all times. New staff are rigorously selected, trained and supervised until they meet the homes high standards. We have an extra member of staff to cover day-care as requested at the last inspection. Merrydale DS0000062066.V355491.R01.S.doc Version 5.2 Page 26 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, 36 and 38 - People who use the 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 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. Merrydale DS0000062066.V355491.R01.S.doc Version 5.2 Page 27 EVIDENCE: Management – The registered manager Mrs Cluett has been in post for over three years. She has achieved the NVQ at level 4 in care and is currently working towards achieving the Registered Managers Award (RMA). In addition, she updates her knowledge, skills and competence with periodic training in care related subjects specific to the service provided by the home. Staff spoken with during the site visit confirmed that regular staff meetings and formal supervision sessions were taking place. They felt the home was well managed; staff morale was high and communication was good. During the site visit we had an opportunity to observe in a general sense the way the home functions. It was clear from the interactions between the manager, staff and the residents that the manager is held in high regard. She showed kindness, understanding and respect towards all the residents. The manager returned the home’s assessment when we asked for it. However, in discussions during the site visit she recognised that more detail could have been included. Especially about what people want and what the home is doing to make sure the service provides good outcomes for them. Quality assurance – The home has a system of seeking the views of people who use the service by way of a survey questionnaire, copies of which were available for inspection. It focuses in the main on the residents but also takes account of the views of day care users and those of visiting friends and relatives. We noted a survey had been produced in Braille for those with a sight impairment who preferred this format. There is a separate survey for the food provided by the home, as it is the topic most talked about at residents meetings. The manager confirmed that the results of the surveys are used to improve the service and an analysis sheet was available to show the outcomes. Other areas that inform the home’s quality assurance are: • • • In-house care plan reviews. Staff meetings and supervision sessions. Residents meetings every two months. Merrydale DS0000062066.V355491.R01.S.doc Version 5.2 Page 28 • Maintenance and renewal records, although there is no formal planned programme. We looked at the proprietor’s reports on the monthly monitoring of the conduct of the home. The reports were available for inspection. The sample we looked at lacked detail about the quality of the service being provided. As a best practice recommendation improvements could be made if the report covered: • • • • • How equality is being promoted How peoples’ diverse needs are being met The results of interviews with residents and staff The inspection of the premises The inspection of records of events Residents’ monies – The home prefers the residents or their representatives to take responsibility for their own financial affairs and a lockable facility is available in each room. However, they have in place a system to safeguard the monies of those who do not wish, or are unable to make other arrangements. At the site visit we checked the system by way of dip sample and found it to be in good order, with receipts for purchases kept. Transactions were accurately recorded and balanced against expenditures. Health and safety – The home’s pre-inspection information sent to the Commission by the manager confirmed that policies and procedures are in place to ensure safe working practices in the home. A sample of records was viewed during the site visit including accident records, fire alarm tests and risk assessments, public liability insurance, and gas and electrical tests, all of which were in good order. Staff training records showed, and staff confirmed that mandatory training is scheduled and updated in manual handling, first aid, fire training, infection control and food hygiene. Provider’s Annual Quality Assurance Assessment The assessment identified what the service does in this area: • • The management of the home continues to be based on openness and respect, working closely with the staff team. Always to the view of a person centred approach. With this in mind the health, safety and welfare of service users and staff are protected at all DS0000062066.V355491.R01.S.doc Version 5.2 Page 29 Merrydale • • • • times. Clients’ finances that we deal with are kept secure, recorded and monitored regularly. Manager has achieved N V Q 4 working on RMA at present, also business skills in care. Deputy has achieved N V Q 4. Assistant manager working on N V Q 3. Merrydale DS0000062066.V355491.R01.S.doc Version 5.2 Page 30 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 N/A 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 4 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 3 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 3 Merrydale DS0000062066.V355491.R01.S.doc Version 5.2 Page 31 Are there any outstanding requirements from the last inspection? No 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. Standard Regulation 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 OP33 Good Practice Recommendations Reports by the provider on the outcome of visits to monitor the conduct of the home should contain more detail about the quality of the service being provided. Reports should cover: • How equality is being promoted • How peoples’ diverse needs are being met • The results of interviews with residents and staff • The inspection of the premises • The inspection of records of events Merrydale DS0000062066.V355491.R01.S.doc Version 5.2 Page 32 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone, Kent ME16 9NT 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 Merrydale DS0000062066.V355491.R01.S.doc Version 5.2 Page 33 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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