Inspection on 29/06/07 for Merryfield

This inspection was carried out on 29th June 2007.

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

Merryfield 18/10/06

Merryfield 07/03/06

Merryfield 26/09/05

Merryfield 03/03/05

Merryfield 07/09/04

Merryfield 06/01/04

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 09/07/2008.

CARE HOME ADULTS 18-65 Merryfield 20 Merryfield Close Damson Wood Solihull West Midlands B92 9PW Lead Inspector Julie Preston Key Unannounced Inspection 29th June 2007 09:30 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 DS0000004526.V338634.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. DS0000004526.V338634.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Merryfield Address 20 Merryfield Close Damson Wood Solihull West Midlands B92 9PW 0121 711 7274 0121 7117274 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) Damson Care Mrs Susan Sheldon Care Home 3 Category(ies) of Learning disability (3) registration, with number of places DS0000004526.V338634.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 18th October 2006 Brief Description of the Service: The service at 20 Merryfield Close is provided in a domestic three bedroomed house in a residential area of Solihull. It is registered to provide care, support and accommodation to three adults with learning disabilities. The current service users are three men. There are no aids or adaptations in the home, as they are not required to meet the needs of the service user group. Information is shared with service users via house meetings, which take place on a regular basis. Local facilities and amenities are within walking distance of the home, with the main shopping area of Solihull also within reasonable distance by bus. Staffing is provided by a small staff team, with sleeping-in provision. The fees charged to service users range from £1000 to £1500 per week, of which contributions are made according to individuals benefit entitlement. There are no extra charges made to service users. DS0000004526.V338634.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This visit was unannounced and took place over half a day. Two service users were at home for a short time in the morning and they talked about the plans they had made for the day, the quality of the food offered and some of the ways they make choices and decisions about their lives. The service users made written comments about what it is like to live in the home. Time was spent looking at records that describe how service users are cared for and helped to keep safe and healthy and talking to staff about how they support service users. The inspector looked around the building to make sure that it was warm, clean and comfortable. Some information was looked at before this visit took place. The information is sent each year to the CSCI by the care provider and includes details about staff training and the things the home does well or needs to do better. There were no immediate requirements after this visit. This means that there was nothing urgent that needed to be done to make sure service users stayed safe and well. What the service does well: Service users are involved in planning the way they are cared for and helped to be independent so that they are in control of their daily lives. One person said, “I like to help with chores around the house”. Lots of activities take place, which service users have chosen and enjoy doing to enable them to have a fulfilling lifestyle. There are good systems in place to help service users stay healthy and safe. Service users like the staff team and get on well with them. One person said, “I always get listened to and staff are friendly” Procedures are in place for people to make complaints if they have any and service users feel that they are always listened to by staff. The building is warm, clean and homely so that service users live in a comfortable place. DS0000004526.V338634.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. DS0000004526.V338634.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection DS0000004526.V338634.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users needs are assessed before they move into the home so they can be confident their needs can be met there. Information is available which describes the home so that service users can determine that the services and facilities will meet their needs, before they move in. EVIDENCE: The home has no vacancies and the current service user group have lived in the home for over seven years. A statement of purpose, which describes the services and facilities available within the home, had been completed. The document was written in plain language and provided a lot of information about the skills and training of the staff team, access to leisure and medical services for people that live in the home and the arrangements for maintaining their health and safety. The service user guide was observed. This had clearly been developed in consultation with people that live in the home and featured comments from DS0000004526.V338634.R01.S.doc Version 5.2 Page 9 them, such as “I like living here, staff help me to help myself” and “I have my own bedroom, I chose the colour for it”. Photographs of the premises and a description of local amenities were included so that prospective service users could make a more informed choice about whether to move into the home. The registered provider confirmed that admissions in emergency circumstances are not accepted by the home. This was recorded in the statement of purpose, so that a person moving in would do so only after a planned admission. The procedure for admission was discussed with the registered provider and a member of staff. It was explained that referrals are received from the funding agency and that an assessment of need would be expected from that agency. The home has its own assessment procedure, which is used to establish that the person’s needs can be met there and which goes on to form the basis of the person’s plan of care. All service users living in the home made comments in writing to confirm that they had chosen to live there and had received information about the home before moving in. It was evident from sampling service users records that a planned admission had taken place for each person, following assessment of their individual needs. DS0000004526.V338634.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is a good system in place for care planning and risk assessment that involves consultation with service users to enable their individual needs to be met and their independence promoted. Service users make decisions about their lives and receive good support from staff to do so. EVIDENCE: Two care plans were sampled. Both had been recently reviewed, involving the service user and staff that work with them. This is done on a monthly basis. Staff explained that the purpose of the monthly review is to establish that plans of care reflect service users needs and preferences. DS0000004526.V338634.R01.S.doc Version 5.2 Page 11 There was evidence that service users changing needs and preferences had been responded to by the staff team, such as choosing new college courses and using public transport independently. Care plans that describe service users’ assessed individual needs were seen to be linked to risk assessments that identified controls in place to minimise hazards and promote independence, such as making hot drinks and preparing meals. Some of the information contained in service users records was seen to be historical and no longer reflected their current needs. It is recommended that this be stored separately to the up to date records so that staff, particularly new staff, have accurate information about how to provide support to service users. From discussion with staff it was evident that they know service users well and understand how to support them with their day to day lifestyles in a manner that is respectful of their independent living skills. House meetings take place every four to six weeks. Records sampled showed that issues such as holidays and activity planning are discussed. Written comments received from service users confirmed that this takes place and that they are happy with the opportunities available to make choices and decisions about their lifestyles. DS0000004526.V338634.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16, 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are consulted about their lifestyles and their independence in the home and community is promoted. EVIDENCE: Service users take part in a range of activities each week, which are agreed and planned for according to the person’s preferences as identified in their plan of care. Daily records sampled showed that service users go out on a regular basis to such activities as college courses, evening social clubs, work placements and to the cinema each week. People living in the home use public transport to get around, some travelling independently. Where this is the case, staff were able to describe the steps DS0000004526.V338634.R01.S.doc Version 5.2 Page 13 that had been taken to safeguard the person whilst travelling, such as providing a mobile telephone and assisting the person to learn routes of travel. Some service users attend local colleges and it was reported that they do so independently. A member of staff commented that this had been planned for and that communication diaries are in place so that there is a means of contact between college tutors and staff at the home about each person’s learning and progress at college. Records sampled identified that service users continue to be involved in household tasks, such as ironing and cleaning their bedrooms, which helps them to develop their independence skills. One person stated, “I like to help with chores around the house”. Care plans included information about the support needed by individuals to keep in touch with their friends and relatives. One person commented “I see my family for the weekend”. Each service user has a key to their bedroom and to the front door of their home so that they maintain their privacy and independence. Service users are included in shopping for and preparing meals. Menus sampled showed that a range of food is offered consisting of fresh produce and service users “favourites” such as Sunday roasts. Records of food consumed by individual service users are now kept. These records establish that a well balanced and nutritious diet is offered and received. Service users commented that they enjoy the meals provided and that there is always a choice of food. DS0000004526.V338634.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are effective systems in place to meet service users personal and healthcare needs. Medicine management is robust so that the well being of service users is maintained. EVIDENCE: Staff members commented that service users continue to have good skills to manage their personal care, which was reflected in the care plans sampled. The assistance needed for each person had been clearly recorded within the plan and reviewed on a regular basis to ensure the information was accurate and consistent with individuals’ needs. A number of male staff are employed at the home, which is consistent with the gender of the service user group. The home has implemented Health Action Planning for service users. This is a personal plan about what a person needs to stay healthy and what healthcare DS0000004526.V338634.R01.S.doc Version 5.2 Page 15 services they need to access. The plans sampled described how staff should support service users to maintain their health such as attendance at specific clinics, regular exercise and weight checks to record weight loss as part of a healthy eating plan. The health care records sampled showed that service users had visited the GP, dentist, psychologist and chiropodist as necessary and the contact had been documented so that staff were aware both of the reason for the appointment and the outcome. The home provides satisfactory secure storage for service users medicines. Staff have received accredited training in the safe handling of medicines to help them understand the importance of giving out medication safely. Certificates were observed to evidence this. Boots Pharmacy supply the medication to the home using the monitored dosage system in blister packs. The Medication Administration records (MAR) cross-referenced with the blister packs indicating that medication had been given as prescribed. Written protocols were in place for the administration of PRN (as required) medicines. Staff were able to describe the circumstances under which such medicines should be given in order for the service user to maintain good health. DS0000004526.V338634.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are adequate procedures in place for service users to make complaints if they have any. There are adequate systems in place to protect service users from harm and abuse. EVIDENCE: There have been no complaints within the home or made to the CSCI within the last twelve months. The complaints booklet, given to service users was observed. The document contained information about how to raise a complaint and was written in plain language, which staff stated to be in keeping with service users communication needs. Service users commented that they know who to speak to if they wish to complain about anything in the home and went on to say that this was a very rare occurrence. All of the people living at Merryfields stated that the staff team listen to them and act upon what they say. A copy of the home’s adult protection procedure was observed that included multi agency guidelines from the funding authority which explain how to respond to incidents of disclosed or suspected abuse. Staff at the home have DS0000004526.V338634.R01.S.doc Version 5.2 Page 17 received training in adult protection and demonstrated satisfactory knowledge of how to protect service users. DS0000004526.V338634.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users live in a pleasant and comfortable home. EVIDENCE: Merryfields is a domestic style residence that looks no different to other properties in the area. The home is situated close to public transport routes, which is important to service users as they use buses to travel to activities and their college placements. Bedrooms are situated both on the ground and first floor of the home and there is adequate shared space for service users to sit together in the lounge and kitchen/dining room. Since the last inspection, in October 2006, the lounge and kitchen have been redecorated creating a more pleasant environment for service users. DS0000004526.V338634.R01.S.doc Version 5.2 Page 19 The home has one bathroom, consisting of a bath with overhead shower, toilet and hand basin. The facilities meet the needs of the current service user group. The washing machine is located in the kitchen as there is no space for it to be sited elsewhere. There are procedures in place to ensure that laundry tasks are not completed when food is being prepared and eaten so that risks to service users health and safety are reduced. The home was seen to be clean and warm throughout and furnished to a good standard for the comfort of service users. DS0000004526.V338634.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are supported by a well trained and competent team of staff who have good understanding of their individual needs. Recruitment procedures safeguard service users by ensuring only suitable staff are employed. EVIDENCE: Five members of staff are employed on a permanent basis, with two additional people who provide occasional cover as required. The AQAA (Annual Quality Assurance Assessment) completed by the registered manager prior to this fieldwork identified that four of the five permanent staff have achieved NVQ Level II training in care or above. The recruitment records of the most recently appointed member of staff were observed. Checks of the person’s suitability to work in the home had been made and the file contained evidence of a satisfactory Criminal Records Bureau check, references, completed application form and proof of identification. DS0000004526.V338634.R01.S.doc Version 5.2 Page 21 The records also included a completed induction programme, which showed that the staff member had received information about caring for service users and maintaining their health and safety within the first few days of their employment. Service users made positive comments about the staff team, “I always get listened to and staff are friendly” and “staff always discuss with me about things I want to do”. It was evident from discussion with staff present at this visit that they know service users well and understand how to support people within their day to day lives. One service user commented, “I am very happy living here”. Staff records sampled indicated that regular training opportunities are in place so that staff understand how to meet service users needs and maintain their safety. DS0000004526.V338634.R01.S.doc Version 5.2 Page 22 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed and promotes the protection and well being of the service users who live there. EVIDENCE: The registered provider is a qualified learning disabilities nurse and has owned the home for over ten years. The registered provider has day to day contact with the home. The registered manager has achieved her Registered Manager’s Award and NVQ Level IV in care. The registered provider explained that he has implemented a weekly checklist to audit some systems and practice within the home for the benefit of service DS0000004526.V338634.R01.S.doc Version 5.2 Page 23 users such as reviewing menus and following up on the outcome of service users’ meetings. The written comments received from service users indicated that they are involved in the running of the home and make decisions about their lifestyles on a regular basis. Other methods of assuring and monitoring the standard of care and services provided include frequent house meetings and monthly reviews of care plans, which include input from each service user. Health and safety records were examined. Regular checks of the smoke alarms had been made each week and fire drills had taken place to enable service users to practice how to evacuate the home in the event of an emergency. Service users stated that they were aware of the action to take in the event that the smoke alarms sounded and the staff team have received fire safety training to further protect service users. Certificates were in place, which showed that gas and electrical appliances had been tested and serviced for the protection of service users. DS0000004526.V338634.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X DS0000004526.V338634.R01.S.doc Version 5.2 Page 25 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 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 YA6 Good Practice Recommendations The home should consider archiving out of date information on service users files to make records easier to read for staff. 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