Inspection on 07/03/06 for Merryfield

This inspection was carried out on 7th March 2006.

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 found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 8 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Merryfield 29/06/07

Merryfield 18/10/06

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 Brenda O`Neill Unannounced Inspection 07 March 2006 02:35 Merryfield DS0000004526.V277807.R01.S.doc Version 5.1 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 Merryfield DS0000004526.V277807.R01.S.doc Version 5.1 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. Merryfield DS0000004526.V277807.R01.S.doc Version 5.1 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 Merryfield DS0000004526.V277807.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 26th September 2005 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. Local facilities and amenities are within walking distance of the home, with the main shopping areas of Shirley and Solihull also within reasonable distance. Staffing is provided by a small staff team, with sleeping-in provision. Merryfield DS0000004526.V277807.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out over an afternoon in March 2006 and was the second of the two statutory visits to the home for this inspection year. To get a full overview of all the standards assessed this report should be read in conjunction with the report written following the inspection on September 26th 2005. During this visit the communal areas of the home were seen, two residents and one staff file were sampled as well as other documentation. The inspector spoke with the manager, proprietor, one staff member and two of the residents. What the service does well: What has improved since the last inspection? The safety of the residents had been improved with the regular checking of the smoke detectors and the updating of fire training for staff. To ensure the residents received their PRN (as and when necessary) medication at the correct times individual guidelines had been written for staff to follow. Written records were being kept of reviews evidencing that residents had been consulted, what had been discussed and any outcomes. Merryfield DS0000004526.V277807.R01.S.doc Version 5.1 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. Merryfield DS0000004526.V277807.R01.S.doc Version 5.1 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 Merryfield DS0000004526.V277807.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 The above standards were not assesses however the manager was fully aware of the need to undertake comprehensive assessments should there be any new admissions to the home. EVIDENCE: The residents at the home had lived there for a number of years and prior to their admission full assessments of their needs had taken place. The manager was fully aware of the need to complete comprehensive assessments of any prospective residents and that in such a small environment full consultation with the existing residents would be imperative. Merryfield DS0000004526.V277807.R01.S.doc Version 5.1 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 9 There was a good system in place for care planning and risk assessments that involved consultation with the residents. The manager needed to ensure that all care plans and risk assessments were updated regularly to reflect the current needs and risks of the residents EVIDENCE: Two resident files were sampled and both included care plans, personal details, numerous risk assessments and behaviour management plans. One of the care plans had been recently updated to reflect the current needs of the resident and included areas such as family, relationships, physical support needs and behaviour. The other care plan included information on all the required areas but this had not been updated recently. There was evidence that reviews were taking place with the residents to discuss their needs and if they were satisfied with the service they were receiving. Both files sampled included numerous risk assessments including the use of every day equipment in the home and behaviour management. One of the risk behaviour management plans seen was drawn up with the resident and the psychologist. Merryfield DS0000004526.V277807.R01.S.doc Version 5.1 Page 10 This gave very good details of how to manage any presenting behaviours however it stated this was to be reviewed monthly and there was no evidence that this was happening and when discussing with the manager it was evident that the behaviours had subsided since the original plan was put in place. The manager needed to ensure that all risk assessments and behaviour management plans were reviewed regularly and reflected the current needs of the residents. Merryfield DS0000004526.V277807.R01.S.doc Version 5.1 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 15 Appropriate personal and family relationships were encouraged and enabled by staff at the home. EVIDENCE: All the residents at the home had contact with their families. Two of them had very regular contact and visited family members and sometimes stayed overnight. The other residents had less contact but he did speak to the inspector about his family members and visiting them on occasions. The manager discussed with the inspector that two of the residents were very sociable people and had their own circle of friends either from college, clubs attended or other placements. The other resident did not mix as easily and was quite happy being in contact with his family and the staff at the home. He would go out socially and on holidays with staff but did not have any close friendships outside the home. The manager was very aware that this could tend to make him a little isolated and tried to encourage him to get out and about as much as possible. Standards 11, 12, 13, 14, 16 and 17 were assessed at the previous inspection and all found to be met. Merryfield DS0000004526.V277807.R01.S.doc Version 5.1 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 The resident’s personal and health care needs were being met. EVIDENCE: All the residents were generally quite independent in relation to personal care and needed only prompting or minimal support. Any assistance that was required was detailed on their personal files. The inspector was informed that residents continued to enjoy good health. There was documented evidence that where applicable residents kept regular appointments with psychiatrists and at diabetic clinics. One resident monitored his own blood sugar levels, with supervision from staff, in relation to his diabetes. All residents attended the local G.Ps surgery as necessary and had access to dentists and opticians as necessary. The staff at the home had access to the relevant health care professionals if they had concerns about the residents’ mental well-being. The medication system was not fully assessed at this inspection however the requirement made following the last inspection in relation to individual guidelines for the administration of PRN medication was seen to have been met. Merryfield DS0000004526.V277807.R01.S.doc Version 5.1 Page 13 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): No judgement. EVIDENCE: These standards were assessed at the last inspection and found to be met. No complaints had been lodged at the home or with the CSCI. One adult protection issue/concern had been raised with Social Care and Health and was fully investigated by them. The issues/concern raised were not upheld. Merryfield DS0000004526.V277807.R01.S.doc Version 5.1 Page 14 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 27, 28, 30 The home provided residents with a well maintained and comfortable environment in which to live. EVIDENCE: Only the communal areas and bathroom of the home were viewed at this inspection. The communal areas were comfortable with a good standard of furnishings and fittings and comprised of a lounge and kitchen. The inspector was informed that a decorator had been booked to redecorate some areas of the home including the kitchen stairs and landing. The home would not be able to accommodate residents with any mobility difficulties as it was not accessible to wheelchairs and there was no lift. There were several risk assessments in place for individual residents for the use of equipment such as the microwave and kettle. There were also risk assessments for the use of the shower and bath. The home had one combined toilet and bathroom with a shower fitted over the bath. The issue of an additional toilet being installed in the house had been discussed with the proprietor at a previous inspection. Merryfield DS0000004526.V277807.R01.S.doc Version 5.1 Page 15 He stated this had been discussed at past inspections and he had asked a plumber to explore this issue and no space could be found to accommodate this due to the size and location of the house. The home was clean and hygienic. The washing machine was located in the kitchen however there was no incontinence at the home and the laundry system was appropriate. Merryfield DS0000004526.V277807.R01.S.doc Version 5.1 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34, 35 The staffing levels appeared adequate to meet the needs of the residents and there were good relationships evident. All new staff needed to undertake induction training in line with the specifications laid down by Skills for Care to ensure they were equipped with the skills and knowledge necessary to fulfil their roles. EVIDENCE: The numbers of staff on duty depended on the activities the residents were taking part in. The proprietor attended the home almost daily and was seen as part of the staff team. One member of staff slept in at the home every night. Staffing levels appeared to meet the needs of the residents. The staff spoken with during the course of the inspection knew the residents well and were well aware of their needs and their personalities. The residents were very comfortable in the presence of the staff, proprietor and manager. There were three staff employed at the home. Two had worked there for some time the other employee was quite new. The two longstanding employees both had NVQ level 3 and had undertaken a variety of other training including, adult protection, managing confrontation, safe handling of medicines and fire training. The manager needed to ensure that there was evidence on site that the staff had undertaken updated training in food hygiene, as they were responsible for all the cooking at the home. Merryfield DS0000004526.V277807.R01.S.doc Version 5.1 Page 17 It was also noted that for new employees the only record of induction was a basic first day tick list. The manager needed to ensure that any new staff received induction training over the first twelve weeks of employment that covered all the areas specified by skills for care. The recruitment files for the new employee were sampled and they included a completed application form, two written references, proof of I.D. and evidence that a CRB check had been applied for. The manager informed the inspector that a POVA first check had been carried out but there was no evidence of this on site and the file did not include any evidence that the person was physically and mentally fit for the job. It was also strongly recommended that the application form was further developed to enable more details to be entered about employment history. Merryfield DS0000004526.V277807.R01.S.doc Version 5.1 Page 18 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 42 The manager ensured the smooth running of the home in a competent manner. The health and safety of staff and residents were well managed. EVIDENCE: The manager of the home demonstrated a very good knowledge of the needs of the residents in her care. She had several years experience of caring for people with a learning disability and had achieved the required qualifications. It was evident throughout the inspection that relationships between the manager, residents and staff were very good. Health and safety were well maintained and the requirements made following the last inspection had been met. These were in relation to updating fire training for staff and ensuring that the smoke detectors were checked regularly. The proprietor carried our regular health and safety checks around the home and the staff hand over sheets included such things as checks on fridge temperatures and smoke detectors. Merryfield DS0000004526.V277807.R01.S.doc Version 5.1 Page 19 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 X 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 X 23 X ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 3 28 3 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 2 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 X X 2 X LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 3 16 X 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 X X 3 X X X X 3 X Merryfield DS0000004526.V277807.R01.S.doc Version 5.1 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 YA6 Regulation 15(1)(c) Requirement All care plans must be regularly updated to ensure they reflect the current needs of the residents. All risk assessments and behaviour management plans must be regularly updated to ensure they reflect the current needs of the residents. The COSHH file must be further developed to include individual data sheets for substances used. (Previous time scale of 01 June 2005 not met time scale of 01 December 2005 not assessed for compliance at this visit.) All staff must be checked against the POVA register prior to their commencing their employment and evidence of this must be available for inspection. (Previous time scales of 01 April 2005 and 01 December 2005 not met.) Staff files must include all the information/documentation detailed in schedule 2 of the Care Homes Regulations. (Previous time scales of 01 May 2005 and 01 December 2005 not DS0000004526.V277807.R01.S.doc Timescale for action 14/04/06 2. YA9 13(3) 14/04/06 3. YA30 13(3) 01/05/06 4. YA34 19(1) 01/04/06 5. YA34 19(1) Sch2 14/04/06 Merryfield Version 5.1 Page 21 met.) 6. YA35 18(1)(a) The manager must ensure that all new employees complete an induction programme that complies with the specifications laid down by Skills for Care. There must be evidence on site that all staff have up to date food hygiene training. The registered provider must ensure that appropriate quality assurance monitoring systems are in place. (Previous time scales of 13 November 2004 and 01 July 2005 not met. Time scale of 01 December 2005 not assessed for compliance at this visit.) 01/06/06 7. 8. YA35 YA39 18(1)(a) 26 01/05/06 01/06/06 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 YA34 Good Practice Recommendations It was strongly recommended that the application form be further developed to enable more details of employment history to be entered. Merryfield DS0000004526.V277807.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Birmingham Office 1st Floor Ladywood House 45-46 Stephenson Street Birmingham B2 4UZ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Merryfield DS0000004526.V277807.R01.S.doc Version 5.1 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!