Inspection on 08/12/06 for Merryfield House Nursing Home

This inspection was carried out on 8th December 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 House Nursing Home 23/08/05

Merryfield House Nursing Home 09/06/05

Merryfield House Nursing Home 11/10/04

Merryfield House Nursing Home 29/04/04

Similar services:

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

St Vincents

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

CARE HOMES FOR OLDER PEOPLE Merryfield House Nursing Home 33 New Yatt Road Witney Oxfordshire OX28 1NX Lead Inspector Kate Harrison Unannounced Inspection 8th December 2006 9:30 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 Merryfield House Nursing Home DS0000027164.V317412.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. Merryfield House Nursing Home DS0000027164.V317412.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Merryfield House Nursing Home Address 33 New Yatt Road Witney Oxfordshire OX28 1NX 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) 01993 775776 merryfieldhome@aol.com Mrs Kuldip Kaur Dhanani Jill Timms Care Home 24 Category(ies) of Old age, not falling within any other category registration, with number (24) of places Merryfield House Nursing Home DS0000027164.V317412.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Admission of one resident only under the age of 65 in the PD category at any one time 23rd August 2005 Date of last inspection Brief Description of the Service: Merryfield House is a care home with nursing, providing care and accommodation for 24 residents. The home is situated in a residential area of Witney, close to amenities, and is surrounded by its own grounds. The building is a converted and extended older property, with a passenger lift to the first floor of the original building. The extension is at ground level, and is connected to the main house by a covered corridor that also provides a small seating area. The majority of the rooms are for single accommodation and five rooms can be shared. The home has a laundry and kitchen on the premises. Care is organised by the registered manager and the deputy manager, and the nursing, care and housekeeping staff provide the services. Building to the side of the link corridor is expected to start in 2007, and will mean that the home can then provide a dining room. The weekly fees range in cost from £567 to £660. Merryfield House Nursing Home DS0000027164.V317412.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Commission has, since the 1st April 2006, developed the way it undertakes its inspection of care services. This inspection of the service was an unannounced ‘Key Inspection’. The inspector arrived at the service at 09.30 hours and was in the service for 5.5 hours. This inspection was a thorough look at how well the service is doing. It took into account detailed information provided by the service’s manager, and any information that CSCI has received about the home since the last inspection. The inspector saw all areas of the home and looked at records and documents relating to the care of the residents. The inspector asked the views of the residents, relatives and health and social care professionals about the home through questionnaires (comment cards) that the Commission had sent out. Nine relatives and four health care professionals, including GPs, replied to the Commission’s comment cards and their views are reflected in this report. The inspector had meaningful conversations with several residents on the day, and also spoke to six relatives. All the residents who replied via the Commission’s comment cards or who spoke to the inspector praised the qualities of the staff and the management of the home. Relatives also highly praised the home, one relative saying that the management is ‘excellent’. The registered manager and her care team are very aware of how to care for people from different backgrounds, and currently care very well for people with a disability. Policies are in place to make sure that staff members take into account culture, ethnicity and religion when planning the care of individuals, and the home knows that they can contact the individual responsible for diversity matters at Oxfordshire County Council if advice is needed. From the evidence seen the inspector considers that this home would be able to provide a good service to meet the needs of people from different backgrounds. What the service does well: The pre-admission process is well managed. Health and personal care is well planned and delivered. The residents enjoy daily life and have choice and control over their social lives. Visitors are very welcome. All the residents seen by the inspector were happy with the quality of the food, and one resident said that at times the food was ‘close to excellent’. Recruitment and training of staff is well managed, and the residents benefit from the welltrained staff. The residents appreciate the continuity of staff at the home, and have confidence in the home’s strong leadership. Merryfield House Nursing Home DS0000027164.V317412.R01.S.doc Version 5.2 Page 6 The management carries out surveys and checks to make sure that the quality of the service continues to improve. The home works well with other care professionals, and with this support one resident has returned home into the care of her family. 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. Merryfield House Nursing Home DS0000027164.V317412.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Merryfield House Nursing Home DS0000027164.V317412.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3. The home does not provide intermediate care. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The statement of purpose is available at the home, and the service user guide and the last inspection report is freely available in the entrance hall. Three individuals files were checked to assess the home’s admission procedures. Following an initial enquiry a senior member of staff collects information from the individual’s care manager or from the family, and visits the individual to complete the home’s initial assessment form. One resident said that the manager had visited her and had discussed the move to Merryfield House thoroughly with her. All necessary information was available for the individuals checked, including the hospital’s nutritional risk assessment for one individual. This allowed the home to continue caring for the individual in the same way as the hospital without interruption. The home’s service user guide was given to the Merryfield House Nursing Home DS0000027164.V317412.R01.S.doc Version 5.2 Page 9 prospective resident’s daughter when she visited the home, and recorded as given. A copy of the contract given to the resident and her family was in her file, and a preliminary nursing assessment was developed so that the staff members knew how to care for the resident on admission. One resident described her admission process as ‘a quick caring response when the need arose’. All the residents who replied to the Commission’s comment cards said that they received enough information about the home before they moved in. Merryfield House Nursing Home DS0000027164.V317412.R01.S.doc Version 5.2 Page 10 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, 10 and 11. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a key worker system in use so that residents and carers know who is responsible for the care of individuals. The home uses their own set of care plans, developed from the Activities of Daily Living model, and personalises the delivery of care with extra care plans depending on the individual’s need. The care staff members know that all the residents will have the Activities of Daily Living care plans, and so care for the residents on this basis. Each individual resident has an index of needs so it is easy for any carer to quickly find the information they need. The care plans seen were very personalised and contained clear instructions for staff members, with reasons why the action was necessary. For example the care plan addressing one resident’s social needs instructed staff to give the resident the newspaper every day, because she enjoyed reading it. Merryfield House Nursing Home DS0000027164.V317412.R01.S.doc Version 5.2 Page 11 Residents are encouraged to take care of themselves as much as possible, and the extent to which individuals can care for themselves is documented in the care plans. Risk assessments and care plans were detailed and complete, and the residents told the inspector that they were very well cared for. At the first review meeting some weeks after admission the care plans are discussed with relatives, and relatives are asked to sign a form to show that they are involved with the development of the care plan. When further reviews take place relatives are invited to sign the form again to show their ongoing involvement. One resident’s relatives told the inspector that the staff worked as a good team and that the care was ‘close to excellent’. Adjustable beds are available, and staff members have access to other equipment to make sure that residents have all the equipment they need. Medication policies and procedures are in place and staff members who have responsibility for medication receive regular update training. Medication was checked for two individuals and was appropriately managed. Appointments with health professionals are arranged as necessary, and residents are helped to keep the appointments. One resident said that the manager usually took her to her appointments. All the residents who replied to the Commission’s comment cards said that staff ‘always’ listen and act on what they say, and that they receive the care and support they need. Relatives told the inspector how staff members carefully help the resident to chose coordinating clothes, and how they respect their privacy when they come to visit. Staff members receive training on how to treat residents with respect and on customer care, and residents said that all the staff ‘are excellent’. The registered manager has a particular interest in the care of individuals who are dying, and has taken training in the national Gold Standard Framework. She has developed procedures, including wishes on resuscitation, to make sure that residents, relatives and staff members are well supported during the process, and that residents’ wishes are respected. Merryfield House Nursing Home DS0000027164.V317412.R01.S.doc Version 5.2 Page 12 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. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The schedule of Christmas activities was displayed in the home, showing the extra activities planned for the month of December, including a Christmas party, a session with Museum Box of Christmas Past and a New Year ‘Singalong’. The dog from Pets as Therapy was in the home on the day, and residents said how they enjoyed the variety of activities arranged on a regular basis, including weekends. Individual activities are included, such as massage and aromatherapy. All the residents who replied to the Commission’s comment cards said that activities were ‘always’ arranged that they could take part in, though some chose not to take part. Residents know that their visitors can come when they want to, and visitors told the inspector that they feel very welcome. One resident’s visitors said that visiting Merryfield House ‘was the closest thing to coming home’, and that staff members made them feel very welcome. Merryfield House Nursing Home DS0000027164.V317412.R01.S.doc Version 5.2 Page 13 Residents are encouraged to manage their own affairs for as long as they can do so, though at present no resident is able to manage their own finances. One resident has, with the help of a close relative, chosen to leave the home and return to live with her relative, as her health is much improved. The home is working closely with other agencies to provide support and help, so that the family can be together for as long as possible. The chef has good systems to enable her to know the food needs and preferences of new residents as soon after admission as possible. She has a good knowledge of all the residents’ food preferences, and sees all the residents daily to deliver breakfast and to discuss the day’s menu. All the residents seen by the inspector were happy with the quality of the food, and one resident said that at times the food was ‘close to excellent’. Meals are served on individual trays, as there is no dedicated dining room, although plans are in place to provide one next year. Staff members sensitively helped those unable to eat independently, and are skilled in encouraging residents to eat. One relative said that, thanks to the staff, her relative had gained over two stones in weight. Merryfield House Nursing Home DS0000027164.V317412.R01.S.doc Version 5.2 Page 14 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. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home’s complaints procedure is displayed in the hall and complies with legislation. All the residents know how to make a complaint and whom to address any complaint to. The complaints procedure is available in large print for residents who have impaired vision. One complaint was made to the home regarding residents since the August 2005 inspection, and this was managed according to the home’s procedure. The Commission has not received information from any complainant since the August 2005 inspection. The home has policies and procedures in place to safeguard residents from abuse, and training is provided for staff from induction and at regular intervals after induction. Merryfield House Nursing Home DS0000027164.V317412.R01.S.doc Version 5.2 Page 15 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. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: On the day of the inspection visit the home was clean, bright and hygienic. Plans are in place to start the building work in the near future so that a dining room will be provided for the residents, and residents are looking forward to this development. Safety issues are taken seriously and the manager has contact with the local fire safety officer about arrangements in the home. The person responsible for maintenance has a good system for staff members to report maintenance issues, and the grounds are well maintained. There are two laundry areas in the home, and infection control procedures are in place to minimize the spread of infection. The residents and relatives had no concerns about the management of personal laundry. Merryfield House Nursing Home DS0000027164.V317412.R01.S.doc Version 5.2 Page 16 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. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home always has a registered nurse on duty, and has increased the numbers of care staff available to make sure that two members of staff are available in both the original building and in the new wing to meet the needs of the residents. One member of staff is also responsible for residents using the communal areas. The home operates a ‘staff bank’ system, so that if carers are needed for extra shifts the carer can be found from within the home, so that the residents benefit from the continuity of care. The home takes part in the Oversees Nurses Programme through Northampton University in England, and is helping four individuals who qualified as nurses overseas to complete the course necessary to gain their Registered Nurse qualification. One student at a time is studying while the home has two or three individuals working as carers while they wait to do the course. This additional expertise helps the home to give a high level of care to the residents Staff are encouraged to start the National Vocational Qualification (NVQ) Level 2 in care, and are supported to continue training. At present five carers have gained the qualification and three more will soon be completing the course. Merryfield House Nursing Home DS0000027164.V317412.R01.S.doc Version 5.2 Page 17 New care staff members complete the home’s induction programme within six weeks of starting work at the home, and the programme is based on the Skills for Care standard. Ongoing training and updating is provided on care topics and customer care training is provided for all staff. Other staff training is also encouraged, such as NVQ training for housekeeping staff, and training on appropriate activities provision. Residents and relatives praised the staff members, saying that they are always ready to help: ‘nothing is too much trouble’, ‘staff are excellent’, ‘very willing staff’, are some of the comments made. Three staff files were seen to check the home’s recruitment procedure, and all the necessary safety checks are carried out. The quality assurance survey carried out three times a year asks respondents views about staff members, and the May 2006 report shows that staff are seen as friendly, skilled and organized and that relatives have very positive relationships with the staff. Merryfield House Nursing Home DS0000027164.V317412.R01.S.doc Version 5.2 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The majority of the residents do not manage their personal finances and are subject to Power of Attorney. The home keeps very small amounts of petty cash for a few residents, and keeps records appropriately. The registered nurse manager has worked at the home for several years, has completed all the necessary training and has a very good understanding of how the Care Standards Act affects her work. She has encouraged the development of a senior care team at the home, and consequently the home runs smoothly when she is not present. Merryfield House Nursing Home DS0000027164.V317412.R01.S.doc Version 5.2 Page 19 The home consistently provides a good service, and the manager continually seeks out ways of improving the home. She is responsible for health and safety at the home and maintains records to ensure that the home operates safely, and that the home’s health and safety policy is implemented. A new post of general manager has been created to oversee the management of the three homes in the group. The proprietor, the general manager and the home’s manager provide the home’s management team and the proprietor manages the financial side of the business. Quality assurance surveys are carried out three times a year, involving relatives, and the results are available and given to relatives, residents and the Commission. The home has a development plan, and the manager expects the extension to be completed this year, so that the home will have a dining room, and residents will have an improved social life. The home has a track record of continually seeking improvement through staff training, improving the environment and through acting on feedback from relatives and residents. Comments from residents and relatives included: ‘probably the best home in the area’ and ‘ this is the best home in the area’. Merryfield House Nursing Home DS0000027164.V317412.R01.S.doc Version 5.2 Page 20 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 4 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 4 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 4 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 4 X 3 X X 3 Merryfield House Nursing Home DS0000027164.V317412.R01.S.doc Version 5.2 Page 21 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. Refer to Standard Good Practice Recommendations Merryfield House Nursing Home DS0000027164.V317412.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Oxford Office Burgner House 4630 Kingsgate Oxford Business Park South Cowley, Oxford OX4 2SU 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 Merryfield House Nursing Home DS0000027164.V317412.R01.S.doc Version 5.2 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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