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Inspection on 27/10/05 for Merrymeet

Also see our care home review for Merrymeet for more information

This inspection was carried out on 27th October 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 no outstanding requirements from the previous inspection report, but made 9 statutory requirements (actions the home must comply with) as a result of this inspection.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Potential residents are provided with clear information to enable them to make a decision on whether the home is the right one for them. Once admitted to the home, residents receive a comprehensive needs assessment. Individuals are consulted and fully participate throughout this process. One resident said, " Moving into this home is the best thing that has ever happened to me." The home received a commendation for the way that residents were encouraged to identify their own needs and the way in which they would prefer them to be met. A further commendation was made for the way in which a resident was supported in establishing their right to freedom of movement in the local community. The home places high importance on ensuring that residents have a safe and comfortable environment in which to live. Any shortfalls in the environment that are considered to be a risk to residents` welfare are addressed immediately.

What has improved since the last inspection?

A safe system of administration of medication had been put in place since the last inspection and the two environmental health and safety requirements had been satisfactorily addressed. All staff had agreed to undertake NVQ training and 50% funding had been secured for staff to attend mandatory health and safety training. Finally, improvements had been made to the recording of residents` financial transactions to ensure that accurate and up to date records were being held.

CARE HOME ADULTS 18-65 Merrymeet 5 & 7 Tootal Grove Salford Gtr Manchester M6 8DN Lead Inspector Val Bell Unannounced Inspection 27th October 2005 14:00 Merrymeet DS0000008353.V257357.R01.S.doc Version 5.0 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 Merrymeet DS0000008353.V257357.R01.S.doc Version 5.0 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. Merrymeet DS0000008353.V257357.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Merrymeet Address 5 & 7 Tootal Grove Salford Gtr Manchester M6 8DN 0161 737 5606 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mr Bradley Rawlinson Mrs Joan Rawlinson Mr Peter Christopher Kelly Care Home 14 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (9), Mental Disorder, excluding of places learning disability or dementia - over 65 years of age (5) Merrymeet DS0000008353.V257357.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home accommodates a maximum of 9 younger adults requiring care by reason of mental disorder (excluding learning disability or dementia) and 5 named older people requiring care by reason of mental disorder (excluding learning disability or dementia). When any of the named older people leave, the category of registration will revert to that of younger adults requiring care by reason of mental disorder. The home must, at all times, employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. Care staffing levels must not fall below the minimum levels specified by the previous regulatory authority 4th March 2005 2. 3. 4. Date of last inspection Brief Description of the Service: Merrymeet is a care home providing personal care and accommodation for a maximum of fourteen adults with enduring mental ill health. The home does not specifically offer a rehabilitation service, although personal development and learning independent living skills are encouraged. The home I situated in the Eccles area of Salford, in a residential area. The premises are in keeping with the local community. The home is close to local facilities and public transport routes. At the time of inspection there were fourteen residents living in home and two of the residents were in hospital. Merrymeet DS0000008353.V257357.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was carried out over two days, Thursday 27th October and Wednesday 2nd November. The home manager was present on the second day of inspection. Various records, including care plans, were examined and a tour of the building was undertaken. Conversations were held with six residents, staff and management. Six of the seven requirements made at the previous inspection had been addressed. What the service does well: What has improved since the last inspection? A safe system of administration of medication had been put in place since the last inspection and the two environmental health and safety requirements had been satisfactorily addressed. All staff had agreed to undertake NVQ training and 50 funding had been secured for staff to attend mandatory health and safety training. Finally, improvements had been made to the recording of residents’ financial transactions to ensure that accurate and up to date records were being held. Merrymeet DS0000008353.V257357.R01.S.doc Version 5.0 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. Merrymeet DS0000008353.V257357.R01.S.doc Version 5.0 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 Merrymeet DS0000008353.V257357.R01.S.doc Version 5.0 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): 1 and 2 Prospective residents are provided with relevant information so that they can decide if the home is the right place for them. Thorough assessments of need enable the home to ensure that the needs of individual residents can be met. EVIDENCE: Prospective residents were provided with clear written information about the home and staff took the time to sit down and explain this to individuals. Additionally, individuals were offered several opportunities to visit the home to get to know the residents and staff and to have a meal and overnight stay prior to making a decision on whether to move into the home. Robust multi-disciplinary assessments of need were carried out prior to admission and the home continued to assess individuals’ needs following admission. There was evidence that staff took prompt action to address residents changing needs. Merrymeet DS0000008353.V257357.R01.S.doc Version 5.0 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, 8, 9 and 10 Failure to undertake regular care plan and risk assessment reviews and to ensure that monitoring information is readily available potentially places residents at risk of not having all their needs met. Additionally, inappropriate recording of residents’ personal information potentially compromises the privacy and dignity of residents. The staff worked hard in consulting and involving residents in the day-to-day running of the home. This enabled residents to contribute to decisions that affected the quality of their life experiences. EVIDENCE: Each resident had a care plan in place and there was evidence that resident’s had been involved in developing their care plans. Not all care plans had been reviewed on a regular basis. A requirement was made accordingly. The daily report sheets were examined and the language used by staff was found to be respectful towards the residents. One entry in the daily report stated that a resident’s next of kin had requested that they wished to be kept informed if there were any problems. As this information had been recorded in this way it would not be readily available to staff. Consequently, a good practice recommendation was made for the registered person to devise a personal information-recording sheet to be held in the care plans. Additionally, the Merrymeet DS0000008353.V257357.R01.S.doc Version 5.0 Page 10 outcome of health appointments had also been recorded in the daily records. A requirement was made to implement a separate recording system so that resident’s health could be more easily monitored and reviewed. Residents told the inspector that the staff consulted them on day-to-day issues concerning the running of the home and residents were participating in daily tasks around the home. Risk assessments had been undertaken where appropriate although some of these had not been subject to regular review. Examination of the staff message book revealed that some personal information had been recorded. Residents’ personal information must be stored confidentially and securely in their care plans to comply with the requirements of the Data Protection Act 1989. By the second day of inspection the manager had addressed this with the team in a staff meeting. Merrymeet DS0000008353.V257357.R01.S.doc Version 5.0 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): 11, 13, 14 and 17 Residents were encouraged to maximise their independence and to fully participate in their local community. The way that staff achieved this was commended. This enabled residents to be self-determining and to develop a sense of community identity. EVIDENCE: Throughout the inspection staff were observed to encourage residents to be self-determining and independent and this was also confirmed in conversation with residents. Residents had completed lifestyle self-assessments, which identified their preferences, choice and aspirations for self-development. This was considered to be an area of best practice and the home received a commendation. During the inspection residents’ were observed to come and go freely in accessing local community facilities. One resident said that he enjoyed taking the home’s dog out for a walk, going out shopping and for a coffee. Other resident’s said they enjoyed visiting friends and relatives. In conversation with residents it was clear that they had developed a sense of community identity. One of the resident’s had recently experienced Merrymeet DS0000008353.V257357.R01.S.doc Version 5.0 Page 12 discrimination from some of the homes neighbours. This issue had been handled very well by the home by inviting the neighbours into the home to meet residents and to dispel the misconceptions and assumptions that people had formed. This was considered to be an area of best practice for which the home received a commendation. Residents praised the quality of the catering provided by the home. Menu’s recorded in a diary demonstrated that a wholesome and varied diet was provided. However, no food alternatives had been recorded for a resident who was a diabetic and a resident who was on a low fat diet. The home must ensure that they provide evidence that they are meeting the needs of individuals on special diets by recording the alternatives offered. Fridge and freezer temperatures were recorded daily and residents were able to make themselves drinks and snacks at any time. One of the resident’s said, “I can choose what meals I have and mealtimes are flexible.” Merrymeet DS0000008353.V257357.R01.S.doc Version 5.0 Page 13 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 and 20 Residents were confident that staff would take prompt action to address any health concerns that they had. Safe systems in the administration of medication ensured that the health and safety of individuals was protected. EVIDENCE: Resident’s complete lifestyle self-assessments and this, together with the homes comprehensive needs assessment, ensures that they receive personal support in line with their individual preferences. Care plans provided evidence that resident’s health needs were being met. The home had taken prompt action in making referrals to health professionals in situations where residents had identified health concerns. From information recorded in care plans it was evident that residents had access to the full range of community healthcare services. The shortfalls in medication recording, identified at the previous inspection had been addressed. Due to the way that medication administration records were designed, staff were finding it difficult to record their checking of medication received weekly in the home. A recommendation was made for this issue to be discussed with the pharmacist and a solution to be agreed. Merrymeet DS0000008353.V257357.R01.S.doc Version 5.0 Page 14 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): 22 and 23 Inappropriate recording of complaints potentially places residents at risk of having their right to confidentiality compromised. The absence of staff training in abuse awareness potentially places the health and safety of residents at risk. EVIDENCE: No complaints had been received since the last inspection. The homes system for recording complaints in a hardback book did not comply with the requirements of the Data protection Act 1989. Complaints must be recorded individually so that they can be filed in resident’s records. The home had the local authority procedure for the protection of vulnerable adults from abuse (POVA). However, staff had not had training in the awareness of abuse and a requirement was made accordingly. Merrymeet DS0000008353.V257357.R01.S.doc Version 5.0 Page 15 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, 26, 27 and 30 A rolling programme of redecoration, maintenance and refurbishment ensures that residents are afforded a safe and comfortable environment in which to live. EVIDENCE: Requirements made at the last inspection had been addressed. On a tour of the home the premises were found to be clean, hygienic and no offensive odours were present. Décor, furnishings and fittings were domestic in nature and of good quality. There was evidence of an ongoing re-decoration and maintenance plan and several items of the homes equipment had been replaced. Suitable and appropriate bathing and toilet facilities had been provided for use by residents. The light fitting in the downstairs shower-room had come loose and was not fitted with a cover leaving exposed live wires. A requirement was made to isolate this shower-room until the light fitting had been repaired. The registered manager informed the Commission that this had been attended to the day following this inspection. Merrymeet DS0000008353.V257357.R01.S.doc Version 5.0 Page 16 A sample of bedrooms was inspected and these were found to be comfortable and suitably furnished and decorated. In conversation with the inspector residents praised the quality of the homes environment and also commented that they valued their private space. One resident said, “Moving into this home is the best thing that’s ever happened to me.” Merrymeet DS0000008353.V257357.R01.S.doc Version 5.0 Page 17 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): 35 Significant progress had been made in implementing a staff development programme. This ensured that residents were being cared for by a welltrained, skilful and knowledgeable staff team. EVIDENCE: The home had been successful in obtaining 50 funding towards mandatory health and safety training courses. All the staff employed had agreed to undertake NVQ training. All staff had received training in the control of infection. Merrymeet DS0000008353.V257357.R01.S.doc Version 5.0 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): 42 The homes attention to health and safety matters ensured that resident’s welfare was protected. EVIDENCE: The manager stated that fire alarm tests, water temperature checks and electrical appliance testing were up to date. No further health and safety issues were identified during the inspection. Merrymeet DS0000008353.V257357.R01.S.doc Version 5.0 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X 3 X X X Standard No 22 23 Score 2 2 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 X 3 2 2 Standard No 24 25 26 27 28 29 30 STAFFING Score 3 X 3 2 X X 3 LIFESTYLES Standard No Score 11 4 12 X 13 4 14 3 15 X 16 X 17 Standard No 31 32 33 34 35 36 Score X X X X 3 X CONDUCT AND MANAGEMENT OF THE HOME 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Merrymeet Score 3 X 3 X Standard No 37 38 39 40 41 42 43 Score X X X X X 3 X DS0000008353.V257357.R01.S.doc Version 5.0 Page 20 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. 1 Standard YA6 Regulation 15 (2) (b) Requirement Care plans must be reviewed at least every six months or more frequently as residents needs change. The outcome of residents’ health appointments must be recorded so that they can be monitored and reviewed on a regular basis. Risk assessments must be reviewed at least every six months or more regularly if residents’ needs change. Resident’s personal information must be recorded in a confidential way and stored securely to comply with the requirements of the Data Protection Act 1989. The food alternatives offered to residents who have special diets must be recorded. The registered person must introduce a complaints log that complies with the requirements of the Data Protection Act 1989. Staff must receive training in awareness of abuse and the protection of vulnerable adults from abuse. The light fitting in the downstairs DS0000008353.V257357.R01.S.doc Timescale for action 08/12/05 2 YA6 14 (2) 08/12/05 3 YA9 15 08/12/05 4 YA10 17 (1) (b) 08/12/05 5 6 YA17 YA22 16 (2) (i) 22 08/12/05 08/12/05 7 YA23 13 (6) 08/01/06 8 YA27 13 (4) 08/12/05 Page 21 Merrymeet Version 5.0 9 YA37 9 shower room must be repaired. The shower room must be isolated until the light fitting has been made safe. The manager must be qualified to NVQ 4 in care and management by 31.12.05. 31/12/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard YA6 YA20 Good Practice Recommendations The registered person should develop residents personal details sheets so that relevant information is available to staff at all times. The registered person should take advice from the local pharmacist on how to record the checking of weekly medication supplies received into the home. Merrymeet DS0000008353.V257357.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection CSCI, Local office 9th Floor Oakland House Talbot Road Manchester M16 0PQ 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 Merrymeet DS0000008353.V257357.R01.S.doc Version 5.0 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!