Inspection on 09/11/06 for Merrymeet

This inspection was carried out on 9th November 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 no outstanding requirements from the previous inspection report, but made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Merrymeet 16/02/06

Merrymeet 27/10/05

Merrymeet 04/03/05

Merrymeet 16/06/04

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

CARE HOME ADULTS 18-65 Merrymeet 5 & 7 Tootal Grove Salford Gtr Manchester M6 8DN Lead Inspector Val Bell Unannounced Inspection 9th November 2006 11:00 Merrymeet DS0000008353.V310812.R01.S.doc Version 5.2 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.V310812.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. Merrymeet DS0000008353.V310812.R01.S.doc Version 5.2 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.V310812.R01.S.doc Version 5.2 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 16th February 2006 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 is 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. Merrymeet DS0000008353.V310812.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was conducted during daytime hours on 9th November 2006. During the inspection various records, including two care plans were examined. Conversations were held with management, staff and two residents and a tour of the communal areas was undertaken. The registered manager had completed and returned the pre-inspection questionnaire prior to the inspection. What the service does well: What has improved since the last inspection? This section is not applicable as there were no areas identified for improvement at the previous inspection. Merrymeet DS0000008353.V310812.R01.S.doc Version 5.2 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.V310812.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 Merrymeet DS0000008353.V310812.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Residents could be confident that the home would ensure that individual’s needs would be assessed in order to determine if the home was the right place for them to live. EVIDENCE: The files of the two residents admitted to the home during the previous twelve months were examined for evidence that their needs had been assessed. Both these residents had received thorough assessments of their needs by social services and one resident also had been assessed by the hospital where he had been an in-patient. The home had also conducted in-house assessments of need and the risks associated with the provision of their care had been identified. These assessments enabled the home to make a decision on whether these people’s needs could be met. Merrymeet DS0000008353.V310812.R01.S.doc Version 5.2 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, 7 and 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The quality of care planning ensured that residents would receive the support necessary to enable them to develop to their full potential. Care plans should be further developed to provide written evidence that residents are involved in decisions taken that affect their day-to-day lives. Failure to keep a residents care plan up to date places that individual at risk of not having his current needs met. EVIDENCE: The two people admitted to the home in the previous twelve months were case-tracked to establish if the home had systems in place to provide evidence that individual’s needs were being met. Care plans had been developed from these residents’ assessments of need and the care plans detailed the specific care and support that was to be provided. The monitoring and recording of outcomes was generally to a high standard, Merrymeet DS0000008353.V310812.R01.S.doc Version 5.2 Page 10 demonstrating that people were encouraged to develop their full potential and to maximise their independence by taking responsibility for decisions that affected their lives. However, one of the care plans was dated January 2006. It was evident from this resident’s diary records that his physical health needs had changed significantly in the previous ten months although the care plan had not been reviewed and updated to reflect this. Care plans must be subject to regular review and more frequently as residents’ needs change. It was evident from residents’ feedback that the home involved them and their representatives in developing their care plans and decisions that were taken that restricted their rights to choice and freedom. In this respect, care plans could be improved by encouraging residents and/or their representatives to sign their care plans to provide written evidence that they agree to the contents. For example, to protect residents from the risk of fire it was customary for individuals to hand their cigarettes to staff for safekeeping before retiring to bed at night. This information should be included in residents risk assessments. Risk assessments had been undertaken for the two residents case-tracked. A good practice recommendation was made for these assessments to be further developed by including more detail about the management of risk, such as in the prevention of falls. From conversations with staff, management and residents it was evident that the home put the needs of residents first. Additionally, throughout the inspection it was observed that staff consistently treated residents with respect and made every effort to encourage residents to be self-determining. With this in mind, a good practice recommendation was made to consider adopting a person centred approach to care planning. The registered manager said he was keen to undertake research in this area. Merrymeet DS0000008353.V310812.R01.S.doc Version 5.2 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): 12, 13, 15, 16 and 17 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to the service. Residents are treated as individuals and their equality and diversity needs are valued and supported by the home. People are encouraged to develop to their full potential and become fully integrated members of their community. EVIDENCE: The home encouraged residents to continue to take part in activities engaged in prior to entering the home. One of the residents had a keen interest in art and was attending a weekly art class. The manager stated that this person’s ambition was to study for a degree in this subject and the home would provide the necessary support for him to achieve this. This is an area of best practice and the home received a commendation. There was evidence that residents were participating fully in their local community. Information was available for them about local activities and opportunities that they could access. This included advice and support groups Merrymeet DS0000008353.V310812.R01.S.doc Version 5.2 Page 12 provided by specialist organisations, such as Alcoholics Anonymous and it was evident that residents were accessing such services. It was pleasing to note that attention was being paid to recognising and valuing residents’ cultural identity. For example, a resident spent many years in the merchant navy and from conversations previously held with the inspector it was evident that this period of his life was extremely important to him and the experiences had been a great influence on his personal identity. On his behalf, the manager had undertaken research, on the Internet to obtain information about the history of the ship this resident had served on. This had provided the resident with a positive outcome to his sense of wellbeing. This is an area of best practice and the home received a further commendation. Care plans contained written evidence that a high level of support is provided to enable residents to develop and maintain their personal and family relationships. Staff evidently viewed these relationships as a valuable resource and had taken the opportunity to use these resources creatively to enhance residents’ wellbeing and personal development. This had created new opportunities for one resident in particular in enabling him to develop a valued lifestyle. This was again identified as best practice and was commended. Throughout the inspection the atmosphere in the home was very relaxed and this evidently promoted residents independence and freedom of movement. Daily routines were flexible and residents could choose when to be alone or in company. Residents are expected to take responsibility for keeping their private space clean and tidy, and to help with household tasks although support is available if needed. The home has a pet dog and it was clear that this provided companionship to the residents and a sense of responsibility in residents ensuring that the dog is exercised daily. The inspector was present during the midday meal, which was flexible and relaxed. Staff were overheard to ask each individual resident what they preferred for their meal demonstrating that choice is more important than having a fixed menu. Resident’s choice of meals is recorded on a daily basis. The manager had implemented the ‘Safer Food, Better Business’ guidelines that had been introduced with the food hygiene legislation introduced from January 2006 and these records had been kept up to date. Merrymeet DS0000008353.V310812.R01.S.doc Version 5.2 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Residents have access to flexible routines and the full range of community healthcare services, which has positive outcomes for their health and wellbeing. However, a breakdown in communication had the potential to place the health of a resident at risk. EVIDENCE: Conversations with staff and observation during the inspection provided evidence that residents are supported according to their preferences and personal care was provided in private. Daily routines were flexible and residents could choose when to get up and go to bed. Aids, such as continence wear, had been provided following obtaining professional advice. Care plans and daily records provided evidence that residents had access to the full range of community healthcare services. A practice nurse visited the home during the inspection to administer influenza vaccinations to the residents. The home was following good practice guidelines in recording residents health appointments and their outcomes. These comprehensive records provided useful information for reviewing the care and support needed. Merrymeet DS0000008353.V310812.R01.S.doc Version 5.2 Page 14 One minor shortfall was identified. A member of staff had recorded that a resident had experienced swallowing difficulties the previous Sunday and that he had asked to see his doctor. The member of staff had forgotten to pass this information on to the care team. Consequently, this had not been followed up. It was acknowledged that this particular member of staff was new and that the omission was an oversight as communication in the home is generally very good. Merrymeet DS0000008353.V310812.R01.S.doc Version 5.2 Page 15 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Robust policies for listening to the concerns and complaints of residents and the protection of vulnerable adults from abuse provided protection to the safety and welfare of residents. EVIDENCE: The home had a complaints procedure and a system for recording any complaints received, although no complaints had been made at the time of this inspection. The home had adopted Salford council’s policy and procedures of the protection of vulnerable adults from abuse. In conversation with the two staff on duty the inspector was told that they had received training in the awareness of abuse, which confirmed the information provided in the pre-inspection questionnaire. Merrymeet DS0000008353.V310812.R01.S.doc Version 5.2 Page 16 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 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. Residents are provided with a clean, hygienic and pleasant living environment. However, failure to take action in response to the issues identified by the fire officer potentially places the safety and welfare of the residents at serious risk. EVIDENCE: A tour of the communal space and the basement was undertaken on this inspection. A redecoration programme had taken place since the previous inspection and this had resulted in significant improvements to the living environment. It was noted that a coffee table in the annexe off the dining area had a hairline crack in the glass top. This did not appear to pose an immediate risk to the safety of residents although it was recommended that the glass top be removed. The manager stated his agreement to this. The garden area had been pleasantly improved to provide a range of plants and shrubs and a raised patio area with tables and seating for the residents. However, it was of concern that the raised patio area had no protective Merrymeet DS0000008353.V310812.R01.S.doc Version 5.2 Page 17 barriers fitted, which could pose a risk of falling if residents stumbled near the edge. Of serious concern was the issue of the provider’s failure to address the issues raised by the fire officer at his inspection of the home in May 2006. Remedial action was required in several areas and although a fire door leading to the basement had been replaced the remainder of the work was outstanding. The inspector was told that a contractor had been instructed to carry out the work although progress had been slow. The remedial action required by the fire officer must be given priority and a written report submitted to the Commission once all work has been completed. The home was clean and hygienic and no unpleasant odours were present. Cleaning schedules were in place and up to date and staff had completed a twelve-week course in infection control. Merrymeet DS0000008353.V310812.R01.S.doc Version 5.2 Page 18 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, 34 and 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Residents are afforded protection by the homes robust policy on recruitment, which ensures that the right kind of staff are employed to meet their needs. Residents can be confident that staff will be trained and they will have the necessary skills and knowledge in order to meet their needs effectively. EVIDENCE: A conversation was held with a member of staff on duty. She said that she had been employed at the home since September 2005 and had received a full induction following her appointment. Since then she had received training in all aspects of health and safety and had completed NVQ level 2 in care. She had also attended a number of work-related training courses, including challenging behaviour, mental health awareness and the awareness of abuse. Her line manager had provided regular supervision. She stated that the home was a good place to work because the management were supportive and she felt like a valued member of the team. Two members of staff who were on duty had been recruited by the home in the previous fourteen months. Both staff confirmed that the home had obtained up to date Criminal Record Bureau disclosures and two written references prior to their appointment. Merrymeet DS0000008353.V310812.R01.S.doc Version 5.2 Page 19 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, 39 and 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The home is well managed within a philosophy that places the needs of the residents first. Residents can be confident that their views are important to the home and that action would be taken to address any shortfalls that might be identified. EVIDENCE: The registered manager was suitably qualified and experienced and there was a clear sense of accountability within the staff team. Staff understood the requirements of their roles and what was expected of them. It was evident that the staff team had developed good working relationships with residents, their relatives and health and social care personnel. The home was displaying the required information such as the registration certificate and a current certificate of public liability insurance. Merrymeet DS0000008353.V310812.R01.S.doc Version 5.2 Page 20 Staff told the inspector that they got on well with the manager and they found him to be approachable and reliable. The manager has consistently responded well to requests for information from the Commission. The home had a well-developed quality assurance system and satisfaction surveys had been completed by health and social services professionals, relatives and residents. The fact that there was a high percentage response to the number of surveys issued evidences that good multi-disciplinary relationships are in place. Comments from these surveys included: • “The home operates to a high standard in maintaining the privacy and dignity of residents and staff always follow the advice given. There is a good attendance rate at appointments and staff have forged good relationships with general practitioners”. (Psychiatrist) “I send medical students to the home and they have found the care staff to be friendly and good at communicating. Keep up the good work!” (General practitioner) “The staff are kind, caring and helpful. The care goes beyond what you would expect of a care home”. (Relative) • • These positive comments were echoed in what residents had to say. One resident commented that he felt safe and could always talk to staff if he had any worries or concerns. There were no further health and safety issues other than those identified in the section on the environment in this report. Merrymeet DS0000008353.V310812.R01.S.doc Version 5.2 Page 21 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 3 23 3 ENVIRONMENT Standard No Score 24 2 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 2 3 X 3 X LIFESTYLES Standard No Score 11 X 12 4 13 4 14 X 15 4 16 X 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 2 3 X 3 X 3 X X X 3 Merrymeet DS0000008353.V310812.R01.S.doc Version 5.2 Page 22 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. 1. Standard YA6 Regulation 15 (2) (b) Requirement The registered person must ensure that care plans are reviewed on a regular basis and more frequently as residents’ needs change. The registered person must ensure that action is taken to address health concerns expressed by residents. The registered person must ensure that a protective barrier, such as railings, is fitted to the patio area. The registered person must submit a written report to the Commission detailing the remedial work that has been carried out as required by the fire officer. Timescale for action 09/12/06 2. YA19 13 (1) (b) 09/12/06 3. YA24 13 (4) 09/01/07 4. YA24 13 (4) 09/12/06 Merrymeet DS0000008353.V310812.R01.S.doc Version 5.2 Page 23 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 YA6 Good Practice Recommendations Residents should be encouraged to sign their care plans to provide written evidence that they agree to the contents. The registered person should consider researching developments in person centred thinking with a view to developing person centred care planning. Care plans should detail the reasons why decisions that restrict individuals rights to choice and freedom have been taken and by whom. Risk assessments should be further developed to include information on how risks are to be managed, such as the prevention of falls. The glass top on the coffee table in the annexe should be removed. 3. YA7 4. YA9 5. YA19 Merrymeet DS0000008353.V310812.R01.S.doc Version 5.2 Page 24 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.V310812.R01.S.doc Version 5.2 Page 25 - 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. 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