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Inspection on 22/08/05 for Merrywick Hall

Also see our care home review for Merrywick Hall for more information

This inspection was carried out on 22nd August 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Poor. 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 but made no statutory requirements on the home.

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

The service users like living at Merrywick Hall. The staff develop good care plans based on needs assessments. Service users and relatives are involved in drawing up the plans. The home has developed good relationships with the local community nursing team. A visiting nurse said, `This is a lovely home. My colleague or myself come in every week and look forward to coming. The staff are always helpful and if we leave any treatment instructions they are always carried out.` Service users feel they can approach staff and management to discuss their needs and wishes. One said, `If I want anything I ask whichever staff is on duty and they sort things out for me. If I wasn`t happy with things or something was worrying me I would speak to staff or Maggie (the manager)`. New staff receive induction training and within this mandatory training is incorporated including moving and handling.

What has improved since the last inspection?

Service users are occupied in meaningful activities and have been encouraged to participate in the local community in both paid work and voluntary work. The manager feels she has a deeper understanding of the protection of vulnerable adults and is very clear about what action she would take if required.

What the care home could do better:

Residents meetings had been held on a regular basis to ensure that residents are consulted on all aspects of their lives, however these had lapsed and the manager must ensure that they continue. Staff receive mandatory training to ensure they employ only safe working practices but there are no staff who hold the Learning Disability Award or an NVQ qualification and no staff are registered on these courses. The manager has not implemented training for staff in the Protection of Vulnerable Adults and this must take place to contribute to the continued safety of service users. In relation to health and safety, requirements were made that the manager must ensure weekly testing of the fire alarm and emergency lighting. The gas certificate was out of date and the manager must arrange retesting and forward a copy to the Commission. At the last inspection a requirement was made to carry out risk assessments for unguarded radiators. It was found that these were not in place although the manager stated radiator guards were due to be fitted next month. Risk assessments must be completed for any activity that has the potential to cause harm to service users.

CARE HOME ADULTS 18-65 Merrywick Hall 41 New Road Hedon East Yorkshire HU12 8EW Lead Inspector Ros Sanderson Unannounced 22 August 2005 09.30 am nd 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 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 Stationary 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. Merrywick Hall J53 J04 S19695 Merrywick Hall V244064 230805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Merrywick Hall Address 41 New Road Hedon East Yorkshire HU12 8EW 01482 899477 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Willerfoss Home Mrs Margaret Rose Scott Private Care Home 27 Category(ies) of LD - Learning Disability Mixed Gender 27 registration, with number of places Merrywick Hall J53 J04 S19695 Merrywick Hall V244064 230805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 24/2/05 Brief Description of the Service: Merrywick Hall is a care home providing personal care and accommmodation for up to twenty seven service users who have a learning disability. It is owned by Willerfoss Homes, which is a private company. The home is located in the town of Hedon that is situated on the border of Hull and the East Riding. It is close to all local amenities including shops, the post office, local pubs and gives access to local transport. The home comprises of a large detached property set in its own well maintained grounds and has been adapted and converted for use as a residential care home and a bungalow. There are fourteen single bedrooms and four shared rooms in the main house and the bungalow provides independent living accommodation for up to five. Wheelchair users are accommodated on the ground floor as there is no passenger or stair lift at the home. Merrywick Hall J53 J04 S19695 Merrywick Hall V244064 230805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place over six and a half hours including time spent in preparation. The inspection process involved talking and listening to service users and staff, looking around the home and looking at service user and staff records. Records relating to health and safety were also inspected. Time was spent observing activity within the home. The inspection focused on the majority of the key standards. The registered manager was available for the majority of the inspection and discussions took place with her throughout the inspection. At the end of the inspection the findings were discussed and agreed with the manager. What the service does well: What has improved since the last inspection? Service users are occupied in meaningful activities and have been encouraged to participate in the local community in both paid work and voluntary work. The manager feels she has a deeper understanding of the protection of vulnerable adults and is very clear about what action she would take if required. Merrywick Hall J53 J04 S19695 Merrywick Hall V244064 230805 Stage 4.doc Version 1.40 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. Merrywick Hall J53 J04 S19695 Merrywick Hall V244064 230805 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Merrywick Hall J53 J04 S19695 Merrywick Hall V244064 230805 Stage 4.doc Version 1.40 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 standard(s) 2 The home is aware, through the assessment process, of prospective service users needs and aspirations and the manager is able to assure service users that their needs will be met. EVIDENCE: All people expressing a wish to use this service have a full and comprehensive assessment carried out. The initial needs assessment is carried out by the care manager responsible and the homes assessment is in addition to this. Details of all people involved in the assessment are recorded and the service users are encouraged to sign this document to indicate agreement. This needs assessment is used to develop the plan of care for the service user. The manager stated that in the case of a new admission to the home she would visit them in hospital or their own home and give them information about the home. At this visit she would also complete the needs assessment. Families and friends are involved at this stage with the service users consent. Merrywick Hall J53 J04 S19695 Merrywick Hall V244064 230805 Stage 4.doc Version 1.40 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 standard(s) 6 &9 Residents are able to exercise choice and risk in their lives through their involvement and participation in the care planning process. EVIDENCE: Care plans are completed in detail with involvement from the service users and/or their families. The home operates a key worker system and service users spoken with knew whom their key worker was. The care plans are reviewed on a regular basis in addition to the annual care management review to ensure the plans continue to be relevant for the service user. Service users and their relatives / representatives are invited to the review’s and their views and wishes are recorded and taken into account. Resident’s wishes regarding activities are recorded and appropriate risk assessments are in place regarding these so that service user choices and wishes can be met safely. To make sure healthcare needs are met the manager and staff ensure the service users have access to other health professionals when required. The comments of a community nurse visiting the home were very favourable and are included later in this report. To aid the service users understanding of the care plans a recommendation is made that the care plans are developed in a pictorial format. Merrywick Hall J53 J04 S19695 Merrywick Hall V244064 230805 Stage 4.doc Version 1.40 Page 10 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 standard(s) 12,13,16,17 Service users lead busy and fulfilling lives within the home and the local community. Meals provided are of the service users choice and are varied and nutritious. EVIDENCE: The care plans showed that the service users are involved in a wide variety of their chosen activities. On the day of inspection many service users were out either at work or local day centres. Service users at the home appeared happy and occupied. One of the service users said ‘There is enough going on at the home to keep us busy’. They also stated that they enjoyed cleaning and tidying and kept their own bed-sit room clean and tidy. They also had taken responsibility for keeping the lounge clean. Another resident said ‘There is no time to be bored here, I really enjoy going out and joining in with things.’ A holiday has been planned which is an annual event where service users are given the opportunity to visit Spain. Some of the service users have been assisted by staff to gain employment or volunteer work in the local community. Merrywick Hall J53 J04 S19695 Merrywick Hall V244064 230805 Stage 4.doc Version 1.40 Page 11 The chef at the home consults with the service users about what meals are offered. He discusses the menu for the following week each week with service users who are able. He incorporates their wishes into the week’s menus. By choice the service users have a snack lunch and their main meal in the evening. Snacks and drinks are available at all other times. Service users living in the bungalow are encouraged to prepare their own snacks at lunchtime. The kitchen provides the main meal. Merrywick Hall J53 J04 S19695 Merrywick Hall V244064 230805 Stage 4.doc Version 1.40 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 standard(s) 18,19,20 Service users are cared for safely and in a manner in which they prefer and which promotes choice and independence. EVIDENCE: The care plans showed that individual routines, likes and dislikes had been recorded and were reviewed on a regular basis. The plans identified how service users liked to be supported and in discussions with staff it was clear that they were aware of individual needs and wishes. Routines in the home are very flexible allowing service users choice and control in their lives. The care plans clearly identify the health care needs of service users and it was evident on looking around the home that specialised equipment is available to care for service users and encourage independence. Aids and adaptations in the home also encourage service users to be more independent. Care plans showed that the advice and input of healthcare professionals is sought when required. A community nurse was visiting during the inspection and said, ‘This is a lovely home. My colleague or myself come in every week and look forward to coming. The staff are always helpful and if we leave any treatment instructions they are always carried out’ Merrywick Hall J53 J04 S19695 Merrywick Hall V244064 230805 Stage 4.doc Version 1.40 Page 13 Staff spoken with were very clear about health needs of the service users and advice given by professionals. The staff were observed interacting with service users in a way that promoted dignity and respect and encouraged service users to participate in conversations. Policies and procedures in place ensure that medications are stored and handled safely by staff. There are no service users that self medicate at this time. Merrywick Hall J53 J04 S19695 Merrywick Hall V244064 230805 Stage 4.doc Version 1.40 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 standard(s) 22 &23 People using this service feel they are listened to, safeguarded and their well being protected. EVIDENCE: Policies and procedures are in place to inform service users and relatives about the homes stance on dealing with complaints and allegations of abuse. There was an ongoing complaint at the home involving some neighbours. Residents meetings have been held in the past every six months, however these had lapsed. The last meeting was in December 2004. Service users spoken with said they felt they were listened to and able to have their say on a day-to-day basis. One said, ‘If I want anything I ask whichever staff is on duty and they sort things out for me. If I wasn’t happy with things or something was worrying me I would speak to staff or Maggie (the manager)’. Staff spoken with were very clear about the types of abuse that could occur. The manager was very clear on how she would deal with allegations of abuse should she receive one. The manager had received training on Adult Protection but had not yet cascaded this training to the care staff. Requirements were made in relation to arranging residents meetings on a regular basis and ensuring staff receive Protection Of Vulnerable Adults training. Merrywick Hall J53 J04 S19695 Merrywick Hall V244064 230805 Stage 4.doc Version 1.40 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 standard(s) 24&30 Merrywick Hall is a safe, pleasant place in which to live. EVIDENCE: Merrywick Hall is suitable for its stated purpose. Service users are accommodated on the ground floor if they have mobility problems as the home does not have a lift. Adaptations have been made to the home to encourage independence for service users. Furnishings are domestic in nature and well maintained. Service users bedrooms are personalised and individual. Service users living semi independently in the bungalow have the benefit of a safe, pleasant home in which to live. A recent visit from the fire officer had highlighted problems in the home in relation to fire prevention and these had all been actioned immediately. The laundry is sited away from the kitchen and dining room. The laundry equipment in the home meets requirements and the laundry area has impermeable flooring and walls that are easily washable. There are plenty of hand washing facilities around the home and staff have completed training in infection control. The home provides staff with personal protective clothing when necessary. Merrywick Hall J53 J04 S19695 Merrywick Hall V244064 230805 Stage 4.doc Version 1.40 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 35 Service users are supported well by staff. Staff would benefit from additional training. EVIDENCE: Service users are very appreciative of the staff at Merrywick Hall. The staff are very familiar and clear about the care needs of the clients. The safety of service users is ensured by the fact that all staff have completed mandatory training so only safe systems of work are carried out in the home. Each member of staff has regular supervision and appraisals that are used to identify and highlight training needs. Staff spoken with said that they feel able to approach the manager about any training they may wish to undertake relevant to their roles. Staff files showed evidence of induction training. There is a general reluctance among staff spoken with to undertake NVQ training. The home does not use the Learning Disability Award Framework to inform staff. There are currently no staff that hold an NVQ qualification. No progress in this area had been made since the last inspection. A requirement was made in respect of this. Merrywick Hall J53 J04 S19695 Merrywick Hall V244064 230805 Stage 4.doc Version 1.40 Page 17 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 42 Service users have their health protected. To ensure that their welfare and safety is protected the requirements made in this report must be addressed. EVIDENCE: The manager ensures that all staff receive training in moving and handling, fire safety, first aid and infection control so they care for service users safely. Staff receive induction training to ensure they are suitable to care for the service users. Safety certificates for equipment within the home are current and any requirements made had been attended to. The electrical wiring certificate and PAT certificate were current. COSHH requirements were maintained. Risk assessments are in place for safe working practices with the exception of unguarded radiators. The accident book showed that all accidents were recorded and reported under regulation 37 and RIDDOR requirements where required. Merrywick Hall J53 J04 S19695 Merrywick Hall V244064 230805 Stage 4.doc Version 1.40 Page 18 The gas safety certificate had expired in September 2004 and the weekly fire safety checks had not been completed since July 2005. Despite a requirement on the last report and receipt from the home of an action plan confirming the work had been carried out, risk assessments were not in place for unguarded radiators. The manager stated that radiator guards are due to be fitted next month. Requirements were made in respect of the above. Merrywick Hall J53 J04 S19695 Merrywick Hall V244064 230805 Stage 4.doc Version 1.40 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 ENVIRONMENT Score 3 1 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 x x x x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x x x 3 Standard No 11 12 13 14 15 16 17 x 3 3 x x 3 3 Standard No 31 32 33 34 35 36 Score x x x x 1 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Merrywick Hall Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score x x x x x 1 x J53 J04 S19695 Merrywick Hall V244064 230805 Stage 4.doc Version 1.40 Page 20 YES 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 23,35 Regulation 13(6) Requirement The registered manager must arrange for all staff to receive training in the Protection of Vulnerable Adults. The manager must encourage staff to undertake LDAF training and register on an NVQ training programme to ensure they are appropriately qualified. The registered manager must arrange regular residents meetings within the home to ensure that residents are consulted about day to day life and activities. A current gas safety certificate must be forwarded to the Commission The manager must carry out risk assessments for unguarded radiators and control measures put in place for identified risks. The registered manager must ensure that the weekly tests of fire alarms and emergency lighting is brought up to date and maintained. Timescale for action 1/11/05 2. 35 18(1(a)) 31/12/05 3. 42 16(m,n) 1/10/05 4. 5. 42 42 13(4(a)) 13(4(b)) 1/10/05 On receipt of this report. On receipt of this report and maintained thereafter. 6. 42 23(c(v)) Merrywick Hall J53 J04 S19695 Merrywick Hall V244064 230805 Stage 4.doc Version 1.40 Page 21 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 6 Good Practice Recommendations To aid service user understanding of the care plans the manager should consider developing the plans in a pictorial format. Merrywick Hall J53 J04 S19695 Merrywick Hall V244064 230805 Stage 4.doc Version 1.40 Page 22 Commission for Social Care Inspection Unit 4 Triune Court Monks Cross York YO10 4DQ 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 Merrywick Hall J53 J04 S19695 Merrywick Hall V244064 230805 Stage 4.doc Version 1.40 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. 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