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Inspection on 13/06/05 for Meyrin House

Also see our care home review for Meyrin House for more information

This inspection was carried out on 13th June 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report 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 staff at the home was all very positive about the training they receive at the home and one staff member commented, "training has improved tenfold". Visitors said they were able to come to the home whenever they want and were always made to feel welcome. Residents and visitors spoke very positively about the atmosphere and the care that was given in the home. A relative said, "it`s a lovely little home with a friendly atmosphere" and a resident said, "the staff are all very, very good, nothing is too much trouble".

What has improved since the last inspection?

The home has had magnetic closures put on some doors. These will automatically close if there was a fire, but it allows doors to be kept open and improve the ventilation in the home.

What the care home could do better:

An assessment is not always done by the home before admission to see if it will be suitable to meet somebody`s care needs, and although residents and visitors are very happy with the care they are receiving, it was not always clearly written in the care plans. Some items of furniture are worn and need replacing, and the kitchen units need repairing. The back garden cannot be used by the residents, as it needs to be enclosed in order to make it safe, however the proprietor intends to submit a plan this summer for improvements to this area. Four bedrooms on the first floor had an offensive odour, one was a shared room. The manager is often needed to work as a carer and is then unable to do her managerial jobs. The activities in the home are dependant on the carers having time, and the residents confirmed that they don`t go out and have little entertainment apart from television.

CARE HOMES FOR OLDER PEOPLE Meyrin House 35 Hobleythick Lane Westcliff-on-Sea Essex SS0 0RP Lead Inspector Christine Bennett Unannounced Monday 13th June 2005 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 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. Meyrin House I56 I06 S15456 Meyrin V231582 130605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Meyrin House Address 35 Hobleythick Lane Westcliff-on-Sea Essex SS0 0RP 01702 437111 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) info@strathmorecare.com Strathmore Care Miss Elizabeth Ann Hay CRH Care Home 18 Category(ies) of DE Dementia (18) registration, with number OP Old Age (18) of places Meyrin House I56 I06 S15456 Meyrin V231582 130605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: The home may accommodate 18 people of either sex who fall into the catagory of Old Age or Old Age with Dementia. Date of last inspection 10th January 2005 Brief Description of the Service: Meyrin House is a large house situated in Westclliff on Sea close to Southend Hospital, and with good access to local bus routes. It has been tastefully converted for its current use, and provides accommodation on two floors for eighteen residents of either sex. The home is registered for older people and older people with dementia. The home has ten single and four double bedrooms, a large open plan lounge-diner with a small visitors/quiet area off the lounge area. There is a small patio and garden area and limited parking to the rear of the building. Meyrin House I56 I06 S15456 Meyrin V231582 130605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection on 13th June 2005, which took place over 9 hours. The inspection process included discussions with the manager, 3 members of staff, 1 agency staff, 1 district nurse, 3 residents and 5 visitors to the home, which included the local vicar and his assistant. A tour of the premises was undertaken and an inspection of sample records and policies. The inspector would like to thank everybody who was involved in the inspection process. What the service does well: What has improved since the last inspection? The home has had magnetic closures put on some doors. These will automatically close if there was a fire, but it allows doors to be kept open and improve the ventilation in the home. Meyrin House I56 I06 S15456 Meyrin V231582 130605 Stage 4.doc Version 1.30 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. Meyrin House I56 I06 S15456 Meyrin V231582 130605 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Meyrin House I56 I06 S15456 Meyrin V231582 130605 Stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3,6 Pre admission assessments are not always carried out which could mean an admission to the home could be unsuitable. EVIDENCE: Records examined and people spoken with gave varying accounts of admission to the home. Two visitors said that social services had organised the admission but nobody from the home had been to visit their relative to ascertain if their needs could be met. A member of staff confirmed that the assessment is often done after the resident has been admitted or sometimes information is telephoned to them with a written assessment arriving after admission. One visitor confirmed that although her relative had not had a pre admission assessment, he was admitted on a 4-week trial and then a review was held involving the family and social services. The home does not provide intermediate care. Meyrin House I56 I06 S15456 Meyrin V231582 130605 Stage 4.doc Version 1.30 Page 9 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8,9 Minor shortfalls in the completion of care plans could mean that the needs of a resident are not fully met. Medication policies and procedures are in place to protect the well being of residents. EVIDENCE: Individual care plans are kept and monthly reviews performed. Two care plans examined had failed to record significant changes to a resident’s needs. The monthly review had stated no change but one resident had been fully ambulant and was now being nursed in bed. This resident was also assessed as high risk for pressure sores but no plan was in place to manage this situation. Another care plan had failed to record that the resident had been referred to a physiotherapist and there was no risk assessment in place relating to pressure sores. The records did not reflect the quality of the care being given, which residents and relatives said was good. The district nurse was seen visiting the home and the home uses the services of 4 GP surgeries. One resident had recently seen the optician and the chiropodist visits the home on a regular basis. Medication procedures within the home were seen to be appropriate and accurate. Meyrin House I56 I06 S15456 Meyrin V231582 130605 Stage 4.doc Version 1.30 Page 10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13 Social activities should continue to be developed to improve the occupation of residents in the home. EVIDENCE: The local vicar was visiting the home and confirmed that he comes once a month to conduct a service with the residents. Staff confirmed that earlier they had been throwing a beanbag with residents. There is at present not a secure garden area for residents to sit in, and residents and visitors confirmed that they do not have outings. It was the birthday of one of the residents and although she received flowers from a relative and a staff member was seen to be sitting next to her, helping her open her cards, she had no visitors and sat in the lounge all day. One visitor said that she felt the residents would enjoy more music and visiting pets. Visitors confirmed that they are always made to feel welcome in the home and one said, “It’s a friendly place”. Another said that she could visit whenever she chooses and has been invited to lunch on occasions. Meyrin House I56 I06 S15456 Meyrin V231582 130605 Stage 4.doc Version 1.30 Page 11 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16,18 The complaints procedure is satisfactory. Appropriate arrangements are in place to protect residents from abuse. EVIDENCE: The home has a satisfactory complaints procedure. There have been no complaints since the last inspection. Staff had a good understanding of reporting abuse and they confirmed that they had received training in the Protection of Vulnerable Adults from Abuse. Visitors confirmed that staff are always kind to residents, one said, “I have never seen any nastiness”. Meyrin House I56 I06 S15456 Meyrin V231582 130605 Stage 4.doc Version 1.30 Page 12 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19,24,26 Improvements to furnishings and areas in the home would enhance the quality of the residents’ lives. EVIDENCE: A tour of the building revealed areas that need attention. The kitchen had cupboard doors missing and areas of damage to the work surface. Divan beds in the bedrooms were frayed and stained and some wardrobes and chairs were damaged and need replacing. The proprietor had recently appointed a Service Support Officer, who had already been to the home and was intending to remedy these areas of concern. Generally the home was very clean, but there were 4 bedrooms on the upper floor, which had an offensive odour. One of these was a shared room, where one resident was incontinent and the other was not. The manager said that she does not have a carpet shampooer in the home and has to borrow one from other homes, and therefore cannot clean the carpets as often as needed. The front garden is laid to lawn but fronts a busy road and is opposite a boys’ school, therefore is not suitable for the residents’ use. The rear garden has mainly been concreted to provide parking Meyrin House I56 I06 S15456 Meyrin V231582 130605 Stage 4.doc Version 1.30 Page 13 in this very busy area. A small area has been set aside for residents’ use but it has not been developed and is not enclosed. The proprietor has confirmed that a plan will be in place this summer for development. The laundry area has no individual baskets for residents’ clothes and clothes are not labelled, therefore this can cause confusion with sorting clothes. The manager said she would like masks and a sealed macerator provided in the sluice area to prevent cross infection. Meyrin House I56 I06 S15456 Meyrin V231582 130605 Stage 4.doc Version 1.30 Page 14 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,28,29,30 Staff recruitment procedures are good offering protection to residents. Staffing levels available at times are not sufficient to meet residents’ needs. Staff training is provided in a planned way to give them the skills to care for residents in the home EVIDENCE: The home employs a cook and a housekeeper but there are times when the care staff have to undertake these chores in their absence. They are also responsible for the laundry and any activities in the home. The manager confirmed that there are times when she is not able to be supernummary to fulfil her managerial role. It was noticed that when the care staff were assisting people to their bedrooms, the residents in the lounge were left unattended for a long period. Some members of staff are working very long hours and the manager was advised to monitor this situation to ensure it was not detrimental to staff health or residents’ care needs. The files of 2 members of staff were studied and they evidenced that a robust recruitment process was being followed which protects the residents. The home provides a thorough induction programme and training opportunities for staff. One staff member has NVQ level 3 and 3 have just had confirmation of their acceptance to do NVQ level 3 with another 2 waiting for confirmation. The manager was able to confirm future training opportunities for staff including nutritional needs of the elderly, pressure area care, infection control and grief and mourning. Not all training files had been completed, and this must be addressed. Meyrin House I56 I06 S15456 Meyrin V231582 130605 Stage 4.doc Version 1.30 Page 15 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32 The home has a manager who provides leadership to staff to ensure residents receive consistent good care EVIDENCE: The manager has worked at the home for 6 years and been in post for 4 years. She has completed her NVQ level 4 and is an NVQ assessor. Staff spoken with said that they found the manager approachable. One staff member said, “the manager likes people to use common sense”. Residents and visitors confirmed that they felt confident that any concerns would be sorted out. Meyrin House I56 I06 S15456 Meyrin V231582 130605 Stage 4.doc Version 1.30 Page 16 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 2 x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 x 15 x COMPLAINTS AND PROTECTION 2 x x x x 2 x 2 STAFFING Standard No Score 27 2 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 3 x x x x x x Meyrin House I56 I06 S15456 Meyrin V231582 130605 Stage 4.doc Version 1.30 Page 17 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 3 Regulation 14 Requirement The registered person shall ensure the needs of a resident can be met by the home prior to admission The registered person shall review the care plan to reflect a residents changing needs The registered person shall provide facilities for recreation to increase the occupation of residents The registered person shall provide adequate furniture suitable to the needs of the resident The registered person shall keep the home free from offensive odour The registered person shall ensure the premises are kept in a good state of repair both internally and externally The registered person shall ensure that at all times the home is staffed in such numbers appropriate for the health and welfare of residents Timescale for action 1/8/05 2. 3. 7 12 15 16(2)(n) 1/8/05 1/10/05 4. 24 16(2)c 1/10/05 5. 6. 26 19 16(2)(k) 23(2)(b) 1/8/05 1/10/05 7. 27 18(1)(a) 1/8/05 Meyrin House I56 I06 S15456 Meyrin V231582 130605 Stage 4.doc Version 1.30 Page 18 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. 3. 4. 5. Refer to Standard 9 16 23 30 36 Good Practice Recommendations The registered person attach a picture of the resident to MAR sheets for easy recognition The complaints procedure is updated to include details of CSCI The shared bedroom facilities have residents with equal dependencies in them The registered person should ensure that individual staff training records are accurate and up to date The registered person should develop supervision and the recording of supervision with staff Meyrin House I56 I06 S15456 Meyrin V231582 130605 Stage 4.doc Version 1.30 Page 19 Commission for Social Care Inspection Kingswood House Baxter Avenue Southend-on-Sea Essex, SS2 6BG 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 Meyrin House I56 I06 S15456 Meyrin V231582 130605 Stage 4.doc Version 1.30 Page 20 - 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!