Inspection on 28/06/06 for Meyrin House

This inspection was carried out on 28th June 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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.

Other inspections for this house

Meyrin House 24/02/09

Meyrin House 23/04/08

Meyrin House 14/06/07

Meyrin House 05/01/06

Meyrin House 13/06/05

Meyrin House 10/01/05

Meyrin House 02/08/04

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Claremont House

Oak Ridge

Sun Court Nursing Home

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Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Meyrin House 35 Hobleythick Lane Westcliff On Sea Essex SS0 0RP Lead Inspector Christine Bennett Key Unannounced Inspection 28th June 2006 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Meyrin House DS0000015456.V300772.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Meyrin House DS0000015456.V300772.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Meyrin House Address 35 Hobleythick Lane Westcliff On Sea Essex SS0 0RP 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) 01702 437111 Strathmore Care Miss Elizabeth Ann Hay Care Home 18 Category(ies) of Dementia (18), Old age, not falling within any registration, with number other category (18) of places Meyrin House DS0000015456.V300772.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 05/01/06 Brief Description of the Service: Meyrin House is a large house situated in Westclliff on Sea close to Southend Hospital. 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. It 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. It has good access to local bus routes. The home has an updated Statement of Purpose and Service User Guide, which are available in the entrance hall. A copy of the last inspection report is kept in the office. The current scale of charges as at July 2006 is between £345.31 - £497 per week. Extras charged are for hairdressing, chiropody, toiletries and newspapers. Meyrin House DS0000015456.V300772.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The key site visit was unannounced and took place on 28th June 2006 over a seven hour period. At this inspection all the key standards and the progress since the last inspection were assessed. A pre inspection questionnaire had been completed by the home prior to this visit, and 11 surveys sent to residents, of which 2 were returned, 12 to relatives, of which 1 was returned, and 4 to general practitioners and other health professionals, of which 1 was returned. The assistant manager was available throughout the day to assist with the inspection process. A tour of the premises took place and a random selection of records and policies were examined. Time was spent with the residents, observing care practices, and conversation took place with most of them. Staff were also given the opportunity to speak with the inspector. Feedback was given to the assistant manager at the end of the site visit. What the service does well: What has improved since the last inspection? Some redecoration has taken place and some furniture has been replaced. Meyrin House DS0000015456.V300772.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. Meyrin House DS0000015456.V300772.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Meyrin House DS0000015456.V300772.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,3,6 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. Lack of detail in the pre admission assessment does not identify if the home can meet individual needs. EVIDENCE: The Statement of Purpose and Service User Guide have been updated in April 2006 and contain the information that residents need to know before choosing to live at the home. These are displayed in the entrance hall to the home. An individual copy of the Service User Guide is not given prior to admission. A copy of the last inspection report is stored in the office. The company head office arranges the admission of residents to the home. The company has recently introduced a revised form. This allows for more information to be recorded and a better assessment of whether the home can meet individual needs. The pre admission assessment was looked at for three residents that had recently been admitted to the home but none of them had enough information recorded to confirm that their needs could be met. The Meyrin House DS0000015456.V300772.R01.S.doc Version 5.2 Page 9 deputy manager said that the home often only obtains this information on the day of admission. Residents and their relatives are given the opportunity to visit the home before they are admitted where possible. One resident’s survey felt that enough information was given before moving in whilst the other commented, “ I was transferred from the hospital without any prior permission or inspection of facilities available or families mutual consent until after installation”. Meyrin House DS0000015456.V300772.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. Care plans do not always have the information recorded to ensure individual needs are met. Medication procedures protect the residents. EVIDENCE: The care plans were looked at for three residents who moved into the home since the last inspection. The completion of these forms had improved but there were shortfalls in the recording of some information. There was no evidence to show that the resident or their relative had been involved in the planning of care or any reviews, although a relative replied in the survey that they are consulted about the care and this issue had been discussed at a staff meeting in June 2006. The registered provider is in the process of formulating a new plan and is incorporating the views of other health professionals before this plan is implemented. It is intended to be a more comprehensive document for staff to use. Meyrin House DS0000015456.V300772.R01.S.doc Version 5.2 Page 11 All residents have access to local health care services, including GPs, district nurses, continence advisors, opticians and dentists. A chiropodist who is a regular visitor to the home said that the staff are always responsive to any medical liaison he has requested, and the residents are well cared for. A home visit was requested from the GP during the site visit for a resident who was unwell and they attended promptly. One resident survey was happy with the care provided, stating they always receive the care and support they need and staff are always available. The other one felt that staff were sometimes available and sometimes listened and acted on what they said. It also commented that staff interaction with residents is very poor. Staff spoken with had a very good knowledge of each resident and their individual needs and residents spoken with at the site visit said they were happy with the care given. The home has a medication policy and procedure. Evidence must be available that these are reviewed and updated regularly. Medication was stored and recorded correctly on three random records. Staff who administer medication had received accredited training within the last year. The home has an allocated visitors room if privacy is required when relatives visit. Any post received by the home is given to the residents unopened and there is a telephone in the hall if they wish to make a private telephone call. One of the care staff was seen to knock on a bedroom door before entering the resident’s room. Shared rooms have screening to give privacy and maintain the dignity of individuals when personal care is given. Meyrin House DS0000015456.V300772.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. Staff provide any activities depending on their time and ability but there are still long periods when residents are not occupied/attended. EVIDENCE: The manager has attended a training session relating to activities and there is an activities sheet displaying what activities are taking place. The home has recently purchased a new video recorder and plans are in place for a singer to come into the home and a summer barbecue has been organised with relatives invited. Two parties had recently taken place celebrating a wedding anniversary and the cup final. The assistant manager explained that, due to their frailty, a lot of one to one activity is done, mainly chatting to residents about old times. At the site visit, most residents sat in the lounge with the television on. During the afternoon a member of the care staff spent time with a small group of people singing with them, although a television was on nearby. Residents can spend long periods alone when staff are busy with other tasks. A church service is held once a Meyrin House DS0000015456.V300772.R01.S.doc Version 5.2 Page 13 month, and the mobile library visits, but residents do not have the opportunity to go on outings unless their relatives are able to take them. The garden is not secure and is therefore unable to be used by the residents. The registered provider had stated that a plan relating to the garden would be submitted in the summer of 2005 but this has not happened. This area was discussed with the operations manager, who visited during the site visit. Of the two surveys received back from residents, one was happy with the activities offered by the home and the other said that there were sometimes activities that they can take part in. The residents were complimentary about the food that is given and during the site visit a lunch of roast chicken, potatoes and two vegetables, with an alternative of omelette and chips was offered. It looked appetising and any assistance needed was given sensitively. Nutrition charts are kept to record the food eaten. Both surveys stated that they were happy with the food offered, although one mentioned that fresh fruit is not made available. Meyrin House DS0000015456.V300772.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are protected by the home’s complaint procedure and staff knowledge of POVA. EVIDENCE: The complaints procedure is presently under review by the Company. One complaint has been received by the home since the last inspection. This had been investigated by an outside consultancy and had remained unresolved. It had been recorded in the complaints book, although the outcome had not been written. The home also has a compliments book and cards and letters were seen from past residents and relatives, thanking the home for care given. There have been no POVA issues at the home since the last inspection. A new member of staff had a good knowledge of forms of abuse and how to report it. She said that it had been covered as part of her induction. Meyrin House DS0000015456.V300772.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,26 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. Some areas of the home do not provide a safe environment for the residents. EVIDENCE: The registered provider has made some improvements to the home since the last inspection. These include a keypad entry system, some new beds and bedspreads, some new lounge chairs and two new dining tables and chairs. The dining room, lower hall and office have been painted. There are still areas in the home that are looking “tired” and furniture in individual and communal rooms that needs to be replaced. The garden area is not secure and residents are unable to use it unless staff are available. At the site visit, the patio door leading to the garden was open and at times there were no members of staff present. This could be hazardous to residents. Meyrin House DS0000015456.V300772.R01.S.doc Version 5.2 Page 16 The laundry area has no safe working practice information readily available to give staff instructions on the temperatures to be used for soiled linen and procedure to follow for infection control. The deputy manager was able to describe the process satisfactorily. Gloves and aprons are not kept in the laundry, although there is liquid soap and paper towels. The deputy manager explained that these are kept elsewhere and fetched when needed. The bin in the laundry did not have a lid and dirty gloves were exposed, posing a risk of infection. The home was very clean and there were no unpleasant odours in the communal areas of the home. Several bedrooms had offensive odours of urine. Odour control was discussed with the operations manager. Meyrin House DS0000015456.V300772.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to the service. The home needs to show improvement in recruiting, deployment of staff and staff training in order to improve the outcomes for people using this service. EVIDENCE: Staff records were examined for two members of staff who had been recruited since the last inspection. There were shortfalls on these files. One had no references on file, although there was evidence that these had been sent for. Both of these files evidenced that a POVA 1st had been received after the employment commencement date. Staff spoken with said that the atmosphere in the home has improved. One member of staff said that she thinks there are enough staff and the care is good. She described a thorough induction programme and had a very good knowledge of individual residents. She was very knowledgeable on the needs of residents with dementia and ways to improve their life. Five care staff have achieved NVQ level 2 or above and two have recently commenced NVQ level 3 training. Staff were very positive about the training Meyrin House DS0000015456.V300772.R01.S.doc Version 5.2 Page 18 programme available to them. The company has a training officer who identifies training needs of staff. The staff rota was examined and it identified that some staff are working more than 60 hours a week. The home has been sent a memo by the director of the company to ensure that staff do not work excessively long hours. There are also periods on some evenings when there are only two members of staff on duty from 6. 15pm onwards. The home must review the dependency of the residents and ensure there are enough staff at all times to meet their needs. The duty rota should accurately reflect the hours worked by each staff member, this refers to staff who work in more than one home where shifts overlap. Meyrin House DS0000015456.V300772.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,36,38 Quality in this outcome is adequate. This judgement has been made using available evidence including a visit to this service. The manager provides stability to the home but must develop the quality assurance programme to evidence that the home is run in the best interests of the residents. EVIDENCE: The manager has achieved her NVQ 4 in care and management and attends ongoing training in order to maintain her skills. She is supported in her role by a deputy manager. At a previous inspection she had felt unable to carry out all her managerial tasks, due to the necessity of working as a member of the care team on frequent occasions. As she was on holiday during the site visit, this will be followed up at the random inspection. Meyrin House DS0000015456.V300772.R01.S.doc Version 5.2 Page 20 The home does not hold residents/relatives meetings. The assistant manager explained that residents are spoken with on a one to one basis. These chats are not minuted. A quality assurance audit carried out by an external consultancy in May 2005 identified “the need for communication between residents and staff to improve through residents support meetings, and training for staff, to raise awareness that resident feedback represents an integral part of continuous improvement of care”. Staff meetings are held monthly and are minuted. Money held by the home for individual residents was checked randomly and was correct and the relevant records were accurate with receipts seen. Supervision is given to staff every two months and was evidenced in a staff file. Policies and procedures for the home are in the process of being reviewed and updated where necessary. The home has a good record of health and safety compliance. Seven members of staff hold a first aid certificate. Meyrin House DS0000015456.V300772.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 Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 2 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 1 X X X X X X 2 STAFFING Standard No Score 27 2 28 3 29 1 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 X 3 3 X 3 Meyrin House DS0000015456.V300772.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? YES 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 OP3 Regulation 14 Requirement The registered person must ensure the needs of a resident can be met by the home prior to admission. This refers to the completion of the assessment form and ensuring the home has all the information before a resident is admitted. This is a repeat requirement The registered person must review the care plan to reflect a residents changing needs. This refers to the inclusion of residents/relatives in any reviews and managing any risks. This is a repeat requirement Timescale for action 01/10/06 2. OP7 15 01/10/06 3. OP12 16(2)(n) The registered person must 01/10/06 consult the residents and provide facilities for recreation to increase their occupation. This is a repeat requirement The registered person must provide external grounds which DS0000015456.V300772.R01.S.doc 4. OP19 23 (2) 01/10/06 Meyrin House Version 5.2 Page 23 5. OP24 16(2)c are suitable and safe for residents. This is a repeat requirement The registered person must provide adequate furniture suitable to the needs of the resident. This is a repeat requirement The registered person must keep the home free of offensive odours and ensure safe disposal of waste. The registered person must ensure that at all times the home is staffed in such numbers appropriate for the health and welfare of the residents. This is a repeat requirement 01/10/06 6. OP26 16 (2) (k) 01/10/06 7. OP27 18(1)(a) 01/10/06 8. 9. OP29 OP33 Schedule 2 24 The registered person must 01/10/06 operate a safe recruitment system The registered person must 01/10/06 maintain a quality assurance system for reviewing and improving the quality of care provided by evidencing that the home is run to suit the residents. 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 OP1 Good Practice Recommendations The registered person should supply a copy of the Service User Guide to a resident before moving into the home to allow them to make an informed choice. DS0000015456.V300772.R01.S.doc Version 5.2 Page 24 Meyrin House 2. 3. OP16 OP37 The registered person should record the outcome of complaints The policies and procedures of the company should be regularly reviewed and updated. The manager has the time allocated to fulfill her managerial role. 4. OP31 Meyrin House DS0000015456.V300772.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection South Essex Local Office 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 DS0000015456.V300772.R01.S.doc Version 5.2 Page 26 - 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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