Inspection on 10/07/07 for Murreyfield House

This inspection was carried out on 10th July 2007.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Murreyfield House 07/07/08

Murreyfield House 20/07/06

Murreyfield House 12/01/06

Murreyfield House 18/08/05

Murreyfield House 24/02/05

Murreyfield House 21/04/04

Murreyfield House 18/03/04

Similar services:

Snydale Care Home

Abbey The

Larchfield Manor

Hawkhills

Beeches The - North Yorkshire County Council

The Grove Waltham

Carentan House

Ravensworth Lodge

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

CARE HOMES FOR OLDER PEOPLE Murreyfield House 342-344 Beverley Road Hull East Yorkshire HU5 1LH Lead Inspector George Skinn Key Unannounced Inspection 10th July 2007 09:30 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 Murreyfield House DS0000000863.V345310.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. Murreyfield House DS0000000863.V345310.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Murreyfield House Address 342-344 Beverley Road Hull East Yorkshire HU5 1LH 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) 01482 492778 01482 470084 Carol Lesley Olive Murrey Mrs Ann Elizabeth Murrey Care Home 23 Category(ies) of Dementia - over 65 years of age (23), Old age, registration, with number not falling within any other category (23) of places Murreyfield House DS0000000863.V345310.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 20th July 2006 Brief Description of the Service: Murreyfield is one of two homes privately owned by Carol Murrey and is part of a small family run business with a sister home in Cottingham. Murreyfield was originally two terraced townhouses that have been converted into a care home. The home is registered to care for up to 23 older people of either gender, who may also suffer from dementia. Accommodation is on three floors with 9 double and 5 single rooms. Communal space consists of a 3 separate lounges and an open plan lounge/dining area. There is an enclosed patio/garden area to the rear of the home. Murreyfield is situated on Beverley Road approximately 1 mile from Hull city centre. Nearby are local shops, pubs, churches and the home is on a major bus route into Hull. There is some available car parking to the rear of the home and on nearby side streets. The current scale of charges are £287.50-£368.50 per week. Additional charges include hairdressing, chiropody, magazines, papers, toiletries and taxis when requested. Murreyfield House DS0000000863.V345310.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced site visit undertaken over 8 hours. Prior to the inspection surveys were obtained from service users, relatives, staff and some health care professionals. During the site visit service users and staff were interviewed, records were looked at and the building was inspected. A special observation was undertaken which looked closely at a group of service users for a 2-hour period; this was to look closely at their lives and the way the staff interacted with them. What the service does well: What has improved since the last inspection? The home has improved the way the laundry is handled to make sure that service users clothes are not lost. The home now makes sure that the service users receive the right medication at the proper time. Murreyfield House DS0000000863.V345310.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. The summary of this inspection report can be made available in other formats on request. Murreyfield House DS0000000863.V345310.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 Murreyfield House DS0000000863.V345310.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. JUDGEMENT – we looked at outcomes for the following standard(s): 3&6 People who use this service experience good quality outcomes in this area. Service users needs are assessed prior to moving into the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: All service users have an individual file, a sample of these were looked at and contained evidence of assessments being undertaken by the placement officer and the home. The assessment undertaken by the home forms the basis of the service users’ care plans. Following the last inspection it was recommended that the Statement of Purpose is made available to the service users; this has now been addressed by the home and relatives and some service users confirmed that they had received information prior to moving into the home. The home does not admit service users for intermediate care. Murreyfield House DS0000000863.V345310.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, & 10 People who use this service experience good quality outcomes in this area. All service users have a plan of care. Service users are assisted to make decision about their lives Service users are protected by the homes policy and procedure for handling medication. Service users are treated with dignity and respect. This judgement has been made using available evidence including a visit to this service. EVIDENCE: All service users have a plan of care and those looked at contained written evidence of reviews and risk assessments. Evidence of service user involvement in formulating care plans was variable some contained signed agreements with the service user or their representatives; others contained no evidence of agreements. Murreyfield House DS0000000863.V345310.R01.S.doc Version 5.2 Page 10 The care plans contain information on how to met the needs of the service users on a daily basis. These also contained information on how service users’ quality of life was to be enhanced and any goals achieved for daily living. Daily entries were made for each service user along with monthly key worker up dates. These routinely documented the well-being of the service user, these reflected their changing needs and indicate how the care plan had been changed. Risk assessments were in place; these focused on keeping the service users safe and did not reflect any aspirations or personal development. There was evidence that the risk assessments were updated on a regular basis. Risk assessments for the use of bed-rail were not based on current good practise and legal requirements. These were mainly agreements with relative as to the use of bed rails and did not fully ensure the safety of the service users. The home’s handling of medication was seen to be of an acceptable standard, there was a clear audit trail of medication. Following the last inspection the home were required to improve the delivery of medication to ensure that service users received medication on time; this has been addressed and systems have been put in place to ensure service user receive medication on time. Staff have received training with regard to administering medication, this was via the Hull collage and Social Services. Observation made indicated the staff treat the service users with respect and their dignity was upheld. Shared rooms are fitted with privacy curtains and staff were observed to take service users to their rooms if they needed any personal tasks undertaking. Murreyfield House DS0000000863.V345310.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 People who use this service experience adequate quality outcomes in this area. Generally service user are stimulated however those with dementia or complex needs are left for long periods un-stimulated. Service users are enabled to maintain contact with relatives and friends. Service users are able to exercise control over their lives. Service users are provided with a good provision of food. This judgement has been made using available evidence including a visit to this service. EVIDENCE: As part of the site visit a Short Observational Framework for Inspection (SOFI) was undertaken. This is a special tool which is used periodically by the CSCI to assess the quality of the interaction between the staff and the service users. The SOFI is split into 5-minute time frames over 2 hours; areas focussed on are the wellbeing of the service users, engagement and staff interaction. The Murreyfield House DS0000000863.V345310.R01.S.doc Version 5.2 Page 12 decision to use the SOFI was because of the allegations made as part of the safeguarding adults referral about the lack of stimulation for the service users. The SOFI was undertaken in one of the lounges, and four service users chosen at random were observed over a 2-hour period. The lounge was comfortable and decorated to a reasonable standard. There were enough chairs for all service users to be seated comfortably. The lounge was used as a main thoroughfare to access other part of the building. Over the two-hour period those service users state of wellbeing was mainly positive, the rest of their time was split between being passive and sleeping; there was a small period of time when service users were withdrawn. During the observation the instances of staff interaction was good. Examples of this were staff talking with service users, ensuring their comfort and reading newspapers and magazines together. There was instances poor interaction. Examples of this were staff asking question and not waiting for a reply, giving service user a cup of tea but not telling them it was there. There were instances of negative/neutral interaction. Examples of this were asking in general if service users were ok but again not waiting for an answer. Over all the interaction was task orientated and mainly revolving around taking service users to the toilet and giving drinks. There were a few examples of meaningful interaction where staff were genuinely interested in the service users, speaking about their lives and experiences and talking about relatives visits. There were instances during the two-hour period where service users were not engaged with anything or anybody, one service user was not spoken with or interacted with anyone during the entire two-hour period. There were some examples of service users interacting with other service users and these were good. There were a few instances of staff using the lounge as a thoroughfare and on some occasions walked through the lounge without speaking to any of the service users. During the site visit the activities worker was on duty, she was observed to take service users to the shops and doing service users’ nails. When spoken with she stated that the service users mainly chose activities and she arranged group activities. Murreyfield House DS0000000863.V345310.R01.S.doc Version 5.2 Page 13 There was no evidence that the home provide any specialist stimulation to met the needs of those service users with complex needs or those service user with dementia. Observations made during the site visit indicate that the quality and quantity of the food was good. Service users spoken with confirmed their satisfaction with the food provided comments included “the food is very good always plenty of it” “there is always a choice especially at tea time”. Observation indicated that staff assisted service users sensitively and appropriately letting the service user set the pace and sitting at eye level. Observation made during the site visit indicated that visitors are made welcome to the home. Those relatives spoken with confirmed they were made to feel welcome and were consulted on a regular basis by the home about the care of their relative. Murreyfield House DS0000000863.V345310.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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 People who use this service experience adequate quality outcomes in this area. Service users’ knowledge about the homes complaint procedure was variable. Service users are generally protected from abuse but lack of knowledge amongst the staff leaves service users vulnerable. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a complaints procedure and this is included in the statement of purpose and the service user guide. All the service users are given the same information regarding the home’s complaint procedure, when interviewed some could remember this and others could not. Relatives spoken with confirmed that they were aware that home had a complaints procedure and they were aware of whom to complaint to. The home has a complaints log three complaints were recorded. One had been invested following information passed on via the CSCI, one had been received internally and one had been referred through the local authority safe guarding adults’ team. The home had dealt with the first two complaints in a satisfactory manner. The log indicated that the complaints had been recorded, what action the home Murreyfield House DS0000000863.V345310.R01.S.doc Version 5.2 Page 15 had taken and if the complainant was satisfied with the outcome. The home are waiting for confirmation of the outcome of the safe guarding adults investigation. Staff interviewed confirmed they knew that they had a responsibility to report any suspicion of abuse but knowledge on how this was achieved was variable. All staff knew they had to go to the manager but not all knew they could make a direct referral to the safe guarding adult team if the manager response was not satisfactory. The home has the East Riding of Yorkshire and Hull joint safeguarding adults procedure. Murreyfield House DS0000000863.V345310.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 People who use this service experience good quality outcomes in the area. Service users live in reasonably well-maintained environment. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home was generally clean and tidy. Service users’ rooms were clean and there were no malodours. There are two lounges for the service users to choose from but the majority stick to the same lounge. There is a seating area near the dining area and those service users who are more dependent on the staff to meet their needs sit in this area. Murreyfield House DS0000000863.V345310.R01.S.doc Version 5.2 Page 17 The majority of the accommodation in the home is in shared rooms there are no en-suite facilities. There was written evidence that the service users have agreed to share a room. The home has limited ability to accommodate those service users who do not whish to share, however, one service user has a double room to her self as she chose not to share. The home has an ongoing maintenance program but the work is reactive rather than proactive. Evidence was seen of work being done to the ceiling in the dining area following a leak in the flat roof. The deputy stated that this had been repaired provisionally and the repair had been dealt with through the insurance company. Following the last inspection the home was required to address the issues around laundry going missing and conduct an audit, this they have done and no concerns were raised about this during the site visit. Murreyfield House DS0000000863.V345310.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 People who use this service experience good quality outcomes in this area There are enough staff on duty to meet the service users’ needs The home’s recruitment procedure adequately protects the service users. Staff receive basic induction and mandatory training. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Evidence seen during the site visit indicated that there are enough staff on duty to met the needs of the service users; the home is complying with the minimum requirements set by the Department of Health for staffing levels in residential homes. Staff files looked at contained evidence of proper recruitment check in the form of a Criminal Records Bureau check (CRB) health checks and references. Records indicate that staff receive induction training and this was confirmed by the staff when interviewed. The staff also receive mandatory training and this is updated as required. Murreyfield House DS0000000863.V345310.R01.S.doc Version 5.2 Page 19 There was written evidence that the home have formulated a training plan aimed at developing staff skills through developmental interviews and opportunities to participate in out sourced training. There are more than 50 of the staff trained to NVQ level 2. Murreyfield House DS0000000863.V345310.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, & 38 People who use this service experience adequate quality outcomes in this area. There is weak evidence to indicate the home is run in the best interest of the service users. Service users are protected by the homes health and safety policies. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There was no evidence which would indicate that the registered manager has completed the Registered Mangers Award or up dates her knowledge and skills in line with the changing needs of the service users. Murreyfield House DS0000000863.V345310.R01.S.doc Version 5.2 Page 21 Evidence would indicate that the bulk of the daily running of the home is the responsibility of the deputy manager, who has completed the Registered Managers award. It is strongly recommended the registered person make application to the CSCI for the registration of the deputy as manager of the home. The home have a quality assurance system in place which seeks the views of service users; however there was very little evidence in the homes Annual Quality Assurance Assessment (AQQA), which the home are required to submit to the CSCI prior to the inspection, which would indicate there has been much planning in the future development of the service. The statements made in the AQQA are reactive rather than proactive and do not indicate a well thought out structured approach to the development of the home or the service it provides. The home has health and safety policies and procedure in place which the staff adhere to. Staff and service users spoken with stated that the deputy manager is approachable but they saw very little of the manager and thought the deputy was the manager. Murreyfield House DS0000000863.V345310.R01.S.doc Version 5.2 Page 22 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 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 X 3 X X 2 Murreyfield House DS0000000863.V345310.R01.S.doc Version 5.2 Page 23 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 OP7 Regulation 15 Requirement Timescale for action 30/03/08 2 OP7 3 OP8 4 OP12 The registered person must ensure that all service users’ care plans are agreed. This will ensure that all those involved in the care of the service users understands and agrees the actions to be taken. 15 The registered person must ensure that all service users’ care plans include a meaningful assessment of the service users’ emotional wellbeing. This will ensure that the service users’ personal goals and any aspirations will be met. 12, 13, 18 The registered person must & 19 ensure that the use of bed rails is in strict compliance with current codes of practice and legislation. This will ensure the homes compliance with current legislation and ensure the safety of the service users. 5, 12, 16 The registered person must & 23 ensure that there are opportunities for those service users with more complex needs or dementia to engage in meaningful activities. This will DS0000000863.V345310.R01.S.doc 30/03/08 30/09/07 30/11/07 Murreyfield House Version 5.2 Page 24 5 OP18 5, 13, 17, 18, 19, 20, 22 & 37 6 OP31 4, 5 18 & 18 ensure that those service users with dementia are not sat for long periods un-stimulated. The registered person must ensure that all the staff have received and understood safeguarding adults training. This will ensure that the service users are in safe hands and their wellbeing and safety is protected. The registered person must ensure that the registered manager is qualified and competent to run the home. This will ensure that the home is run in the best interests of the service users. 30/01/08 30/03/08 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 OP13 Good Practice Recommendations It is recommended that the use of the lounges as main thoroughfares is reviewed and the staff made aware of the implications of their actions in influencing the quality of life of the service users. It is recommended that the registered person submit an application for registration of the deputy manager as the registered manager. 2 OP31 Murreyfield House DS0000000863.V345310.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Hessle Area Office First Floor 3 Hesslewood Country Office Park Ferriby Road Hessle HU13 0QF National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Murreyfield House DS0000000863.V345310.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. 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