Care Home: Merryfield

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What the care home does well People are given information about the home, before they move in so that they can decide whether they want to live there. Records that explain how people like and need to be cared for are well written and understood by the staff team so that people`s needs are met. Medicines are well managed so that people receive their medication safely. People have lots of opportunities to make choices and decisions about their lives. The home is good at helping people stay in touch with friends and relatives so that people do not lose contact with those who are important to them. Independence is promoted so that people retain and develop their skills. Staff have training to help them understand how to offer care to people and meet their needs. There is a good system of employing new staff so that people who live in the home do not have unsuitable staff working with them. People who live in the home said good things about the staff team and enjoy their company. We were told, "The staff are brilliant, you can have a laugh with them and they`re cool". What has improved since the last inspection? The home had one recommendation made at our last visit, which was to review the way in which care files were arranged so that old and irrelevant information was stored separately to current and relevant information. This had been done which made individual records much easier to read. What the care home could do better: Areas in the bathroom and kitchen have not been repaired which does not look pleasant for people who live in the home. One care plan for managing a person`s health needs did not clearly explain how to do so, which could lead to the person not receiving the care and support they require. Key inspection report Care homes for adults (18-65 years) Name: Address: Merryfield 20 Merryfield Close Damson Wood Solihull West Midlands B92 9PW     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Julie Preston     Date: 1 3 0 8 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Adults (18-65 years) Page 2 of 27 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 27 Information about the care home Name of care home: Address: Merryfield 20 Merryfield Close Damson Wood Solihull West Midlands B92 9PW 01217117274 01217117274 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Damson Care care home 3 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: The maximum number of service users who can be accommodated is: 3 The registered person may provide the following category of service only: Care Home Only (Code PC); To service users of the following gender: Either; Whose primary care needs on admission to the home are within the following categories: Learning Disability (LD) 3 Date of last inspection Brief description of the care home The service at 20 Merryfield Close is provided in a domestic three bedroomed house in a residential area of Solihull. It is registered to provide care, support and accommodation to up to three adults with learning disabilities. The current service users are three men. There are no aids or adaptations in the home, as they are not required to meet the needs of the people who live there. Information is shared with people via house meetings, which take place on a regular basis. Local facilities and amenities are within walking distance of the home, with the main shopping area of Solihull also within reasonable distance by bus. Staffing is provided by a small staff team, with sleeping-in provision. Fees are varied according to peoples individual Care Homes for Adults (18-65 years) Page 4 of 27 Over 65 0 3 Brief description of the care home needs. The home can provide further information. Care Homes for Adults (18-65 years) Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: We spent half a day at the home. The people who live there and the staff were given limited warning that we would be visiting. This was done so we could be sure people would be in when we turned up. Before our visit took place we looked at information from the homes Annual Quality Assurance Assessment (AQAA) and any notifications (these tell us about any events that have happened which affect the well being of people) they had sent to us. We case tracked two people who live in the home. Case tracking includes meeting people and talking about the care they receive or watching staff supporting them, looking at their care records and medicines and the way that they are helped to make choices and decisions. This assists us to understand the experiences of people who live in the home. Care Homes for Adults (18-65 years) Page 6 of 27 We looked at records of staff training and recruitment, health and safety records and the food people are offered. We looked around the building to make sure that it was clean, warm and comfortable. We spoke in detail to one person living in the home and to the staff team on duty. The registered manager was available to answer our questions about the day to day running of the home. There were no immediate requirements made as a result of our visit. This means that there was nothing urgent that needed to be done to promote peoples health and well being. Care Homes for Adults (18-65 years) Page 7 of 27 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 27 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples needs are assessed before they move into the home so they can be confident that the home is suitable for them. Evidence: There have been no new people admitted to the home since our last inspection in 2007. Therefore we did not assess this key minimum standard and our judgement remains the same as in June 2007. Care Homes for Adults (18-65 years) Page 10 of 27 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples needs are clearly recorded in a plan of care so that staff have accurate information upon which to make sure those needs are met. People make choices and decisions about their lifestyles so that they maintain their independence. Evidence: We looked at care plans and risk assessments for two people that live in the home. These documents contain important information about the support people need within their day to day lives. Each plan clearly reflected peoples needs and had been reviewed within the last six months to ensure that the information was relevant to individuals current needs. Care plans that describe peoples assessed individual needs were linked to risk assessments that identified controls in place to minimise hazards and promote Care Homes for Adults (18-65 years) Page 11 of 27 Evidence: independence, such as making hot drinks, cooking and traveling independently. The staff that we spoke to demonstrated awareness of the support each person needs in their day to day lives and clearly know them well. People said that they were well supported to maintain and develop their independence. We were told, I feel more independent here than anywhere else. I go out when I want to. All the staff help me to help myself. From discussion with staff and looking at records it was evident that effort has been made to present information to people in a format that meets their needs. For example, pictures had been included in a care plan to describe the areas that a person needed help with. House meetings take place on a regular basis so that people are included in making decisions about the way their home is run. Care Homes for Adults (18-65 years) Page 12 of 27 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are consulted about their lifestyles and their independence in the home and community is promoted. Evidence: People told us that they have busy lives and take part in a range of activities each week both at home and in the community. Each person has a record that describes what their social and leisure interests are so that they can plan activities each week that they enjoy. Daily records showed that people had opportunities to go out and do things that interest them. Independence is promoted by the staff team and people are enabled to access some activities without staff support. This has been planned so that risks to individuals are identified and reduced. People told us that they really appreciated having the Care Homes for Adults (18-65 years) Page 13 of 27 Evidence: opportunity to maintain and develop their independence. Records sampled identified that people continue to be involved in household tasks, such as ironing, cooking and cleaning their bedrooms, which helps them to develop their skills and contribute toward the running of their home. Within care records it was evident that peoples cultural and religious needs had been considered. Staff provide support for individuals to attend local church services on a regular basis. One person told us that this was very important to him. People are supported to keep in touch with their friends and relatives. This is recorded so that staff understand how much support each person needs to maintain their relationships. One person said that he uses the house phone to call his friends and often sees them for a drink in the evenings at a local pub. People are included in shopping for food and preparing meals. Menus sampled showed that a range of food is offered consisting of fresh produce and favourites such as Sunday roasts. We were told that people are encouraged to cook for themselves where they are able to so that they do not lose skills that they have acquired. Care Homes for Adults (18-65 years) Page 14 of 27 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are effective systems in place to meet peoples personal and health care needs. Medicines are being well managed so that people receive their medication safely and as prescribed. Evidence: People continue to have good skills to manage their personal care, which was reflected in the care plans sampled. The assistance needed for each person had been clearly recorded within the plan and reviewed on a regular basis to ensure the information was accurate and consistent with individuals needs. A number of male staff are employed at the home, which is consistent with the gender of people who live there. The home has implemented Health Action Planning. This is a personal plan about what a person needs to stay healthy and what health care services they need to access. The plans sampled described how staff should support service users to maintain their health such as attendance at specific clinics, regular exercise and weight checks to Care Homes for Adults (18-65 years) Page 15 of 27 Evidence: record weight loss as part of a healthy eating plan. The health care records sampled showed that people had visited the GP, dentist, asthma clinic, psychologist and chiropodist as necessary and the contact had been documented so that staff were aware both of the reason for the appointment and the outcome. We saw records which showed that care plans had been reviewed each month describing any health care appointments and changes to peoples health care needs. Staff told us that this enabled them to keep up to date with the support individuals need to stay healthy and well. The home provides satisfactory secure storage for medicines. Staff have received accredited training in the safe handling of medicines to help them understand the importance of giving out medication safely. We looked at records and supplies of medicines for two people. There were no anomalies in medication records that may indicate medicines had not been given as prescribed. We looked at records for a person with diabetes. The care plan did not clearly describe the range of acceptable blood/sugar level readings, so that staff could respond appropriately if readings were outside the norm. There have been no medicines errors reported to us in the past twelve months, which indicates that medication is being well managed in the home. Care Homes for Adults (18-65 years) Page 16 of 27 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are procedures in place to enable people to raise concerns and complaints about the service. People are confident that any concerns or complaints will be taken seriously by the staff team. The home has policies, procedures and staff training which should protect people from the risk of harm and abuse. Evidence: There have been no complaints within the home or made to us within the last twelve months. People told us that they were aware of the procedure for making complaints and were confident that should they do so staff would take action to resolve matters. One person told us that he would raise any concerns or complaints directly with the manager but had never had reason to do so. The home has a procedure for safeguarding vulnerable people, which is made available to the staff team as part of their induction. Further training in safeguarding had been provided to staff this year. There have been no safeguarding issues raised on behalf of people living in the home Care Homes for Adults (18-65 years) Page 17 of 27 Evidence: within the last twelve months. One person said, I feel very safe here. Care Homes for Adults (18-65 years) Page 18 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a clean and pleasant environment that meets their needs and promotes their independence. Evidence: Merryfield is situated in the Damson Wood area of Solihull and is a short bus ride from the town centre. Public transport routes are nearby, which is important to people who live in the home as they use buses to access local amenities. The home has a quiet cul de sac location and looks no different to others in the street. Bedrooms are situated both on the ground and first floor of the home and there is adequate shared space for people to sit together in the lounge and kitchen/dining room. Since our last visit laminate flooring has been fitted on the ground floor, which staff commented was easier to keep clean and looked pleasant. The home has one bathroom, consisting of a bath with overhead shower, toilet and hand basin. The facilities meet the needs of the group of people currently living at Merryfield. A build up of mould growth was seen on the bathroom ceiling, which Care Homes for Adults (18-65 years) Page 19 of 27 Evidence: looked unsightly. The home was clean on the day we visited, with no odours that may indicate poor cleansing routines. We saw a copy of a report by Environmental Health officers made in August 2009 which referred to the need to repair a part of the kitchen wall and ceiling that had been damaged. There had been no progress to make such repairs on the day we visited. Care Homes for Adults (18-65 years) Page 20 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported by a well trained and competent team of staff who have good understanding of their individual needs. Recruitment procedures safeguard people who live in the home by ensuring only suitable staff are employed. Evidence: Six members of staff are employed at the home on a permanent basis. The AQAA (Annual Quality Assurance Assessment) completed by the registered manager prior to this fieldwork identified that three staff have achieved National Vocational Qualifications in care. This should contribute toward the deployment of a knowledgeable and skilled team of staff for the benefit of people who live at Merryfield. The recruitment records of the most recently appointed member of staff were observed. Checks of the persons suitability to work in the home had been made and the file contained evidence of a satisfactory Criminal Records Bureau check, references, completed application form and proof of identification. Training records showed that a range of opportunities had been provided to staff. Care Homes for Adults (18-65 years) Page 21 of 27 Evidence: Certificates were available to show that staff had completed training in health and safety, basic food hygiene, safeguarding, first aid and infection control. Training in diabetes care, epilepsy awareness and fire safety is planned for later in the year. This should contribute to the staff team having the skills and knowledge necessary to meet peoples needs and promote their health and well being. People made positive comments about the staff team. We were told, The staff are brilliant, you can have a laugh with them and theyre cool. Care Homes for Adults (18-65 years) Page 22 of 27 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well managed and peoples health and safety is promoted and protected. There are systems in place to listen to the views of people who live in the home and to develop and improve the standards of care provided. Evidence: The home has a registered manager who has professional qualifications that are appropriate to her role. The registered provider has owned Merryfield for over twelve years and has daily contact with the home. This person is a learning disabilities nurse. Both the manager and provider have many years experience in the field of social care. There are systems in place to review the quality of care provided in the home. Monthly health and safety audits are completed so that potential risks are identified promptly. Questionnaires had been issued to people asking for their opinion of the running of the home. We saw that the questionnaires had been designed with plain language and pictures to make them easier to understand for people who do not read. One person told us, We are involved in everything that goes on here. Care Homes for Adults (18-65 years) Page 23 of 27 Evidence: Other methods of assuring and monitoring the standard of care and service provided include frequent house meetings and monthly reviews of care plans, which include input from each person and their key worker. A number of checks are made to make sure that peoples health and well being is protected. We looked at some records that show this has happened. The smoke alarms had been tested on a regular basis to make sure that they were working properly. People had taken part in fire drills so that they had opportunities to practice leaving the building in the event of an emergency. the fire evacuation procedure was discreetly displayed in the home and people were able to tell us what to do in the event of the alarms sounding. Training records showed that all staff have taken part in health and safety training. This should contribute toward promoting peoples health and safety. The home does not currently test portable electrical equipment to made sure that items are safe for people to use. Care Homes for Adults (18-65 years) Page 24 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 25 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 42 23 Arrangements must be 10/11/2009 made to review the safety of portable electrical equipment. To make sure that electrical equipment is safe for people to use. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations 1 20 Care plans for people with diabetes should be reviewed so that they clearly state the action to take if blood/sugar levels vary from what is normal for the person. The maintenance programme should include plans to repair the damaged kitchen wall to comply with the recent Environmental Health report so that any risks to peoples health and safety are reduced. The maintenance programme should include removing the mould growth from the first floor bathroom ceiling so that people have a more pleasant environment in which to bathe. 2 24 3 30 Care Homes for Adults (18-65 years) Page 26 of 27 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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