Care Home: Merrymeet

What the care home does well They ensure that they are able to meet the needs of people before they go to live at the home. A detailed assessment process was available to identify people`s needs and wishes. Residents of the home told us that they were happy with the service they received and that they were encouraged and supported to make their own decision about their life. People are supported and encouraged to access educational facilities and have a presence in the local community. People`s needs are met by a team of staff who are knowledgeable about their needs and wishes. The home provides a safe, clean and comfortable environment. Merrymeet is well managed and run in the best interest of the people living there. What has improved since the last inspection? They had made some improvement to the detail of the information recorded in individual risk assessments. They had fitted a rail around the outside patio to improve the safety of the area. Improvements have been made to how the service informs us about things that have happened in the home. What the care home could do better: No requirements have been made in this report. However, several good practice recommendations have been made relating to the health and personal care, staffing, the environment and the conduct and management sections of this report. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Merrymeet 5 & 7 Tootal Grove Salford Gtr Manchester M6 8DN     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Adele Berriman     Date: 0 1 1 1 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. 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. the things that people have said are important to them: They reflect 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. 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 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 28 Information about the care home Name of care home: Address: Merrymeet 5 & 7 Tootal Grove Salford Gtr Manchester M6 8DN 01617375606 Telephone number: Fax number: Email address: Provider web address: merrymeethome@yahoo.co.uk Name of registered provider(s): Name of registered manager (if applicable) Mr Peter Christopher Kelly Type of registration: Number of places registered: Mr Bradley Rawlinson,Mrs Joan Rawlinson care home 14 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia Additional conditions: Care staffing levels must not fall below the minimum levels specified by the previous regulatory authority The home accommodates a maximum of 9 younger adults requiring care by reason of mental disorder (excluding learning disability or dementia) and 5 named older people requiring care by reason of mental disorder (excluding learning disability or dementia). The home must, at all times, employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. When any of the named older people leave, the category of registration will revert to that of younger adults requiring care by reason of mental disorder. Date of last inspection Brief description of the care home Merrymeet is a care home providing personal care and accommodation for a maximum of fourteen adults with enduring mental ill health. The home does not specifically offer Care Homes for Adults (18-65 years) Page 4 of 28 Over 65 5 9 Brief description of the care home a rehabilitation service, although personal development and learning independent living skills are encouraged. The home is situated in the Eccles area of Salford, in a residential area. The premises are in keeping with the local community. The home is close to local facilities and public transport routes. At the time of inspection there were fourteen residents living in home. Care Homes for Adults (18-65 years) Page 5 of 28 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: three star excellent 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 carried out an unannounced visit to Merrymeet on Friday 31 October 2008. We arrived at 1045 hrs and left at 1820 hrs. During the visit we looked at a selection of records, policies and procedures including care plans, medication records and staff files. We spoke to five residents, two staff and the manager to gain their views on Merrymeet. Prior to our visit they completed an Annual Quality Assurance Assessment (AQAA). This assessment gave them the opportunity to tell us what they do well, what improvements they have made in the last twelve months and what their plans for Care Homes for Adults (18-65 years) Page 6 of 28 improvement were for the next twelve months. The AQAA included the information we asked for. Three people who live at Merrymeet and four of the staff team completed a survey form prior to our visit and told us their thoughts about the service. The cost of the service is between 450 and 695 pounds per week. 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 set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 28 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 28 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. People can be assured that their needs are assessed before they move into Merrymeet to ensure that their needs to be met in full. Evidence: They had a clear process for assessing peoples needs prior to them moving into the home. The assessment gave the opportunity to record peoples needs and wishes relating to their mental and physical health, their personal history, family structure, leisure and social contacts, mobility, interpersonal skills, cognition, religious preferences and their current medication. The pre admission assessment also considered known risks to people in their day to day life. They told us that once a persons needs had been assessed they would be invited to have a meal or if possible an overnight stay to get to know people and see if the home was suitable for them. Care Homes for Adults (18-65 years) Page 10 of 28 Evidence: We saw the needs assessment of one person who had recently moved to Merrymeet. The information was detailed and they told us that more information would be added as the person settled in. Care Homes for Adults (18-65 years) Page 11 of 28 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. Staffs awareness of individuals needs and lifestyle choices ensured that their needs were met. Evidence: We saw the care plans of four people resident at Merrymeet. They considered peoples specific needs and actions that needed to be taken to support these needs. The documents also recorded people individuals personal goals. The majority of the care plans contained detailed information about how peoples needs were to be met. One document that we saw contained information about an individuals specific behaviour. Information was not available about how the person should be supported when they demonstrated that particular behaviour. Detailed information about peoples support needs should be recorded to ensure that they receive the support they require at all times. Care Homes for Adults (18-65 years) Page 12 of 28 Evidence: They told us that peoples care plans were reviewed every three months or more often if a persons needs or wishes changed. It is recommended that a record of when care plans are reviewed and updated is maintained to demonstrate when a persons plan of care has changed. Staff told us that they are always given up to date information about the needs of the people they support. They told us that following the last inspection they had further developed how they record risks to individuals. Generalised risk assessments for all aspects of peoples day to day lives are carried out as part of the homes admission process. People living at Merrymeet told us that they were encouraged to participate in planning their care and support. We saw examples in some care plans of individuals having input into their care plan, for example, planning financial management. During the visit we saw staff interacting with people in a positive, empowering manner. They told us that the manager and staff encouraged them to make their own decisions in their lives. Care Homes for Adults (18-65 years) Page 13 of 28 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 encouraged and supported to access community based facilities. Evidence: People living at Merrymeet told us that they were encouraged to participate in activities within the home and in the local community. Several people accessed regular activities including photography, art and gardening. One person was attending a course on brick laying and another person participated in delivering local newspapers around the community. They told us that people had participated in the local Weaste in Bloom gardening competition and that they hoped to obtain a greenhouse so that people can garden throughout the year. Care Homes for Adults (18-65 years) Page 14 of 28 Evidence: Staff demonstrated a good awareness of what support people needed in maintaining their personal relationships. People living at Merrymeet told us that they can make their own decisions on what they do throughout the day, during the evenings and at weekends. They told us that staff listen and act on what they say. People had a front door key to enable them to go out and return when they wished. People told us that they liked the food at the home and that they had a choice of what they wanted to eat. One person had a role in maintaining the kitchen; he told us that he enjoyed participating around the home. Care Homes for Adults (18-65 years) Page 15 of 28 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. People had access to a range of community healthcare services to meet their needs. Evidence: Residents told us that they were able to make decisions about what they did throughout their day. Routines around the home were flexible and considered peoples specific needs on a day to day basis. Appointments with healthcare professionals were recorded and they told us support was given to people to attend appointments. We saw evidence that regular contact was maintained with peoples social workers, Community Psychiatric Nurses (CPN) and GPs. Residents spoken to during the visit told us that they always received the medical care and support they required. Policies and procedures were in place for the safe management and administration of medication. We saw that the majority of records were completed appropriately. On two Care Homes for Adults (18-65 years) Page 16 of 28 Evidence: occasions staff had failed to sign the records at the time of administering the medication and a message had been left for them to sign the records. To ensure that accurate records are maintained to demonstrate that people have had their medication, Medication Administration Records should be signed at the time of administration and not retrospectively. Care Homes for Adults (18-65 years) Page 17 of 28 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. Policies and procedures available protected people and gave the opportunity for them to raise concerns. Evidence: The home had a complaints procedure, a copy of which was readily available in the home. A system was in place for recording all concerns and complaints about the service. No complaints had been made within the last twelve months. People living at Merrymeet told us that they knew who to speak to if they were not happy and were aware of the complaints procedure. Staff also told us that they were aware of what action to take if a resident, their relative or their advocate raised concerns about the service. A copy of Salford Social Services safeguarding procedures was available at the home. Two safeguarding concerns had been raised within the last twelve months, both of which had been dealt with under these procedures. They told us that they were in the process of planning awareness training in Salford Social Services procedures for all staff. Care Homes for Adults (18-65 years) Page 18 of 28 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. Merrymeet provides a safe, clean and comfortable environment for people to live. Evidence: A tour of some areas of the home took place. we looked at several bedroom, bathrooms, the kitchen and communal living areas. We saw that bedrooms were personalised with peoples personal effects. The home was comfortably furnished to meet the needs of people. The service has a continual programme of redecoration and they told us that in the next twelve months they planned to landscape the garden to make it more accessible to people. The home was comfortably furnished to meet the needs of the people who live at Merrymeet. We saw that there was a gap in the designated fire doors leading to the smoking lounge. Advice should be sought from Greater Manchester Fire and Rescue Service on how to ensure that these doors would detain a fire if needed. In addition, advice should be sought from the local Environmental Health department about current Care Homes for Adults (18-65 years) Page 19 of 28 Evidence: legislation relating to a smoke free environment. We saw that the home was clean and tidy and people told us that the home was always fresh and clean. Laundry facilities were situated in the basement area of the home where people were supported by the staff team to manage their own laundry. We saw that some water pipe lagging was in need of repair. To minimise any risks to peoples health and safety. Care Homes for Adults (18-65 years) Page 20 of 28 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 can be confident that staff have the skills to meet their needs appropriately. Evidence: We saw staff supporting people in a non-discriminatory supportive manner. The manager and staff demonstrated a good awareness of peoples needs and wishes and had a good understanding of supporting people with mental health needs in a social care setting. Peoplewho live at Merrymeet told us that staff always treat them well. One person told us that the staff were wonderful and kind. Staff told us that their induction into their role covered everything they needed to know to do their job when they started. One member of staff wrote everything I needed to know was covered and explained to me in a proper manner. I am now doing my National Vocational Award (NVQ) 2 to cover all aspects of the job I am doing. They told us that the majority of staff had completed an NVQ level 2 or above award. Staff told us that they were being given training that was relevant to their role, that helps them understand and meet the individual needs of people and that keeps them Care Homes for Adults (18-65 years) Page 21 of 28 Evidence: up to date with new ways of working. They told us that they regularly reviewed the number of staff on duty to ensure that peoples needs can be met at all times. We looked at the files of three staff who had been recruited since the last key inspection. We saw evidence that they were ensuring that appropriate Criminal Record Bureau checks were being carried out prior to the person starting their role. We saw completed application forms on staff files. Two of the forms had not been completed in full with details of previous employment. They should ensure that a full record of a persons employment history is made available. In addition, several references were seen that were addressed to to whom it may concern. It is recommended that all references received are addressed to the person requesting the information to ensure that validity of the information. Care Homes for Adults (18-65 years) Page 22 of 28 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 excellent 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 in the best interests of the people who live at Merrymeet. Evidence: The manager had suitable qualifications and experience for his role. He demonstrated a clear understanding of the needs of the service and it was evident that there were close working relationships with the staff team. They completed an Annual Quality Assurance Assessment which told us about what improvements the service planned to make in the next twelve months. The ethos of the home was very much centered on the needs of the people living at Merrymeet. They gain the views, ideas and requests of individuals on a regular basis to improve the service. Policies and procedures were in place to promote the health, safety and wellbeing of all. Up to date information relating to the servicing of utilities was not available at the Care Homes for Adults (18-65 years) Page 23 of 28 Evidence: home. This information should be available at all times to ensure that appropriate monitoring of services can be carried out. We saw that weekly checks were being carried out on fire detection equipment. The temperature of the hot water was being monitored on a monthly basis. It is recommended that the temperature of hot water is monitored on a weekly basis so that any problems can be detected. Care Homes for Adults (18-65 years) Page 24 of 28 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 28 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 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 6 To ensure that people receive the support they require at all times, care plans should contain detailed information about how people need to be supported when they demonstrate alternative behaviour. To ensure that all information is up to date a record of all care plan reviews should be maintained. 2 20 To ensure that accurate records are maintained of what medication has been administered, records should not be completed retrospectively. Advice should be sought from the local Environmental Health department about the current legislation relating to a smoke free environment. Advice should be sought from Greater Manchester Fire and Rescue Service about ensuring the that the door leading to the smoke lounge would operate appropriately if required. Pipe lagging in the basement area of the home should be replaced. Information relating to previous employment should be fully demonstrated on application forms to ensure that the employer is fully aware of the persons employment history. To ensure their validity, all completed reference requests 3 24 4 24 5 6 30 34 Care Homes for Adults (18-65 years) Page 26 of 28 should be addressed to the person requesting the information. 7 42 To ensure appropriate monitoring of health and safety, information relating to the servicing of utilities should be maintained at the home. To reduce risk, the hot water temperatures in the building should be tested on a weekly basis. 8 42 Care Homes for Adults (18-65 years) Page 27 of 28 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. 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