Inspection on 03/03/08 for Generals Meadow

This is the latest available inspection report for this service, carried out on 3rd March 2008.

CSCI found this care home to be providing an Good service.

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

Generals Meadow 27/10/05

Generals Meadow 04/11/04

Generals Meadow 10/06/04

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOMES FOR OLDER PEOPLE Generals Meadow Generals Meadow St Clare Road Walmer Deal Kent CT14 7PY Lead Inspector Wendy Gabriel Unannounced Inspection 10:00 3 March 2008 rd 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 Generals Meadow DS0000023401.V359007.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. Generals Meadow DS0000023401.V359007.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Generals Meadow Address Generals Meadow St Clare Road Walmer Deal Kent CT14 7PY 01304 360965 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) Mr Robert Peacock Mr Robert Michael Peacock Mrs Elizabeth Peacock Care Home 19 Category(ies) of Old age, not falling within any other category registration, with number (19) of places Generals Meadow DS0000023401.V359007.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 12th February 2007 Brief Description of the Service: Generals Meadow is a large, detached house situated in a quiet residential area of Walmer and is close to Walmer Castle, the beach, and local shops. The towns of Deal and Dover are only a short drive away. The home is registered to provide care for up to 19 residents. Generals Meadow caters for older people who require a quieter lifestyle, with less organised activities. It is a non-smoking home. Mr. & Mrs. Peacock, the providers, have owned and managed the home for many years. Mrs. Peacock is the registered manager and takes overall responsibility for overseeing all of the care needs of the service users. Mr. Peacock oversees the maintenance and takes a part in the day-to-day running of the home. Mrs. Peacock has an assistant manager and a dedicated team of care and ancillary staff to help her. The home is beautifully maintained and presented in keeping with the style of the house. The front of the home is attractively presented. At the rear there is an attractive garden and patio area on two levels. There is parking in the quiet road to the front of the premises. Fees are in the region of £ 400. - £475. For further information please contact the provider. Generals Meadow DS0000023401.V359007.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means that the people who use this service experience good quality outcomes. The registered providers were on leave at the time of the inspection and the senior carer was in charge that morning. The assistant manager called in for the latter part of the inspection. Both members of staff were very helpful and organised. Some information held on staff files was not available as the registered provider holds them. Some records were looked at and cross-referenced with other documents, an accompanied tour of most of the premises was undertaken and a discussion with the assistant manager and senior carer took place. A relative and some residents also spoke to the inspector. The home was clean, tidy and very well presented. People living in the home were observed to freely access different parts of the home. One person said she had had a lie down that morning and that everyone was free to choose when he or she went to bed and get up. Recommendations made at the previous inspection had either been met or were in the process of being undertaken. What the service does well: What has improved since the last inspection? The home has started to review the care plans and has provided a clear and concise new format. The senior carer said that she had undertaken some of them with the individual residents to ensure they had an input into the contents of the plans. Handwritten entries in medication administration sheets are now countersigned. Adult protection training has increased and there was evidence of arranged courses for more staff to attend. Radiators have nearly all been covered and the remainder are due to be covered. The assistant manager and the senior carer confirmed that supervision is now undertaken but records were not accessible at the time. Generals Meadow DS0000023401.V359007.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. Generals Meadow DS0000023401.V359007.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 Generals Meadow DS0000023401.V359007.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. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents know they will be assessed prior to admission to be assured their needs will be met. EVIDENCE: The home undertakes pre admission assessments and will also use the assessments of the placing agency for people who are not privately funded. The newest resident was case tracked but the full pre-assessment was not available as it was in the registered providers own office. The assistant manager stated it had been undertaken Generals Meadow DS0000023401.V359007.R01.S.doc Version 5.2 Page 9 The assistant manager confirmed that visits are made to individuals in their own home or in hospital by the registered manager, to begin their assessment and that these will continue during a three month trial period. There are opportunities for residents or their representatives to visit the home before admission to assess its suitability for themselves. The statement of purpose and service users guide is available for prospective residents to make an informed choice about where to choose to live. The home does not undertake intermediate care. Generals Meadow DS0000023401.V359007.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10, Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents know their health, personal and social care needs are recorded and that their health needs are met. Residents are protected by medication policies and procedures. Residents feel they are treated with respect. EVIDENCE: Since the last inspection the home has reviewed the care plan format. Although not yet completed, the care plans seen were clear and readily available to staff. Some further detail is to be added to guide staff when undertaking different tasks for residents especially if risk related. The senior carer said that, where possible, individual residents sat with her whilst the plans were being reviewed. The senior said that residents or their advocates would be encouraged to sign the care plans when they are completed. Generals Meadow DS0000023401.V359007.R01.S.doc Version 5.2 Page 11 Medication storage is sound and policies and procedures protect the residents. Staff who have medication administration training are then supervised by a senior member of staff to make sure they are competent and confident. Following a recommendation made at the last inspection, hand written entries on the medication administration sheets the home are now countersigned. There were no gaps or anomalies in the medication administration records seen on this occasion. There was recorded evidence of involvement with health care professionals and the home monitors health care needs in care plans. Records confirm residents have access to a range of medical services. The home gives residents the opportunity to state if they would like nightly checks to their rooms and how often. One person living in the home said she could go to bed and get up when she preferred. She said she had had a lie in that day. When asked if the staff helped in the way the residents preferred, one person roundly commented, “Ooh yes”. It was noted that most residents were referred to by their title and a carer said this is the ethos of the home and only where a resident specifically asks to be called by their first name will this occur. Generals Meadow DS0000023401.V359007.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15,16, Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ know that their preferences are taken into account when activities are arranged. Residents know their rights and choices are promoted. Visitors are welcomed into the home. Menus are varied and take into account dietary needs. EVIDENCE: Although there is an activity person in the home for two afternoons a week, many of the residents prefer not to be part of organised activities. A visitor said that staff will try to encourage her relative to join in with a variety of activities but this was usually refused. A resident said that they preferred to spend time in their room. Preferences are recorded in individual care plans. Some people visit the local retirement centre and one person enjoys attending the local church. The home has use of a people carrier for excursions. Generals Meadow DS0000023401.V359007.R01.S.doc Version 5.2 Page 13 The home has recently had a large conservatory built to the rear of the house and several people who were reading, talking or sleeping occupied this room. The assistant manager is aware that summer may make the conservatory very hot but had contingency plans in place for this including ceiling fans. Staff were observed communicating in a gentle and friendly manner and residents responded warmly to them. The ambience in the home is unhurried and congenial and suits the quieter cultural interests of people living there. A visitor said that she is always warmly welcomed by the staff when visiting the home and that the assistant manager is wonderful. The assistant manager had been away from the home for a week or so and was greeted back that day with genuine warmth by residents. There is a choice of menu and the dinners being served were good quality and looked appetising. One resident confirmed there were always three options on the menu. The home was currently seeking ways of improving one persons’ appetite. The chef maintains a record of peoples known preferences. The dining room is very pleasantly furnished and the tables were attractively set. Meals are served in dishes to each table for the residents to help themselves. Tables are of varying sizes to seat different numbers, this make for a comfortable, non-institutional environment. There was a very good store of fresh, frozen and dried food in the home. Generals Meadow DS0000023401.V359007.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): 18,19, Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a satisfactory complaints procedure in place. Staff adult protection training protects residents. Policies about adult abuse will be improved with the addition of increased guidance for staff. EVIDENCE: The home has a complaints procedure that is available to residents in their statement of purpose. Staff are aware of adult protection issues and adult protection training is being undertaken gradually by all staff. The home has an adult protection policy detailing types of abuse. The policy will benefit from more guidance for staff on appropriate actions to take if they suspect abuse has occurred. A recommendation was made for this. The assistant manager agreed to provide this. The assistant manager stated that all staff have to provide a suitable CRB (Criminal Records Bureau) check before starting employment in the home. A record is maintained of any concerns or complaints and this is supported by any correspondence regarding the matters raised. Generals Meadow DS0000023401.V359007.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19,21,25,26, Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a well-maintained and homely environment. There are sufficient and suitable w.c.s and bathing facilities. The home is clean, pleasant and hygienic. Assessments to windows will facilitate health and safety. EVIDENCE: The home is well maintained and was very clean and hygienic at the time of the inspection. Staff receive infection control training and there are signs regarding infection control in the home. No windows had restrictors and the assistant manager agreed to make risk assessments to ensure residents and staff are safe. A recommendation was made for this. Generals Meadow DS0000023401.V359007.R01.S.doc Version 5.2 Page 16 The carpet in the hall and landing is worn in places and the assistant manager said it was planned to renew these in the near future. The grounds are in the process of having new paving areas and handrails to steps put in. The grounds to the rear are well maintained and offer outside seating areas with pleasant views. One person commented on the views and that it was very nice to be able to sit and look out at the garden. The front of the home has a short gravel drive and garden with a fountain. A recommendation from the last inspection to cover radiators has almost been completed and the remaining radiators are to be covered as some areas, such as a vacant bedroom, are redecorated. Most bedrooms have en-suite facilities, the remaining have a washbasin in the room and bathroom facilities close by. Bedrooms are very pleasantly furnished and are of a good size. Two new baths or showers are being installed in the home. The laundry is away from the residents living and bedroom areas. The assistant manager confirmed that the large washing machine is capable of reaching the high temperatures required for soiled linen. Personal protective equipment such as aprons and gloves is available for staff. The communal areas are very comfortably furnished in a style suitable for the age range of the clients. There was very quiet, age appropriate music playing in the hallway of the home, but no television or radio noise heard elsewhere. All the décor and furnishings are non-institutional and offer comfortable and pleasant surroundings. Generals Meadow DS0000023401.V359007.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30, Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ needs are met by sufficient numbers of trained staff. Recruitment policies protect residents. EVIDENCE: The assistant manager confirmed there were no staff vacancies at the time of the inspection. The registered provider and registered manager live on the premises and ensure there are sufficient care staff and ancillary staff on duty to meet the needs of the residents. The registered manager is also on duty during the day. As well as care staff there is a chef and two domestics on duty. Because the registered provider was on leave, confidential staff files were not available for viewing. The assistant manager stated that all staff must have two references as well as suitable proof of identity, PoVA checks (protection of vulnerable adults) and CRB (criminal record bureau) checks before starting work. The previous inspection report indicated that recruitment practices have been consistently followed. Generals Meadow DS0000023401.V359007.R01.S.doc Version 5.2 Page 18 Some staff have worked in the home for a number of years, providing continuity of care. Evidence of training certificates was seen and there were notices informing staff of forthcoming training. The training matrix indicates that there is over 50 of staff with NVQ 2 or 3. As well as mandatory training the home has undertaken training for some staff in dementia care and other courses related to this age group. Staff undertake induction before being allowed to work on their own in the home. Staff confirmed they had received their annual appraisal. One resident said, “they are good girls” about staff and rapport was seen to be unhurried, considerate and friendly. Generals Meadow DS0000023401.V359007.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,38, Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from an effectively run home but will benefit from further user consultation. Residents’ financial interests are safeguarded. The health and safety and welfare of residents are promoted. EVIDENCE: The registered manager has completed NVQ4 in care and is undertaking the RMA (Registered Managers Award). The assistant manager said that the registered manager is approachable and friendly. Generals Meadow DS0000023401.V359007.R01.S.doc Version 5.2 Page 20 Both the registered manager and the assistant manager regularly update their training. The homes formal quality assurance is limited to a questionnaire for residents. Completed questionnaires had written comments from the assistant manager detailing the homes response to different issues raised. There were also very good and positive comments from residents on the questionnaires. Some residents told the inspector that they were given choices and agreed that they were asked daily for their choices from the menu. The assistant manager agreed to look at further methods of receiving feedback about the care given to residents. A recommendation was made in the last report to formalise feedback from residents and a recommendation is made again. Training is ongoing and is gradually including all staff in mandatory training. Appropriate safety checks have been carried out. Various policies are in place for safety and welfare. A recommendation is made for windows to be assessed for restrictors. Residents’ families or advocates deal with their finances. Generals Meadow DS0000023401.V359007.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X 3 X X X 2 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 3 X 3 X X X X 3 Generals Meadow DS0000023401.V359007.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? NO 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. Refer to Standard OP7 OP18 OP33 OP19 Good Practice Recommendations Further guidance for staff is to be put in care plans and in adult protection policies. The home needs to develop the quality assurance system. This recommendation has been brought forward from the last inspection. Windows are to be risk assessed for restrictors. Generals Meadow DS0000023401.V359007.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Generals Meadow DS0000023401.V359007.R01.S.doc Version 5.2 Page 24 - 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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