Inspection on 07/11/07 for Mead Lodge

This is the latest available inspection report for this service, carried out on 7th November 2007.

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

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

Other inspections for this house

Mead Lodge 26/01/06

Mead Lodge 21/07/05

Mead Lodge 13/01/05

Mead Lodge 08/07/04

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

CARE HOMES FOR OLDER PEOPLE Mead Lodge Crown Road Buxton Norwich Norfolk NR10 5EH Lead Inspector Debby Allen Unannounced Inspection 7th November 2007 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Mead Lodge DS0000057375.V354485.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. Mead Lodge DS0000057375.V354485.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Mead Lodge Address Crown Road Buxton Norwich Norfolk NR10 5EH 01603 279261 01603 279261 meadlodge@clara.co.uk 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) Hillside Commercial Ltd Ms Pamela Neale Care Home 24 Category(ies) of Dementia - over 65 years of age (24) registration, with number of places Mead Lodge DS0000057375.V354485.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 13th November 2006 Brief Description of the Service: Mead Lodge is a privately owned care home providing personal care and accommodation to 24 old people who also have dementia. Mead Lodge is located in the Norfolk village of Buxton and is within walking distance of the shops and other facilities. The service is based in an older modernised building with a new extension. The home has 24 single bedrooms, all of which have en-suite toilets. There is a fully enclosed secure garden and the home has recently adopted a cat, which appears to bring a lot of pleasure to a number of service users. The fees currently average £450 per week and are calculated on the level of care required, each person’s level of independence and the room they choose to occupy. Mead Lodge DS0000057375.V354485.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Care Services are judged against outcome groups, which assess how well a provider delivers outcomes for people using the service. The key inspection of this service has been carried out, by using information from previous inspections, information from the providers, the residents and their relatives, as well as others who work in or visit the home. This has included a recent unannounced visit to the home. This report gives a brief overview of the service and the current judgements for each outcome group. This inspection was carried out over a period of six hours and included a tour of the premises, inspection of staff and service users’ records and the home’s records relating to health and safety. Discussions took place with the Proprietor, manager and deputy. Three relatives and a number of service users were also spoken with. Eight relative’s questionnaires were completed and received prior to the inspection, virtually all of which contained very positive comments such as: “My relative is well supported as an individual...” “The home provides the care needed in the circumstances…” “The home is good at caring for people and knowing their needs…” “The home is clean, tidy and clutter free and they provide good, home-made food…” “My relative is well cared for and the home does everything to make life as pleasant as possible…” “They seem to genuinely care about people and are very friendly…” “It is very much a home from home, where visitors are welcome anytime…” “The mature staff have a good understanding of people’s needs and are very caring…” “Residents appear to be treated with love and respect…” Nine staff questionnaires were also completed and, again, contained mostly positive comments such as: “We provide a safe and happy home for residents…” “We take a holistic view of people’s needs..” “As an EMI home, we deal with he challenging demands of people very well…” “We work to a high standard but there is always room for improvement…” “We have good training…” A few comments were made which, although not positive, were generally written in a constructive manner, and should be given serious consideration by the management and providers. These comments included: Mead Lodge DS0000057375.V354485.R01.S.doc Version 5.2 Page 6 From Relatives “Could do with more care staff at certain times…” “There is a picture of people spending their days sitting in uncomfortable chairs…” “Some people seem to be hurriedly fed and some, that don’t seem to be able to manage, are left to eat and drink on their own…” “There are little or no opportunities for residents to pursue hobbies they used to enjoy…” “The home could do with a dishwasher…” From Staff “Training isn’t always relevant to our role…” “We could do with more time for social interaction with the residents…” “Staffing at weekends can be a problem…” “Would like to encourage families to be more involved…” There were no requirements or recommendations made as a result of this inspection. What the service does well: What has improved since the last inspection? Each service user has a detailed, individual plan of care, which is reviewed regularly. Service Users who have been identified as having developed or being at risk of developing pressure sores have the appropriate intervention recorded in their plan of care. Mead Lodge DS0000057375.V354485.R01.S.doc Version 5.2 Page 7 Nutritional screening is initially undertaken on admission, periodically reviewed and detailed records are kept on the service user’s file. A number of improvements have been carried out in the home, including the replacement of worn carpets. Radiator covers have been fitted to all radiators to help protect service users. All care staff receive formal supervision and appraisals on a regular basis. Regulation 26 visits are carried out each month by the provider and a report is submitted to The Commission. All accidents, injuries and incidents of illness or communicable disease are recorded and reported to The Commission. An annual development plan has been developed for the home. Risk assessments are regularly monitored and reviewed. Care staff and management have undergone training in dementia care. Service users have their own copy of the Service User Guide. Paper towels, soap dispensers and disposable gloves and aprons are now available in communal toilets. Service Users are able to access local amenities and they are offered a varied programme of stimulation and meaningful activity. Pureed/liquefied meals are presented in a manner that is attractive and appealing in terms of texture, flavour and appearance. The unpleasant odours noted in the corridors near the front lounge and top lounge have been eliminated. The kitchen is currently undergoing total refurbishment. A summary of accidents & incidents is maintained for monitoring purposes. What they could do better: Mead Lodge DS0000057375.V354485.R01.S.doc Version 5.2 Page 8 All the requirements and recommendations made as a result of the last key inspection have been met and there are no new requirements following this visit. However, the service and service users will continue to benefit from the ongoing improvements such as the kitchen refurbishment and further works that have been outlined in the AQAA and the home’s Annual Development Plan. 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. Mead Lodge DS0000057375.V354485.R01.S.doc Version 5.2 Page 9 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 Mead Lodge DS0000057375.V354485.R01.S.doc Version 5.2 Page 10 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): 1, 2, 3, 4 & 5 (standard 6 was not applicable on this occasion) Quality in this outcome area is good. The assessment and admissions process has been greatly improved and all information obtained is now clearly recorded in service users’ files and used to compile effective care plans, which helps ensure people’s needs are met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Care plans for three service users were examined during this inspection and the information contained in them was found to be clear and detailed. The admission details were seen to include aspects such as personal profile, general health assessment, daily living needs, social needs and risk assessments. Mead Lodge DS0000057375.V354485.R01.S.doc Version 5.2 Page 11 Information was also noted with regard to specific dementia care, such as a person centred assessment and biography, together with information for care teams in respect of history and reminiscence. Each person was noted to have received a contract and a copy of the Statement of Purpose and Service User’s Guide. Mead Lodge DS0000057375.V354485.R01.S.doc Version 5.2 Page 12 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. Each service user has a detailed care plan which describes their health, personal and social care needs. Service users have access to healthcare professionals and they are protected by the home’s medication policies and procedures. All of these factors help ensure that service users’ health care needs are fully met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Three care plans were inspected and these were seen to have improved greatly since the last key inspection. It was evident that a lot of time and effort has been taken to ensure each service user now has an individual plan of care, which is reviewed and updated on a regular basis and ensures consistent care provision. The contents were seen to include personal information, food & fluid monitoring charts, daily care sheets, records of accidents or incidents, Mead Lodge DS0000057375.V354485.R01.S.doc Version 5.2 Page 13 nutritional assessments, pressure sore charts, daily statements and a record of medical contacts. Each service user also has a ‘specific care plan’, which is an excellent system that is very personal and individual. The headings were seen to be Care Need/Problem, Management/Planning/Goal and Aim Evaluation/Outcome. The areas that were considered under these headings were personal care, mobility/moving & handling, continence, dietary, mental state and social behaviour/care. Weight records were looked at and found to be up to date and co-ordinated in such a way as to enable effective monitoring of weight loss or gain. All the information held on file was seen to be written in a respectful manner and was very descriptive and informative, helping to ensure the consistency and continuity of care provision. Each care plan was noted to have been reviewed on a regular basis. The risk assessments looked at were also seen to be well written, reviewed regularly, up-to-date and relevant. Involvement from healthcare professionals such as District Nurse, GP, Optician, Dietician and Chiropodist was also evident from the care plans. Information contained within the Annual Assurance Quality Assessment (AQAA) and discussions with the manager and deputy, confirmed that the home continues to have very robust policies and procedures with regard to dealing with and administering medication. Regular audits are carried out and all senior care staff are trained in medication handling and administration. During the inspection observations were made of staff knocking on doors before entering and addressing people appropriately. From this the opinion was formed that service users are treated with respect and have their privacy upheld. Mead Lodge DS0000057375.V354485.R01.S.doc Version 5.2 Page 14 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 Quality in this outcome area is good. Service users have the opportunity to take part in a number of activities, hobbies and pastimes and are supported to maintain contact with family, and friends, according to their wishes. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Information contained within the AQAA and discussions held with the manager and deputy confirmed that Mead Lodge provides a varied & flexible programme of activity and stimulation, comprising in-house opportunities as well as use of local amenities. An informal evening church service takes place at Mead Lodge every fortnight, on a Sunday, which service users can choose to take part in. This service is conducted by volunteers from the local Church and there is a monthly communion service. Provision is also made for other denomination ministers/priest to visit service users if required. From documents and records looked at, evidence of other social activities Mead Lodge DS0000057375.V354485.R01.S.doc Version 5.2 Page 15 included: Flower arranging, soft ball games, bingo, craft, organ music, board games, old film or comedy and music & movement. Forthcoming events noted were: Fireworks night, Christmas Table Top Sale and the Christmas Party. It was confirmed that visitors are welcome at the home at any reasonable time and service users can receive visitors in private or may decline to see them if they so choose. It was also confirmed by discussions, records seen and information in the AQAA that the staff at Mead Lodge offer varied, wholesome and nutritious meals to service users and assist people to choose their meals on a daily basis. The menus vary over a four-week period and these are reviewed and altered seasonally. All meals, including pureed food, are presented in a manner that is attractive and appealing and the needs of service users with special dietary requirements are catered for. Mead Lodge DS0000057375.V354485.R01.S.doc Version 5.2 Page 16 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is good. Service users, their families and friends know their complaints will be listened to, taken seriously and acted upon. Procedures are in place that help protect service users from abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Mead Lodge was seen to have a very clear and robust complaints procedure, which is clearly laid out in the service user guide and all of the relatives’ questionnaires stated that they knew how to make a complaint. A summary of the complaints procedure is on display at the front of the home by the visitors book, and a record of complaints made, with subsequent actions and outcomes, is held in the office. Mead Lodge operates an open door approach for staff to comment, complain or make suggestions and they have a robust series of policies relating to different aspects of residents’ rights within the home. Procedures are also in place for responding to suspicion or evidence of abuse or neglect within the home, based upon the Department of Health guidance No Secrets and the Public Interest Disclosure Act 1998. Mead Lodge DS0000057375.V354485.R01.S.doc Version 5.2 Page 17 It was also confirmed that staff have received training for the protection of vulnerable adults at induction level and by means of external courses and the Deputy Manager has attended advanced management skills training in safeguarding adults. Mead Lodge DS0000057375.V354485.R01.S.doc Version 5.2 Page 18 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, 20, 25 & 26 Quality in this outcome area is good. The home provides a clean, safe and well-maintained environment for service users and the indoor and outdoor communal facilities are safe and comfortable. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A tour of the premises was carried out and Mead Lodge was found to be clean, homely and free from offensive odours. The communal areas were warm and inviting and the standard of décor was very good. A number of improvements were seen to have taken place since the last inspection. All the radiators have now been covered, some of the old carpets have been replaced, the main hallway has been redecorated and a number of paintings and photograph montages are on display around the home. Mead Lodge DS0000057375.V354485.R01.S.doc Version 5.2 Page 19 It was also observed that service users now have very respectful and tasteful name plaques and photographs on their bedroom doors. Overall, the service and service users will continue to benefit from the ongoing improvements such as the kitchen refurbishment and further works that have been outlined in the AQAA and the home’s Annual Development Plan. Mead Lodge DS0000057375.V354485.R01.S.doc Version 5.2 Page 20 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. The home has robust recruitment policies and practices, the staff have a good mix of skills and they are trained and competent. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The personnel files were looked at for the manager, deputy and two other staff members. All of these contained documentation such as application form, references, identification and clear, enhanced Criminal Records Bureau (CRB) disclosures, therefore confirming that the home/organisation has robust recruitment procedures, which helps to protect the service users. Training records were looked at and evidence was seen of courses attended such as first aid, fire safety, health & safety, moving & handling, COSHH, food hygiene, protection of vulnerable adults and dementia. Mead Lodge DS0000057375.V354485.R01.S.doc Version 5.2 Page 21 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, 32, 33, 35, 36 & 38 Quality in this outcome area is good. Service users live in a home, which is run in their best interests by a competent manager and staff receive regular support and supervision. Service users’ financial interests are safeguarded and the health and welfare of service users and staff are promoted and protected by the home’s policies and procedures. This judgement has been made using available evidence including a visit to this service. EVIDENCE: It was evident from observations, discussions and records that the owners, manager and deputy have worked extremely hard since the last inspection, with a large number of improvements having been made to the service as a whole. Mead Lodge DS0000057375.V354485.R01.S.doc Version 5.2 Page 22 The manager was awarded the NVQ4 Registered Manager’s Award in October 2006 and also holds a certificate in Advanced Management for Care. Regulation 26 visits are now carried out monthly by the provider and reports are received by the Commission on a regular basis, which helps the owners and The Commission to regularly monitor the home and ensure it continues to operate in the best interests of the service users. Records were seen to confirm that support, supervision and appraisals are far more organised now and staff are receiving these on a regular basis. Detailed health and safety records and risk assessments were also seen to be up to date and relevant, thus confirming the health and welfare of service users and staff are promoted and protected. Mead Lodge DS0000057375.V354485.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 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 3 3 X X X X 3 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 3 3 X 3 3 X 3 Mead Lodge DS0000057375.V354485.R01.S.doc Version 5.2 Page 24 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. Refer to Standard Good Practice Recommendations Mead Lodge DS0000057375.V354485.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Norfolk Area Office 3rd Floor Cavell House St. Crispins Road Norwich NR3 1YF 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. 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