Inspection on 03/09/08 for Meadow Lodge Care Home

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

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.

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Extracts from inspection reports are licensed from CQC, this page was updated on 26/11/2008.

CARE HOMES FOR OLDER PEOPLE Meadow Lodge Care Home Broach Lane Kellington Nr Goole North Yorkshire DN14 0ND Lead Inspector Jean Dobbin Key Unannounced Inspection 4th September 2008 09:10 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 Meadow Lodge Care Home DS0000071491.V370557.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. Meadow Lodge Care Home DS0000071491.V370557.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Meadow Lodge Care Home Address Broach Lane Kellington Nr Goole North Yorkshire DN14 0ND 01977 662 899 01977 663 103 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) Meadow Lodge Care Ltd Mrs Karen Lesley Shann Care Home 25 Category(ies) of Dementia (25), Old age, not falling within any registration, with number other category (25) of places Meadow Lodge Care Home DS0000071491.V370557.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 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: Old Age, not falling within any other category, Code OP - maximum number of places 25 2. Dementia - Code DE, maximum number of places 25 The maximum number of service users who can be accommodated is: 25 New service Date of last inspection Brief Description of the Service: Meadow Lodge is a care home providing personal care and accommodation for 25 older people, who may have dementia. It is situated on the outskirts of the village of Kellington in a rural area, about seven miles from both Selby and Pontefract. The village is on a main bus route to Selby and local village amenities are within walking distance of the home. The building has two storeys, with a ground floor extension, on site car parking and safe, well maintained gardens. There are seventeen single bedrooms, fifteen of which have en-suite facilities and four shared rooms, which don’t have these facilities. Meadow Lodge has a statement of purpose, brochure and service user guide, which are given to people expressing an interest in moving to the home. The latest inspection report, written by the Commission for Social Care Inspection is made available to anyone wishing to read it. Fees to live at Meadow Lodge, provided on 3rd September 2008, are from £415 to £430 a week. Additional charges are made for hairdressing and chiropody, and personal items like newspapers and personal toiletries. Meadow Lodge Care Home DS0000071491.V370557.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 the people who use this service experience good, quality outcomes. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations – but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. This is what was used to write this report. • • Information about the home kept by the Commission for Social Care Inspection. Information asked for, before the inspection, which the manager provides. This is called an Annual Quality Assurance Assessment (AQAA) Information from surveys, which were sent to people who live at Meadow Lodge, to staff and to other professional people who visit the home. 10 were sent to people at the home, and 7 were returned. 9 were sent to healthcare and social care professionals and 6 were completed and returned. 7 were sent to staff at the home and 5 were returned A visit to the home by one inspector, which lasted about 8 hours. This visit included talking to people who live there and their visitors, and to staff and the manager about their work and training they had completed. It also included checking some of the records, policies and procedures that the home has to keep. • • Information about what was found during the inspection was given to the registered manager and the deputy manager at the end of the visit. Meadow Lodge Care Home DS0000071491.V370557.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? This is classed as a new service because Meadow Lodge re-registered earlier this year. However there have been no fundamental changes in the way the home operates as a result of this new registration. It is therefore reasonable to comment on improvements made since the last inspection in January 2008. Staff at the home are now writing in people’s daily records in a way that is more individualised so that the records more clearly show how different people spend their days doing different things. Meadow Lodge Care Home DS0000071491.V370557.R01.S.doc Version 5.2 Page 7 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. Meadow Lodge Care Home DS0000071491.V370557.R01.S.doc Version 5.2 Page 8 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 Meadow Lodge Care Home DS0000071491.V370557.R01.S.doc Version 5.2 Page 9 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 and 6 People who use this service experience good quality outcomes in this area. The pre admission assessment ensures that individual care needs can be met at the home and the people receive information and help to enable them to choose whether Meadow Lodge is the right place for them. We have made this judgement using a range of evidence including a visit to this service. EVIDENCE: The care records looked at showed that people had been assessed before they moved to the home. One person spoken with said that the manager had visited them at their previous address and asked them a lot of questions about the care and support they needed. This reassured them that the staff would know what help they needed if they moved there. They said their relative visited the home and advised them that it would be the right place to move to. People are encouraged to visit and spend a day at the home if possible so that they can meet people and see what it is like. Meadow Lodge Care Home DS0000071491.V370557.R01.S.doc Version 5.2 Page 10 People are given up to date information about the home, what its aims are, and the facilities it provides. The manager could look at offering this information in a different, simpler format. This may be easier for some people moving there, to understand the kind of support the home can provide. However all of the surveys completed by people said that they had received enough information to help them to decide whether to move there or not. One relative said they had talked with local doctors and community nurses to get their views about care homes in the area. Intermediate care is not provided at Meadow Lodge. Meadow Lodge Care Home DS0000071491.V370557.R01.S.doc Version 5.2 Page 11 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 and 10 People who use this service experience good quality outcomes in this area. The quality of care that people get is good, although this is not always well reflected in their care records. We have made this judgement using a range of evidence including a visit to this service. EVIDENCE: The care records belonging to three people were looked at during this visit. These describe the care and support people need to stay in charge of their own lives as much as possible. The plans were put together in a similar format, so were easy to read. They were reviewed each month to make sure they were still relevant and daily records describing day to day routines were also in place. Care staff know people’s needs well, and use information discussed in handovers and meetings to support them in giving the right care. Whilst written records describe the care to be given, those looked at were not very Meadow Lodge Care Home DS0000071491.V370557.R01.S.doc Version 5.2 Page 12 detailed and relied on the carer’s own knowledge. For example ‘needs help with bathing’ or ‘one carer to assist’. One carer was asked how they knew they were giving the right care and they said ‘I just do, and the care plans have all the information in too’. More detailed information would provide written confirmation to staff that the care they are giving is the right care. Most people at the home though are able to tell carers what they want and don’t want. Because the home runs in a way that supports people to stay as independent as possible, the staff consult with people all the time about how much personal help they need. People spoken with said they received good care. ‘The staff look after us so well. They’re lovely girls’. There were some assessments as to whether people were at risk of developing pressure sores, falling, losing weight because of poor appetite or a health problem or needing help with moving and handling. Those identified as ‘at risk’ had a care plan in place describing how that risk was to be managed although this information was also somewhat brief. One person had a history of falls recorded on the initial care plan, but did not have a care plan to say how the home would minimise the risk of another fall. One person had recently attended the hospital, following a recent accident, where they had sustained a serious injury. On their return to the home there was no evidence that the care plan describing how they were to be moved had been reviewed to take the new injury into account. The deputy manager explained that carers routinely assessed the individual before any manoeuvre was carried out because the person’s ability to help, varied from one day to the next, therefore the injury did not change anything. Written care plans should be accurately recording people’s changing needs so that people receive consistent care and staff can be reassured that they are giving the best care. The care records looked at encouraged care staff to make individual judgements but this means that one person may receive different support from another, dependent on who is providing that care. For example ‘to be monitored during the night’ and ‘charts to be used if staff feel the need’. More specific records would clearly identify how often someone is to be monitored, or when charts should be used, so that consistent care is provided. There were good records of communication with healthcare professionals, such as the local doctor, optician and community psychiatric nurse. Surveys returned by the healthcare professionals speak highly of the care provided, and the appropriateness of referrals made to them by care staff. Staff at the home pride themselves on caring for people until the end of their lives, rather than moving them to another home, where nurses worked. One relative commented. ‘I can’t praise them (staff) highly enough’. My relative is bedridden and requires everything to be done for them. The staff are very skilled at providing this care’. Meadow Lodge Care Home DS0000071491.V370557.R01.S.doc Version 5.2 Page 13 Comments from healthcare professionals include. ‘People are looked after by very caring individuals who have a lot of experience’. And ‘carers have a good dialogue with us and are able to discuss needs and are prepared to listen to any advice we may have to offer’. And ‘I feel the care service is so good that it can’t improve’. Medication processes were looked at. The home uses a monthly ‘bubble pack’ system, where drugs are ‘popped out’ of the dispenser. The administration charts were completed appropriately and controlled drug records were satisfactory. Staff have received medication training and some were attending refresher training in the days following the inspection. Controlled drugs were not being stored correctly. Following changes in the law these drugs have to be stored securely in a way that meets specific requirements. The home’s system of storage is not meeting these requirements, and this was discussed with the manager and deputy. Two prescribed items were labelled to be stored in the fridge, but were being stored at room temperature. Another item had to be stored below 30°C, however as the room temperature was not monitored it was unclear whether this was being stored correctly. Correct storage is needed to make sure drugs work to their full potential. The items needing to be kept cold were placed in the fridge in the kitchenette, which is kept locked. The manager needs to make sure the temperature of this fridge is monitored to make sure drugs are being stored at the right temperature and also whether keeping drugs in that fridge is putting people’s safety at risk. Staff were observed chatting with people in a friendly and respectful way. One carer clearly explained how staff make sure people’s dignity is always promoted. People are asked whether they prefer personal care to be provided by male or female carers, and this is provided if possible. The home uses a key-worker system, where an individual worker is assigned to a person living there so that a closer relationship can be developed. However protective pads are on some of the chairs in the lounge and ‘moved about’ according to who is going to sit on the chair. This is likely to be obvious to visitors to the home. The use of these types of measures should be reviewed, as they do not demonstrate respect for people’s privacy and dignity. Meadow Lodge Care Home DS0000071491.V370557.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 and 15 People who use this service experience excellent quality outcomes in this area. People live interesting and stimulating lives and enjoy a varied, nutritious diet. We have made this judgement using a range of evidence including a visit to this service. EVIDENCE: People living at Meadow Lodge have interesting and varied lives and are given support to stay in charge of what they do as much as possible. People say that they decide when to get up and when to go to bed and care staff support them with that choice. One person said ‘I think I could have breakfast in bed, but I choose to get up’. Some people living there are not always able to say what they want, however the staff team know people well and understand people’s behaviours and gestures so that they can work out what help they need. Staff were observed asking people about what they wanted to do. All the surveys completed by people living there said that they always made decisions about what they did each day. People were able to move around the home as they chose and at least one carer is always available in the lounge to respond Meadow Lodge Care Home DS0000071491.V370557.R01.S.doc Version 5.2 Page 15 to people’s requests. After consultation the television was switched off midmorning and some music was put on. A lot of activities and ‘events’ take place either at the home or in the community. Although resident’s meetings are held, staff generally rely on informal feedback to decide whether events should be repeated or not. Entertainers visit the home regularly and staff also provide informal sessions like dancing and quizzes. On the day of the visit there was a lot of laughter and general banter in the lounge, and staff had the time to sit and chat with people. The mobile library visits and one person said they had enjoyed going to the supermarket with a member of staff and buying their own personal items. One person has moved to the home with their budgie. Their visitors said their relative, who loves animals, went with the manager when she went to choose a rescue dog for the home and chose the new name for the dog. The dog is obviously a popular resident in the home. The hairdresser visits each week and was there on the day of the visit. People from the church also visit and people have attended special services at the church in the past. One person said they had enjoyed a recent trip out to Bridlington and explained that another trip to Cleethorpes was planned. One relative spoken with said ‘there’s always plenty of activities and plenty of staff if people want anything.’ Another commented we join in with the activities sometimes and sit out in the garden in summer’. Visitors are welcomed anytime and they say that staff listen to what they say. One visitor came with their dog. Another said they are always offered drinks when they visit and can go and make their own drinks in the kitchenette if they wish. One person telephoned to say that although they have moved house to another part of the country, they were happy to leave their relative at Meadow Lodge even though this meant long journeys each week to visit. They said this was because the home was ‘absolutely brilliant’. They also said that one person continues to visit people at the home, even though their relative no longer lives there. There is a four-week menu rota, which is adapted according to people’s requests. One person said ‘the manager comes round to ask if we like the menu. I asked for lamb chops and they’re on the menu now’. The cook said she speaks to new people, and their families if necessary, when they move to the home to find out their likes and dislikes, however this information isn’t recorded anywhere. The cook does not see this as a problem however as all care staff know this information so if an unfamiliar person was working in the kitchen they could get find out from the staff. On the day of the visit there was savoury mince, carrots, cabbage and potatoes for lunch, with rice pudding for dessert. People spoken with said that the meals at the home were very good. One person said ‘some people moan, but I think they’re ok’. The meals Meadow Lodge Care Home DS0000071491.V370557.R01.S.doc Version 5.2 Page 16 are staggered so that carers can provide support to people who need help at a pace that suits them. Several people require pureed meals. The managers have taken advice from outside professionals to make sure that they are satisfied with the way the home prepares, stores and serves pureed food to the people who need it. Hot and cold drinks were offered to people during the day and jugs of juice were provided for those people who stayed in their rooms. Fresh fruit, home baking, chocolate and crisps are also regularly offered to people. The cook was aware of how to provide more calories in some foods, for those people who did not eat very much. She also recognised that people had a right to eat ‘unhealthy’ foods and would provide those meals if that was their choice. Meadow Lodge Care Home DS0000071491.V370557.R01.S.doc Version 5.2 Page 17 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 and 18 People who use this service experience good quality outcomes in this area. Complaints made to the home are taken seriously and staff are alert to the importance of keeping people safe. We have made this judgement using a range of evidence including a visit to this service. EVIDENCE: The home has a complaints policy and this is explained to people and also provided in the information given to them when they move to the home. All the surveys filled in by people, and those spoken with, said that they would complain if they had concerns. Two people said though that they could ‘never imagine a situation when they would need to’. Similarly visitors spoken with were very clear that they would report concerns and these would be addressed properly. One person said ‘I’ve never had to’. Staff also said that people were encouraged to voice any concerns and these would be taken seriously. The home has received two complaints from relatives in the last few months and these were discussed with the manager. One related to poor communication when a person had changed rooms and the family were not informed in a timely way. The other was about whether staff had behaved appropriately when providing care to a person living there. The manager had investigated and responded to these complaints appropriately. One of the two complainants had written to say they were happy with the way the home had Meadow Lodge Care Home DS0000071491.V370557.R01.S.doc Version 5.2 Page 18 managed their complaint. It would be good practice to always try to obtain written confirmation that people are happy that the complaint has been dealt with to their satisfaction. Staff spoken with, were generally clear about their responsibility of reporting anything, which caused them concern. One person said that they would tell the manager if a person said someone had spoken to them in a nasty way, even if the person asked them not to tell anyone. This is good practice, as this sort of information needs to be reported immediately. The member of staff said ‘you can’t speak to people like that’. Another member of staff was asked what ‘abuse’ meant to them. They said ‘people can’t be shouted at, or ‘taken the Mickey of’ but could not think of any other examples of abusive behaviour. There has been one safeguarding referral made to the local authority earlier this year, when one person was affected by the behaviour of a second person at the home. The managers put systems in place to prevent the incident happening again and the local authority, as the investigating authority, were satisfied with how the manager dealt with the issue. People spoken with all said that they felt very safe living at Meadow Lodge. One person said ‘we love it here. The staff look after us so well’. Meadow Lodge Care Home DS0000071491.V370557.R01.S.doc Version 5.2 Page 19 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 and 26 People who use this service experience good quality outcomes in this area. People live in a comfortable, warm, well-maintained home. We have made this judgement using a range of evidence including a visit to this service. EVIDENCE: Meadow Lodge is situated in a rural setting on the edge of the village. It has well maintained, secure gardens, complete with summerhouse and some parts of the home look out over farmland. Two people spoken with said they particularly liked their room because, with a farming background, they could sit and watch the animals in neighbouring fields. The home, which has disabled access, has a large dining room and separate lounge, with some seating in the entrance area. The lounge has a white ‘orientation’ board, however this contained the previous day’s information at Meadow Lodge Care Home DS0000071491.V370557.R01.S.doc Version 5.2 Page 20 the start of the visit. Private rooms are on both the ground and first floor and shared rooms have screens to provide some privacy. The home was noted to be warm and comfortable. The décor provides a very ‘homely feel’ rather than that of an institution. People’s bedrooms looked at contained things that were important to people, as well as small pieces of furniture. One person said ‘my room is so nice’. Another person was worried about falling out of a single bed, so they have had their double bed brought in. Bathrooms and toilets have been adapted to make them suitable for the people living there. A ceiling tracking system has been fitted in one bathroom so that people can be helped in and out of the bath in a safe manner. People who stay in bed all the time are checked regularly to make sure they are all right. One visitor spoken with said ‘they are always popping in and checking’. The home is sited next to a farm, and although it was not noticeable on the day of the visit, the manager explained that flies could sometimes be a problem in the home. Special ceiling-hung nets have been bought so that particularly frail people who are cared for in bed, are protected from them ‘buzzing around’. A care worker is always available in the lounge to respond to people if they need help. One person showed their pendant call bell, which they wear around their neck, and which enables them to call for assistance wherever they may be. They said staff always answer the bell quickly. Some building work is due to start at the home within the month. This will provide a better, more accessible laundry area and more windows in the lounge and the manager plans to keep people informed about the work, once it starts. A small part of the lounge above a doorway has been affected by a leak and this is to be dealt with at the same time as the refurbishment. The manager makes sure that appropriate aids are available and used to make sure that people living in the home are protected against infection. One carer spoken with confirmed this. Meadow Lodge Care Home DS0000071491.V370557.R01.S.doc Version 5.2 Page 21 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 and 30 People who use this service experience good quality outcomes in this area. People receive good care from well supported, well motivated and well trained staff We have made this judgement using a range of evidence including a visit to this service. EVIDENCE: On the day of the visit there were enough care staff working to meet the needs of the people living there. People spoken with agreed this was the case. Their comments include ‘there are always staff around if people want anything’ and ‘the staff look after us so well’. One staff member said in their survey that ‘the manager will increase and decrease staffing levels, or change staff patterns, so that there is always enough staff to meet the needs of the individuals’. There is a very well established staff group at the home, so they know people’s needs very well. They have a handover at the start of each shift, so they are kept up to date with what is happening in the home. Regular staff meetings also take place, where staff can discuss the needs of individual people in more detail, as well as discussing general issues within the home. The minutes from these show that a range of subjects are discussed, and advice from outside professionals is regularly sought, to confirm that people are receiving the right support. The deputy manager also receives a handover each day so that she Meadow Lodge Care Home DS0000071491.V370557.R01.S.doc Version 5.2 Page 22 knows what’s going on. Staff confirmed these good communication processes in their surveys. One person said. ‘Any new information is passed on at every handover, and also recorded in service-user’s notes’. The staff are well trained. 90 of the staff have achieved a National Vocational Qualification Level 2 Award in Care. People are more likely to be cared for in a consistent way, by people who have a good understanding of the work they do. The deputy manager has attended train the trainer courses so that her knowledge is up to date and she is qualified to provide refresher courses for staff at the home. Some staff were attending refresher training in medication administration in Selby the following week, to make sure their practice was up to date. People spoken with and survey responses say that staff do a good job. Comments include. ‘The staff know what they are doing. They are very competent’. And ‘my relative gets very good care and I am very happy with the service’. And ‘they’re lovely girls’. One person said. ‘I can’t praise them highly enough’. Staff changes happen rarely at the home. The recruitment file of one person was looked at. This contained all the recruitment checks that are required, except that the police check, requested some time before the person started working there, has still not been returned. The home has had a PoVAfirst check done, which makes sure that the person isn’t barred from working in a care setting, because of something that has happened in the past. However this is not a full police check. The manager is aware that this individual must not work unsupervised until the full police check is returned. She says that team leaders who are in day-to-day charge know that this person has to be supervised and is confident that they are still following this process. New staff follow an induction programme, where they learn about the way the home runs and the policies they have to follow. One member of staff confirmed this in their survey. Informal discussions are held in the weeks following starting work, to make sure that the new worker is settled and to confirm that their work is satisfactory. Meadow Lodge Care Home DS0000071491.V370557.R01.S.doc Version 5.2 Page 23 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 and 38 People who use this service experience good quality outcomes in this area. The home is well managed and people are consulted so that they can say what is important for them We have made this judgement using a range of evidence including a visit to this service. EVIDENCE: The home has a very good name in the local area. One person said in their survey response that they ‘obtained information from the normal official channels, but I also talked to nurses and doctors in the area’. The home always has a waiting list and three people currently live there, who have previously lived at other care homes. Meadow Lodge Care Home DS0000071491.V370557.R01.S.doc Version 5.2 Page 24 The manager has worked in the care sector for a number of years and is very experienced. She has a deputy, who, like the manager, has completed extra qualifications to help her with her role. Both managers are described as very supportive and approachable. One person living there said ‘The manager has been round twice to ask if we want anything different on the menu’. People spoken with said they felt very safe living at Meadow Lodge and any concerns would be looked into properly. One person said in their survey ‘I would tell my manager or team leader, who always listen to what we say’. One visitor said ‘I see them (the managers) around the home all the time, you can always speak with them’. Another person added ‘I am very happy with the service’. The managers have a very open style of management. They are constantly consulting with people to make sure they are doing the right thing. One person said ‘ you can just go and see them whenever you want’. Monthly staff meetings allow staff to give their views on the home, families are always included in care review meetings and surveys are sent out periodically to people and visitors so they have the opportunity to say what matters to them. The managers should consider publishing the results of these surveys and informing people of any changes they plan to make as a result of people’s comments. This is so that people will recognise that they are being listened to. The manager should also try to obtain the views of professionals who visit the home, to see if they have suggestions about how the way the home runs, and how it could be improved. The managers carry out internal checks, like recording how many, and where, accidents happen each month to see if changes need to be made, in how the home runs, to minimise the risk of similar future accidents. Medication audits could also be carried out to make sure drugs are being stored appropriately as well as spot checks on the care planning records to make sure that written information is up to date. The home keeps some personal monies for people and all are all kept in separate ‘purses’. The way two people’s monies were managed was looked at. Both had clear records and receipts to show that good systems are in place to make sure people’s monies are being looked after properly. Only the administrator or managers have access to this money, which is securely stored. However, team leaders have access to a small amount of petty cash, so people are able to get some money ay any time. There are a range of health and safety policies and procedures in place. The home has made proper provision to ensure that there are safe working practices by providing staff training in first aid, fire, food hygiene, infection control and safe moving and handling techniques. Meadow Lodge Care Home DS0000071491.V370557.R01.S.doc Version 5.2 Page 25 Whilst generally hazardous products are stored appropriately, denture cleaning tablets were stored in an unlocked cupboard in one of the bathrooms, which is well used, and a tube of the same were clearly visible in a shared room. The manager does need to be satisfied that people are not being put at risk by the way these are being stored. The bathroom cupboard also contained a tube of non-prescription ointment, which had lost its lid. Monitoring arrangements are in place to ensure the delivery of safe hot water. A hot water check for legionella has not been carried out for over eighteen months and again the manager needs to be satisfied that the hot water supply is always maintained above 60°C to minimise the risk of legionella. Fire safety checks are carried out regularly. A check on two safety certificates showed that equipment in the home is well maintained and serviced regularly. There is a gardener and a handyman who carry out regular checks so as to maintain the safety of the premises. Meadow Lodge Care Home DS0000071491.V370557.R01.S.doc Version 5.2 Page 26 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 9 2 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 2 Meadow Lodge Care Home DS0000071491.V370557.R01.S.doc Version 5.2 Page 27 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. 1 Standard OP9 Regulation 13(2) Requirement Timescale for action 31/10/08 2 OP9 13(2) The way controlled drugs are stored in the home must meet the requirements of the Misuse of Drugs Act Regulations 2001 so as to comply with the law. Medicines labelled as needing to 17/10/08 be kept cool, to prevent them ‘going off’, must be stored in a fridge, so that the drug can work as it is meant to. The temperature of the fridge should be monitored and recorded daily to show that the drugs are being stored at the right temperature. The manager should carry out an 17/10/08 assessment to make sure she is satisfied that the present system of storing denture cleaning tablets is not posing a risk to the people living there. 3 OP38 13(4) Meadow Lodge Care Home DS0000071491.V370557.R01.S.doc Version 5.2 Page 28 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP7 Good Practice Recommendations The care records could be written in greater detail, and following an accident or illness should be reviewed to make sure the information is up to date, then signed to say the review has taken place. This would show that the records are a true record of the care delivered. The way continence needs are managed could be reviewed as the current use of protective pads on only some chairs in the lounge means that people with these care needs can be easily identified. This does not respect their privacy and dignity. 2 OP10 Meadow Lodge Care Home DS0000071491.V370557.R01.S.doc Version 5.2 Page 29 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB 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 Meadow Lodge Care Home DS0000071491.V370557.R01.S.doc Version 5.2 Page 30 - 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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