Inspection on 29/08/08 for Meadow View 2

This is the latest available inspection report for this service, carried out on 29th August 2008.

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

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Meadow View 2 15/12/05

Meadow View 2 22/07/05

Meadow View 2 08/03/05

Meadow View 2 04/08/04

Similar services:

Larch Avenue

Alderson Road 12

Cranworth Close Registered Care Home

The Cornerstone

John Street Nursing Home

Pennine Camphill

Whitwood Hall

Muston Road (70)

Extracts from inspection reports are licensed from CQC, this page was updated on 08/11/2008.

CARE HOME ADULTS 18-65 Meadow View 2 The Lawns Bempton Lane Bridlington East Yorkshire YO16 6FQ Lead Inspector Jean Dobbin Key Unannounced Inspection 29th August 2008 1:00pm Meadow View 2 DS0000056629.V370555.R01.S.doc Version 5.2 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 View 2 DS0000056629.V370555.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 Adults 18-65. 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 View 2 DS0000056629.V370555.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Meadow View 2 Address The Lawns Bempton Lane Bridlington East Yorkshire YO16 6FQ 01262 400955 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) www.mencap.org.uk Royal Mencap Society Kjersti Goss Olsen Care Home 4 Category(ies) of Learning disability (4), Physical disability (4) registration, with number of places Meadow View 2 DS0000056629.V370555.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 16th November 2006 Brief Description of the Service: 2 Meadow View is a purpose built semi detached bungalow owned and maintained by New Dimensions Housing Association. The care input is organised and managed by the Royal Mencap Society. The home offers long term accommodation for adults with a learning disability and associated health and behavioural problems including some behaviour that challenges the service. The staff provide personal care, help, advice and guidance with daily living skills and activities, a catering service, a laundry service and domestic and cleaning services. Activities are offered both on and off site. An adapted motor vehicle is available. The home is situated in a residential area of the town and public transport to the town passes nearby. There is an easily accessible garden and on street parking is available. A Statement of Purpose, Service User Guide and the latest inspection report by the Commission for Social Care Inspection are made available for people and their families to read. The weekly fees for living at Meadow View 2 as provided on 29th August 2008 are from £871 to £892 depending on assessed needs. People living there pay additionally for hairdressing, chiropody, personal items, like clothes, toiletries and meals out, and taxi fares. Meadow View 2 DS0000056629.V370555.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 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 View 2, to staff and to other professional people who visit the home. 3 were sent to people at the home, and all were returned. 7 were sent to healthcare and social care professionals and 2 were completed and returned. 6 were sent to staff at the home and 5 were returned A visit to the home by one inspector, which lasted about 3 hours. This visit included talking to people who live there, 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 at the end of the visit. What the service does well: New people don’t move to the home until someone has visited them and found out what sort of help they need. They only move there if everyone is happy that they can be given the right help. Before they move in properly they have lots of visits to the home so that they can meet the other people who live there and all the staff. The people living there can also meet them too. Most of the staff have worked there for a long time. They have had lots of training. This means people are getting the right care from people who know what they are doing. Meadow View 2 DS0000056629.V370555.R01.S.doc Version 5.2 Page 6 People have records that are written in lots of detail and in a way that is interesting to read. People get asked what needs to be put in these records. They can say what is important to them and this gets written down. This shows staff are listening to them. The manager and staff talk with people all the time about what they want to do and when they want to do it. Staff listen to what people say because they want to do the right thing. People are asked if they are happy there and if they aren’t happy, then the manager and staff will try to put things right. The manager and staff try to arrange interesting things for people to do, so that they can try different things and meet different people. They try and organise things that people especially want to do. This may be with one other person, or with a few other people. Either way, people have happenings that they can look forward to. People have nice rooms and they can keep things that matter to them there. Staff know that these rooms are private and don’t go in there without checking with the person that is alright to go in. What has improved since the last inspection? What they could do better: The home could keep better records of what people have for their meals each day. This would help to show that people are eating lots of different foods, and not too much food that’s bad for them. The manager could make sure that when staff write on drug charts that they aren’t used to, that they always sign in the right place. This would help to make sure that people always have their tablets as they are meant to. The manager could make sure that toilet paper is always available for use in the toilets, so that people do not need to ask first if they want to use that toilet. The manager could talk with her manager about how many staff work at the home and make sure there are enough, so that they can still help people living there to have interesting lives. Meadow View 2 DS0000056629.V370555.R01.S.doc Version 5.2 Page 7 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 View 2 DS0000056629.V370555.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Meadow View 2 DS0000056629.V370555.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 2 People who use this service experience good quality outcomes in this area. People are assessed properly before they agree to move to the home and receive information to help both them and their families make an informed choice. We have made this judgement using a range of evidence including a visit to this service. EVIDENCE: One person has moved to the home in the past year, and a second person, who is thinking of moving there was at the home on the day of the visit. The care records described a planned process which began by the manager going and meeting the individual at their previous home and assessing what the person’s needs were, and whether their needs could be met if they moved to the home. This assessment was in the person’s care records, but the person completing it had not signed or dated the document to show when it took place. There then followed a plan where the person visited the home frequently, spending longer and longer periods there, which included overnight stays. This was what the second person was doing. They had just spent three days and two nights at Meadow View 2 and were going back to their ‘old’ home that day. They said they liked the home. If the person chooses to move there a Meadow View 2 DS0000056629.V370555.R01.S.doc Version 5.2 Page 10 review meeting is held twelve weeks after admission. The individual, and their family if appropriate, as well as outside professionals involved in the person’s support attend this meeting. It is to decide whether the admission has worked well and the person is happy and wants to stay at the home. Meadow View 2 provides a Statement of Purpose and service user guide, that describes what happens at the home, what facilities and services it provides, and the staff who work there. It is written in an easy read format in a large print, with lots of photographs, drawings and symbols. This information is given to people who are thinking of moving there and the format means they can look at it as often as they want without having to rely on other people to help them. MENCAP also has a Families Charter, which describes how the organisation is committed to working with families to make sure they have the right information so that people can receive the best possible support. Meadow View 2 DS0000056629.V370555.R01.S.doc Version 5.2 Page 11 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9 People who use this service experience good quality outcomes in this area. People are given the help to express their views and have as much control of their lives as possible, and the care plans are written in a way that supports that choice. We have made this judgement using a range of evidence including a visit to this service. EVIDENCE: Two care plans were looked at, as well as the documentation already gathered for the person thinking of moving there. The care plans are written as if the individual is telling carers what support they need to get on with their lives and is written with the help of the individual, their family and professionals involved in the person’s care. This is good practice and means the records are very individual and describe what matters to the person. They are written in big print and include photographs of people who are important to the person, including people who are no longer alive. They describe care practices, for example ‘I hold my sponge to my eyes whilst staff use the shower to wash my hair’. They describe routine, for example ‘I put my night clothes on at nine Meadow View 2 DS0000056629.V370555.R01.S.doc Version 5.2 Page 12 but don’t always want to go to bed at that time. I sleep with no light on’. And they describe communication needs for example ‘when I am pleased I smile and clap my hands together’. These plans are generally reviewed monthly by the person’s key worker, who is a named member of staff who works more closely with the individual and their family to identify personal goals and interests and how these can be achieved. There are also daily records kept, which describe how individuals are and how they are spending their time. A separate file records assessment of ‘risk’ to an individual. Any identified risk has a written plan describing how the risk is to managed so that the person is not unnecessarily restricted in what they do. These risk assessments are formally reviewed after different periods of time, according to how big the risk is. This review, where the manager records that the way the risk is being managed is still the best way, had not taken place for one person. Whilst this does not necessarily affect the individual’s life, good record keeping demonstrates that staff are monitoring the way people live and making sure that the assessments of risk are up to date and still relevant. The people at Meadow View 2 are unable to make big decisions about their lives because of their disabilities and limited communication skills. Support staff spoken with showed though that they knew people’s likes and dislikes very well and also recognised what mattered to them. They were observed sitting, and talking with people, but also communicating non-verbally, with gestures, smiles and general body language. Staff were observed responding promptly and understood the meaning of people’s different gestures, sounds and behaviours. One person went outside and started swinging on a ‘sun lounger’. The support worker did not stop this behaviour but went outside to make sure the person did not swing too high and risk hurting themselves. Meadow View 2 DS0000056629.V370555.R01.S.doc Version 5.2 Page 13 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17 People who use this service experience good quality outcomes in this area. People are helped and supported to have a say in what matters to them and to maintain links with the community. We have made this judgement using a range of evidence including a visit to this service. EVIDENCE: The people currently living at Meadow View 2 are unable to do any paid work, nor get any benefit from further education due to the level of their disability. However talking to the staff, and reading the care records showed that people still lead varied lives and staff support them as much as possible in maintaining these interests. East Yorkshire Council provides an Outreach service in Bridlington, which supports people from the home in achieving individual goals and maintaining interests. This is provided on a one to one basis and activities include, for Meadow View 2 DS0000056629.V370555.R01.S.doc Version 5.2 Page 14 example, shopping, coffee and lunch stops. One person was away from the home on the day of the visit. One support worker spoken with said the person for whom they were a keyworker had been on the North Yorkshire railway earlier this year and was looking forward to going to Castle Howard in the next few days. They had also had four nights away from the home at a village not too far from Bridlington. They spent regular weekends at home with their parents. These events make sure that people’s lives do not become routine and predictable. Some people attend the Gateway Club, which is an evening social group. One person’s care plan said ‘when we go to the pub I like lager’. More than one staff member though commented on the staffing levels at the home now that two people living there require two support workers with them when they go out, because of their health condition. Staff think this affects people’s daily lives. Events in the community now need to be more carefully planned, as when two staff are supporting an individual away from the home there is usually insufficient staff for another person to go out as well. The survey forms completed by people living there all said that they could decide what to do during the day, evening and weekend though these were all completed with the help of a support worker. The Meadow View bungalows also have a social club, ‘The Toofah club’ where events are organised, both on the site, like a barbeque, and away from the homes, like ten pin bowling and trips out into the countryside. This enables people living in the different homes to meet and socialise. Support staff were observed consulting with people and listening to what they had to say. People’s care plans described their personal routines, which were important to them and staff showed in discussion that they knew people’s needs very well. Routines in the home were organised around the individual’s needs and not for the convenience of the home. The meals are chosen by staff, in consultation with the people living there to accommodate people’s likes and dislikes. Staff were also aware of healthy eating plans and supported one individual in choosing more healthy options whenever possible. Food is bought locally and people living there are involved in deciding what to buy, and going to the supermarket, so that they can influence what is bought. People generally have sandwiches or a snack at midday, with the main meal at teatime. People’s care plans described their likes and dislikes and their preferences for crockery and cutlery. One record said ‘I prefer drinking from a real glass, rather than a plastic one’. Meadow View 2 DS0000056629.V370555.R01.S.doc Version 5.2 Page 15 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 People who use this service experience good quality outcomes in this area. People’s personal and healthcare needs are well met in a sensitive and respectful manner We have made this judgement using a range of evidence including a visit to this service. EVIDENCE: People’s personal care plans are written as if the person is telling a story describing exactly how much help and support they need to be able to ‘get on with their lives’. They are written in a big font, with lots of drawings, photographs and symbols. It is also written in a way that stresses the need to make sure their privacy and dignity is always respected. This includes the support they need when bathing or getting dressed. Both male and female support staff work at the home so that people can have the choice of who helps them with this personal care. The surveys completed by people living there all said that staff listen to what they say and always treat them well. Each person living at Meadow View 2 has a key worker, who as a member of staff assigned to them, works more closely with them to help them achieve interesting and fulfilling lives. They write reviews describing a summary of the Meadow View 2 DS0000056629.V370555.R01.S.doc Version 5.2 Page 16 individual’s personal, health and social care for that month. One person’s summary had not been completed for July, because the member of staff had not been at work. The manager needs to make sure written work is still completed if a support worker is absent. Detailed daily records also describe day-to-day events, so the summary could have been completed from that information. The care plans showed evidence of close working with healthcare professionals. There was evidence of visits to the local doctor and dentist as well as specialist hospital clinics, speech and occupational therapists. One specialist nurse has close contact with the home. They said in their survey. ‘The home communicates well with professionals regarding their healthcare management’ and ‘they (the home) always contacts me if they have concerns’. The manager said that a someone from the home always attends the appointment with the individual. The manager tries to make sure that the person’s key-worker attends these appointments whenever possible, as he or she is likely to be the person from the home who knows the individual the best. Two people living at Meadow View 2 have a physical condition, so that they sometimes need medication, which isn’t given in a tablet/syrup form. All the staff have received training from the specialist nurse to enable them to give this medicine when necessary. The medicines are stored securely. No one at the home is able to look after any of their own drugs. The home uses a system where a month’s supply of tablets are dispensed and ‘popped out’ of a bubble pack dispenser. The administration records had been signed correctly. One person though was at the home as part of a planned process prior to moving there permanently and their record sheets were in a different format to the ones used by the home. This record had been signed in the wrong place, and the manager had to contact the support worker to confirm that the individual had received their drugs correctly. This was discussed with the manager, who needs to make sure that there is a better system in place for next time people stay at the home so that mistakes in recording don’t happen. Meadow View 2 DS0000056629.V370555.R01.S.doc Version 5.2 Page 17 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 People who use this service experience good quality outcomes in this area. People’s concerns are looked into properly and staff are generally alert to signs of abuse and the need to protect people from harm. We have made this judgement using a range of evidence including a visit to this service. EVIDENCE: The complaints process is displayed in the home. It is written in an easy read format, with pictures and symbols to make it easier to understand. The surveys completed by people living there said that they felt safe at the home and indicated that they would tell someone if they were unhappy about something. The complaints policy is also given to people’s family, when their relative moves to the home. Client’s meetings have recently started taking place again after a lapse, and the manager said that this is another opportunity to check whether people were happy with the way the home was running. There has been one complaint since the last inspection, however this was about the potential damage to neighbouring properties from tree roots and the company addressed it to everyone’s satisfaction. Support staff attend safeguarding adults training as part of their induction when they start working for the organisation. All staff have also completed a National Vocational Qualification Level 2 in Care, where safeguarding is one of the areas covered. Staff are alert to changes in people’s behaviours that may signify something is troubling them. One support worker spoken with was Meadow View 2 DS0000056629.V370555.R01.S.doc Version 5.2 Page 18 clear that they would pass on to the manager information that had been told to them in confidence, if this concerned them. This is good practice as it shows the support worker recognises that they can’t agree to keep secrets. They also said they if they witnessed something which concerned them, then they would have no loyalty to that member of staff. The manager needs to satisfy herself that staff know what to do in the event of them hearing or seeing something which may constitute abusive behaviour as one person did not seem clear that they should report their concerns, and not try to find out more about the incident themselves. The manager was aware of her responsibilities of informing the local authority as well as her line manager, should information like this be given to her. These processes are in place to promote people’s safety. People living at Meadow View 2 hold individual named bank accounts and there are detailed and frequently checked records to show that people’s monies are being looked after properly. Recruitment processes also are carried out properly, and all checks are completed and available to look at before someone starts working at the home. This robust process also helps to keep people safe. Meadow View 2 DS0000056629.V370555.R01.S.doc Version 5.2 Page 19 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 People who use this service experience good quality outcomes in this area. People live in a clean, well-maintained home, though the toilet hygiene facilities need addressing in order to maintain people’s dignity. We have made this judgement using a range of evidence including a visit to this service. EVIDENCE: Meadow View 2 is a semidetached bungalow in a small cul-de-sac with three other similar properties, which are each used by MENCAP to provide accommodation for four people with a learning disability. The home has level and wide access for people in wheelchairs, and small gardens, including a patio, with outside seating. The house has a large kitchen, where cleaning materials are safely stored, and a large dining room and lounge. The furniture and décor are domestic in character. There is one bathroom, with a bath and little used shower and two spacious toilets. One toilet looked at did not contain toilet paper or a paper towel bin. People regularly using that toilet know where the toilet roll is stored Meadow View 2 DS0000056629.V370555.R01.S.doc Version 5.2 Page 20 just outside the room, and have been using this system for several years. However if people’s behaviours means that toilet rolls cannot be left in the room then the manager should consider looking at purchasing toilet roll storage systems which cannot be tampered with, so that people do not have to take the toilet roll with them when they go into the room. People have their own room, with wash hand basin. The private rooms are not lockable, but are all furnished differently and contain items that are important for the person living there. Some bedrooms have an easy to clean floor covering, rather than a carpet, though the manager explained that they were thinking of putting a carpet down again in one room. The home was clean, comfortable and well maintained. There were no unpleasant smells. One support worker was asked about how staff would minimise the spread of an infection within the home. They explained that the home kept good supplies of protective wear for staff, but that people living there would have limited understanding of what was happening if there was an outbreak of infection at the home. Staff would manage the situation with support if necessary from healthcare professionals. Meadow View 2 DS0000056629.V370555.R01.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34 and 35 People who use this service experience good quality outcomes in this area. Whilst people are supported by a loyal staff team, who are well trained and well supported, current staffing levels may affect the opportunities people have to integrate in the community. We have made this judgement using a range of evidence including a visit to this service. EVIDENCE: There are a total of ten support staff, including the manager, staffing the home twenty four hours a day. The staff are both male and female and of different ages and backgrounds. There is one support worker awake through the night and one, who sleeps at the home and can be woken if necessary. The night staff are available to help people in both Meadow View 2 and the adjoining home. The staff at the home are responsible for the catering and keeping the house clean, as well as supporting the people living there. Gaps in the rota are covered by existing staff so people living there are supported by people they know, and who know them. The rota is flexible to enable people to be supervised when going out to one-off events in the community. Two of the Meadow View 2 DS0000056629.V370555.R01.S.doc Version 5.2 Page 22 people currently living at Meadow View 2 have health conditions, whose symptoms require that they have two support workers with them when they go out. This impacts on all the people living there. There are less staff available to support other people when these individuals go out, and if there are insufficient staff, then people cannot do the things that they may want to do. For example one person was going out for the day the following week, but they needed two support workers with them and this had to be planned into the rota. Staff spoken with felt that meeting the needs of these two people meant that people generally could not choose to go out in the community at short notice with their key-worker, as often as in the past. The manager needs to review the staffing levels and make sure that there are enough staff on the rota to meet the needs of the current client group. Most of the staff have worked at the home for a number of years and have a good understanding of the needs of the people living there. The manager works alongside the staff so people’s work can be informally monitored and staff can support each other. A report about the home, completed by the Commission, in 2007 asked relatives of people living there for their comments. These included ‘the staff make you welcome and they do a really good job looking after everyone in the home Another said ‘the home keeps the lines of communication open and I am kept very well informed about my relative. They seem to care for all his or her needs. The staff are supported in completing training relevant to the work they do. They receive induction training when they start working there, and one person spoken with confirmed that they had undertaken refresher courses in first aid and fire safety earlier this year. They had also completed a Level 2 National Vocational Qualification in Care. One member of staff said in their survey ‘the support staff receive regular training appropriate to their role, and have regular supervision sessions with their manager’. Only one person has started working at the home since the last inspection was looked at and they had previously worked at another MENCAP home and had transferred to this service. The recruitment process, looked at, at the last inspection, was found to be satisfactory. Good recruitment processes help to keep people safe. Meadow View 2 DS0000056629.V370555.R01.S.doc Version 5.2 Page 23 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 41 and 42 People who use this service experience good quality outcomes in this area. People live in a home run by an enthusiastic manager who has their best interests in mind however improved record keeping would provide better evidence that people receive a balanced diet. We have made this judgement using a range of evidence including a visit to this service. EVIDENCE: The manager of Meadow View 2 was registered with the commission earlier this year. This means the commission has assessed her as being fit to manage the service. She has worked with people with a learning disability in another town and was supported by MENCAP in applying for the position. Staff spoken with said that she was a good manager, and had fitted in well with the established team. She said she was hoping to undertake more training, related to management responsibilities, which would help her with her role. Meadow View 2 DS0000056629.V370555.R01.S.doc Version 5.2 Page 24 She showed in discussion that she had a good knowledge and understanding of the needs of the people living there and the need for good communication between staff. She has recently re-introduced regular meetings for the people living there, so that they can say what matters to them, and influence how the home runs. The Family Charter, which MENCAP supports, stresses the need to work with families so that people receive the best support. Families are encouraged to give their views about how the service operates, both informally and in the regular review meetings held, when their relative’s care and support are discussed in greater detail. The manager completes a series of monthly checks on how the home is running and submits these to her senior manager. These include areas like unexpected incidents at the home, fire safety equipment and visual checks of furnishings and electrical equipment. A senior manager visits the home without warning each month and carries out his own checks on the home to satisfy himself that things are being done properly. Whilst the staff keep a record of the main meals prepared each day these are often not in sufficient detail to demonstrate that the service is providing a varied, nutritious diet. There is no record kept of breakfasts and lunch. The manager needs to keep better records of the meals provided each day, to show that people are receiving a good diet, and this was discussed on the day of the visit. The health and safety of people living at Meadow View 2 is being protected. MENCAP has systems in place, which all four bungalows, in the cul-de-sac, work to. Safety certificates looked at were up to date. Hot water temperature monitoring is carried out, hazardous chemicals are stored securely and fire safety checks are regularly completed. The staff attend regular updates to make sure their knowledge is up to date. One person spoken with confirmed this. On the day of the site visit some staff were attending fire safety training. Meadow View 2 DS0000056629.V370555.R01.S.doc Version 5.2 Page 25 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 3 2 3 3 X 4 X 5 X X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 2 STAFFING Standard No Score 31 X 32 3 33 2 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 3 X 3 X 2 3 X Meadow View 2 DS0000056629.V370555.R01.S.doc Version 5.2 Page 26 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 YA41 Regulation 17(2) Sched 4 Requirement The home must keep a record in sufficient detail of the food provided to people, to demonstrate that they are receiving a satisfactory diet Timescale for action 29/09/08 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 YA20 Good Practice Recommendations The manager should have a system in place where staff have to show they are familiar with medication records they are not used to, so that the risk of signing for drugs given, in the wrong place, is minimised. It is recommended that the manager looks at the facilities provided in one of the toilets to see if improvements could be made to make sure people’s dignity is always respected. The manager could review staffing levels at the home to see if the present levels are preventing people from carrying out the activities that they choose. 2 YA30 3 YA33 Meadow View 2 DS0000056629.V370555.R01.S.doc Version 5.2 Page 27 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 View 2 DS0000056629.V370555.R01.S.doc Version 5.2 Page 28 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!