Inspection on 20/05/08 for Meadowcroft, South Zeal

This is the latest available inspection report for this service, carried out on 20th May 2008.

CSCI found this care home to be providing an Excellent 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.

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Extracts from inspection reports are licensed from CQC, this page was updated on 28/09/2008.

CARE HOME ADULTS 18-65 Meadowcroft, South Zeal 10 The Croft South Zeal Okehampton Devon EX20 2NX Lead Inspector Anita Sutcliffe Key Unannounced Inspection 20th May 2008 13:45 Meadowcroft, South Zeal DS0000071093.V363834.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 Meadowcroft, South Zeal DS0000071093.V363834.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. Meadowcroft, South Zeal DS0000071093.V363834.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Meadowcroft, South Zeal Address 10 The Croft South Zeal Okehampton Devon EX20 2NX 01837 840916 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) meadowcroft@dchs.org.uk Guinness Care and Support Ltd Mrs Alison Denise Sampson Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Meadowcroft, South Zeal DS0000071093.V363834.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 either gender whose primary care needs on admission to the home are within the following category: 2. Learning disability (Code LD) The maximum number of service users who can be accommodated is 5. Date of last inspection Newly registered service Brief Description of the Service: Meadowcroft is a care home providing accommodation and personal care. Although continuing as a care home with no break in residency it was reregistered as a new service December 2007 when its ownership changed to Guinness Care and Support Ltd. Health care needs at the home are met through the community nursing service. The home is staffed 24 hours a day with staff sleeping in the house overnight. The home is in a residential estate in the village of South Zeal on the edge of Dartmoor near the town of Okehampton. The home is domestic in character and consists of two three-bedroom houses that have been made into one and extended. The house has one bed sitting room that is suitable for a person in a wheelchair. On the ground floor there is a kitchen, a small lounge, a large through lounge/ dining room and a room that is used for staff sleeping in. There are also two toilets and a bathroom. On the first floor there are a further 4 bedrooms, a small office, a bathroom and a toilet. Fees at the time of this inspection range from £709 to £1,624 per week. There is an additional charge for: dry cleaning, hairdressing, chiropody and any alternative therapies, swimming pool admission, horse riding, toiletries, holidays and admission on day trips, personal leisure and toiletries, private phone calls and installation, magazines and newspapers and the running costs of the vehicle owned by the residents. Meadowcroft, South Zeal DS0000071093.V363834.R01.S.doc Version 5.2 Page 5 The Statement of Purpose and Service User’s Guide is available at the home on request. Meadowcroft, South Zeal DS0000071093.V363834.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 3 star. This means the people who use this service experience excellent quality outcomes. This key inspection was the first since the service was registered December 2007. It was to check the home’s compliance with the National Minimum Standards for Younger Adults by finding out what it is like to live at Meadowcroft. Prior to the inspection the manager provided factual information about the home and an assessment of strengths and weaknesses in the service it provides, with detail of planned future improvement. We (the Commission) observed interaction between staff and people who use the services and we looked more closely at the service two people receive. We also saw the home’s own quality survey results. The home received two unannounced visits. Care records were examined and all people who use the service were met. For the second visit they were away on holiday. All parts of the home were visited. Discussion was held with the manager. Staff were observed going about their duties and provided information and comment. Some records and policies were examined. What the service does well: People who use the service benefit from a completely residential situation; aspects of the building are very homely and comfortable. There is empathy, trust and understanding between people who use the service, the manager and staff who know people very well. People are treated with respect. One person said she felt very safe at the home and all are protected. The standard of care planning, risk management and health care are very high. Staff felt that what the home does best is: • “Support our clients enabling them to live as normal lives as possible”. • “Staff link together and are able to consider the individual needs of clients and act for them to bring fulfilment of their lives. The focus and good atmosphere in the house is to be person-centred and involve clients with staff enthusiasms”. • “What could the service do better? • “Use aids for the physical limitations of some of our clients. Care for emotional needs of clients”. Meadowcroft, South Zeal DS0000071093.V363834.R01.S.doc Version 5.2 Page 7 Family comments from the home’s quality assurance surveys include: • “Excellent atmosphere”. • “The strength at Meadowcroft has always been the homely atmosphere”. • “Meadowcroft has been the best thing to happen to my son”. • “Resident mix is great”. What has improved since the last inspection? 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. Meadowcroft, South Zeal DS0000071093.V363834.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 Meadowcroft, South Zeal DS0000071093.V363834.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): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who move to Meadowcroft can be assured the home will be suitable for their needs, which will be fully assessed prior to admission. EVIDENCE: The people who live at Meqdowcroft have done so for several years and there have been no recent admissions to the home. However, the needs of people who use the service are regularly reviewed. The manager ensures the home is suitable for people who live there. She has recently supported a person to move to other accommodation which is more appropriate to her needs at this time. Meadowcroft, South Zeal DS0000071093.V363834.R01.S.doc Version 5.2 Page 10 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, & 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service are supported to reach their goals in a well planned and risk managed way. EVIDENCE: We examined the care plans of two people who use the service. Care plans inform staff how to provide the support the person needs/wants. Those needs are agreed with the person themselves and, where appropriate, their family representative or an independent advocate. This was the case during a recent change of accommodation for one person. The care plans/files contain a great deal of information including detailed personal history, important so staff can understand the person in their care. Also, information about how independence, good health, social interaction, mobility and any faith will be supported. The plans had been regularly reviewed and demonstrated good person centred planning. Staff said the Meadowcroft, South Zeal DS0000071093.V363834.R01.S.doc Version 5.2 Page 11 plans provided the up to date information they needed but it was felt they should be separated from more historic information so they are more accessible. However, staff confirmed that they receive up to date information about the needs of people and they were able to describe those needs to us in detail. People who use the service are able to make decisions about their lives and are supported to expand their knowledge and interests. These include paid domestic work, woodworking and gardening. This is done with any risk having been considered, and measures put in place to remove or reduce risk without negatively affecting people’s choice. We found risk assessments were very individual to the person, contained good detail and were clear and useful to staff. People at Meadowcroft are able to follow their interests and there have been no incidents or accidents from doing so. Personal information at the home is kept securely and staff are fully aware of the needs for confidentiality regarding people’s personal data. Meadowcroft, South Zeal DS0000071093.V363834.R01.S.doc Version 5.2 Page 12 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, 14, 15, 16 & 17 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. People who use the service are fully supported to live fulfilled and valuable lives as they wish. EVIDENCE: Staff felt that what they did best was: “Support clients enabling them to live as normal lives as possible”. People were observed being ‘at home’, using the kitchen and facilities. One person had just mixed a sponge cake when we arrived the first visit and others were at a local market. Most people were on holiday when we arrived for the second visit. Those who had not wished to go were following their own interests, having individual time with staff to do so. Meadowcroft, South Zeal DS0000071093.V363834.R01.S.doc Version 5.2 Page 13 One person at the home had regular paid employment until moving to live more independently. Others are involved in rural activities, arts and crafts, woodwork and acting. One has held an art exhibition in the local community. There are visits to social events and clubs and contact is maintained with family, and, when away, the home staff – a post card arrived from those on holiday. Staff said the home is now better than it was at accessing activities for people and ensuring there is the opportunity to follow interests. The home now produces a quarterly newsletter containing photographs and information, such as a recent visit to the Ice Show Exeter and about new staff employed. This also helps family keep up to date with events and people who use the service see their achievements on record. Bedrooms are very personalised and individual. The lounges in the house show that people lead active lives; there are lots of games their time. A large greenhouse contained plans and there are vegetables grown in the garden, which has a lawn, table, chairs and swing chair for relaxation. People who use the service have a key to their own room for independence and privacy. The home has a vehicle available to transport people to activities or appointments. We were told that, although old, it is roadworthy and in use. There is a varied menu available to people. They are able to influence this and they help shop and cook. Fresh fruit and vegetables are available and the cupboards were well stocked with ingredients from which home cooked food is produced. However, the food enjoyed at Meadowcroft has led to the need for professional advice on how to limit weight gain in some. Meadowcroft, South Zeal DS0000071093.V363834.R01.S.doc Version 5.2 Page 14 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): 18,19,20 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. People who use the service can be assured that their health care needs will be met in the manner they choose, by experienced and competent staff. EVIDENCE: We met and read the care files of two people who use the service. They contained very good records of how health care is supported. This included positive health (well woman and well man) checks, which were age and gender appropriate. All personal care and support is provided in private and care planning describes people’s preferences. The registered manager described steps to support/persuade people to have health care appointments where they are fearful, describing slow and measured steps towards achieving this. We saw records of appointments for health checks. Meadowcroft, South Zeal DS0000071093.V363834.R01.S.doc Version 5.2 Page 15 We know from contacts with local health care professionals (GP’s and community nurses) that health care at Meadowcroft is considered to be good and they have no concerns. The home uses a ‘monitored dose’ system of medication that is prepared by the local pharmacist. People are able to manage their own mediation, following risk assessment and with staff support, if they are able. Where staff administer the medicines people had given their consent to do so. Where a person’s medication requires additional training for staff the home keeps a protocol within their care file on how this must be done. Meadowcroft, South Zeal DS0000071093.V363834.R01.S.doc Version 5.2 Page 16 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 & 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service can have confidence that staff will listen to concerns and protect them. EVIDENCE: It was quite evident from observation that people have confidence that staff will listen to concerns and protect them. As they each spend time in the community, for example, regular visits to day services, this also means they are less likely to keep concerns to themselves and are therefore safer. The home also has a complaints procedure, also produced in picture form, so that people with poor literacy skills are more able to understand it. Staff said they are fully aware of how to respond if they have any concerns about the well being of people at the home. They receive regular training in the safeguarding of vulnerable people. We looked at the home’s whistle blowing policy, which should inform staff who to contact if they have concerns. It is displayed openly for all at the home to see. The registered manager says the home has received no complaints. The Commission has received no complaints against the home and there have been no concerns raised about the service. Meadowcroft, South Zeal DS0000071093.V363834.R01.S.doc Version 5.2 Page 17 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 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Meadowcroft is a clean and comfortable home suited to the people who live there. EVIDENCE: Meadowcroft is very much the home of the people who live there. Each has their own bedroom that has been decorated and furnished to reflect their tastes and interests. The dining room and lounges also reflect the people who live in the home and their relaxed approach to using the environment as they wish. The house was fresh and clean. During the second visit staff were taking the opportunity to deep clean all the carpets as most people were away on holiday. Furniture is of normal domestic style and we found it comfortable. Meadowcroft, South Zeal DS0000071093.V363834.R01.S.doc Version 5.2 Page 18 The laundry facility and kitchen are adequate for the needs of the home. We found no health or safety concerns, but some, carpet, although not worn, looked tired and faded in places. We did not see the garden in use but it is accessible and provides space for interests and leisure. Meadowcroft, South Zeal DS0000071093.V363834.R01.S.doc Version 5.2 Page 19 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, 35 & 36 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Staff are safely recruited and deployed in sufficient numbers but training needs are not always met. EVIDENCE: The bulk of the staff team is a very long standing which offers continuity and consistancy for people. Asked if there are enough staff to meet the individual needs of people use the service staff felt there currently were. We also saw that activities are frequent and did not appear to be adversely affected by staffing numbers. The two staff who replied to survey said their employer carried out checks, such as criminal history and references, before they started work at the home. We also saw records of the last staff to be recruited and found all necessary checks had been completed. We looked at staff training records, the home’s own survey results from staff, we spoke with staff and have the surveys they completed for us. Seven staff Meadowcroft, South Zeal DS0000071093.V363834.R01.S.doc Version 5.2 Page 20 members have completed a distance learning course and have achieved a Health and Safety in the Workplace certificate. This has resulted in more awareness of health and safety issues. Staff also receive training in the safeguarding of vulnerable adults and the safe handling of medicines. However, although the home provides a service for people with learning disability, including autism, staff receive no training in autism and very little training in learning disability; that having been provided was considered of very little value. Staff said: “Our manager keeps putting our names forward for training but it is always stopped at HQ” and “I have not been allowed by head office to take important training”. During the inspection staff received confirmation that National Vocational Training (NVQ) is now available to them, but this does not include the award specific to staff who care for people with learning disability, which staff say want and need. Asked if staff meet their manager and are supported one said regularly and one said sometimes. Meadowcroft, South Zeal DS0000071093.V363834.R01.S.doc Version 5.2 Page 21 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 & 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service is run well and in the best interest of people who use it. EVIDENCE: Alison Sampson, the Registered Manager, is waiting to finish the Registered Manager’s Award, which is a measure of competence. People who use the service clearly have great affection and confidence in her. The registered provider is now Guinness Care and Support. Staff and the manager say the change to a new provider has not affected people who use the service. Meadowcroft, South Zeal DS0000071093.V363834.R01.S.doc Version 5.2 Page 22 We saw the home’s recently completed quality assurance surveys. Monthly visits are also made to Meadowcroft by a representative of the organisation to monitor the service. Copies of reports are available to the Commission as is required. There are also residents meetings so people who use the service ‘have a voice’. People’s finances are protected through robust systems to ensure their money and interests are protected. This was observed in practice during the inspection and additional charges to people are clearly described in the home’s literature. The house is well maintained, staff are well trained in health and safety and we found no health and safety concerns during the inspection. Meadowcroft, South Zeal DS0000071093.V363834.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 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 X 2 3 3 X 4 X 5 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 3 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 2 36 3 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 4 13 4 14 4 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 4 3 X 3 X 3 X X 3 X Meadowcroft, South Zeal DS0000071093.V363834.R01.S.doc Version 5.2 Page 24 N/A Are there any outstanding requirements from the last inspection? 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 YA35 Regulation 18(1) Requirement Adequate training must be provided which links the home’s service aims to people’s needs and individual plans, in this case learning disability and autism. Timescale for action 30/11/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Meadowcroft, South Zeal DS0000071093.V363834.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection South West Colston 33 33 Colston Avenue Bristol BS1 4UA 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 Meadowcroft, South Zeal DS0000071093.V363834.R01.S.doc Version 5.2 Page 26 - 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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