Inspection on 09/07/09 for Meadowside

This is the latest available inspection report for this service, carried out on 9th July 2009.

CQC found this care home to be providing an Excellent service.

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

Other inspections for this house

Meadowside 15/05/06

Meadowside 24/10/05

Meadowside 04/05/05

Meadowside 31/08/04

Meadowside 05/04/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

Extracts from inspection reports are licensed from CQC, this page was updated on 16/02/2010.

Key inspection report Care homes for older people Name: Address: Meadowside Meadowside Knowle Park Avenue Staines Middlesex TW18 1AN     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Lesley Garrett     Date: 0 9 0 7 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 27 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Meadowside Meadowside Knowle Park Avenue Staines Middlesex TW18 1AN 01784455097 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: samantha.taylor@anchor.org.uk www.anchor.org.uk Anchor Trust care home 51 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category physical disability Additional conditions: The maximum number of service users to be accommodated is 51 The registered person may provide the following category of service only: Care home only(PC) to service users of the following gender; Either whose primary care needs on admission to the home are within the following category: Physical disability (PD) Dementia (DE) Old age, not falling within any other category (OP) Date of last inspection Brief description of the care home Meadowside is one of many homes managed by the `Anchor Trust, a not for profit organisation. It is situated in a residential area close to shops and Staines town centre and set in its own grounds with parking space at the front of the building The home is registered as a care home for a maximum of 51 older people with dementia, over the age of 65. Accommodation comprises 51 single rooms divided into seven units; each Care Homes for Older People Page 4 of 27 Over 65 0 51 0 51 0 51 Brief description of the care home unit has its own lounge/dining room and kitchenette area. The accommodation is situated over two floors with a lift providing access to the upper floor. Care Homes for Older People Page 5 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This inspection of the care home was an unannounced Key Inspection. Mrs Lesley Garrett, Regulation Inspector, carried out this visit and the registered manager represented the service. We arrived at the service at 10:00 and were in the home for seven hours. It was a thorough look at how well the home is doing. It took into account information provided by the home and any information that CQC has received about the service. The manager for the service supplied CQC with an AQAA (Annual Quality Assurance Assessment) and this document was used to assist with the inspection. The inspector also spent time talking with some of the people using the service and staff members. We looked at how well the service was meeting the key national minimum standards and complying with the regulations and have in this report made judgements about the standard of the service. Documents sampled during the inspection included the homes Care Homes for Older People Page 6 of 27 care plans, daily records and risk assessments, staff files, training records, and the homes safeguarding and complaints policies and procedures. From the evidence seen by us and comments received, we consider that the home would be able to provide a service to meet the needs of individuals who have diverse religious, racial or cultural needs. Care Homes for Older People Page 7 of 27 What the care home does well: What has improved since the last inspection? What they could do better: No requirements were made as a result of this key inspection. Care Homes for Older People Page 8 of 27 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 9 of 27 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who wish to use the service benefit from a pre-admission assessment from a suitably trained person and are able to spend the day at the home as part of the assessment process. Evidence: We looked at the service user guide and statement of purpose. They contained all the information that that would allow people to make an informed choice about the home prior to moving in. The documents are available to all people who use the service and have been recently reviewed and updated. The manager told us that people who wish to use the service benefit from a preadmission assessment. The assessments take place at the home and are carried out by the team leaders. Other carers on duty that day also have input to these assessments and the manager also meets the people who wish to use the service. The manager told us they normally arrive about 10:00 and stay until 16:00 which allows Care Homes for Older People Page 11 of 27 Evidence: for a thorough assessment. The manager also told us that they receive information from social services when a referral has been made by them. The manager told us that it is very rare that assessments take place outside of the home but if this is required the manager will do most of those visits. The home does not offer intermediate care. Care Homes for Older People Page 12 of 27 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The health and personal care that people using the service receive is based upon their individual needs, which is documented in their care plans. The people using the service also have support from healthcare professionals when it is required. Evidence: Four care plan folders were sampled and all contained detailed information about the person using the service. The care plans sampled allowed staff to be able to care adequately for the people using the service as the information contained within this document was detailed. There was evidence that the care plans had been reviewed every month and that people using the service had also participated and agreed the plans. People spoken to on the day confirmed that there had been some consultation with them regarding their care plans. A variety of risk assessments were also observed to be in place and these included an assessments for the use of bed rails. All had been reviewed and agreed with the people using the service. There was no evidence that nutritional risk assessments take Care Homes for Older People Page 13 of 27 Evidence: place. The manager told us that every person using the service is weighed every month and evidence was seen of this practise. Those people who have lost weight are then monitored every week and the cook and staff are informed. The manager told us that she had identified this as an area that she needs to address and plans to implement nutritional risk assessments to the home. The home is supported by four local GP practises. One GP who has the majority of people at the home visits every week and in an emergency. The other GPs will visit when they are called. The manager told us the district nurse also supports the home when requested to do so for skin pressure area advice. There are also palliative care nurses available if the home needs this specialist advice.The home also benefits from visits from the occupational therapist who will advise the home on suitable equipment for specific people using the service. The home has its medications delivered every month by a large chain pharmacy and this is dispensed in blister packs. We sampled some medication administration records and these were found to have no gaps. Policies and procedures are in place for staff that administer the medicines and also protocols for those people using the service that wish to self medicate. Staff that administer the medicines receive training and regular supervision and we saw the documentation for this practise. The carer responsible for the medicines told us that regular audits take place of the medications in each unit. During the day staff were observed to knock on doors prior to entering and were using the preferred names of the people using the service as documented in their care plans. Staff were observed to treat people using the service with courtesy. The communal bathrooms were large and well decorated. Healthcare professional visits take place in the privacy of the persons own bedroom. It was also observed during the day that visitors were able to see their friends or relatives in different areas of the home where they could meet and talk in private apart from the persons own bedroom. Care Homes for Older People Page 14 of 27 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service have access to a varied activity programme which aims to meet all peoples needs. Menus are varied and offer choice and the dining arrangements offer a pleasant mealtime experience. Evidence: The manager told us that the home had recently employed an activities organiser who works full time. She had previously worked in the home as a carer. We met with the activities organiser who was knowledgeable and enthusiastic about her work. On the day of inspection bingo was organised in the large downstairs lounge. The room was full and people using the service were enthusiastic about this activity. One person using the service told us look I have won the bingo prize today. I enjoy bingo but there are other things that are organised and are good. The activities organiser told us that as well as group activities she also ensures that she visits those people who do not want or cannot come out of their bedrooms. She showed us her plans for the future which is to start a memory book for those people using the service. A life history and photographs will be placed in these books with the peoples consent. Care Homes for Older People Page 15 of 27 Evidence: Family and friends are welcome at the home at any time. Visiting is not restricted and people using the service can return to their bedrooms if they wish to see their visitors in private. The manager said that local schools have visited at Christmas to sing Carols but they are not frequent visitors. Church services are held at the home and the manager has contact numbers of other denominations and can contact them if requested to do so. Visits out of the home have also been arranged and the AQAA told us that people using the service will often accompany staff as they walk through the park to deliver or collect prescriptions from the GP surgery. Visits to the local shops, which are not too far away, are also enjoyed . It was observed during the inspection that people who use the service are offered choices on a variety of different topics. The manager told us that staff ask when peoople would like to go to bed and get up in the morning and the time they would like breakfast. Staff were observed to knock on the bedroom doors prior to entering. All bedrooms observed on the day had been personalised with the people using the service having their own possessions around them. The manager told us that she has a head chef who works full time.She is supported by a deputy chef and two catering assistants. Menus are discussed with the people who use the service at their resident meetings. All people who use the service are offered a cooked breakfast. The manager told us that because they eat so well in the morning she found by lunch time they were not eating so much. The main meal of the day is now served in the evening and this has been welcomed by the people using the service and the staff. Tables are laid with tablecloths and napkins and on the day of inspection it was observed that people using the service were helping to lay these tables ready for lunch. One person using the service told us If I was in a restaurant I would compliment the chef. The food is so good here. Care Homes for Older People Page 16 of 27 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service can be confidant that their complaints are listened to and that they should be protected from abuse as the staff team have received training in safeguarding adults. Evidence: The manager told us that she has received five complaints this year. A complaints log is kept and these complaints were observed. All had been investigated, the timescales met and all had been resolved. The complaints procedure is available at the home and is also made available to all people who use the service and their representatives. During this inspection people using the service were asked if they knew how to complain and who to complain to and all said yes. The manager told us that the home follows the local authoritys procedures for the safeguarding of adults. Staff have access to these procedures and the homes own internal policy. The homes internal policy is very long and it is difficult to obtain the information staff may need to make decisions quickly about referring a safeguarding alert. The manager told us that she would write a smaller version that is easily read and available to all staff. Care Homes for Older People Page 17 of 27 Evidence: Staff spoken to on the day confirmed that they had received training in safeguarding adults and the records also confirmed this. The home has a whistle blowing policy that staff also have access to. Staff spoken to on the day were knowledgeable about the local authoritys safeguarding procedures and were clear about their responsibilities. Care Homes for Older People Page 18 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service live in a clean, comfortable and well maintained home and have access to attractive gardens. Evidence: We looked around the home and observed some bedrooms and the communal areas. All bedrooms observed had been personalised and some people using the service were pleased to show us their rooms. The home is divided into small units all of which have their own lounge/dining room and communal bathrooms. The bathrooms were large and well decorated. Hoists were available to assist those people needing that facility into the bath. The manager told us that there is a programme of refurbishment and a home maintenance programme to ensure continuous improvement. There is a large garden which backs onto a park. The downstairs lounge areas have access into the garden and a large willow tree gives shade to those people who choose to sit out on good days. On the day of inspection the fish pond was being emptied and cleaned. The AQAA told us that during the last year furniture and furnishings have been replaced. Bedrooms have been decorated and carpets replaced. Profiling beds have been purchased and this was all seen during a walk around the home. The manager told us that they plan to landscape the garden and introduce some raised flower beds Care Homes for Older People Page 19 of 27 Evidence: so that the people who use the service can be involved with some gardening. Hand towels and soap dispensers were available for staff for hand washing and aprons for use during personal care. The home has a laundry room and documentation confirmed that infection control training had taken place for staff including the house keeping team. No offensive odours were apparent on the day of inspection. The AQAA told us that laundry facilities allow people using the service to be involved if the would like to help with their washing. The manager said this happens only after risk assessments have taken place. Care Homes for Older People Page 20 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff in the home are trained and skilled and in sufficient numbers to support the people using the service. Recruitment practises are robust which should protect the individuals living at the home. Evidence: The home had a relaxed atmosphere and staff were observed to undertake their tasks in a quiet and orderly manner. We observed staff interactions with people using the service all of which were professional and supportive. The manager told us that she writes the staff rotas. The numbers appeared sufficient during the day to meet the assessed needs of the people using the service. The manager told us that the skill mix is always taken into account when looking at the rotas. The manager also stated that she and the deputy are always supernumerary. The home has a team of bank staff to cover empty shifts and therefore the manager does not need to use agency staff. Comments received on the day were all positive about the staff in the home. One person said staff are really good here nothing is too much trouble. We were also told by a person using the service the food is really good. Too much sometimes. Another person said I enjoy the activities after lunch. The manager said that over fifty per cent of care staff have now achieved the National Vocational Qualification (NVQ) at level 2. Records sampled confirmed this and Care Homes for Older People Page 21 of 27 Evidence: confirmed that this training is on going. All new members of staff have an induction and this is also linked to a national organisations common induction skills which in turn links with the NVQ programme.The deputy manager co-ordinates the induction programme. Three employment folders for the staff were sampled. These folders confirmed that the home had in place all the necessary documentation to allow them to employ new members of staff safely. No staff member works on a POVA first they all have to have their full CRB. The training records for the home were observed and confirmed that mandatory training takes place. The deputy manager keeps a training programme that identifies the training requirements for each member of staff. Staff confirmed that they receive regular training and this included safeguarding adults, health and safety, manual handling and fire awareness. Specialist training is also available for example dementia awareness. The deputy manager told us this helps staff have awareness of this disease and helps staff improve the care for those particular people in their care. Staff told us about the new training for staff on the computer. This is called e learning and the deputy told us this has been very popular with the staff. Care Homes for Older People Page 22 of 27 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Management arrangements at the home ensure the staff team is adequately supported and there are clear lines of managerial accountability. An effective quality assurance system has been developed. Evidence: The manager was in charge on the day of the inspection. She has been the manager at the home since August 2008. She has previously been a registered manager at another home within the Anchor group and has achieved her registered managers award. She is supported by a deputy manager and a stable staff team. She has begun to make many changes within the home to improve the lives of the people who use the service. One big change that has been made is the changing of the main meal time to the evening. She told us that many of the people using the service have a cooked breakfast and were then not very hungry when it was lunch time. The chef now serves a lighter lunch and the main meal in the evening. This happens everyday except Sunday when a traditional Sunday roast is served at Care Homes for Older People Page 23 of 27 Evidence: lunchtime. The manager told us that this simple change has had a positive impact on other departments too. The manager keeps her own records of the falls that happen within the home and since the introduction of the evening meal these falls have dropped by two thirds. The night staff have reported that the people using the service sleep most of the night and sleep for longer and there is less wandering. People using the service are also alert and ready for the activities in the afternoon and attendance is up since meal times have been changed. The manager said that before people using the service would often fall asleep in the afternoon. The manager continues to keep records of the incidents and will continue to monitor the situation but feels it has been a very positive move. She also told us that the changes were only implemented following consultation with people using the service and the staff team. The manager told us that she has an open door policy so that people using the service and relatives or representatives can speak to her at any time. On the day of inspection this was observed as relatives came into the office to talk with the manager about issues relating to their family members. There are meeting every month for the people using the service and some relatives attend these meetings and minutes are kept. The operations manager for the service visits unannounced every month to do a Regulation 26 visit and copies of these reports were available for the inspector at the home. Twice a year surveys are sent to the people using the service, relatives and healthcare professionals. The manager receives the results and an action plan in then written if any problems are identified. The home also produces a very informative newsletter and feed back from the surveys can also be given in this document. During the past couple of years the home has had a problem with theft of money from some people using the service. The police and the safeguarding team have been involved and investigations have taken place. The manager kept us informed of these investigations by telephone and Regulation 37 notifications. Following these incidents the manager provided all people using the service safes in their bedrooms where valuables and cash can be kept. The manager told us that the home does not keep money on behalf of the people using the service and the families are invoiced directly from the hairdresser or chiropodist. Documents sampled demonstrated that the home has the necessary health and safety certificates in place. Fire alarms are tested regularly and fire awareness training takes place for all staff. Care Homes for Older People Page 24 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 25 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Older People Page 26 of 27 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 27 of 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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