Inspection on 17/02/06 for 1 - 2 Meade Close

This inspection was carried out on 17th February 2006.

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

The inspector found no outstanding requirements from the previous inspection report, but made 6 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

1 - 2 Meade Close 01/06/07

1 - 2 Meade Close 23/03/05

1 - 2 Meade Close 12/08/04

Similar services:

Ruskin Lodge

Clover House

Dystlegh Grange

The Good Companions

Cuerden Grange Rest Home

Springfield Cottage

Parkside

Park Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOME ADULTS 18-65 1 - 2 Meade Close Urmston Manchester M41 5BL Lead Inspector Joe Kenny Unannounced Inspection 17 February 2006 11:45 1 - 2 Meade Close DS0000005623.V275619.R01.S.doc Version 5.1 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 1 - 2 Meade Close DS0000005623.V275619.R01.S.doc Version 5.1 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. 1 - 2 Meade Close DS0000005623.V275619.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service 1 - 2 Meade Close Address Urmston Manchester M41 5BL 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) 0161 746 8313 0161 746 8343 SCOPE Yvonne Latham Care Home 8 Category(ies) of Learning disability (0), Physical disability (0) registration, with number of places 1 - 2 Meade Close DS0000005623.V275619.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. All service users will fall within the category of learning disability but may have an associated physical disability. 16th August 2005 Date of last inspection Brief Description of the Service: Meade Close is a registered care home providing 24 hour residential support to eight residents who have a learning disability and may have an associated physical disability. The home is located in Urmston and is close to public and local amenities. The home consists of two purpose built bungalows, accommodating four residents who have cerebral palsy. All the bedrooms are single occupancy and have been equipped with aids and adaptations. The home has been adapted to meet the physical needs of residents. Each bungalow is fully wheelchair accessible and parking bays are located close to each house. The home has access to it own minibus, to assist in supporting residents to access public resources. A third building is used for administration purposes. On the day of inspection there were eight (8) service users living at Meade Close, a provision staffed and managed by SCOPE. 1 - 2 Meade Close DS0000005623.V275619.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection of Meade Close was carried out unannounced on the 17 February 2006 and commenced at 11.45. The inspection included discussions with staff on duty at each house and one member of staff employed in the administration building. Records relating to medication, staff rotas, health and safety checks and a random selection of resident’s files were examined. A brief tour of each bungalow was carried out, there was evidence that programmes of refurbishment were being undertaken and would be followed by a programme of decorating. There were two staff on duty supporting three residents. Discussions were held with these members of staff. During the inspection only a selection of the National Minimum Standards were assessed. In order to gain a full picture of how the home meets the needs of residents this report should be read together with the previous and any future reports. What the service does well: The service to residents is provided in two purpose build bungalows, equipped to meet the personal and physical care needs of residents. The level of support is assessed on admission by the placing authority and through the homes own internal assessment process. From discussions with staff it was also confirmed that relatives are actively involved in this process, acting in the interest of their dependant. The adaptations to each house clearly evidence that residents and staff have access to a provision designed to meet the needs of residents. The emphasis on residents being supported to access community resources was also evident on this and previous inspections. The home has access to a minibus to enable residents to maintain this link. Procedures for recruitment and selection of staff and policies and procedures relating to the running of the service ensure residents are supported by competent and skilled staff. 1 - 2 Meade Close DS0000005623.V275619.R01.S.doc Version 5.1 Page 6 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. 1 - 2 Meade Close DS0000005623.V275619.R01.S.doc Version 5.1 Page 7 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 1 - 2 Meade Close DS0000005623.V275619.R01.S.doc Version 5.1 Page 8 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: Procedures relating to the admission process were examined on the last inspection and demonstrated that information is provided to relatives to inform them about the services available to residents. No new admission took place to the home. No further inspection of the above standards was conducted on this inspection. 1 - 2 Meade Close DS0000005623.V275619.R01.S.doc Version 5.1 Page 9 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6 and 7 The assistance and support offered to residents is based on agreed plans of care including input from relatives. The care offered respects residents’ individual needs and choices. EVIDENCE: Information on residents files related specifically to identified needs and set out strategies to support care needs and identified risks. All residents require a high degree of support in all aspects of daily living. This was clearly evident from records and observations of direct intervention and support offered by staff. Relatives are actively involved in the review process and are kept informed by staff of changes in personal and health issues. Relatives meetings are also held and facilitated by the deputy manager or registered manager. Staff confirmed this in discussions on the day of the inspection. 1 - 2 Meade Close DS0000005623.V275619.R01.S.doc Version 5.1 Page 10 An issue relating to deployment of support staff is dealt with in the section on Personal and Healthcare Support. Each bungalow has been purposefully designed to offer a well equipped facility to meet residents’ needs. Since the last inspection additional adaptations have taken place to increase the capacity of aids when supporting individuals. 1 - 2 Meade Close DS0000005623.V275619.R01.S.doc Version 5.1 Page 11 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 13, 16 and 17 The aims and objectives of the home are to support residents, requiring a high level of intervention in all aspects of daily living. EVIDENCE: The home supports individuals who require a significantly high level of support in all aspects of daily living. This is achieved through the support of residents in small, homely but well adapted bungalows. The key worker model of support is used by the home. One resident from house 2 and four residents from house 1 attend day centres throughout the week. Plans of support are developed at the time of admission and constantly reviewed and monitored by staff in consultation with relatives and residents. 1 - 2 Meade Close DS0000005623.V275619.R01.S.doc Version 5.1 Page 12 There is a clear emphasis on developing and maintaining social links with resources and public facilities, which meet residents’ needs. Staff support residents to access social and leisure interests inside and outside of the home. The home continues to have access to a minibus to support residents getting out to local centres and events. Staff stated that they will assist residents to access venues such as MEN Arena for concerts and events of interest to residents. Staff continue to support residents on meal and menu planning, a number of residents are on prescribed peg feeds. Staff demonstrated a clear awareness of dietary needs of residents. There were ample provisions in each house; provisions are purchased weekly with each house having a set budget for provisions. 1 - 2 Meade Close DS0000005623.V275619.R01.S.doc Version 5.1 Page 13 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 and 20 Residents are supported on all personal and health care needs in a way, which respects their assessed needs. Issues relating to appropriate gender deployment and medication procedures must be monitored to protect residents. EVIDENCE: All residents require support and intervention of staff on personal and health care needs. The level of support is detailed in care plans and monitored through the homes review procedures. On the date of the inspection there were three residents in house 2. There were two staff on duty; however, one member of staff was in house 1 as work men were on site. This left the remaining member of staff to support the two female and on male resident. A further member of staff should have been on duty but was on a training day. The home must monitor deployment of staff as the arrangement left a male carer to support the two female residents. Care plans should demonstrate that such issues are discussed with relatives. 1 - 2 Meade Close DS0000005623.V275619.R01.S.doc Version 5.1 Page 14 Staff have access to a communication system interlinking each house or by phone. Medication records indicated that five staff had recently received training in medication procedures and all staff have responsibility for medication. Medication records confirmed medication is checked in and signed by two staff members. Requirements relating to medication made at the previous inspection had been addressed. However, issues relating to signing of medication administration records following administration of medication required addressing. Medication had been administered in the morning but records had not been signed. An additional member of staff should counter sign any written entry on a MAR sheet where additional medication has been received. The records of one medication did not cross reference with that administered and the quantity remaining for administration. There was also a query as to whether a sign had been omitted. The records for this medication required auditing. There was evidence of secondary dispensing of medication. This practice must cease. In the period since the last inspection some additional equipment has been provided in the bathrooms to offer additional ceiling tracking when supporting residents. Each of the bungalows continue to offer a homely setting with evidence of ongoing refurbishment being carried out at the time of the visit, this would be followed up by a programme of decorating. 1 - 2 Meade Close DS0000005623.V275619.R01.S.doc Version 5.1 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 23 Procedures and training on adult protection ensure residents are protected from abuse. EVIDENCE: Procedures relating to adult protection were in place. The indications from discussions with staff were that they had been given the opportunity to read the Local Authority guidelines and had received training on compliance with these guidelines. The organisation is again advised to retain documented evidence that all staff have read the Local Authority procedures and received training. 1 - 2 Meade Close DS0000005623.V275619.R01.S.doc Version 5.1 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 29 The design and lay out of the home ensures residents live in a homely, comfortable and safe environment. EVIDENCE: On the date of the inspection there was evidence of programmes of refurbishment. Fitted wardrobe and drawer units were being fitted in bedrooms. Rooms were suitably furnished and personalised by residents with the assistance of family and staff. Communal areas and corridors would be redecorated following fitting out of bedrooms. These areas were noted to have some staining and markings from equipment and furniture as it was moved about. The grounds to each of the bungalows are spacious and well maintained. Weather permitting it was evident that residents did like to access the grounds. 1 - 2 Meade Close DS0000005623.V275619.R01.S.doc Version 5.1 Page 17 There were plans in place to alter one resident’s bedroom by fitting French windows, which would enable her to access the garden off her bedroom. The organisation had taken action to provide ventilation to the sluicing laundry area in each house. 1 - 2 Meade Close DS0000005623.V275619.R01.S.doc Version 5.1 Page 18 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31 and 35 The needs of residents are met by qualified staff who have clear set roles and responsibilities. EVIDENCE: The manager was not present at the time of the inspection. The manager had contacted the Commission in relation to changes in hours she worked. The proposed changes enabled her to carry out her duties as registered manager. There were two staff on duty supporting three residents, living in bungalow 2. The remaining residents were out on planned activities at day centres. Staffing rotas are drawn up covering a three week period and detail staff working in each house on day support and waking night duty. A sleeping in person is assigned on call and is located in house 2. Staff spoke positively of the support offered to them in supervision sessions, staff meetings and in their own personal training plans. Staff commented that training was comprehensive and topics were relevant to meeting their development needs. Issues relating to deployment of staff are detailed in this report. The overall arrangements for staffing do meet the needs of residents, as staff are assigned 1 - 2 Meade Close DS0000005623.V275619.R01.S.doc Version 5.1 Page 19 to cover evening ( three members of staff) and weekends when residents are not attending planned day services. Staff assist in all domestic and catering duties, there are no designated ancillary staff. 1 - 2 Meade Close DS0000005623.V275619.R01.S.doc Version 5.1 Page 20 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 41 and 42 The health, safety and welfare of residents is promoted and protected by the organisations management and administration procedures. EVIDENCE: Staff working at the home were experienced and competent to care for younger adults with Cerebral Palsy. Staff demonstrated a clear understanding of the needs of each individual and commitment to support them. Procedures’ relating to the finances of residents remains the responsibility of relatives who are supported and encouraged by the home to be involved in care planning and review. Policies and procedures are clearly written and discussed with staff during supervision and training sessions. 1 - 2 Meade Close DS0000005623.V275619.R01.S.doc Version 5.1 Page 21 Information relating to fire protection indicated that the required weekly and monthly tests and checks were being carried out by the home. The home is advised to request staff attend fire drills to sign the register in person. Monthly audits of the serviced are carried out and a copy of the report following the visit is received by the Commission. Some records on care plans had been corrected using Typex. This practice must cease. 1 - 2 Meade Close DS0000005623.V275619.R01.S.doc Version 5.1 Page 22 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 X 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 X 23 2 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 3 30 X STAFFING Standard No Score 31 3 32 X 33 X 34 X 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X X X LIFESTYLES Standard No Score 11 X 12 X 13 3 14 X 15 X 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 2 X 2 X 3 X X X 3 3 X 1 - 2 Meade Close DS0000005623.V275619.R01.S.doc Version 5.1 Page 23 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 YA18 Regulation 18 Requirement The home must monitor deployment of staff in terms of gender appropriate support. Care plans should demonstrate that such issues are discussed with relatives. Medication must be signed following administration of medication. An additional member of staff must counter sign any written entry on a MAR sheet where additional medication has been received. The records of medication must be audited in relation to: medication not cross reference with that administered and the quantity remaining. The practice must cease in relation to secondary dispensing of medication. The home must retain evidence that all staff have had the opportunity to read Trafford Local Authority guidelines and receive training where identified. Timescale for action 09/05/06 2 3 YA20 YA20 13 13 09/05/06 09/05/06 4 YA20 13 09/05/06 5 6 YA20 YA23 13 13 09/05/06 09/05/06 1 - 2 Meade Close DS0000005623.V275619.R01.S.doc Version 5.1 Page 24 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 2 Refer to Standard YA42 YA42 Good Practice Recommendations The home is advised to request staff attend fire drills to sign the register in person Some records on care plans had been corrected using Typex. This practice must cease. 1 - 2 Meade Close DS0000005623.V275619.R01.S.doc Version 5.1 Page 25 Commission for Social Care Inspection CSCI, Local office 9th Floor Oakland House Talbot Road Manchester M16 0PQ National Enquiry Line: 0845 015 0120 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 1 - 2 Meade Close DS0000005623.V275619.R01.S.doc Version 5.1 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. 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. 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