Inspection on 04/11/05 for 186 Meadow Way

This inspection was carried out on 4th November 2005.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 6 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

186 Meadow Way 30/05/08

186 Meadow Way 18/04/07

186 Meadow Way 09/05/06

186 Meadow Way 29/06/05

186 Meadow Way 26/02/05

186 Meadow Way 26/08/04

186 Meadow Way 15/03/04

Similar services:

Chesham House

Argyll House

Dorset Lodge

Acacia House

Falcon House

Dial House Nursing Home

Cromwell Avenue (9)

Abbey Lodge

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

CARE HOME ADULTS 18-65 178 Meadow Way Jaywick Clacton On Sea Essex CO15 2SF Lead Inspector Gaynor Elvin Unannounced Inspection 4th November 2005 14:00 178 Meadow Way DS0000017724.V264760.R01.S.doc Version 5.0 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 178 Meadow Way DS0000017724.V264760.R01.S.doc Version 5.0 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. 178 Meadow Way DS0000017724.V264760.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service 178 Meadow Way Address Jaywick Clacton On Sea Essex CO15 2SF 01255 431301 01255 431301 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) Mr S T Lewis Mr S T Lewis Care Home 3 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (3) of places 178 Meadow Way DS0000017724.V264760.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 29th June 2005 Brief Description of the Service: 178 Meadow Way is a small care home, which is registered to provide accommodation, support and personal care to three service users with a mental health disorder. The home is located in a residential area in Jaywick Sands, within close proximity to the beach, shops, cafés and public house.A local bus service provides access to the nearest town of Clacton on Sea, approximately 2 miles away, for local amenities such as day centres, local hospital, sports centre, swimming pool, library and colleges and the town centre. 178 Meadow Way DS0000017724.V264760.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place one day in November 2005, over three hours. The inspection process included a tour of the premises, discussion with the deputy manager and a service user and examination of documents and records. Meadow Way has previously lacked progress and direction in ways expected to meet with Regulatory Requirements and the National Minimum Standards (NMS) and was risk assessed as high. This inspection focused on those areas assessed at the previous inspection, which had not met NMS. All of the ten statutory requirements had been addressed from the previous report, six had been met and four partially met. Thirty two NMS and service user outcomes were examined during this inspection, twenty six were met and six were partially met, concluding the home had made progress in some areas of delivery, and in line with other services, is progressing towards attainment of good care outcomes and NMS, at a steadier pace than previously identified. What the service does well: What has improved since the last inspection? What they could do better: The home needs to continue to explore engagement and therapeutic co-operation, programme, through the use of flexible and with service users to build self-esteem, purposeful lifestyle. various approaches to facilitate within the service users support responsive engagement strategies and increase participation in a 178 Meadow Way DS0000017724.V264760.R01.S.doc Version 5.0 Page 6 The home must further develop a system for looking at and measuring the quality of care being provided for the service users within the home. 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. 178 Meadow Way DS0000017724.V264760.R01.S.doc Version 5.0 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 178 Meadow Way DS0000017724.V264760.R01.S.doc Version 5.0 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): 1& 3 Written information is provided for prospective service users and their families, enabling them to make an informed choice. The home promotes the opportunity to visit the home as an essential part of the pre admission process. EVIDENCE: Since the last inspection The Statement of Purpose and the Service User Guide documents had been reviewed and updated to include all the relevant information required to enable prospective service users to make an informed choice with regard to the services and facilities the home offers. Unplanned admissions were avoided and prospective service users were offered a trial visit. The deputy manager described a thorough pre admission process, through which an assessment would be carried out to ensure the home was able to meet the individual’s needs and ensure compatibility with the current service users. There were only two service users currently accommodated at Meadow Way, both male, and the carers were male, the deputy manager indicated the home would not consider a prospective female service user at the current time. 178 Meadow Way DS0000017724.V264760.R01.S.doc Version 5.0 Page 9 The home has currently been refurbished to include an additional bedroom and an additional bathroom. Upon completion the home is looking to apply to the Commission for a variation to the current conditions of registration to provide care and accommodation from three to four service users. 178 Meadow Way DS0000017724.V264760.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): The care planning process and supporting documentation was being progressed positively, providing clear information for staff to deliver consistently the appropriate care and support required by each individual. EVIDENCE: Service user care planning documents and associated information was examined as part of a case tracking approach. Progress was being made in addressing the shortfalls previously highlighted with regard to the content of care plans. They provided clear information and were developed according to assessed needs, detailing how the service user is to be supported in achieving outcomes. The deputy manager confirmed that the improved care plans enabled staff to be clear about individual requirements and provide appropriate and consistent support, prompting appropriate monitoring and review for future planning. This was particularly evident with regard to the health care needs of one individual. The care plans incorporated risk assessments and risk management strategies detailing how the individuals required support in managing their own safety and protection. 178 Meadow Way DS0000017724.V264760.R01.S.doc Version 5.0 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): 11, 12, 13, 14, 15,16 & 17 Service users required more support and encouragement in ways to motivate participation and maximise strengths and interests and increase participation in meaningful activities. Service users rights were respected and staff actively encouraged them to be involved in decisions within their daily life. Family and friendship links are actively encouraged and supported. EVIDENCE: Mental and physical health needs restricted prospects for the current service users to seek employment or further education. Service users were watching television, when asked how they spent their day, one said the home had recently purchased a monitor and computer games, which occupied some time but generally they were bored. One said he used to enjoy carpentry. Individual activity programmes had been developed but they were unfocused and lacked structure, particularly in identifying ways to motivate, explore and extend the individuals potential and aim for a purposeful lifestyle. Staff spoken 178 Meadow Way DS0000017724.V264760.R01.S.doc Version 5.0 Page 12 with said the service users were not minded to participate or engage in activities due to short attention spans, behavioural problems and lack of motivation. Working towards smaller achievable goals in the short term could be more motivating for the individual. Social inclusion within the community was promoted but limited for the current service users due to their physical health needs. During discussion, the deputy manager indicated that the service strongly encouraged family links and adopted a partnership approach with family members, which was paramount in increasing chances of successful rehabilitation. In one situation the home has been instrumental in re establishing family contact. Mealtimes were flexible and prepared to the individual’s choice. Nutritional and eating needs for one individual was arranged according to medical and dietetic advice, food intake and weight was strictly monitored within care planning arrangements, and providing accurate information for future assessment by healthcare professionals. 178 Meadow Way DS0000017724.V264760.R01.S.doc Version 5.0 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, 19 & 20 Healthcare needs were recognised and addressed, service users were supported in receiving continuing care and attending follow up appointments. Staff engaged positively with each individual and demonstrated a good understanding of the service users supported and treated them with dignity and respect. EVIDENCE: Staff interaction with service users was observed to be friendly, helpful and understanding with service users responding in a relaxed manner. Times for getting up and going to bed were flexible however service users at times required prompting and motivating to get up as part of their support programme. Positive improvements had been made with regard to arrangements for planning and monitoring appropriate action to meet identified health care needs. This was reflected in the individual plan and action plans were clear and concise informing staff for an effective and consistent delivery of care. The home had initiated contact with appropriate health professionals for additional assessment and guidance to inform practice and work collaboratively to meet 178 Meadow Way DS0000017724.V264760.R01.S.doc Version 5.0 Page 14 service users specific needs in relation to continence, physical and mental health. The current service users did not self medicate. Policies and procedures relating to the safe administration and handling of medication were in place to guide staff. Staff had received medication training accessed from the local pharmacist, who focused mainly on the supply system used; the deputy manager was in the process of seeking further medication training. 178 Meadow Way DS0000017724.V264760.R01.S.doc Version 5.0 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): 22 Arrangements for responding and acting upon any complaints were satisfactory. EVIDENCE: The home has a detailed complaints policy and procedure and is included in the Service Users Guide for reference. Staff comments indicated that they felt comfortable in raising any concerns informally. No complaints had been received by the home or the CSCI in the last twelve months. 178 Meadow Way DS0000017724.V264760.R01.S.doc Version 5.0 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, 25, 26, 27, 28, 29 & 30 The home was suitable for its stated purpose, accessible, safe and maintained to a high standard, meeting service user’s individual and collective needs in a comfortable and homely way. EVIDENCE: The premises were in keeping with the local community, domestic and unobtrusive, offering access to local amenities, local transport and relevant support services. Building works continued and considerable progress had been made in improving individual and communal accommodation for the service users. A new large conservatory, overlooking the meadow at the back of the house, provided an additional sitting room with the added benefit of an unobtrusive, purpose built kitchen facilities for service users to prepare their own snacks and drinks. Central heating provided heat to the conservatory enabling continued use during the winter months. A loft conversion was in progress and once completed will provide an office and separate room for night sleep in staff with separate washing facilities and shower room. 178 Meadow Way DS0000017724.V264760.R01.S.doc Version 5.0 Page 17 Alterations had been made to the smaller two of the three bedrooms to acquire the required useable floor space to meet NMS and service users individual needs. An additional bathroom had been installed, providing a minimum of one toilet and one bathroom per two service users and would provide separate facilities for future prospective female service users. Three of the four bedrooms had been refurbished to a high standard, new sinks installed with tile splash backs and lockable wall safes provided, suitable to meet service users needs and lifestyles. Bedrooms promoted individuality, decorated according to the individuals’ choice and personalised with service users belongings. New laundry facilities were provided within a new extension to the front of the building. Although the laundry was not fully completed, a new industrial washing machine had been installed which met disinfectant guidelines in line with infection control, to meet a previous statutory requirement. Following assessment the provision of an electronic back raiser and a Water low bed mattress, which is waterproof and reduces the risk of pressure sores, has been provided to meet the physical needs of one individual. 178 Meadow Way DS0000017724.V264760.R01.S.doc Version 5.0 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): 32, 33 & 35 Staff were appropriate in numbers to meet the needs of the current service users. Training and development opportunities have improved since the last inspection, enabling staff to develop their knowledge and understanding to effectively support the service users in the home. EVIDENCE: One member of staff was on duty supporting the two current service users. The staff team was small and comprised of the Registered Manager, the deputy manager, one day support worker and one sleep in support worker during the night. The home needs to regularly review staffing levels in the case of changing needs of service users or when an additional service user is admitted. An annual training and development plan identified the training already received and planned for staff during the current year and met with staff’s identified individual and collaborative training requirements in line with the service aims and service users needs. Recent training in Mental Health Awareness had provided staff with an introduction and an increased awareness of the factors leading to mental illness, understanding behaviours linked to and the impact mental health problems have on daily living. 178 Meadow Way DS0000017724.V264760.R01.S.doc Version 5.0 Page 19 The deputy manager had re commenced training in NVQ level four in care and management and had just 2 modules to complete. The remaining support workers have not yet secured a place to commence NVQ level 2 in care. 178 Meadow Way DS0000017724.V264760.R01.S.doc Version 5.0 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, 38, 39, 41, 42 & 43 Effective investment has been placed into the areas requiring improvement to enable the home to meet its stated purpose and demonstrate progression towards good care outcomes for service users. EVIDENCE: The home demonstrated that positive action has progressed since the last inspection to implement requirements identified in the last three CSCI inspection reports with regard to essential elements of management, training and development of a knowledgeable staff team and efficient and responsible care planning to help ensure delivery of structured and consistent care. Since the last inspection the Registered Manager, Mr Lewis, has commenced NVQ level four in Care & Management and attended update in some areas of core training. Mr Lewis has resumed a more active managerial role within the home, working along side the Deputy Manager, who continues to play a key role within the management team. 178 Meadow Way DS0000017724.V264760.R01.S.doc Version 5.0 Page 21 Service users presented a comfortable relationship with the management and the home was observed to promote an open atmosphere. The home has begun the process of quality monitoring by seeking views on the service through questionnaires, feedback from service users generally confirmed satisfaction, unfortunately the home had not received any response from questionnaires sent out to other stakeholders. Further development of the quality monitoring and assurance system is required to look at and evaluate care practice and outcomes for service users. Record keeping practice had improved to a level that promoted the protection, safety and welfare of the service users. General risk assessments and risk management strategies were in place to inform staff of actions to be taken to reduce any risk to service users, including potential risks identified during the refurbishment of the building. Temperature control valves had been placed on all hot water outlets to prevent scalding. During refurbishment arrangements fire safety signage, fire retardant automatic self closer doors had been installed, risk assessments were in place in line with fire safety guidance. A new fire alarm and detector system had been installed but was not yet connected and the home was still working on the old system. 178 Meadow Way DS0000017724.V264760.R01.S.doc Version 5.0 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 X 3 X X Standard No 22 23 Score 3 X ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 3 3 X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 3 3 LIFESTYLES Standard No Score 11 2 12 2 13 3 14 2 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score X 2 3 X 3 X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 178 Meadow Way Score 3 3 3 X Standard No 37 38 39 40 41 42 43 Score 2 3 2 X 3 3 3 DS0000017724.V264760.R01.S.doc Version 5.0 Page 23 Yes 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 Regulation Requirement The Registered Manager must ensure service users receive appropriate support and encouragement to meet aspirations and assessed needs, take part in valued and fulfilling activities to reach potential and a purposeful lifestyle. This is a third repeat requirement not met within set timescales of 1st Dec 2004, 1st June 2005 & 1st September 2005. The Registered Manager must ensure that service users are in competent safe hands by ensuring 50 of care staff in the home are working to obtain NVQ level 2/3 by an agreed date. The Registered Manager must ensure successful completion of NVQ level 4 in Care and Management before September 2006. The Registered Manager must ensure an effective quality assurance and monitoring system is in place to measure DS0000017724.V264760.R01.S.doc Timescale for action 01/03/06 YA11YA12YA14 16 2 YA32 18 01/03/06 3 YA37 9 30/09/06 4 YA39 24 01/03/06 178 Meadow Way Version 5.0 Page 24 success in achieving care outcomes, incorporating continuous self monitoring, review and evaluation to project an annual development plan for the home and demonstrate development for each service user. 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 178 Meadow Way DS0000017724.V264760.R01.S.doc Version 5.0 Page 25 Commission for Social Care Inspection Colchester Local Office 1st Floor, Fairfax House Causton Road Colchester Essex CO1 1RJ 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 178 Meadow Way DS0000017724.V264760.R01.S.doc Version 5.0 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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