Inspection on 13/08/08 for 46-48 Meadowleaze

This inspection was carried out on 13th August 2008.

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

The inspector found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

46-48 Meadowleaze 13/08/07

46-48 Meadowleaze 23/10/06

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 46-48 Meadowleaze Longlevens Gloucester Gloucestershire GL2 0PR Lead Inspector Mr Simon Massey Key Unannounced Inspection 13th August 2008 10:00 46-48 Meadowleaze DS0000067084.V369662.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address 46-48 Meadowleaze DS0000067084.V369662.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. 46-48 Meadowleaze DS0000067084.V369662.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 46-48 Meadowleaze Address Longlevens Gloucester Gloucestershire GL2 0PR 01452 530113 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) www.brandontrust.org The Brandon Trust Mr Jose Ignacio Fernando Serra Ubeda Care Home 5 Category(ies) of Learning disability (0) registration, with number of places 46-48 Meadowleaze DS0000067084.V369662.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home only- Code PC to service users of either gender whose primary care needs on admission to the home are within the following categories: 2. Learning disability - Code LD The maximum number of service users who can be accommodated is 5. Date of last inspection 13th August 2007 Brief Description of the Service: The home is situated on the outskirts of Gloucester. Meadowleaze was formerly two adjoining semi-detached houses. Adaptations have been made to provide one detached property. There is a parking area at the front of the house, with ramped access to the front door and railings. The home is in keeping with other houses in the estate. All residents have single bedrooms which are located on the ground or first floor. In addition there is a dining room and two sitting areas. Service users also have access to the kitchen. A stair lift has been fitted and there are other aids and adaptations throughout the home provided in accordance with people’s needs. Up to date information about fee levels was not obtained during this visit. Copies of the Statement of Purpose and Service Users Guide are supplied to prospective service users. 46-48 Meadowleaze DS0000067084.V369662.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. This inspection was unannounced and took place on the 13th August 2008. The inspector met with all the service users, three members of staff, and the registered manager. Staff were observed supporting and working with the service users. Records relating to care planning, medication, health and safety and staffing were examined. An inspection of the environment was also carried out. What the service does well: What has improved since the last inspection? What they could do better: The home needs to continue to implement its care planning changes for all the service users. The home needs to take steps to eliminate any offensive odours. The home needs to have a period of consistent management. The home must ensure that its fire risk assessment is fit for purpose and appropriately reviewed and dated. 46-48 Meadowleaze DS0000067084.V369662.R01.S.doc Version 5.2 Page 6 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. 46-48 Meadowleaze DS0000067084.V369662.R01.S.doc Version 5.2 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 46-48 Meadowleaze DS0000067084.V369662.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 1 & 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Statement of Purpose and Service User Guide provide accurate and accessible information to service users and prospective admissions to the home. EVIDENCE: There have been no admissions since the previous inspection and the home currently has one vacancy. There is an admissions policy in place that complies with the regulations and meets the current standards. The home have reviewed and updated their Statement of Purpose and Service User Guide and draft copies have been supplied to the Commission. These documents provide all the required information and also contain photographs of the accommodation. The service has also produced a DVD, which provides visual information to prospective service users. 46-48 Meadowleaze DS0000067084.V369662.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 6,7 & 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A framework exists for care planning and risk assessment and the improvements being implemented will make the process more person-centred. People using the service are enabled to make meaningful choices, helping them to feel in control of their lives. EVIDENCE: The home presently accommodates four service users, three of whom are elderly gentlemen aged 70 and above. All have care plans in place and the service is currently updating the format of these plans using a more “person centred” approach. The format used is called “Planning for Life” and fully involves the service users in the drawing up of plans and the subsequent reviewing. The manager and staff explained how these changes would benefit the service users. The home is currently in the process of archiving and streamlining some of the files to make them easier to use and the most recent information more easily accessible. All service users have daily diaries completed by the care staff and keyworkers also complete a monthly summary report of events and issues. Plans 46-48 Meadowleaze DS0000067084.V369662.R01.S.doc Version 5.2 Page 10 document the care and support that is required for each individual and provide guidance on how this should be delivered. Each person has a pen picture in their file and a communication guide for use by staff. One service user explained how they thought their care plan was used by the staff to help them and also how they had contributed to its development. A behaviour management plan was in place for one person and records showed that this had been regularly reviewed. The individual files contained good detail around personal histories, living skills and likes and dislikes. A number of risk assessments were seen and these were up to date and correctly reviewed. At the previous inspection a requirement was made about the storage of confidential information. These practices have been reviewed and the office arrangements changed. All paperwork and files was correctly stored and confidential information was securely located. 46-48 Meadowleaze DS0000067084.V369662.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12,13,15, 16 & 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are supported to pursue their interests and hobbies, and are able to access the local community with support or independently if they are able. Service users are encouraged to eat healthily but their right to choose is respected by the staff team. EVIDENCE: The service users all have daily and weekly routines that are appropriate to their age and needs. All service users expressed satisfaction with the lifestyles they were being supported to follow. People thought they had enough opportunities for trips out, both during the day and at weekends. One person described a photography course he was doing and another talked about trips out to a lunch club. Everyone was positive about the facilities they have in their rooms and the communal areas. There was evidence that people are supported to keep in touch with families with records of visits and telephone calls being kept. One person described a recent journey he had made with staff to visit his sister. 46-48 Meadowleaze DS0000067084.V369662.R01.S.doc Version 5.2 Page 12 Service users stated that their privacy was respected by staff and other service users and people always knocked before entering their rooms and that they were left on their own if that was what they wished. Service users can have keys to their rooms if they choose. All service users said they enjoyed living at the home. One service user who has previously lived independently explained how this was something that she was planning to do again in the future. They felt that the staff were helping to rebuild their confidence and daily living skills. They were also hoping to increase the amount of time they went out independently, which they have been risk assessed as being able to do. Service users were very positive about the quality and variety of food and the kitchen was well stocked with fresh and packaged produce. All food was correctly stored and labelled. Healthy menus are encouraged but choice is respected. One person was receiving help and advice from a dietician on the day of the inspection and they explained how the staff help and encourage them to follow a healthy eating plan. 46-48 Meadowleaze DS0000067084.V369662.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 18, 19 & 21 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Guidance and recording supports service users to receive their personal care in a way that promotes their privacy and dignity. Satisfactory arrangements are in place for the handling of medication, promoting service users’ wellbeing and encouraging their independence. EVIDENCE: Records show that people are supported to attend various health appointments and appropriate records and details are maintained in the personal files. Advice and guidance is sought form various outside professionals when needed. The care plans provide information about how personal care should be delivered and service users were positive about the support they received from staff in meeting these needs. The medication storage and administration were examined and found to be in order. The home has a new storage facility and the problems identified at the previous inspection have been addressed. All staff must undertake medication training before they are permitted to carry out administration. One person explained how he was being supported to give up smoking through advice and the use of nicotine patches. 46-48 Meadowleaze DS0000067084.V369662.R01.S.doc Version 5.2 Page 14 Staff have undertaken training in palliative care and dementia awareness. 46-48 Meadowleaze DS0000067084.V369662.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 22 & 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provides a safe environment for service users in which they are respected and treated with dignity. The home has satisfactory arrangements and procedures in place for the protection of service users. EVIDENCE: The home has a complaints file that is kept up to date and records examined showed that a recent complaint had been dealt with appropriately and the Commission correctly informed. Service users spoken with said they felt able to raise concerns and make a complaint if they wished and one person gave an example of a concern they had raised with the staff that had been dealt with correctly. The Commission has received no complaints in relation to this service since the previous inspection. Records of service users’ finances were seen. These appeared to be in order, with regular balance checks being completed, and checks being countersigned on a daily basis. Staff have completed training in Adult Protection. 46-48 Meadowleaze DS0000067084.V369662.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 24 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users benefit from a home that is well maintained and decorated and provides a comfortable homely environment. Service users are supported and encouraged to personalise their living space and are involved in decisions relating to the redecoration of the home. EVIDENCE: The home was comfortable and homely throughout, with several rooms having been recently decorated. The remaining parts of the home are due to be done shortly. An upstairs communal area has been created in what was formally the office, and this is a comfortable space for staff and service users. The home has three bathrooms, which meet the needs of the service users, including a specialised wet room. The new office space downstairs has been a positive development according to staff and has also provided a new storage facility for medications. All the bedrooms were personalised and decorated according to individual taste and preference and people expressed satisfaction with their personal accommodation. 46-48 Meadowleaze DS0000067084.V369662.R01.S.doc Version 5.2 Page 17 On the day of the inspection there was a slight odour through parts of the ground floor and the source of this was explained to the inspector. This was commented upon at the previous inspection visit and the home needs to make greater efforts to deal with this. The outside of the property is reasonably maintained and the rear garden provides a private and secure area for the service users. 46-48 Meadowleaze DS0000067084.V369662.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 32,34 & 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are supported by a staff team that relates well to them and has a positive approach to their care and support. Improved formal supervision of staff and improved team working should produce improved outcomes for service users. EVIDENCE: Service users were very positive about the staff team with a number of positive comments being made, including “ the staff are really nice”, “they are very helpful” and “the staff are friendly and my key-worker is lovely”. Service users and staff were observed interacting in a positive and appropriate manner and all service users appeared comfortable and confident in their home. Staff were observed encouraging choice and anticipating needs and relating well to the service users. The manager has returned to work after an extended absence and steps are being taken to improve team working and communication. An “away day” for the whole team was due to take place the following week and through supervision staff are being given clear guidance over the range of their individual responsibilities. The staff communication book also demonstrated 46-48 Meadowleaze DS0000067084.V369662.R01.S.doc Version 5.2 Page 19 how the management are trying to direct the staff team towards continually improving practice. There has been a period when staff supervision sessions became less frequent but this is now being addressed, with monthly sessions being booked. The manager is using a new structured supervision format provided by Brandon Trust to assist in this process. All the current staff team except one have completed NVQ training and all were up to date with the required statutory training. Additional training has also been undertaken in palliative care, deaf awareness and dementia. Staff interviewed said they thought they worked well as team and were supportive of one another and communicated well, though people thought that this could be further improved. Staff spoken to demonstrated a good understanding of the needs of the service users and were able to explain how needs are met and reviewed. Staff also showed good awareness of the importance of reviewing needs and the increased challenges that future changes may bring. Staffing files were examined and found to be in order with all pre-employment checks being completed and the correct information being recorded. The Provider has recently agreed to increase the care hours and the home is currently recruiting additional staff. This will also mean more management hours will be available. Records showed that staffing levels have been maintained with occasional use of bank staff. The bank staff are known to the service users, which helps with the continuity of care. 46-48 Meadowleaze DS0000067084.V369662.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 37, 39 & 42 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users benefit from a home that is generally well managed, organised and committed to providing quality care and support but a period of consistency is required to consolidate the changes being made. Systems are in place that help to monitor and improve the quality of the service. EVIDENCE: The home has had an extended period when the manager was absent and a temporary manager was in place. The acting manager had begun addressing a number of the issues and requirements identified at the previous inspection. There have also been some staffing changes during this time. The manager has only recently returned to work but was positive about the future and explained how they planned to improve the care planning system, update the filing and recording systems and work closely with the Provider. Staff said they felt well supported by the management and that the home was provided with leadership and direction. It is evident that a period of time is 46-48 Meadowleaze DS0000067084.V369662.R01.S.doc Version 5.2 Page 21 required for the management to implement and monitor the changes that are being introduced. The home had addressed the issues and requirements that were identified at the previous inspection. All equipment within the home had been serviced and records kept of this. Staff have received training in how to use the various hoists and lifts. The fire safety records were examined and all checks and servicing had been completed. The home’s fire risk assessment was not dated and is in a different format to the one that is supplied by the Provider, the Brandon Trust. The service must ensure that’s its risk assessment complies with the fire regulations and is correctly reviewed and dated. The manager explained how the home will be implementing a system of quality assurance used by the Provider across all their services. The home has been having Regulation 26 inspections and reports of these were seen in the home. These have been completed by different senior managers from within the Brandon Trust. The home has also previously supplied questionnaires to service users and their relatives. 46-48 Meadowleaze DS0000067084.V369662.R01.S.doc Version 5.2 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 3 2 3 3 X 4 X 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 x 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 x LIFESTYLES Standard No Score 11 x 12 3 13 3 14 X 15 3 16 3 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 X 3 X X 3 x 46-48 Meadowleaze DS0000067084.V369662.R01.S.doc Version 5.2 Page 23 no 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 YA42 Regulation 23(4) Requirement The home must review its fire risk assessment and ensure it is fit for purpose and correctly dated. The home must ensure that the environment is free from offensive odours Timescale for action 30/10/08 2. YA30 16 (2) k 30/10/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations 46-48 Meadowleaze DS0000067084.V369662.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection South West Colston 33 33 Colston Avenue Bristol BS1 4UA National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI 46-48 Meadowleaze DS0000067084.V369662.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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