Inspection on 12/09/05 for 7 The Mead

This inspection was carried out on 12th September 2005.

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 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

7 The Mead 08/05/06

7 The Mead 16/05/05

7 The Mead 11/11/04

7 The Mead 16/04/04

Similar services:

Trevaylor Manor

Stallcombe House

Stroud Lodge

The Woodmill

Woodland Vale

Bolealler House

Claremont Nursing Home

Althea Park House

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

CARE HOME ADULTS 18-65 Mead (7 The) 7 The Mead Warminster Wiltshire BA12 8RB Lead Inspector Alyson Fairweather Announced 12 September 2005 th 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 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 Stationary 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. Name D51_D01_S28265_Mead7The_V239178_120905_Stage4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Mead (7 The) Address 7 The Mead Warminster Wiltshire BA12 8RB 01985 215800 01985 218543 themead@rethink.org Rethink Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Vacant Care Home 6 Category(ies) of MD Mental Disorder (6) registration, with number of places Name D51_D01_S28265_Mead7The_V239178_120905_Stage4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 16th May 2005 Brief Description of the Service: The Mead is a care home for six adults in mental health recovery, provided by the Rethink organisation. The building itself is owned by Kennet Housing Association and is made up of two semi-detached houses which have been connected into one larger house. There are six individual bedrooms upstairs and a smoking room, a lounge and a large dining room downstairs. The home is situated at the end of a quiet residential cul-de-sac within short walking distance of Warminster town centre and public transport facilities. There is a large, secluded garden to the rear of the house and a small lawned area to the front, with some parking available. Name D51_D01_S28265_Mead7The_V239178_120905_Stage4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection took place over one day in September. Four residents were at home and three spoke with the inspector. Four staff members were spoken to. Written feedback was received from three residents and one set of parents. The manager showed the inspector round the premises, and a number of records were inspected, including care plans, health and safety records and medication systems. One extra visit had been made to the home by the pharmacy inspector in order to give advice about medication recording and storage. What the service does well: What has improved since the last inspection? What they could do better: Medication policies and procedures had been improved, and training is given in medication administration to all new staff. The medication cupboard had been moved to maintain an even temperature, and all the things which had been found wrong at the last inspection had been amended. However, there was still one incident where medication was not being disposed of in the correct way, and the manager has been asked to make sure that this is done in future. Name D51_D01_S28265_Mead7The_V239178_120905_Stage4.doc Version 1.40 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. Name D51_D01_S28265_Mead7The_V239178_120905_Stage4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Name D51_D01_S28265_Mead7The_V239178_120905_Stage4.doc Version 1.40 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 standard(s) 4 Prospective residents have the opportunity to visit the home in advance of moving in to see if it will meet their needs. EVIDENCE: All prospective residents are invited to visit the home before they come to stay permanently. They are invited for meals and over night stays, which gives them a chance to meet other residents and the staff, and to decide whether they feel that the Mead will meet their needs. These visits also give staff a chance to obtain more information about the resident, and to start developing a care plan which will support the resident in meeting their goals for the future. One new resident had been for several visits, and had decided that he wanted to move in. He said that he was very happy with the way he was being supported and that he was being encouraged to have an active life outside of the Mead. The visits which potential residents make are supported by the Community Mental Health Team (CMHT) who are usually the referrers. Name D51_D01_S28265_Mead7The_V239178_120905_Stage4.doc Version 1.40 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 standard(s) 6 and 7 Care plans reflect the needs and personal goals of residents, which means that staff are able to support them in the way they wish. They are supported and encouraged to make their own decisions. EVIDENCE: The information which was held in care plans for the residents was greatly improved. Each person now has a recovery plan which looks at what they want to achieve and how they can best be supported to reach these goals. One resident wanted to learn to cook, and was being given weekly cookery lessons, as well as making a list of ingredients needed and going food shopping. The daily diary sheets, which used to be completed by staff, are now completed by the individual residents, apart from one who chose not to do so. They record the activities they have taken part in that day as well as noting how they have felt during the day. It is also planned to have an Advance Directive on file for residents, which will spell out their wishes regarding treatment options should they become unwell. The care plan layout has also improved, with sections for the most recent Care Programme Approach (CPA) reports, risk assessments, recovery plans, correspondence and the assessment information collected before the resident moves in. While staff at the Mead take great care to make Name D51_D01_S28265_Mead7The_V239178_120905_Stage4.doc Version 1.40 Page 10 sure that residents sign and agree the recovery plans, it was disappointing to note that the ones sent to the home by the CMHT have no resident signature. Residents who were spoken to said that they were supported by staff to make their own decisions, and that they were encouraged to manage their own finances where possible. There are weekly residents’ meetings, with an agenda devised by the residents. Two of the residents have been involved in producing minutes of these meetings on the computer. Name D51_D01_S28265_Mead7The_V239178_120905_Stage4.doc Version 1.40 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 standard(s) 12, 13 16 and 17 Social and leisure activities are varied and tailored to individual need, with residents choosing what they wish to do. People’s rights and responsibilities are recognised in their daily lives. Mealtimes are an enjoyable time, and residents are offered a healthy diet. EVIDENCE: There was a marked improvement in the number of activities which residents took part in. Although the inspection started early in the morning, several residents were up and about in the garden and preparing shopping lists. One resident was hovering the downstairs part of the house. Three residents are now cooking every day for themselves, and they have devised a cleaning rota which means that household tasks are divided out evenly and according to choice. Residents have decided that they wanted someone to wake them up in the mornings, so at the weekly meetings one resident is allocated this task. An activities sheet has been introduced and this highlights all the things which are available to do in the next few weeks. Whilst residents still do not have work placements or attendance at courses, their activity levels have greatly Name D51_D01_S28265_Mead7The_V239178_120905_Stage4.doc Version 1.40 Page 12 increased, and their independence and motivational levels have been supported by the staff team. One resident owns a car, and can go on various expeditions. Others go shopping or to the local pub and some enjoy going for long walks. One resident was planning to look for IT training. The food provided in the home was of a good quality, with several residents doing their own shopping and cooking. All residents who self cater have kitchen induction training, including hygiene control and safe handling of foods. There is ready access to the kitchen, and people can have snacks if they want to. A good supply of fruit and vegetables was available and healthy eating options are encouraged. Discussion was held with the manager about the consumption of alcohol by various residents, and a decision was made that this should be monitored. If it was felt that residents’ drinking was causing a problem to themselves or others, this should be discussed with the residents both individually and as a group, with the residents themselves being part of the house decisions. Name D51_D01_S28265_Mead7The_V239178_120905_Stage4.doc Version 1.40 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 standard(s) 20 Self medication is encouraged and supported as much as possible, and residents are protected by the home’s policies and procedures for dealing with medicines. EVIDENCE: Medication policies and practice had been greatly improved since the last inspection. Although no one totally self medicates, support and encouragement is given to those residents who want to try, and this is done on a daily or weekly basis. Procedures are now in place for Clozaril management, both in boxes and in blister packs, and medication support plans are now in place for all residents. There is induction training in medication administration for all new staff, and this is assessed after six months or if an error is made by staff. A recent visit by the Commission for Social Care Inspection (CSCI) pharmacy inspector had pointed out that the temperature of the drugs cupboard was too high. This had immediately been rectified, and the cupboard had been moved to a new, cooler location. However, on examination of the medication stock in the cupboard, it was found that one identified tablet was lying in a box. It was thought by the manager that this tablet had been dropped and was to be returned to the pharmacy. The drug returns book had not been signed, and the medication had not been identified. The manager has been asked to ensure Name D51_D01_S28265_Mead7The_V239178_120905_Stage4.doc Version 1.40 Page 14 that any medication which is to be returned to the pharmacy has the name and dose of the tablet identified and that the staff member responsible for medication administration at the time signs for this. The current practice is to keep all these tablets together in a box, and it is recommended that these are kept individually stored. Name D51_D01_S28265_Mead7The_V239178_120905_Stage4.doc Version 1.40 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 standard(s) 22 and 23 Each resident has a copy of the home’s complaints procedure, and have their views listened to and acted on. The policies and procedures the home has in place try to ensure that residents are safeguarded from abuse and harm. EVIDENCE: The home has a complaints procedure which gives details of the time in which complaints will be investigated, and who will be responsible for making sure it happens. It also gives details of how to contact the Commission for Social Care Inspection (CSCI). All residents are given a copy of the home’s complaints procedure when they come to live there. The manager and staff take all complaints seriously, and record the nature of the complaint, any action taken and the outcome. No complaints have been received about the home by the CSCI. The home has copies of the “No Secrets” document, as well as the organisational policy and procedure on responding to allegations of abuse. The manager and the team leader have booked to attend Wiltshire’s Vulnerable Adults training, and all are encouraged to report any incidences of poor practice. A “Whistle Blowing” procedure is also available for all staff, and risk assessments are in place for all residents. All staff have Criminal Records Bureau (CRB) checks and are checked against the Protection of Vulnerable Adults (POVA) register. Name D51_D01_S28265_Mead7The_V239178_120905_Stage4.doc Version 1.40 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 standard(s) 24 and 30 The care which residents and staff take to maintain the home means that residents live in a homely, comfortable safe environment, which is clean and hygienic. EVIDENCE: The Mead is made up of two semi-detached houses which have been connected into one larger house. There are six individual bedrooms upstairs and a smoking room, a lounge and a large dining room downstairs. There is a large secluded garden to the rear of the house and a small lawned area to the front. The Mead is a comfortably furnished home, with residents’ bedrooms decorated in a homely way and each containing individual personal items. Residents now have a rota for their household chores, although these are still supported by staff when necessary. It was clean and hygienic, with policies and procedures in place for the maintenance of the building. Name D51_D01_S28265_Mead7The_V239178_120905_Stage4.doc Version 1.40 Page 17 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33 Residents are supported by an effective staff team. EVIDENCE: One member of staff spoken to was enthusiastic about the support she had had from both colleagues and the manager. She said that she felt able to ask questions if there were things she didn’t know and that everyone was really helpful. Staff spoken to were seen to be extremely well informed about the wellbeing of all the residents, and able to discuss any detail. One commented that the staff role was “promoting the independence of residents”. There was a good rapport observed between residents and staff. Name D51_D01_S28265_Mead7The_V239178_120905_Stage4.doc Version 1.40 Page 18 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 39 Residents know that their views, and those of their families, underpin the monitoring and review of care practice. EVIDENCE: There are various quality assurance methods used in the home, including regular monthly visits to the home by the provider’ representative. Comprehensive reports of these visits are sent to the CSCI. House meetings are held weekly and the organisation conducts its own internal audit. The service users who responded to the CSCI all said they liked living in the home, that they were treated well and felt safe there. One family who wrote to the CSCI said they were “more than satisfied with their son’s care and the help and attention given to him”. The home has its own resident questionnaire, but it is recommended that this is further developed to seek the views of families and outside professionals who have involvement with the home. Name D51_D01_S28265_Mead7The_V239178_120905_Stage4.doc Version 1.40 Page 19 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 x x x 3 x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x x x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x x x 3 Standard No 11 12 13 14 15 16 17 x 3 3 x x 3 3 Standard No 31 32 33 34 35 36 Score x x 3 x x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Name Score x x 2 x Standard No 37 38 39 40 41 42 43 Score x x 3 x x x x D51_D01_S28265_Mead7The_V239178_120905_Stage4.doc Version 1.40 Page 20 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 20 Regulation 13 (2) Requirement The manager must ensure that any medication which is to be returned to the pharmacy has the name and dose of the tablet identified and is signed for by staff. Timescale for action 12/09/05 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 20 39 Good Practice Recommendations Medication to be returned to the pharmacy should be stored in a way that makes it easily identifiable. The home’s quality assurance programme should be further developed to include the views of families and outside professionals who have involvement with the home. Name D51_D01_S28265_Mead7The_V239178_120905_Stage4.doc Version 1.40 Page 21 Commission for Social Care Inspection Avonbridge House Bath Road Chippenham Wiltshire, SN15 2BB 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 Name D51_D01_S28265_Mead7The_V239178_120905_Stage4.doc Version 1.40 Page 22 - 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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