Inspection on 21/10/05 for Dingle Meadow Care Centre

This inspection was carried out on 21st October 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Dingle Meadow Care Centre 20/10/08

Dingle Meadow Care Centre 06/12/06

Dingle Meadow Care Centre 01/02/06

Dingle Meadow Care Centre 16/03/05

Dingle Meadow Care Centre 27/08/04

Dingle Meadow Care Centre 24/02/04

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Maple Lodge

Heathlands

Aston Court Nursing Home

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Ravenhurst

Bank House

Inspirations

Ashcroft Hollow Nursing Home

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

CARE HOMES FOR OLDER PEOPLE Dingle Meadow Care Centre Goldencrest Drive Oldbury West Midlands B69 2DR Lead Inspector Mrs Mandy Beck Unannounced Inspection 21st October 2005 09:00 X10015.doc Version 1.40 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 Dingle Meadow Care Centre DS0000038425.V261947.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 Older People. 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. Dingle Meadow Care Centre DS0000038425.V261947.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Dingle Meadow Care Centre Address Goldencrest Drive Oldbury West Midlands B69 2DR 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) 0121 552 9355 0121 544 2442 Southern Cross Care Homes No 2 Limited Ms Anette Mole Care Home 46 Category(ies) of Dementia - over 65 years of age (12), Old age, registration, with number not falling within any other category (34) of places Dingle Meadow Care Centre DS0000038425.V261947.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. One service user (female) identified in the variation report dated 8 August 2005 may be accommodated at the home in the category SI(E). This will remain until such time that the identified service users placement is terminated. Date of last inspection Brief Description of the Service: Dingle Meadow Care Centre is a purpose built care establishment which is situated in a residential area within easy access to Oldbury town centre. It is close to public transport routes to local areas, Birmingham, Dudley and Wolverhampton and within easy access of the M5/M6 motorway network. There is a car park at the front and rear of the premises. The garden is situated at the rear of the property. There is level access to the front and entrance is via a key pad system. Service users accommodation is en-suite and on three floors that are accessed via passenger lift or stairs. There are forty-one single and two double rooms. Communal space consists of two lounge/dining areas on the ground floor. There are a number of bathrooms with assisted bathing facilities and toilets situated through the premises. Balmoral unit has provision for 12 service users who have dementia, it has a communal lounge and separate dining room. All of the bedrooms are en-suite and located within the unit. The home provides activities for service users and has an open visiting policy Dingle Meadow Care Centre DS0000038425.V261947.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection carried out by two inspectors between 0930 hours and 1730hours. The inspection included a tour of the building, discussions with both service users and staff. The home has had a change of ownership since the last inspection and is now owned by Southern Cross Healthcare Limited. The home is therefore going through a period of adjustment with the introduction of new policies, procedures and paperwork. As a result of this not all of the requirements from the previous inspection were assessed and will therefore remain outstanding. What the service does well: What has improved since the last inspection? What they could do better: The home needs to review it’s current staffing levels and ensure that the staff and skill mix is sufficient to meet the needs of the service users. Care risk assessments need to have a clear management plan and should be incorporated into the service users individual care plans. There has been an improvement in the way that care records are completed since the last inspection. Dingle Meadow Care Centre DS0000038425.V261947.R01.S.doc Version 5.0 Page 6 The environment is pleasantly decorated however the unpleasant odour in some of the service users bedrooms needs to be addressed. There is a lack of storage facilities within the home, some bathrooms are unused because service users are unable to access them due to the amount of items stored there. The home needs to ensure that all equipment is in good working order to prevent undue distress to the service users. 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. Dingle Meadow Care Centre DS0000038425.V261947.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Dingle Meadow Care Centre DS0000038425.V261947.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,3,4,5 Service users do have appropriate information to be able to make an informed choice about where they live. The home manager visits prospective service users at home prior to admission to assess their needs and ensure that they can be met at the home. Every service user is encouraged to have a trial visit and to make a decision about the suitability of the home for their individual needs EVIDENCE: The manager and the deputy manager always visit prospective service users prior to admission to Dingle Meadow in order to assess their needs and to ensure that the home can meet those needs. The assessment tool they use covers all aspects of care as required by the National Minimum Standards. The company is currently reviewing and updating the statement of purpose and the service user guide and is in the process of consulting with the manager before being made ready for publication. This will be further assessed at the next inspection. Each service user is encouraged to have a trial visit to the home and they can spend the whole day there if they wish sampling the food and the activities and talking to other service users about daily life at Dingle Meadow. Dingle Meadow Care Centre DS0000038425.V261947.R01.S.doc Version 5.0 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 All service users have a care plan and care risk assessments to ensure that their individual needs are met and are reviewed regularly. Medication is administered safely although storage of medicines could be improved. All service users are treated with dignity and respect. EVIDENCE: Service users files showed evidence of regular review on a monthly basis in most cases. However one service user plan had not been reviewed since July. Discussion with service users indicated that the care they receive corresponds with the care that has been planned. Staff need to make sure that when completing care risk assessments they reflect the service users current needs and not the previous months score. Work needs to be undertaken by care staff to develop care plans further by including elements of their care risk assessments to minimise the potential for risk and injury. For example, one service user was assessed as at high risk of falling and had a care plan that addressed his poor mobility but didn’t include any plan that managed the potential for falls. Dingle Meadow Care Centre DS0000038425.V261947.R01.S.doc Version 5.0 Page 10 Medication is generally administered and recorded safely but staff do need to make sure that they are recording when they administer creams and ointments. The medication storage cupboard needs to be tidied up and all medications that are no longer in use should be disposed of appropriately, such as medicines that belonged to service users who were no longer at the home. Throughout the inspection staff were observed knocking before they entered service users rooms, toilets and bathrooms and discussion with service users also indicated that the staff always treat them with respect and dignity and by their preferred term of address. Comments from service users included “they always have a smile on their face” and “they help me and never grumble”. Dingle Meadow Care Centre DS0000038425.V261947.R01.S.doc Version 5.0 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Service users are offered a variety of activities that they themselves have requested. Service users are encouraged to make choices and exercise control over their lives. Mealtimes are a relaxed occasion, food looks appetising and all of the tables are pleasantly presented. Service users are encouraged to maintain contact with their families and the local community EVIDENCE: The home has taken steps to improve the amount of activity each service user has by conducting an a recent survey of their interests via a questionnaire. The recruitment of an activity coordinator has bought some coordination to the planning of activity. Staff admit at times that it can be difficult to get some service users motivated to take part. Service users also acknowledge this, some of the comments from them included “they do do things but I don’t want to take part”, “they try really hard to keep us busy”. The dementia care unit has a designated activity place and service users take full advantage of this enjoying the music, painting and the relaxing atmosphere. Local church representatives visit on regular basis to provide a church service and communion if required. These visits are planned in advance and a notice is available on all notice boards throughout the home. Each of the service users rooms are personalised with photographs, ornaments and furniture from their homes. The home also has two cats, another service user has her own cat, who at the time of inspection appeared very content in it’s surroundings. Dingle Meadow Care Centre DS0000038425.V261947.R01.S.doc Version 5.0 Page 12 At mealtimes everybody has a choice of meal, the tables are attractively laid. Mealtimes are an unhurried affair and seem to be enjoyed by all service users. Staff are currently working to provide the home with pictorial menus to make choosing food easy for some service users. Dingle Meadow Care Centre DS0000038425.V261947.R01.S.doc Version 5.0 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These standards were not assessed at this inspection EVIDENCE: Dingle Meadow Care Centre DS0000038425.V261947.R01.S.doc Version 5.0 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20,21,22,24,26 The home is generally clean and tidy and in a good state of repair. The environment appears to be safe and well maintained. Service users rooms are decorated with their own possessions and have a homely feel to them. There are sufficient lavatories and washing facilities. There is appropriate access to both indoor and outdoor communal facilities. EVIDENCE: The home is generally clean and tidy, however some of the service users bedrooms have a very offensive odour and this should be addressed as soon as possible. There are sufficient bathrooms and toilets to meet service user need but only one bathroom is currently in use, the remaining bathrooms are largely inaccessible because they are being used as storage space for mattresses, hoists and general equipment. It was also noted that one of the hoists is not working because the charger has been lost, staff have been asked to locate a new one as soon as possible. All of the service users bedrooms visited were pleasantly decorated and filled with photographs, furniture and other personal possessions. Dingle Meadow Care Centre DS0000038425.V261947.R01.S.doc Version 5.0 Page 15 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27 Staff numbers are not sufficient to meet the dependency and needs of the service users. EVIDENCE: Staffing numbers do not meet the needs of service users. The home is staffed with the following: 0800 to 1400 1400 to 2000 2000 to 0800 1 senior care and 4 care staff 1 senior care and 4 care staff 1 senior care and 2 care staff During the inspection service users commented “I have asked for a bath but they can’t do it today I’ll probably get it tomorrow”, “the staff are always happy but they don’t have much time to sit and talk to us”, “I’d like to go out more but I need someone to go with me, they can’t always come”. Service users are having to wait for care staff to be available so that they can receive personal care or help with social activity. An immediate requirement was issued asking for a review of staffing numbers and of the dependency of service users to ensure that their needs are being met with current staff numbers. The manager has also been asked to consider using a dedicated staff group for the dementia unit. The home also has domestic, laundry and catering staff employed daily. Dingle Meadow Care Centre DS0000038425.V261947.R01.S.doc Version 5.0 Page 16 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): This standard was not assessed at this inspection EVIDENCE: Dingle Meadow Care Centre DS0000038425.V261947.R01.S.doc Version 5.0 Page 17 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People 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 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X 2 3 3 2 X 3 X 2 STAFFING Standard No Score 27 2 28 X 29 X 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X X X X x Dingle Meadow Care Centre DS0000038425.V261947.R01.S.doc Version 5.0 Page 18 Are there any outstanding requirements from the last inspection? Yes 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 OP22 Regulation 12,14 Requirement The registered provider and manager must ensure that a loop system is provided in the home as section 9 of the homes statement of purpose states that this facility is already provided. (previous timescale 01/05/05 not met) To ensure up to date care plans are generated for all service users who have been identified as “high risk” in respect of falls, nutrition and pressure sore development To establish and introduce a written prevention of falls management policy and procedure which complies with national policy frameworks and good practice guidelines (previous timescale 16/04/05 not met) The registered provider must endure that the manager receives regular, formal and fully recorded supervision sessions (previous timescale of 16/04/05 not met) Timescale for action 30/01/06 2 OP7 13 30/01/06 3 OP7 13 30/01/06 4 OP36 10,9 30/01/06 Dingle Meadow Care Centre DS0000038425.V261947.R01.S.doc Version 5.0 Page 19 5 OP33 24 The manager must put in place a quality monitoring system and ensure that all the requirements of this standard are met. (some new policies and procedures have been issued) (previous timescale of 16/05/05 not met) Provide a policy on volunteers and how and when they will receive training and supervision if the home policy is to recruit volunteers (previous timescale of 16/05/05 not met) To ensure that an up to date statement of terms and conditions/contract is issued to all service users. Terms and conditions/contract must include all of the information as required by the NMS 2.2 including room to be occupied (previous timescale of 16/05/05 not met) To provide evidence that care plans are drawn up with involvement by the service user and/or their representative (previous timescale of 16/05/05 not met) To progress and complete the current programme of refurbishment including replacement (outstanding redecoration of 3 bedrooms) (previous timescale of 16/05/05 not met) To ensure that all staff receive foundation training to TOPSS specifications within the first six months of employment (previous timescale of 16/05/05 not met) 30/01/06 6 OP29 18 30/01/06 7 OP2 5 30/01/06 8 OP7 15 30/01/06 9 OP19 23 30/01/06 10 OP30 18 30/01/06 Dingle Meadow Care Centre DS0000038425.V261947.R01.S.doc Version 5.0 Page 20 11 12 OP37, OP33 OP9 12 13 13 OP11 12 14 OP26 13 15 16 OP26 OP38 23 13 To review all policies and procedures to ensure they reflect the practices of Dingle Meadow To improve the storage, administration and recording of all medication, creams and ointments. To ensure that all creams are labelled with date of opening. (previous timescale of 16/05/05 not met) To obtain service users wishes and preferences with regard to terminal care and formalities to be observed following death. To record on individual service user plans. (this has been addressed in respect of 75 of service users) (previous timescale of 16/05/05) To provide the Commission for Social Care Inspection with a detailed and comprehensive action plan to include timescales for action to improve infection control measures in the following areas: 1) to ensure that laundry walls are impermeable (previous timescale 16/05/05 not met) To undertake the following, repair to the stained and ripped ceiling panels in the laundry The registered provider and manager must risk assess the laundry in respect of the lack of fixed ventilation. The findings from this risk assessment must be documented and addressed accordingly. (previous timescale of 01/04/05 not met) 30/01/06 30/01/06 30/01/06 30/01/06 30/01/06 30/01/06 Dingle Meadow Care Centre DS0000038425.V261947.R01.S.doc Version 5.0 Page 21 17 OP26 13 18 OP26 16,23 19 OP26 13 20 OP26 18 21 22 OP7 OP22 17 23 The registered provider and manager must ensure that the offensive odour on the third floor corridor is eradicated (previous timescale of 01/04/05 not met) The registered provider and manager ensure that the laundry staff only use disposable gloves not the reusable type (previous timescale of 01/04/05 not met) The registered provider and manager must ensure that the offensive odour in bedrooms 43,34,and 36 is eradicated The registered provider and the registered manager must ensure that there are sufficient staff to meet the needs of the service users All service user records are kept up to date and reflect current needs and are regularly reviewed The registered manager needs to ensure that all of the hoists are in working order and that the battery charger for the hoist is purchased 30/01/06 30/01/06 30/01/06 30/01/06 30/11/05 30/11/05 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 OP26 Refer to Standard Good Practice Recommendations A review of the baffle locks on the dementia unit is completed because it was observed that some of the staff were unable to reach the handles and were using a walking stick to gain access to rooms Dingle Meadow Care Centre DS0000038425.V261947.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Halesowen Record Management Unit Mucklow Office Park, West Point, Ground Floor Mucklow Hill Halesowen West Midlands B62 8DA 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 Dingle Meadow Care Centre DS0000038425.V261947.R01.S.doc Version 5.0 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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