Inspection on 20/09/05 for Green Meadows

This inspection was carried out on 20th September 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 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

Green Meadows 25/07/07

Green Meadows 06/12/06

Green Meadows 01/02/06

Green Meadows 14/02/05

Green Meadows 26/08/04

Green Meadows 10/03/04

Green Meadows 10/02/04

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

CARE HOMES FOR OLDER PEOPLE Green Meadows Green Lane Denmead Hampshire PO7 6LW Lead Inspector Isolina Reilly Unannounced 20 September 2005 9.00am 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 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. Green Meadows 20050920 Green Meadows X10015 UN Stage 4 S37294 V251785.dot Version 1.40 Page 3 SERVICE INFORMATION Name of service Green Meadows Address Green Lane Denmead Hampshire PO7 6LW 023 9225 5328 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) Hampshire County Council Mrs Pearce CRH - Care Home 42 Category(ies) of DE(E) - Dementia - over 65 - 42 registration, with number OP - Old Age - 42 of places Green Meadows 20050920 Green Meadows X10015 UN Stage 4 S37294 V251785.dot Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 14th February 2005 Brief Description of the Service: Green Meadows is a purpose built residential care home registered for 42 older persons, including those with dementia. The home is owned and managed by Hampshire County Council. Accommodation is provided in four units across two floors, and benefits from a large landscaped garden and extensive views over the countryside. Each unit has a lounge dining room, small kitchen, bathroom and toilet, as well as service user bedrooms. There are additional communal areas including a spacious lounge and smaller seating areas, hairdressing salon and a day centre on site, which is available to all service users. Green Meadows 20050920 Green Meadows X10015 UN Stage 4 S37294 V251785.dot Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. On the day of this unannounced visit the opportunity was taken to look around the home, view records and talk to service users and staff. The manager of the home assisted the inspector during the visit. The inspector was able to speak with twenty-one service users, three relatives and one community carer. Eight staff including the deputy manager were also spoken with. The home has supplied extra written information for this inspection prior to the visit. The CSCI received comments in writing from service users and friend and family. What the service does well: What has improved since the last inspection? What they could do better: The home is to records for all medicines coming into the home and medicated creams kept in service users’ bedroom are labelled with their name. Green Meadows 20050920 Green Meadows X10015 UN Stage 4 S37294 V251785.dot 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. Green Meadows 20050920 Green Meadows X10015 UN Stage 4 S37294 V251785.dot Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Green Meadows 20050920 Green Meadows X10015 UN Stage 4 S37294 V251785.dot Version 1.40 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 standard(s) 3 and 6 Since the last inspection, the home has met the requirement to potential new service users’ assessments including risks. This has resulted in an admission process that is well managed. The home does not provide ‘Intermediate Care’. EVIDENCE: The inspector observed that the home’s Statement of Purpose and Service User Guide including a copy of the menu was on display by the main notice board. Five service users files were sampled and three were seen and discussed in detail with in the individual. Admission records sampled demonstrated that full needs and risk assessments are completed by the referring Social Services Care Manager. The records from the home’s admission assessment were also present and found to be detailed and have met the requirement issued at the previous inspection Two of the service users files sampled had recently been admitted to the home. The manager and staff explained that service users and families are Green Meadows 20050920 Green Meadows X10015 UN Stage 4 S37294 V251785.dot Version 1.40 Page 9 encouraged to viewed the home prior to them coming to stay. The service users and relative spoken with confirmed this. The service users and relatives spoken with confirmed they were made welcome, shown around the home and introduced to other service users and staff. The files sampled showed that a full assessment had been recorded prior to and on admission and reflected the information given by the service users spoken with. All the service users spoken with confirmed that they liked the home, felt comfortable and safe. The manager confirmed that the home does not provide ‘intermediate care’ rehabilitative short-term type care for Social Services. Green Meadows 20050920 Green Meadows X10015 UN Stage 4 S37294 V251785.dot Version 1.40 Page 10 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 standard(s) 7, 8, 9 and 10 The service users are well looked after in respect of their personal and health care needs in such a way as to promote privacy and dignity. Since the last inspection the home has improved the care planning so there is a clear and consistent system in place providing staff with the information they need to meet service users’ needs. Links with the community are good and enrich service users’ social and cultural opportunities both within the home environment and external. The systems for the administration of medication are good with clear and comprehensive arrangements being in place to ensure service users medication needs are met. The home will ensure that comprehensive records are kept of all medicines entering the home. Since the last inspection, the policy and procedure for ‘When required medicines’ has been adequately updated. EVIDENCE: Five service users files were sampled and three were seen and discussed in detail with in the individual. All three-service users stated that they were fully involved in the review of their care plan and that they were an accurate representation of their needs and had signed their notes. The service users spoken with were all very complimentary of the care provided by the home. Stating that staff are very helpful, polite, appear to Green Meadows 20050920 Green Meadows X10015 UN Stage 4 S37294 V251785.dot Version 1.40 Page 11 know what they are doing and look after them well. They also said that the staff are always respectful and mindful of their privacy and dignity. The relatives spoken with also confirmed this. However, one service user was unhappy about the introduction of uniforms stating that this made the home look and feel like an institution. This was discussed with the manager who confirmed that the service users views had been forwarded to senior management within Hampshire County Council who were responsible for the uniforms being implemented. The inspector observed the staff interacting with the service users and found them to be attentive and professional. There were staff around most of the time in the communal areas. The care plans contained written risk assessments and instructions to staff on how to look after the individual service users. The records also included names of relatives, friends, health care professionals and social services care managers who are involved in supporting the resident. A resent photograph was seen on all the files and records of instructions on care when dying and death. The home is in the process of implementing the new Hampshire County Council Care Plan system that will enable the home to maintain the necessary level of information. There were also records of doctor/nurse visits and information on outpatient, dental, optician and chiropractic appointments. The doctor from a local surgery visits twice weekly other doctors will undertake home visits when requested. The manager confirmed that individual mobility aides are available or if used from stock these were clearly identified for the individual following appropriate infection control protocols. The staff were observed administering medication appropriately and the good medication administration practices are reflected in the homes policy and procedures that were briefly sampled. The administration and disposal records of medication were seen by the inspector and found to be satisfactory. It was noted that the checks undertaken on all medication received are not consistently recorded. This was discussed with the manager and deputy who gave a verbal undertaking to ensure that records including signatures are consistently keep of all medication received. The storage of ‘control drugs’ was checked and found to be satisfactory. Records for administration and stock levels for ‘control drugs’ were also check and found to be correct. The inspector viewed the home’s medication storage cupboard and found it to be clean with medication stored correctly in date and in sufficient quantities. The minimum and maximum thermometer for the medication fridge needed a new battery. This was done immediately. During the tour of the home, two pots of creams (over the counter creams) being used for skin care were found to be unlabelled. This was discussed with Green Meadows 20050920 Green Meadows X10015 UN Stage 4 S37294 V251785.dot Version 1.40 Page 12 the manager and deputy who gave a verbal undertaking to ensure that all medicated lotions and creams are labelled with the service users name and date the cream was first opened. The manager explained that staff receive regular updating on the safe handling and administration of medicines training from the local pharmacy. A copy of the Royal Pharmaceutical Guidelines for residential care was available in the home’s medication file. Green Meadows 20050920 Green Meadows X10015 UN Stage 4 S37294 V251785.dot Version 1.40 Page 13 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 standard(s) 12, 13, 14 and 15 The service users experience a stimulating and varied life at the home with visitors encouraged, various formal and informal structured activities are made available including visiting clergy. The meals in this home are good offering both choice and variety, catering for special dietary needs in pleasant settings. EVIDENCE: The inspector observed several service users reading the daily newspapers and appropriate background music was playing. The service users spoken with said that they liked the music. They also confirmed that they take part in several activities like quizzes, carpet games and reminiscing and they also enjoy most of the outside entertainers that visit the home. Activities and special events were advertised on information boards around the home. It was noted that large print books were available and the home has a craft room. This is predominately used by one service user who makes various articles. One resident explained that she liked to go to church but now found it difficult because of her health but was pleased to attend the services regularly held at the home. The home has a staff member who has a special remit for activities and records are kept of activities offered. Green Meadows 20050920 Green Meadows X10015 UN Stage 4 S37294 V251785.dot Version 1.40 Page 14 The relatives spoken with feel the service users are very well cared for and one relative said that they are also encouraged to attend special events if they wish. All the service users stated that the day routine is flexible and a meal can be put aside should they wish. The cook and assistant spoken with explained that the home caters for special diets mainly diabetic. The inspector was able to sample the four-week menu rota and found it to be varied and balanced. The menus showed that two options were offered and the cooks explained there was often up to four different choices. The records of hot food probe, fridge and freezer temperatures were available and satisfactory. All the service users spoken with found the food very good and that there was always a choice of meals. The staff were observed asking the service users which meal they would like as the meal were being served. The meal was observed by the inspector and found to be relaxed, unhurried and the food attractively presented at tables with table clothes. Green Meadows 20050920 Green Meadows X10015 UN Stage 4 S37294 V251785.dot Version 1.40 Page 15 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 standard(s) These standards will be assessed at the next inspection. EVIDENCE: Green Meadows 20050920 Green Meadows X10015 UN Stage 4 S37294 V251785.dot Version 1.40 Page 16 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 standard(s) 19 and 26 The home presents as a clean, homely, comfortable and suitable environment for the service users. The standard of the décor within the home is good with evidence of on-going maintenance. EVIDENCE: The service users stated that the home is always clean, warm and no offensive odours were detected. They also confirmed that there has been on going decorating most recently the corridors. Several service users stated that they were happy with their bedrooms and had been able to bring some of their own furniture and personal effects. The home has a maintenance, repair and redecoration scheme. The home has recently installed a new ‘nurse call system’. New fire smoke excluding strips have been fitted to four doors identified by Hampshire Fire and Rescues service. Green Meadows 20050920 Green Meadows X10015 UN Stage 4 S37294 V251785.dot Version 1.40 Page 17 All the bedrooms were seen on a tour around the home and were found to be clean, bright and warm, furnished to the individuals taste and many had been personalise. All service users’ spoken with felt there were enough toilets and bathrooms or showers. During the tour of the home the inspector noticed that all the communal hand sinks have liquid soap for washing hands, disposable paper towels and staff appropriately using gloves and disposable aprons. The laundry rooms appeared appropriate, clean tidy with washable floors and walls. The washing machines and tumble dryers are industrial and have the appropriate infection control washing programmes. The service users also have access to separate purpose built hairdressing room. The home has separate staff sleeping room, sitting and changing area. Green Meadows 20050920 Green Meadows X10015 UN Stage 4 S37294 V251785.dot Version 1.40 Page 18 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 30 Since the last inspection, the staff training has continued to improve ensure that they have the necessary knowledge and skill to meet the needs of the service users. EVIDENCE: The service users spoken with described the staff as ‘caring, friendly, helpful and there when they are needed.’ All the service users spoken with said there was sufficient staff around. One service user explained that the staff know what they are doing, although the new staff are still learning but supported by the other staff. The staff spoken with stated that they have been working at the home for some time and recall that the induction programme run by the home was useful. The files sampled held records of the individual staff home’s own induction’ training covering the key areas with the signatures of the staff member and trainer. The manager confirmed that the home’s induction programme meet the Skills for Care minimum standards for induction. The staff spoken with confirmed that the home continues to provide and support staff to achieve qualifications in care to National Vocational Qualification level 2 and 3. The home’s training records show that the home undertakes training by staff and management with specialist skills and qualifications, Hampshire Social Green Meadows 20050920 Green Meadows X10015 UN Stage 4 S37294 V251785.dot Version 1.40 Page 19 Services training courses and expertise awareness session from district nurses. The staff spoken with confirmed that they undertake training regularly. The inspector was able to sample training certificates and other records of training undertaken by the staff. Since the last inspection, the home has delivered update training in specialist areas including Adult protection, dementia and is in the process of disseminating the new Hampshire County Council infection control policy. This meet the requirement issued at the previous inspection. The home has a positive supportive ethos and staff training. The training records also show that staff have received training in relevant health and safety subjects including food hygiene, moving and handling and medication. Green Meadows 20050920 Green Meadows X10015 UN Stage 4 S37294 V251785.dot Version 1.40 Page 20 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31 The home is run well by an experienced manager supported by deputy manager and Hampshire County Council departments. EVIDENCE: The manager has many years experience within social care field for older people and those with dementia type needs. This is evident in the good service provided and a happy staff team. She undertakes regular updating training with the staff team and has a National Vocational Qualification Registered Manager’s Award. The staff spoken with confirmed that there is a clear line of authority within the home. The manager is always looking for ways to improve the service and efficiency. Green Meadows 20050920 Green Meadows X10015 UN Stage 4 S37294 V251785.dot Version 1.40 Page 21 The manager confirmed the internal audit for the home has been completed. The home’s formal quality assurance and monitoring process will be fully inspected at the next visit. Green Meadows 20050920 Green Meadows X10015 UN Stage 4 S37294 V251785.dot Version 1.40 Page 22 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 x x x x x x 3 STAFFING Standard No Score 27 x 28 x 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x x 3 x x x x x x x Green Meadows 20050920 Green Meadows X10015 UN Stage 4 S37294 V251785.dot Version 1.40 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 Regulation Requirement Timescale for action 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. Refer to Standard Good Practice Recommendations Green Meadows 20050920 Green Meadows X10015 UN Stage 4 S37294 V251785.dot Version 1.40 Page 24 Commission for Social Care Inspection 4th Floor Overline House Blechynden Terrace Southampton, Hampshire SO15 1GW 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. 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