CARE HOMES FOR OLDER PEOPLE
Green Meadows Green Lane Denmead Hampshire PO7 6LW Lead Inspector
Marilyn Lewis Unannounced Inspection 09:30 25th July 2007 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 Green Meadows DS0000037294.V346467.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 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 DS0000037294.V346467.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Green Meadows Address Green Lane Denmead Hampshire PO7 6LW 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) 023 9225 5328 Hampshire County Council Mrs Rachel Jane Pearce Care Home 42 Category(ies) of Dementia - over 65 years of age (42), Old age, registration, with number not falling within any other category (42) of places Green Meadows DS0000037294.V346467.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 6th December 2006 Brief Description of the Service: Green Meadows is a purpose built care home providing accommodation 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 residents’ bedrooms. There are additional communal areas including a spacious lounge, smaller seating areas and a hairdressing salon, which is available to all residents. The residents also have the use of additional recreational space in the old day centre facility. The registered manager said during the inspectors visit to the home that the current fees are £392 per week but this is dependent on the person’s financial situation. Green Meadows DS0000037294.V346467.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The last inspection report and information gathered since the last inspection including a visit to the home has been taken into account when writing this report. The unannounced visit to the home took place on the 25th July 2007. During the visit the inspector met with the registered manager, deputy manager, care staff, residents, a visitor and a district nurse. The inspector walked around the home and looked at care plans and risk assessments and records including those for medication, staff recruitment and training, complaints and fire safety checks and drills. At the time of the visit thirty-six residents were living at the home. Three of the residents had dementia. What the service does well:
Residents said that they liked living at the home. Comments included ‘the care is first class’ and ‘it’s very good here, the staff like a laugh with you’. No one is admitted to the home without an assessment of care needs to ensure the home can meet their needs. Prospective residents and their relatives are encouraged to visit the home and meet with staff and residents before making a decision about living there. A district nurse visiting the home said that communication with staff was good and she felt that staff followed her instructions well, ensuring that residents received the appropriate support. Records seen indicated that the health care needs of the residents were being met. Residents said that they enjoyed the activities provided at the home. On the day of the visit a communion service had been held by a local minister for residents who wished to attend and a bingo session was held late morning. Residents said that they were told what activities were due to take place and could decide for themselves if they wished to participate. Residents said that there was a good choice of meals and other alternatives were always available if the two main choices were not to their liking. Meals served were well presented and the atmosphere in the dining rooms was relaxed. Green Meadows DS0000037294.V346467.R01.S.doc Version 5.2 Page 6 The home has a clear complaints policy and residents said that they felt able to talk with the registered manager or a senior member of staff with regard to any complaints or concerns. Staff were receiving training in the protection of vulnerable adults and were aware of the procedures to follow should abuse be suspected. The home looked clean and homely. Residents said that they liked their rooms and the communal areas. One resident said that she had appreciated being able to take some of her personal items with her to the home. Residents said that they felt there were sufficient staff on duty and staff said that the levels of staffing were flexible and additional staff were on duty when the care needs of the residents increased. The home used robust procedures when recruiting new staff. Records seen contained all the information required including two written references. Criminal Records Bureau (CRB) and Protection of Vulnerable Adult (POVA) checks had been completed before new staff members were allowed to start work at the home to ensure they were suitable to work with vulnerable people. Staff said that they were encouraged to obtain qualifications and attend training sessions in topics relevant to the needs of the residents. The registered manager runs the home well and acts on information received from residents and their relatives regarding the quality of care provided at the home. What has improved since the last inspection?
Some of the care plans seen at the last inspection did not provide clear information on the current needs of the residents and the actions required by staff to meet those needs. Care plans seen on this visit showed evidence of regular review and residents admitted for respite care had been reassessed on each visit, to ensure the documents provided up to date information. A requirement was made at the last inspection for arrangements to be made for the safe administration of medication, including Insulin. At this inspection the procedures for administering Insulin remained the same but was due to change to the ‘pen’ system very shortly which would provide a safer procedure. A nurse specialising in Diabetes had provided training for staff who administered Insulin and signed to confirm their competency in the procedure.
Green Meadows DS0000037294.V346467.R01.S.doc Version 5.2 Page 7 What they could do better: 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. Green Meadows DS0000037294.V346467.R01.S.doc Version 5.2 Page 8 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 Green Meadows DS0000037294.V346467.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3, 5 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. No one is admitted to the home without a care needs assessment to ensure the home can meet their care needs. Prospective residents and their relatives are able to visit the home before making a decision about taking a place there. The home does not provide intermediate care. EVIDENCE: The registered manager said that all new residents are admitted following a request from a care manager. The care manager provides a care needs assessment and the registered manager follows this up by visiting the prospective resident at their home or hospital, if an inpatient at the time of the referral. During the visit the registered manager completes another care needs assessment, with if possible the involvement of relatives. Green Meadows DS0000037294.V346467.R01.S.doc Version 5.2 Page 10 Assessments seen for two residents who had recently been admitted to the home, contained information on all care needs including mobility, medical health and personal hygiene. The registered manager said that she also takes into account the level of care dependency of both the new resident and the other residents to ensure staff at the home are able to meet the care needs of all if the new resident is admitted. Prospective residents and their relatives are able to visit the home prior to making a decision about taking a place there. The registered manager said that a care manager had recently brought a prospective resident to the home for them to meet with staff and residents. One resident spoken with said that they had visited the home and seen their room before making a decision and another resident said that her relatives had visited on her behalf. A trial period of approximately twenty-eight days is given to provide time for new residents to settle into life at the home. The home admits residents for respite care but does not provide intermediate care. Green Meadows DS0000037294.V346467.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are involved in the reviewing of their care plans and their health care needs are being met. The registered manager has addressed the concerns regarding the administration and storage of medicines, thereby minimising the risks to the health and safety of residents. EVIDENCE: Care plans were seen for six residents. One of the residents had only been admitted the previous day, two of the residents had been admitted for respite care and three of the residents had been living in the home for some time. Care plans for the resident recently admitted contained good information on the care needs of the resident including nutritional, personal care, mobility and medication.
Green Meadows DS0000037294.V346467.R01.S.doc Version 5.2 Page 12 Care plans seen for residents admitted for respite at the last inspection did not show evidence of review for each visit to ensure the resident’s current care needs had been identified. Care plans seen at this visit for the residents admitted for respite care contained good information and the plans had been reviewed for each respite admission to ensure the current care needs of the residents were identified and the actions required to meet those needs documented. The care plans for the residents who had been living at the home for sometime also showed evidence of regular review. However some of the information provided in the care plans had not been dated and the staff member completing the record had not signed which could lead to confusion as to when the care needs had changed. Risk assessments were contained in the plans including those for the risk of falls, manual handling and bathing. Some of the risk assessments were vague and needed more details such as a risk assessment for bathing stated that there was a risk of falling but did not provide guidance such as the temperature of the water. The assistant manager said that a new system had just been introduced whereby senior staff had been given different responsibilities for ensuring care plans and risk assessments were rewritten and kept under review. New risk assessment forms were being introduced that would document the risks in a clearer format and would ensure that the risk assessments were written to include a breakdown of the risks and the actions required to minimise the identified risks. Two residents spoken with said that they were aware of what was written in their care plans and said that a staff member went through it with them. They said that their care plans were kept in their rooms so they could read them as they wished. Health records seen indicated that residents’ health care needs were being met. Visits from GPs and other health workers were documented in the health records. A resident said that they asked staff if they wanted to see their GP and a visit was arranged. A district nurse visiting the home said that communication with staff was very good and staff followed her guidance and instructions well. The assistant manager said that only staff who had received training in the safe administration of medication were allowed to give out the medicines. Systems are in place to record and monitor medication brought into the home and for disposal of unwanted items. Medication records seen contained two gaps where the staff member administering the medicines should have signed. The registered manager said that she knew which staff member had been on duty that evening and that she Green Meadows DS0000037294.V346467.R01.S.doc Version 5.2 Page 13 would speak with the staff member with regard to the correct procedures for completing the records when administering medication. Following the visit the registered manager notified the inspector that she had spoken with the staff member concerned. Records for controlled drugs matched the amount held for the resident whose records were checked. A quantity of controlled drugs were due to be returned to the pharmacy. The assistant manager said that a staff member was going to return the drugs and would get the pharmacist to sign to confirm receipt of the drugs. It would be advisable for two staff members to return the drugs so that there is a witness to the process. Three residents self- administer their own medicines. One of the residents kept her medicines in a locked drawer while the other two kept them in a drawer that was not locked. The registered manager said that this was due to the layout of their rooms and their preference for where furniture was placed. The registered manager said that she would discuss the risks to other residents when medicines were not stored in locked drawers with the two residents and if needed move the furniture so that they were able to easily access their locked drawer. Following the visit the registered manager notified the inspector that the three residents had been asked to store their medicines in their locked drawer or lock the door of their room when they left it. At the time of the last inspection concerns were raised regarding the drawing up of insulin for one resident. The district nurse drew up insulin for the two doses needed per day and for seven days at a time. The insulin was stored in containers in the fridge with each container marked with the dose and time of administration. This was agreed as unsafe practice. The district nurse is still drawing up insulin for a week at a time but arrangements are in place to change the system so that ‘pen’ doses are used which provide a safer method of storage. Staff have been trained to administer the insulin and confirmation of the competency of the staff member was seen signed by the nurse specialist for diabetes. Procedures for the administration of the insulin were not available although staff spoken with were aware of the procedures to follow. The registered manager said that procedures would be written immediately and they were forwarded to the inspector the following day. Risk assessments are in place for the use of oxygen in a resident’s room. During the visit staff were seen to knock on doors and wait before entering residents rooms and bathrooms. Residents said that they were treated with respect at all times and they were able to lock the door to their room as they wished. Green Meadows DS0000037294.V346467.R01.S.doc Version 5.2 Page 14 Green Meadows DS0000037294.V346467.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are able to participate in social activities, receive visits from family and friends as they wish and their cultural and religious needs are being met. Residents enjoy the choice of meals provided at the home. EVIDENCE: Staff complete a form for each resident on their admission to the home that provides information on the cultural and religious needs of the resident. Information seen included the religion of the resident and whether they wished to attend church services, any special dietary needs and details such as special clothing they required for religious or faith purposes. Residents, who wished to, had attended the weekly communion service that morning provided by the vicar of the local Anglican Church. The minister of the local Baptist Church also holds a monthly service at the home. A resident said that there is always something to do at the home and she very much enjoyed the quizzes. Residents said that they also enjoyed the bingo session held late morning that day. One resident said that staff had told her
Green Meadows DS0000037294.V346467.R01.S.doc Version 5.2 Page 16 the bingo session was taking place but she preferred to spend time in her room. The home does not employ an activities co-ordinator but a carer is employed for additional hours to provide activities for the residents. External entertainers including musicians visit the home and a resident said that the ‘Songs from the last 60 years’ had been good. Residents said that they could receive visitors at any time and a visitor spoken with said that she was always made to feel welcome at the home. The care plans seen for one resident said that staff were to assist the resident in writing letters and making telephone calls to maintain contact with family and friends. The cook said that he was provided with information regarding the dietary needs of the residents and also their preferences for food items. The cook had been notified that the resident admitted the previous day required a special diet. Some of the residents required their food to be pureed and the cook said that two residents had asked that the food be pureed as one and not as separate items, which he did. Residents were offered a choice of two main meals but alternative meals were always available if they wished them and residents confirmed this. Residents all said that the food provided at the home was good and there was plenty of it. The choice of meals for lunch on the day of the visit was roast beef with Yorkshire pudding, cabbage, swede and potatoes or cold meat salad followed by sponge pudding and custard. Meals seen were well presented and residents said that the food was ‘tasty’. One resident said that the Yorkshire pudding was the ‘best she had tasted’. Green Meadows DS0000037294.V346467.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents feel that all complaints will be taken seriously and acted upon and they are protected by staff awareness for the protection of vulnerable adults. EVIDENCE: The home has a complaints policy in place that indicates who will investigate the complaint and timescales for the process. A copy of the complaints policy was contained in the records of each resident kept in their rooms. The complaints log indicated that all complaints were taken seriously and acted upon quickly. Three residents said that if they had any complaint they would talk with the registered manager or one of the senior staff members. The residents said that they felt sure the matter would be looked into and any actions needed taken. The residents said that they had never had the need to make a complaint. All staff members except five had received training in the protection of vulnerable adults. Dates had been arranged for the five who needed to attend training sessions. Staff spoken with were clear about the procedures to follow should abuse be suspected. Policies and procedures including Hampshire County Council’s
Green Meadows DS0000037294.V346467.R01.S.doc Version 5.2 Page 18 Protection of Vulnerable Adults and Whistle Blowing were readily available for staff. Green Meadows DS0000037294.V346467.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22, 23, 24, 25 and 26 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 clean and homely environment for all who live and visit there. EVIDENCE: The home is a purpose built care home with accommodation for forty- two residents provided on two floors. Stairs, stair lifts and a passenger lift provide access to each floor. Accommodation is provided in ‘units’ to enable residents to live in a more homely environment, with a number of bedrooms, bathroom and toilet facilities, a small sitting room and dining area with kitchenette in each of the units. Green Meadows DS0000037294.V346467.R01.S.doc Version 5.2 Page 20 Residents also have access to a large lounge and activities room on the ground floor. One room has been fitted with hairdressing equipment and the hairdresser visits weekly. The home looked clean and homely. Residents are all accommodated in single rooms and those spoken with said that they liked their rooms. One resident said that she ‘had all she needed in her room. Rooms seen had been personalised with small items of furniture, pictures, ornaments and plants. One resident said that she had appreciated being able to ‘bring her bits and pieces’ into the home with her as they held a lot of memories. Some of the residents’ rooms were fitted with overhead hoists to assist staff in the moving and handling of residents with impaired mobility. A staff member said that they had received training in the use of the overhead hoists. A call alarm system is provided throughout the home. Sufficient bathroom and toilet facilities are provided for residents and those seen during the visit looked clean and in good order. Assisted baths are provided that enables all the residents to take a bath with assistance should they wish one. At the time of the last visit, various toiletries were stored in the bathrooms that could have been for communal use that could have increased the risk of cross infection. On this occasion no toiletries were seen in the bathrooms. A pleasant garden with sitting areas is situated to the rear of the property. Green Meadows DS0000037294.V346467.R01.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are supported by staff who are recruited through robust procedures and who receive the training they require to do their jobs and fully support the residents. EVIDENCE: Residents spoken with said that they felt sufficient staff were on duty and they did not have to wait long when they requested assistance. Staff also said that sufficient staff were on duty for each shift. The deputy manager said that staffing levels were flexible and additional staff were on duty when the dependency needs of the residents increased. The home employs the registered manager, deputy manager, four assistant managers, three night care co-ordinators and thirty carers. Five carers were on duty in the mornings, four carers in the afternoons and two carers plus a night care co-ordinator at night. The registered manager or the deputy manager were also on duty each day. Separate staff were employed for administration, catering and domestic duties. Twenty of the thirty carers hold or are in the process of obtaining NVQ level 2 or above in care. Staff said that they were encouraged by the registered
Green Meadows DS0000037294.V346467.R01.S.doc Version 5.2 Page 22 manager and the deputy manager to obtain qualifications that would enhance their care skills. Training records indicated that staff received training in mandatory subjects such as moving and handling and food hygiene as required. Dates had been arranged for staff who required refresher training in these areas. Arrangements were also in place for staff to receive training in dementia care. At the time of the inspection three residents at the home had been assessed as having early dementia and the registered manager said that the training had been arranged to ensure the needs of the residents and any admitted later with dementia were fully met. The home follows Hampshire Count Council’s recruitment procedures when recruiting new staff. The registered manager said that some staff were currently being redeployed from the Home Care service. Records were seen for three staff members, one of whom had been employed since the last inspection. The records contained all the information required including two written references and there was confirmation that a Protection of Vulnerable Adult (POVA) and Criminal Records Bureau (CRB) checks had been completed before staff commenced work at the home to protect the safety of the residents. Green Meadows DS0000037294.V346467.R01.S.doc Version 5.2 Page 23 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35, 36 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is run in the best interests of the residents. The registered manager is addressing the need for some staff members to attend fire drills to ensure they are aware of the appropriate actions to take should an incident occur, minimising the risk to safety of the people living and visiting the home. EVIDENCE: The registered manager Rachel Pearce has been the manager of the home since 1999. Mrs Pearce is known at the home by her maiden name of Rachel Reed. Mrs Pearce has good experience of the care sector and she holds NVQ 4 in Care and Management and a certificate in Personal Social Services
Green Meadows DS0000037294.V346467.R01.S.doc Version 5.2 Page 24 Management. Mrs Pearce attends all relevant training sessions to ensure has the up to date knowledge and skills to run the home. Staff said that they received good support from the registered manager and residents said that they found her caring and easy to talk with. The registered manager operates an open door approach to management and staff, residents and visitors said that they were able to talk with her at any time. A staff member said that staff meetings were held regularly and she found them very helpful. The registered manager said that separate meetings for care staff, domestics and night staff were held every two months and a general meeting was held four monthly or more frequently if needed to ensure staff were updated on any changes to procedures. Senior staff met weekly. Residents meetings were held in each of the units of the home on a three monthly basis. A resident said that she was always told when a meeting was due to take place and liked to go and discuss any changes to ‘life at the home’. A customer survey was also completed for residents, staff and relatives. Information obtained from the last survey indicated that people were satisfied with the quality of care provided at the home. The home keeps small amounts of money for residents. The monies are stored individually in a safe place and records are kept of all transactions. Records seen for three residents matched the amounts held. Staff said that they received regular supervision and records seen confirmed this. The registered manager said that Individual Performance Plans were being developed for each staff member that would contain supervision and annual appraisals records. During the visit to the home staff were observed using appropriate procedures for the moving and handling of residents and they used protective clothing where necessary to reduce the risk of cross infection. However in some residents bedrooms denture cleaning tablets were clearly on view and this could pose a risk for those residents with dementia who could enter the rooms unaccompanied. The deputy manager said that she would arrange for the tablets to be stored in the residents locked drawers. Items such as cleaning fluids, which could be hazardous to health, were stored safely. Certificates were seen to indicate that maintenance checks for utilities and electrical appliances were undertaken regularly. Fire records showed that fire safety equipment was checked weekly or monthly as needed but records for fire drills indicated that some staff had not attended a fire drill in the last year which could put people at risk in the event of an incident. Green Meadows DS0000037294.V346467.R01.S.doc Version 5.2 Page 25 The registered manager notified the inspector following the visit that arrangements were being made for all staff to attend fire drills. Green Meadows DS0000037294.V346467.R01.S.doc Version 5.2 Page 26 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 x x 3 x 3 N/a HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 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 3 17 X 18 3 3 3 3 3 3 3 2 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 3 X 2 Green Meadows DS0000037294.V346467.R01.S.doc Version 5.2 Page 27 Are there any outstanding requirements from the last inspection? NO 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 OP38 Regulation 13 (4)(a) Requirement To minimise the risk to the safety of residents, denture cleaning tablets, which could pose a risk, should be stored safely and not kept on view. All staff should attend fire drills to ensure they are aware of the appropriate actions to be taken should an incident occur. Timescale for action 25/08/07 2. OP38 23(4)(e) 25/08/07 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 Green Meadows DS0000037294.V346467.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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
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