CARE HOMES FOR OLDER PEOPLE
Home Meadow Comberton Road Toft Cambridgeshire CB3 7RY Lead Inspector
Joanne Pawson Unannounced 17 June 2005 @ 10:00 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. Home Meadow I53 I03 15160 Home Meadow v232624 170605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION
Name of service Home Meadow Address Comberton Road, Toft, Cambridgeshire, CB3 7RY 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) 01223 263282 01223 264201 Home Meadow Limited Mrs Dawn Mills Care Home 34 Category(ies) of Dementia - over 65 years of age(8), Old age, registration, with number not falling within any other category (26) of places Home Meadow I53 I03 15160 Home Meadow v232624 170605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION
Conditions of registration: No Date of last inspection 18th October 2004 Brief Description of the Service: Home Meadow is situated in the village of Toft approximately seven miles from the centre of Cambridge. There is a public house in the village and a shop that provides a wide range of services including a post office. A limited bus service operates between Toft and Cambridge.The building is single storey and is divided into five flats. Each flat accommodates between five and eight people. One of the flats is for service users who have mental confusion and another flat accommodates ‘respite’ service users. Each flat consists of a bathroom with WC, a further WC, a kitchenette, and a lounge/dining area and between five and eight single bedrooms. The home has a day centre with a large lounge and service users in the home use this for communal gatherings when the day centre is not in use. The home has well maintained gardens. Home Meadow I53 I03 15160 Home Meadow v232624 170605 Stage 4.doc Version 1.30 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was the first inspection for Home Meadow for 2005/06. This unannounced inspection took place for four hours and was carried out by one inspector between 9.00 and 13.00hrs. On the day of inspection eleven residents were spoken to. Other methods used for the inspection included reading documentation, speaking to staff, speaking to the manager and a tour of the home. The home is pleasantly decorated with items that residents have made during activity sessions and makes the long corridors looks cheerful. The district nurse who was in the home during the inspection said ‘she had nothing but praise for the home’. What the service does well: What has improved since the last inspection?
The complaints procedure has been updated to clearly define the different stages of the procedure. The Staffing levels have increased to provide more staff at busy times of the day.
Home Meadow I53 I03 15160 Home Meadow v232624 170605 Stage 4.doc Version 1.30 Page 6 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. Home Meadow I53 I03 15160 Home Meadow v232624 170605 Stage 4.doc Version 1.30 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 Home Meadow I53 I03 15160 Home Meadow v232624 170605 Stage 4.doc Version 1.30 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) These standards were not inspected during this inspection. EVIDENCE: Home Meadow I53 I03 15160 Home Meadow v232624 170605 Stage 4.doc Version 1.30 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 standard(s) 7,8,9,10,11 Systems of care planning were clear and well laid out and would be a useful tool in guiding staff about how to support those living in the home. Residents are supported to access health care professionals to ensure that they are receiving the appropriate treatment and care. Staff were seen encouraging service users to make their own decisions about their lives to the best of their abilities with help and guidance from staff when necessary. EVIDENCE: Care plans of three residents living in the home were seen and they contained information needed by the staff. Staff were aware of the contents of care plans. One resident said that he was not aware of his care plan. The manager stated that all residents had been made aware of the care plans. Risk assessments were completed and contained the necessary information and stated that residents should still be encouraged to be as independent as possible. A manager was observed administrating medication. She asked the residents if they wanted their PRN medication rather than just giving it to them.
Home Meadow I53 I03 15160 Home Meadow v232624 170605 Stage 4.doc Version 1.30 Page 10 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) 12,13,14,15. Residents are offered a healthy diet and mealtimes are relaxed. Time is taken by staff to find out about a residents background and likes and dislikes and these are taken into consideration when planning activities. Residents enjoy different groups from the local community visiting and performing. Staff encourage residents to take control and be as independent as possible where appropriate. EVIDENCE: The care plans looked at contained a detailed pen portrait of the resident including employment, family, interests and hobbies and important events in their life. Care staff were observed interacting with residents. The staff members gently encouraged residents to do as much as possible for themselves but when needed the staff member helped the resident. A wide range of in-house activities are offered. On the day of the inspection residents were all helping to do a crossword. One resident spoken to said she always looked forward to the crossword session. Home Meadow I53 I03 15160 Home Meadow v232624 170605 Stage 4.doc Version 1.30 Page 11 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) 16,17,18 The homes system for dealing with complaints were satisfactory as were the arrangements for ensuring the protection of residents from abuse. EVIDENCE: The complaints log was inspected. There has been one complaint made since the last inspection. The complaint was investigated and the necessary action taken. Care staff receive training in the protection of vulnerable adults. Home Meadow I53 I03 15160 Home Meadow v232624 170605 Stage 4.doc Version 1.30 Page 12 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) 19,20,21,22,23,24,25,26 The long corridors have been made more homely by decorating them with items made by residents in the craft sessions such as painted plaques and plates. The home grounds, and equipment available is suitable for the residents living there. Access doors to the home were not secure on the day of the inspection; this could put residents at a potential risk. EVIDENCE: The home is well maintained and clean. Resident’s bedrooms are pleasantly personalised with their own items. Residents stated that they could have a television in their bedroom if they wanted to. One resident said she enjoyed watching television on her bedroom. The front door was propped open on the day of the inspection. In one of the bathrooms used disposable razors and hairbrushes were found in a cupboard by the bath. These should be disposed of to reduce the risk of cross infection or accident. One of the senior managers stated that items should have been disposed of when they had been used.
Home Meadow I53 I03 15160 Home Meadow v232624 170605 Stage 4.doc Version 1.30 Page 13 On the day of the inspection the front doors were propped open and the inspector was able to walk into the home without any staff enquiring who she was. Home Meadow I53 I03 15160 Home Meadow v232624 170605 Stage 4.doc Version 1.30 Page 14 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) 27,28,29,30 The staff level was adequate to meet the needs of the residents at time of the inspection. Staff were clear about their roles and were aware of the needs of the residents. The homes recruitment policy and processes help to ensure that service users are protected from potential abuse. EVIDENCE: Five members of staff were observed working with the residents. It was clear that they had built up professional and friendly relationships with the residents. Residents stated that they liked the staff. One resident stated that she likes to stay up to spend time with the night staff. Staff files were inspected and had the necessary recruitment information such as application forms, references and criminal record bureau checks. Home Meadow I53 I03 15160 Home Meadow v232624 170605 Stage 4.doc Version 1.30 Page 15 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) 31,32,33,34,35,36,37,38 The home was properly managed and the staff benefit from strong leadership and guidance to ensure that residents have a good quality service. The home carries out the required health and safety checks to provide a safe environment for the residents. EVIDENCE: The residents and staff said that they could speak to the manager about any issues they may have. There is always a manager of senior carer on shift and a manager on call in case of an emergency. Records relating to the three service users and the home were up to date and held securely in the flats or in the office. Records held on behalf of residents were checked and found to be accurate. Various health and safety checks are carried out a regular basis and recorded.
Home Meadow I53 I03 15160 Home Meadow v232624 170605 Stage 4.doc Version 1.30 Page 16 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 x x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3
COMPLAINTS AND PROTECTION 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 Standard No 16 17 18 Score 3 3 3 3 3 3 3 3 3 3 3 Home Meadow I53 I03 15160 Home Meadow v232624 170605 Stage 4.doc Version 1.30 Page 17 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 OP25 Regulation 13(4) Requirement Arrangements must be put in place no later than the 15th July 2005 to ensure that no unauthorised person can enter without first being seen by an member of staff. (This was a requirement from the previous inspection). The home must take measures to prevent the risk of cross infection. Timescale for action 15th July 2005 2. OP25 13(3) 15th July 2005 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 Home Meadow I53 I03 15160 Home Meadow v232624 170605 Stage 4.doc Version 1.30 Page 18 Commission for Social Care Inspection CPC1, Capital Park Fulbourn Cambridge CB1 5XE 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 Home Meadow I53 I03 15160 Home Meadow v232624 170605 Stage 4.doc Version 1.30 Page 19 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!
