Inspection on 03/02/06 for Little Meadows

This inspection was carried out on 3rd February 2006.

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

Little Meadows 30/03/10

Little Meadows 08/05/09

Little Meadows 14/05/07

Little Meadows 21/08/06

Little Meadows 13/07/05

Little Meadows 25/01/05

Little Meadows 30/06/04

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Westmead

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Little Meadows 1 Poplar Avenue Cross Heath Newcastle Staffordshire ST5 9HR Lead Inspector Peter Dawson Unannounced Inspection 3rd February 2006 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 Little Meadows DS0000004974.V282135.R01.S.doc Version 5.1 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. Little Meadows DS0000004974.V282135.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Little Meadows Address 1 Poplar Avenue Cross Heath Newcastle Staffordshire ST5 9HR 01782 711669 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) Mr Rashid Baserat-Ahari Mrs Jennifer Diane Baserat-Ahari Mrs Jennifer Diane Baserat-Ahari Care Home 19 Category(ies) of Dementia - over 65 years of age (4), Old age, registration, with number not falling within any other category (19), of places Physical disability over 65 years of age (8) Little Meadows DS0000004974.V282135.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 13th July 2005 Brief Description of the Service: Little Meadows is a large detached house which has been extended over the years to provide high standard accommodation. It is conveniently situated on the outskirts of Newcastle served by public transport. The resident proprietors have operated the home since original registration in 1987.Accommodation is on 2 floors with shaft lift access to the first floor. There are 3 lounges and separate dining area. There are 17 single and 1 shared bedroom, all have ensuite facility, the shared room also has walk-in shower. furnishings and equipment are to an exceptionally high standard. The home is registered for up to 19 residents, 4 of whom may require dementia care and 8 may have a physical disability.The exterior of the building provides a very pleasant safe garden area with patio and sitting areas attractively laid out, there are ramps/handrails for safety. There is CCTV to protect the home. Both the internal and external areas of the building are maintained to a high standard. The proprietors have constantly sought to further extend the already high standards of the total environment. Little Meadows DS0000004974.V282135.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. At the time of this unannounced inspection there were 15 people in residence including 2 on respite care. There were 4 vacancies. Most residents were seen and many spoken to together and separately. All indicated high levels of satisfaction with the care provided at Little Meadows and warm and positive relationships noticed and confirmed with staff. Two visitors were seen and expressed very positive views about their relative who was present for respite care. They remarked about very friendly and relaxed atmosphere in the home and said they were made to feel very welcome and could visit at any time. They were sufficiently impressed with the home to be instrumental in the transfer of a relative to Little Meadows from another home nearby. All staff on duty were spoken to and made a valuable contribution to the inspection process. They showed commitment to residents and spoke enthusiastically about fund raising activity and their determination to further extend the activities programme in the home. The high standard environment continues to be well maintained and all requirements/recommendations as always have been satisfactorily addressed. What the service does well: A small home providing a homely atmosphere and close personal relationships between residents, staff and visitors. The environmental standards at Little Meadows are exceptionally high and are well maintained. Flexibility of routines allows chosen lifestyles to be accommodated. Several residents have meals in their bedrooms as they wish. Food provision is good. There has been traditionally a high level of satisfaction with food provision in this home. Little Meadows DS0000004974.V282135.R01.S.doc Version 5.1 Page 6 What has improved since the last inspection? 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. Little Meadows DS0000004974.V282135.R01.S.doc Version 5.1 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 Little Meadows DS0000004974.V282135.R01.S.doc Version 5.1 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): 1-5 Introductions to the home are the preferred option prior to admission. A care management assessment had not been obtained for new resident and the person admitted without category of registration. Application must now be made for MD category for admissions to cover this situation. Further admissions in the category must not take place until approval is given by the Commission. EVIDENCE: There is a copy of the Statement of Purpose/Service Users guide available in the home for residents and prospective residents and their families. All residents have contracts provided either by sponsoring Local Authorities, or in relation to self-funding residents – by the home. Assessments were inspected relating to a new resident. She had been admitted for respite care with the possibility of permanent care. Little Meadows DS0000004974.V282135.R01.S.doc Version 5.1 Page 9 No Care Management Assessment had been obtained. The Manager had carried out her own assessment of the person which was to the required standard. The person had visited the home for the day prior to admission and the family had also visited the home for pre-admission discussions. It later became clear that this person has mental health needs which were not evident at the point of admission. The resident was found to have a CPN and Consultant Psychiatrist had been involved. Although staff at this home have received some training in mental health awareness they have not made application to include MD (mental disorder) in their admission categories. This admission was therefore arranged without approved category. The home must make application for additional categories to admit people with mental health needs – admission without category is a breach of the Regulations. Little Meadows DS0000004974.V282135.R01.S.doc Version 5.1 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 the following standard(s): 7 – 10 Care plans were to a good standard and contained comprehensive information. They were reviewed on a regular basis. The needs of a recently admitted resident were not identified at the point of admission and contravened the homes approved categories for admission. This must be rectified with application for increased categories. Medication records inspected were satisfactory. The medication system in the home has been improved and now provides a safe system of medication administration. Residents confirmed that they were treated with respect and their privacy ensured. Little Meadows DS0000004974.V282135.R01.S.doc Version 5.1 Page 11 EVIDENCE: Care plans were sampled and were to a good standard. It is recorded on a format introduced 2 years ago and provides the necessary comprehensive information required to provide care. Monthly reviews are an integral part of the care plan format and are carried out as required. Most residents are reviewed on an annual basis with Social Work staff. In relation to a recently admitted resident a care management assessment had not been obtained, the home had carried out the required pre-admission assessment but mental health needs which later became evident were not perceived. The person was not weighed upon admission and is slight in stature and does not eat consistently. It is important that all residents are weighed upon admission as a benchmark for monitoring possible weight loss. The person has low motivation and spends time in bed with indications of possible depression. This is being further investigated/clarified by the home and relates also to the requirement to apply for extension of categories for admission mentioned above. A care plan of long-stay resident was inspected and found to contain all the required information. The plan was reviewed regularly and on a 6 monthly basis the last review recording that the person was “very happy with her care at Little Meadows”. There was good and accurate recording of health care needs. The District Nursing Service are visiting two residents relating to leg dressings, one sustained in wheelchair outing with relatives the other whilst at home. The home have purchased a leg protector of their own volition to ensure protection from wheelchair footplate. Medication is supplied to the home from nearby pharmacy. A good service is reported. The system was inspected and accurate recording of medication on MAR sheets were seen with appropriate returns to the pharmacy countersigned by the pharmacy. Medication was exampled to be reviewed on a regular basis with GP’s. A recent review of anti-psychotic medication prescribed PRN but not used was discontinued by the GP. Residents spoken to said that they received personal care with dignity, privacy and respect. A male member of staff was appointed to the home recently and female residents stated a continued preference for personal care by a female member of staff. This was respected. Little Meadows DS0000004974.V282135.R01.S.doc Version 5.1 Page 12 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 - 15 Residents and visitors confirmed that chosen lifestyles matched expectations. Visitors are welcomed into the home and move freely around. They are encouraged to take residents out on visits where possible. The range and frequency of activities in the home have been extended. The home wish to further expand on this. There is a high standard food provision in this home. EVIDENCE: Most residents were spoken to in the lounge areas and some in the privacy of bedrooms. All spoke highly about the homes commitment to chosen lifestyles. They felt that their choices were known and accommodated. A resident admitted 6 months ago was seen in her bedroom where she spends her time, preferring not to sit in the lounge/communal areas. Little Meadows DS0000004974.V282135.R01.S.doc Version 5.1 Page 13 Initially she was reluctant to socialise at all but now had made many friends in the home and several visit here on a regular basis in her bedroom, she has other visitors too and remarks that “sometimes it is a little too much”.- Her chosen lifestyle is met with care and meals provided in her bedroom where she receives visitors as she wishes. Visiting relatives of a man admitted for respite care spoke highly of the care provided for him – he was 90 years of age on the day prior to this inspection and had received many cards, family visits and party. He was to have a further surprise party with local dignitary attending. The relatives were so impressed that they were negotiating to transfer a member of the family from another home in the area to Little Meadows. There are 3 lounge areas the main 2 lounges on the ground floor provide a choice of company and seating. The lounge on the first floor is of excellent standard and décor but attracts few residents and is used often to receive visitors. This is a relatively small home and the lounge facilities on the ground floor are quite adequate, comfortable and homely where residents socialise throughout the day. The large separate dining area which is also the designated smoking area doubles as a social setting also. Activities in the home are not planned and involve the usual indoor games etc. The home have sought to extend the activities on offer, both inside and outside the home. There has been considerable fund raising for comforts funds by staff and external visits organised to include pub meals and trips to local places of interest. The internal activities have been extended to include music to movement, and several entertainers of varying types and taste brought into the home which residents clearly enjoy. Posted in the home for visitors information is a list of the additional activities outlining the cost and money spent from fund raising. The home are actively looking to extend further the range of activities and seeking some specialist advice on this. Several residents go out with visitors which is the preferred option. Two go out weekly to local pub with relatives/friends. This is a positive move which further enhances the high standards of care provided at Little Meadows. Food provision is good at this home. This was again confirmed in discussions with residents who said there were choices of dish at all mealtimes and the quality and quantity of food were good and satisfactory. There has traditionally been a high level of satisfaction with food provision in this home. Little Meadows DS0000004974.V282135.R01.S.doc Version 5.1 Page 14 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): 16 – 18 Standards relating to Complaints & Protection were found to be met. EVIDENCE: There is a complaint procedure posted in the reception area of the home and available to all residents and visitors. One complaint of a domestic nature has been received and dealt with adequately by the home since the last inspection. There have been no complaints to the Commission. There is a written policy/procedure relating to abuse and clear instructions to staff concerning the reporting of suspected or actual abuse. The Manager states that all staff area aware of the procedures and new staff given specific information. There is a copy of the vulnerable adults procedures in the home. Little Meadows DS0000004974.V282135.R01.S.doc Version 5.1 Page 15 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 – 26 A very high standard environment which meets all National Minmum Standards. Improvements have been made to the handling of soiled laundry. EVIDENCE: This is a high standard environment which meets all the National Minimum Standards. Furnishings, fittings, equipment and décor are all to a very high standard. There has been an ongoing re-investment programme by the proprietors over the years. All areas are regularly decorated and upgraded as required. The external garden and patio areas of the home reflect those inside the home. The provision and standards are excellent. Little Meadows DS0000004974.V282135.R01.S.doc Version 5.1 Page 16 There is good access to the garden area from the home and good quality seating areas located in the different parts of the garden area. This area is used extensively by residents during the summer months. Many remark that they engage in conversation with members of the public passing the home which is on a major road out of Newcastle. Residents enjoy the changing scenery and excellent seating areas. Two residents who enjoy the open air, sit inside facing an exit door which is often open even in the winter months allowing them to have the best of both worlds –they can sit in warmth with some fresh air and play music they enjoy whilst chatting together and with passers-by. All bedrooms have en-suite facilities and there is an assited bathroom on each floor with adequate numbers of toilet areas located near to the communal areas. All bedrooms are fitted with high standard furnishings and equipment, are bright, adequate in size and well personalised. A mal-odour in bedroom identified at the time of the last inspection and related to continence management has been satisfactorily addressed. The home is safe for access both internally and externally. There are adequate hand/grab rails in en-suite and bathroom/toilet areas with assisted facilities in the toilet areas. The standards of hygiene and cleanliness throughout the home were, as usual, to a very high standard. Following a requirement of the last report the home now operate the red (degradable) bag system for handling foul laundry. The bags are placed directly into the washing machine which washes at up to 95c. This reduces the handling of this laundry and therefore improves potential cross-infection risks. Little Meadows DS0000004974.V282135.R01.S.doc Version 5.1 Page 17 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 – 30 Staffing levels are at the required level. Staff training is in place for statutory training. Other courses are accessed also. Staff seemed competent and committed to resident care. Recruitment procedures require review. Evidence of POVA or CRB check prior to employment must be kept and all items listed in Schedule 2 of the regulations must be obtained for all staff. EVIDENCE: The staffing levels remain constant in the home as to the required level. There are 12 care staff in the home plus the Registered Manager who also provides some direct care hours. The weekly staffing hours average around 300. There are a minimum of 2 care staff on duty during the day and invariably an additional person from 10 – 6 (influenced sometimes by staff absences). Care staff and Manager are involved in food preparation, there are no catering staff employed. There is a housekeeper employed 20 hours per week and additional hours provided on the 2 days she is not on duty. Little Meadows DS0000004974.V282135.R01.S.doc Version 5.1 Page 18 The proprietors live on-site and are available to be called as necessary. There is one waking night care worker and senior person sleeping in on call. These arrangements have been reviewed and strengthened. The Manager and Deputy (who also lives on site) are now rostered to cover all sleeping-in duties and are readily available if called. A portable telephone is carrie dby the waking night care worker to ensure immediate access to the person sleeping in on-call. Staffing levels are adequate at this time for the perceived dependency levels of residents. Over 66 of care staff have been trained to NVQ2 standard or above and other presently studying. The home has met this required standard by 2005. There is an ongoing training programme for all staff and this includes statutory training. Staff recruitment procedures can be strengthened. Records relating to a recently appointed carer indicated that there was no evidence of a POVA First check prior to employment, although the Manager said one had been obtained but shredded. There was a subsequent satisfactory CRB check on file but evidence of check prior to employment must be available for inspection. All the documents required for staff listed in Schedule 2 of the Regulations had not been obtained, these included copy of birth certificate and recent photograph. Little Meadows DS0000004974.V282135.R01.S.doc Version 5.1 Page 19 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): 31 – 38 Standards relating to Management & Administration were found to be met. EVIDENCE: The Registered Manager has the required experience and qualifications to run the home. This is a small home and there is a close and open working relationship between staff, manager and proprietors. Regular staff meetings are held approximately 3 monthly (minutes not seen on this visit). The home does not handle finances on behalf of residents. All are encouraged to manage their own financial affairs with assistance from relatives if required. Little Meadows DS0000004974.V282135.R01.S.doc Version 5.1 Page 20 Moving & Handling training has been provided for all staff. Fire records inspected showed that all checks and servicing of equipment had been carried out as required. The fire alarm system was checked with certificate from service engineer on 8.12.05. All staff have received fire training and drills as required. There was recent training in first aid for all staff and medication training for those administering medication. Infection control practices in the laundry have been improved. COSHH items are stored in secure cupboards in the laundry area. Risk assessments are in place relating to resident activity and the building. All reportable incidents under Regulation 37 have been notified to the Commission as required. Little Meadows DS0000004974.V282135.R01.S.doc Version 5.1 Page 21 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 3 2 2 3 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 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 Standard No Score 16 3 17 3 18 3 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 3 3 3 3 3 Little Meadows DS0000004974.V282135.R01.S.doc Version 5.1 Page 22 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 OP4 Regulation CSA 2000 Requirement Timescale for action 04/02/06 2 3 OP8 OP29 Application must be made for registration of categories for people with mental health needs (MD) 12(1) All residents must be weighed 04/02/06 upon admission. 19(1) Sched. Evidence of POVA First checks 04/02/06 2. prior to employment must be provided and all documents defined in Schedule 2 provided for all staff. 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 Little Meadows DS0000004974.V282135.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Stafford Office Dyson Court Staffordshire Technology Park Beaconside Stafford ST18 0ES 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 Little Meadows DS0000004974.V282135.R01.S.doc Version 5.1 Page 24 - 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. 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