Inspection on 06/12/06 for Long Meadow Nursing Home

This inspection was carried out on 6th December 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

Long Meadow Nursing Home 08/12/05

Long Meadow Nursing Home 06/05/05

Long Meadow Nursing Home 18/11/04

Long Meadow Nursing Home 17/09/04

Long Meadow Nursing Home 15/12/03

Similar services:

Abbey The

Snydale Care Home

Hawkhills

Larchfield Manor

Beeches The - North Yorkshire County Council

The Grove Waltham

Carentan House

Ravensworth Lodge

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

CARE HOMES FOR OLDER PEOPLE Long Meadow Nursing Home 60 Harrogate Road Ripon North Yorkshire HG4 1SZ Lead Inspector John McGarva Key Unannounced Inspection 6th December 2006 09:30 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 Long Meadow Nursing Home DS0000027940.V322482.R02.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. Long Meadow Nursing Home DS0000027940.V322482.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Long Meadow Nursing Home Address 60 Harrogate Road Ripon North Yorkshire HG4 1SZ 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) 01765 607210 01765 690308 Long Meadow (Ripon)Limited Mrs Susan Taylor Care Home 47 Category(ies) of Old age, not falling within any other category registration, with number (47), Physical disability (47), Physical disability of places over 65 years of age (47), Terminally ill (3) Long Meadow Nursing Home DS0000027940.V322482.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users in the category PD must be: i) aged 55 years or over ii) require nursing care 8th December 2005 Date of last inspection Brief Description of the Service: Long Meadow is situated in the Southern suburbs of Ripon and is registered as a care home with nursing for up to 47 service users. The building has been suitably adapted for its current purpose, to create modern facilities in a traditional, comfortable home setting. The fees charged at 01/12/06 are between £450 - £550 per week. Long Meadow Nursing Home DS0000027940.V322482.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report relates to an unannounced inspection that took place on Wednesday 6th December 2006. The manager, Mrs Susan Taylor was available to assist with the process throughout. The inspection lasted 4.5 hrs (10.00 am to 3.30pm). There were 42 residents in the home and all were in receipt of nursing care. The inspection focused on the key standards as well as addressing issues, which were identified at the last inspection. The manager and staff spoken to provided information in an open and professional manner. An inspection of some areas of the premises took place, including bedrooms, lounge and dining areas, bathrooms and kitchen. Discussions took place with the manager, carers, and residents. What the service does well: What has improved since the last inspection? Long Meadow Nursing Home DS0000027940.V322482.R02.S.doc Version 5.2 Page 6 Since the change of management in January there is a much more relaxed and collegiate atmosphere in the general running of the home. The staff feels that the manager is more approachable and that their views are listened on a day-to-day basis and also in the regular meetings that take place. This is also a feeling communicated to the residents spoken to. A water cooler has been provided and is available for use by the residents, staff and visitors. A power assisted ‘Stand aid’ has been provided. There have been improvements to the general decoration of the communal areas, corridors as well as some of the individual bedrooms. 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. Long Meadow Nursing Home DS0000027940.V322482.R02.S.doc Version 5.2 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 Long Meadow Nursing Home DS0000027940.V322482.R02.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The resident’s needs are sufficiently assessed thereby providing the staff with sufficient information on which the care plans of the residents can be developed. EVIDENCE: Evidence from the case tracked residents records confirmed that pre-admission assessment sheets are completed prior to admission. The manager or undertakes these either in hospital or the resident’s place of residence prior to admission. Closer communication with Social Services in regard to care management plans prior to admission has provided the home with greater detail so that the home can determine whether they can meet the needs of the placement. Intermediate Care (Standard 6) is not provided in this home. Long Meadow Nursing Home DS0000027940.V322482.R02.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The staff provides a good standard of care which is appreciated by the residents and their relatives and friends. EVIDENCE: There were forty-two residents in on the day of inspection and many require significant nursing care. Dependency of residents in care homes is increasing and in Long Meadow there were four bedfast, nineteen doubly incontinent, twenty-six requiring transport by wheelchair and fifteen with mental health needs. Nearly all residents require help with washing and toileting and many need assistance with their feeding. The residents spoken to were all pleased with the quality of their care. “Staff are good, work hard, nice place altogether”. The daughter of a resident said that the home had cared for her father for over two years and she was very pleased with the care given to him. She also said Long Meadow Nursing Home DS0000027940.V322482.R02.S.doc Version 5.2 Page 10 that whenever there is criticism she ‘always receives the attention of the manager who is very good in addressing the issues’. “The manager, Mrs Taylor, is amenable and approachable”. There are individual folders for each of the home’s residents into which all information relating to their care plan and needs are kept. Both the care and nursing staff are involved in the documentation of the residents care on a daily basis. There is no ‘Key worker’ system whereby the care staffs are allocated to a group of residents. The nursing staffs have a system of group allocation of residents. The care plans are specific to the individual resident and identify all pertinent issues, which helps ensure that all health and social needs are met. The timings of the daily statements are recorded utilising the 24hr clock. The medications are stored and administered in accordance with recommended practice. The controlled drug stocks of one resident was checked against the records and found to be correct. All controlled medications are recorded in the controlled drug book and appropriately checked on a regular basis. Long Meadow Nursing Home DS0000027940.V322482.R02.S.doc Version 5.2 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This Judgement has been made using available evidence including a visit to this service. The home is meeting the resident’s social and dietary needs in a sensitive and caring manner. The quality of the meals provided is good and commented on favourably by staff and residents alike. EVIDENCE: The resident’s routines of daily living are tailored to their needs and choice and there is a care assistant who helps provide activities for 12 hrs per week. The residents were currently deployed in the making of paper flowers and Christmas cards. Entertainers are arranged on a regular basis and this was alluded top by the residents spoken to. Visitors can attend at any time they choose, day or night with drinks provided for them routinely and also meals when required. Eighteen of the residents require assistance with feeding and this is managed in a sensitive and unhurried manner. Long Meadow Nursing Home DS0000027940.V322482.R02.S.doc Version 5.2 Page 12 The residents were very complimentary about the quality of the food provided, and the staff spoken to also confirm that the meals were of consistently good quality. Observation of the lunchtime meal provided evidence that residents were able to make choices about them. The meal was unhurried. There is a system of coloured trays that helps identify particular groups such as diabetic, assisted feeding required as well as green for those who can manage to feed themselves. The kitchen looked well arranged with stainless steel surfaces throughout. There are good systems in place for the regular cleaning of surfaces and equipment as well as regular monitoring of the fridge and freezer temperatures. The cook had received food hygiene certified training but two new assistants in the kitchen were yet to undertake this training. Long Meadow Nursing Home DS0000027940.V322482.R02.S.doc Version 5.2 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a relevant complaints procedure and the staff has received abuse awareness training. EVIDENCE: The complaints procedure of the home meets the required standard and now includes reference to the NYCC ‘No secrets’ document. A copy of this document is available in the home to see. Staff spoken to confirmed that they had received training in abuse issues and that there is videotape available to help them to identify abuse. There are records to show that there has been recent training of the care staff in abuse issues and their responsibilities in this regard. The residents are made aware of how to access advocacy groups and other avenues for their rights to be exercised and protected. There have been no complaints made about the service either to the home or the CSCI in recent times. Long Meadow Nursing Home DS0000027940.V322482.R02.S.doc Version 5.2 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. More up-to-date moving & handling equipment should be provided to help facilitate the resident’s transfers between surfaces. EVIDENCE: The premises meet the standards for homes registered before 2002. Located in very pleasant grounds, which are kept in a good condition with easy access by wheelchair being provided. It is on two floors and there is a vertical lift providing level access to all areas. There are twenty-seven single rooms, fourteen of which have en-suite toilet facilities and five double rooms, which do not have en-suite facilities. Long Meadow Nursing Home DS0000027940.V322482.R02.S.doc Version 5.2 Page 15 There has been some decoration to the communal and corridor areas as well as individual bedrooms and this has been done to a good tasteful standard. The bathrooms are provided with the basic ‘wind-up’ type hoists and the possibility of upgrading these was discussed with the manager. The up lighter fitting in the ground floor bathroom does not provide sufficient light to enable the routine observations of the resident’s skin to take place. There are no assisted shower facilities available and residents and staff mentioned this to the inspector. There are three mechanical mobile hoists and a power-assisted ‘Stand-Aid’ to help facilitate the safe transfer of the residents between surfaces. There are three sluice rooms, two on ground floor and one on the first floor, with one sluice disinfector, (Pneumatic midi) located on the ground floor. The commode pans were being immersed in bleach in a bath, due to the malfunction of the sluice disinfector. This bathroom was not currently in use and the disinfector is soon to be repaired. Liquid soap and disposable paper towels are provided in the resident’s rooms to help facilitate good safe practice. The staff also have their own potable bottles of antiseptic ‘hand rub /gel’. Only eight of the resident’s rooms have benefit of lockable space for them to store their money, valuables or drugs. There are five beds, which are adjustable to alter the mattress profile. There are no height adjustable beds and this as discussed with the manager. A programme to provide height adjustable beds will be undertaken on an incremental basis. Long Meadow Nursing Home DS0000027940.V322482.R02.S.doc Version 5.2 Page 16 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Satisfactory recruitment practices are followed and the numbers of Care staff trained to NVQ Level 2 or above is commendable. EVIDENCE: There is sufficient permanent care and nursing staff to meet the present needs of the residents. Due to high dependency of the residents there is little time for the staff to spend on conversation or in socialising with them. Twelve of the sixteen care staff have NVQ Level 2 or above qualifications, representing 75 of the total number, thereby exceeding the recommended 50 standard. There is a named nurse system on place whereby there is identified nursing staff allocated to particular residents and helps ensure the continuity of care. Currently the care staffs are not allocated to any particular group of residents. The recruitment procedures at the home meet the required standard, including Criminal Record Bureau (CRB) checks. Long Meadow Nursing Home DS0000027940.V322482.R02.S.doc Version 5.2 Page 17 The care staff confirmed that mandatory training episodes in Health & Safety, Fire Safety, and First aid, Basic food hygeine, Moving & Handling and Abuse awareness had taken place. Foundation and induction training is in place although thr records are not kept with the staff’s personal file. Some records are in composite form whereby all the names who have undergone some training is kept in a book or list. The advisability of keeping each member of staff’s records in one place for easy access and auditing was discussed with the manager. Long Meadow Nursing Home DS0000027940.V322482.R02.S.doc Version 5.2 Page 18 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed by a manager who enjoys the support and confidence of the staff. The management of the home is focused on benefits to the residents and there is a caring ethos in the home. EVIDENCE: Mrs Susan Taylor is the new manager who has been in post since January 2006 and was officially registered by CSCI on 13th October 2006. She is a first level nurse who has many years of experience in management of the care of the elderly and other groups. Long Meadow Nursing Home DS0000027940.V322482.R02.S.doc Version 5.2 Page 19 She has made good progress in addressing issues, which were identified in the last inspection report. These relate to records of residents care, servicing of equipment, staff recruitment and training, hot water monitoring and quality assurance. Additionally, and importantly, she has changed the atmosphere and ambience of the home significantly insofar as the staff are much more relaxed and find her style approachable and supportive. The residents preferred regimes in relation to breakfast in bed and timings are now acknowledged and facilitated. The staff confirmed that since January 2006 they had been able have latex gloves, antiseptic gel/rub, and that regular meetings are held with them and the ancillary staff so that they can contribute to the discussions that take place in relation to the management of the home. Individual supervision of the care staff has taken place. Quality assurance questionnaires are distributed to 10 of the resident monthly and also the relative’s. The electrical Pat testing records indicated that this was done in April 2006 and the wiring certificate is dated 23-08-04 and is for five years. There were records of fire training, drills, and alarm testing available to see. There are readily accessible service records relating to the hoists, gas appliances, lifts etc. Long Meadow Nursing Home DS0000027940.V322482.R02.S.doc Version 5.2 Page 20 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 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 Standard No Score 16 3 17 X 18 3 3 3 3 2 3 2 3 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 3 3 Long Meadow Nursing Home DS0000027940.V322482.R02.S.doc Version 5.2 Page 21 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 OP24 Regulation 23 (2)(m) Requirement Lockable facilities must be provided for each of the resident’s rooms. Timescale for action 01/06/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2. 3. Refer to Standard OP21 OP21 OP22 Good Practice Recommendations The lighting in the ground floor bathroom should be improved. Assisted shower facilities should be provided. Power-assisted hoists for the bathrooms should be provided. Power-assisted mobile hoists should be provided. Height adjustable beds should be provided for the nursing cases. 4 OP24 Long Meadow Nursing Home DS0000027940.V322482.R02.S.doc Version 5.2 Page 22 Commission for Social Care Inspection York Area Office Unit 4 Triune Court Monks Cross York YO32 9GZ 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 © 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 Long Meadow Nursing Home DS0000027940.V322482.R02.S.doc Version 5.2 Page 23 - 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!