CARE HOMES FOR OLDER PEOPLE
Long Meadow Nursing Home 60 Harrogate Road Ripon North Yorkshire HG4 1SZ Lead Inspector
Bridgit Stockton Unannounced 6 May 2005 09:30 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. Long Meadow Nursing Home J53 JO4 S27940 Long Meadow V223125 060505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION
Name of service Long Meadow Nursing Home Address 60 Harrogate Road Ripon North Yorksire HG4 1SZ 01765 607210 01765 690308 N/A Long Meadow (Ripon) Limited 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) Mrs Carole Wilson Care Home with Nursing 47 Category(ies) of Old age, not falling within any other category registration, with number (47) of places Terminally ill (3) Physical disability (47) Physical disability over 65 years of age (47) Long Meadow Nursing Home J53 JO4 S27940 Long Meadow V223125 060505 Stage 4.doc Version 1.30 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 Date of last inspection 18/11/04 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 suitable adapted for its current purpose, to create modern facilities in a traditional, comfortable home setting. Long Meadow Nursing Home J53 JO4 S27940 Long Meadow V223125 060505 Stage 4.doc Version 1.30 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection was carried out over a period of 3 hours on 6 May 2005. The home did not know the inspection was going to take place. The plan for the inspection was to check whether the home had met previous requirements and recommendations; to talk with service users about living in the home; to meet with care staff and the home’s management team; and to look at records. What the service does well: 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.
Long Meadow Nursing Home J53 JO4 S27940 Long Meadow V223125 060505 Stage 4.doc Version 1.30 Page 6 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 Long Meadow Nursing Home J53 JO4 S27940 Long Meadow V223125 060505 Stage 4.doc Version 1.30 Page 7 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3&6 Assessments of all new residents takes place prior to them living at Long Meadow. This is to ensure that individual care needs can be met within the service. EVIDENCE: The assessment documentation and recording of a new resident was good and In sufficient detail so as to make it possible for the care needs to be identified and from which a comprehensive care plan has been developed. The manager confirmed that she visits all new residents prior to admission, and takes into consideration the equipment they require and the dependency of the other residents living at the home and the bedroom available with regard to location and size of room. The staff spoken to explained how they were able to meet the needs of the residents and spoke with individual knowledge of particular residents. Outcome number 6 is not relevant to Long Meadow Long Meadow Nursing Home J53 JO4 S27940 Long Meadow V223125 060505 Stage 4.doc Version 1.30 Page 8 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 Individual health and personal care needs are well met but improvements are needed in the recording of risk assessments. EVIDENCE: All residents have a plan of care. The care plans of four residents were inspected and found to be of good quality with careful and thoughtful strategies to address particular needs or problems. There was evidence of involvement of specialist healthcare people such as the community psychiatric nurse and the dietician. Whilst risk assessments were documented in the care plans for such things as moving and handling and the use of bed rails, they were not in sufficient detail or reviewed and updated on a regular basis. For example a moving and handling risk assessment did not state what hoist to be used or what sling size was required or if it had been reviewed recently. A nurse was observed giving out the lunch time medication. This was done sensitively and professionally and was in keeping with good practice on the administration of medication. The medication record charts were correctly filled in and a stock check of one resident’s medication was done and was correct. Long Meadow Nursing Home J53 JO4 S27940 Long Meadow V223125 060505 Stage 4.doc Version 1.30 Page 9 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 Flexible visiting arrangements allow the residents to maintain good and regular contact with family and friends. Residents living at the home are supported to have choice and control over how they choose to live. EVIDENCE: Residents confirmed that they could have as many visitors as they like and at any time they chose. The visitors are made to feel welcome during their visits and there were several visitors coming and going during the inspection. People spoken to follow their own hobbies and participate in activities outside of the home according to their wishes. Two residents attend a coffee morning each week and said they really enjoyed this. Residents said they also enjoy card making and musical bingo, they said that there was nearly always some organised activity daily and they could choose to attend if they wanted to participate. Without exception, service users said that the food was good. Observation of the lunchtime meal provided evidence that residents were able to make choices about the meals they wished to eat. The meal was unhurried. There was seven staff available to assist over the lunchtime, and a trained nurse administering medication. Long Meadow Nursing Home J53 JO4 S27940 Long Meadow V223125 060505 Stage 4.doc Version 1.30 Page 10 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) None of these outcomes were assessed on this occasion EVIDENCE: Long Meadow Nursing Home J53 JO4 S27940 Long Meadow V223125 060505 Stage 4.doc Version 1.30 Page 11 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) 26 The environment in the home is good and provides residents with an attractive, comfortable and homely place to live EVIDENCE: Individual bedrooms and communal areas were suitably furnished and decorated in a style liked by people living there. Residents spoken to said they liked being able to bring into the home small items of furniture along with pictures and photographs to make there own rooms more pleasant and feel more like home. The communal areas of the home were clean and residents confirmed that their bedrooms were also cleaned to a good standard. A new bedroom extension has just been completed and is decorated and furnished to a good standard. Some of the paint work in the communal areas of the home such as the skirting boards in the main hall way and corridor requires attention, this was obviously wheel chair damage.
Long Meadow Nursing Home J53 JO4 S27940 Long Meadow V223125 060505 Stage 4.doc Version 1.30 Page 12 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) None of these outcomes were assessed at this inspection EVIDENCE: Long Meadow Nursing Home J53 JO4 S27940 Long Meadow V223125 060505 Stage 4.doc Version 1.30 Page 13 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) None of these outcomes were assessed on this occasion EVIDENCE: Long Meadow Nursing Home J53 JO4 S27940 Long Meadow V223125 060505 Stage 4.doc Version 1.30 Page 14 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 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 x x x x x x x 3 STAFFING Standard No Score 27 x 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x x x x x x x x x x Long Meadow Nursing Home J53 JO4 S27940 Long Meadow V223125 060505 Stage 4.doc Version 1.30 Page 15 yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard Regulation none Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard 8 Good Practice Recommendations it is recommended that risk assessments of service users are reviewed and recorded in more detail to ensure needs can be met safely. Long Meadow Nursing Home J53 JO4 S27940 Long Meadow V223125 060505 Stage 4.doc Version 1.30 Page 16 Commission for Social Care Inspection York Area Office Unit 4, Triune Court Monks Cross York, YO32 9GZ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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