CARE HOMES FOR OLDER PEOPLE
Maudes Meadow Windermere Road Kendal Cumbria LA9 4QJ Lead Inspector
Paula Malaney Unannounced Inspection 24th November 2005 10:30 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 Maudes Meadow DS0000035531.V255759.R01.S.doc Version 5.0 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. Maudes Meadow DS0000035531.V255759.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Maudes Meadow Address Windermere Road Kendal Cumbria LA9 4QJ 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) 01539 773092 01539 773087 Cumbria Care Mrs Shirley Robson Care Home 28 Category(ies) of Dementia - over 65 years of age (10), Old age, registration, with number not falling within any other category (28) of places Maudes Meadow DS0000035531.V255759.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. The service must at all times employ a suitably qualified and experienced manager who is registered with the National Care Standards Commision. The home is registered for a maximum of 28 service users to include: - up to 28 service users in the category of OP (Old age not falling within any other category) - up to 10 in the category of DE(E) (Dementia over 65 years of age). The staffing levels in the home must meet the Residential Forum Care Staffing formula. When single rooms of less than 12 sqm usable floor space become available they must not be used to accommodate wheelchair users, and where existing wheelchair users are in bedrooms of less than 12 sqm they must be given the opportunity to move to a larger room when one becomes available. 25th May 2005 3. 4. Date of last inspection Brief Description of the Service: Maudes Meadow is a residential care home registered with the Commission for Social Care Inspection to provide accommodation for up to 28 older people, 10 of whom may have dementia. The home is owned by Cumbria County Council and carried on by Cumbria Care, a County Council business unit. Mrs Shirley Robson is employed as the registered manager of the home. Maudes Meadow is in a quiet residential area, a short walk away from Kendal town centre and local amenities. The property is a purpose built two storey building and has a passenger lift to help residents access accommodation on the first floor. The home provides twenty eight single bedrooms. There are wash hand basins in all the bedrooms and accessible toilet and bathing facilities close to all the accommodation used by residents. The accommodation is arranged into three living units, each with its own kitchen, sitting and dining areas. The home is set in pleasant grounds which are well maintained and accessible to the people living there. Maudes Meadow DS0000035531.V255759.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection was unannounced and was carried out on 24th November 2005 and 25th January 2006. The inspection focussed on how well the home meets the needs of the people living there. This was assessed by speaking to residents, visitors, care staff and the manager, observing activity in the home and examining the records held. What the service does well: What has improved since the last inspection?
The systems for consulting with residents have improved such that residents know their views are listened to and they can affect how the home is run. Staff training needs have been identified and staff are trained and skilled to provide a high standard of care. Staff records have been improved and contain the information required to ensure staff are safe to work with residents. Maudes Meadow DS0000035531.V255759.R01.S.doc Version 5.0 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. Maudes Meadow DS0000035531.V255759.R01.S.doc Version 5.0 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 Maudes Meadow DS0000035531.V255759.R01.S.doc Version 5.0 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): 3, 4 and 6. Admissions to the home are well managed and residents know that the support provided is suitable meet their needs. EVIDENCE: Residents’ needs are assessed before they are offered accommodation in the home. The needs assessments are used to ensure that the home can provide the support individuals require. Care staff are knowledgeable about the support residents need and provide a high standard of care. Residents and visitors made many positive comments about the home and the staff working there. Maudes Meadow does not provide intermediate care and Standard 6 does not apply. Maudes Meadow DS0000035531.V255759.R01.S.doc Version 5.0 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 the following standard(s): 8, 9 and 10. Residents are treated with respect and their privacy and dignity are protected. Residents are supported to access health care services and their health and welfare are maintained. The medication procedures need to be improved to ensure that residents are not placed at risk. EVIDENCE: Residents receive health care from local GP practices and from health care specialists as they require. Residents are supported to attend routine health care appointments including chiropody and dental services. Residents are treated with respect and care staff take appropriate actions to maintain their privacy and dignity. Residents are placed at risk due to failure to follow medication procedures. A number of areas of weakness were identified including failure to record administration of medication, unsafe storage of prescribed creams and some residents not having timely access to nonprescribed medication for common ailments such as pain relief. Action was being taken to remedy the shortfalls identified. Maudes Meadow DS0000035531.V255759.R01.S.doc Version 5.0 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 the following standard(s): 13, 14 and 15. Residents make choices about their lives in the home. Visitors are made welcome and residents maintain contact with their families and friends as they choose. Meals are well planned and provide a nutritious diet. EVIDENCE: Residents make choices about their lives including where to spend their time and the visitors they see. Staff in the home respect the decisions residents make. Visitors are made welcome and are comfortable in the home and approaching the staff and manager. Visitors said they could visit the home “anytime” and said, “staff are very good at keeping you informed about things”. Meals are well planned and residents choose what they want to eat from a menu which is changed regularly. Menus had been discussed with residents and changes made in response to the comments received. Maudes Meadow DS0000035531.V255759.R01.S.doc Version 5.0 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 the following standard(s): 18. Residents are protected by the home’s procedures and staff knowledge and awareness. EVIDENCE: Care staff receive training in the procedures to follow if they are concerned about a resident’s safety or welfare. Advice is taken from appropriate agencies outside of the home if concerns are identified. The home has good procedures to protect residents’ financial interests. Maudes Meadow DS0000035531.V255759.R01.S.doc Version 5.0 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 the following standard(s): 19 and 26. Maudes Meadow provides a pleasant, comfortable and safe environment for residents to live in. EVIDENCE: Maudes Meadow was purpose built as a care home for older people and the accommodation is suitable to meet the needs of the people living there. The home is well maintained and is decorated and furnished to a high standard. The home has a maintenance plan and areas requiring attention are identified and remedial work carried out in a timely manner. The home is clean and hygienic and provides a pleasant and comfortable environment for residents to live in. Maudes Meadow DS0000035531.V255759.R01.S.doc Version 5.0 Page 13 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): 28, 29 and 30. Residents benefit from receiving support from staff who are skilled and trained and are recruited using safe procedures. EVIDENCE: Care staff have received a range of training to give them the skills to provide a high standard of care and to carry out their duties safely. Staff work with residents in a patient and unhurried manner and provide support as individuals require. Residents are comfortable with the staff working in the home and made many positive comments about the staff and standard of care provided. Residents and visitors said, “The staff in here are lovely” and “the staff work very hard”. New staff are recruited using thorough procedures to ensure they are suitable to work with residents. Maudes Meadow DS0000035531.V255759.R01.S.doc Version 5.0 Page 14 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, 33, 35 and 38. The home is well managed. Residents receive the support they need and their safety and welfare are protected. EVIDENCE: Maudes Meadow is well run and residents are safe living there. Good procedures are in place to protect residents’ financial interests. Meetings are held with residents to obtain their views about the home and action is taken in response to their comments. Residents know they can affect how the home is run. The home provides a safe environment for residents to live in. Maudes Meadow DS0000035531.V255759.R01.S.doc Version 5.0 Page 15 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 3 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 X 8 3 9 1 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 X 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 3 X X 3 Maudes Meadow DS0000035531.V255759.R01.S.doc Version 5.0 Page 16 Are there any outstanding requirements from the last inspection? Yes 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 OP9 Regulation 13 Requirement Accurate records must be kept of all prescribed creams administered to residents. (Previous timescale 30/6/05) Medication kept in residents bedrooms must be stored safely. Residents must have access to appropriate medication, including non-prescription medicines, as they require. Ordering procedures must be reviewed to ensure that there is a continuous supply of medicines. All MARs must be complete for strength of medication. Records for receipt should specify the amount of actual medication received into the home and checks for errors must be more thorough. All medicines must be stored securely. Medicines must be administered as prescribed and all administrations and nonadministrations must be recorded accurately.
DS0000035531.V255759.R01.S.doc Timescale for action 24/11/05 2 3 OP9 OP9 13 13 24/11/05 24/11/05 4 OP9 13 01/02/06 5 6 OP9 OP9 13 13 01/02/06 01/02/06 7 8 OP9 OP9 13 13 01/03/06 01/02/06 Maudes Meadow Version 5.0 Page 17 9 10 OP9 OP9 13 13 11 OP9 13 An up-to-date list of current medication must be maintained at all times. The manager must clarify current medicines with the resident’s GP and district nurses and establish a protocol for use of glucose gel for the treatment of hypoglycaemia. The manager must discuss with the supplying pharmacist a method by which to identify tablets in an MDS that require dispersion in water or other administration requirements. 01/02/06 01/02/06 01/02/06 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 Maudes Meadow DS0000035531.V255759.R01.S.doc Version 5.0 Page 18 Commission for Social Care Inspection Eamont House Penrith 40 Business Park Gillan Way Penrith Cumbria CA11 9BP 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 Maudes Meadow DS0000035531.V255759.R01.S.doc Version 5.0 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!
