CARE HOMES FOR OLDER PEOPLE
Maudes Meadow Windermere Road Kendal Cumbria LA9 4QJ Lead Inspector
Paula Malaney Unannounced Inspection 5th May 2006 11:00 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 Maudes Meadow DS0000035531.V290274.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. Maudes Meadow DS0000035531.V290274.R01.S.doc Version 5.1 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 www.cumbriacare.org.uk 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.V290274.R01.S.doc Version 5.1 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 Commission for Social Care Inspection. 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. 24th November 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. Fees charged to residents include all care, accommodation, meals and laundry. Fees are charged weekly and for the financial year 2006 to 2007 range from £363.00 - £422.00 per week, depending on the level of care a resident requires. Residents pay separately for their own toiletries, newspapers and hairdressing. Information about the services provided and fees charged is included in the information given to residents and their families. Copies of recent Commission for Social Care Inspection inspection reports are displayed in the home and provided to prospective residents on request. Maudes Meadow DS0000035531.V290274.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection was unannounced and included a visit to the home on 5th May 2006. The inspection focussed on how well the services provided in the home meet the needs of the people living there. This was assessed by speaking to residents and their families, speaking to care staff and the manager, observing activity in the home and examining the records which care homes are required to keep. The views of residents, their families, social workers and health care professional were also obtained by a postal survey. What the service does well:
Residents receive a high standard of care which meets their needs. The management team in the home are committed to providing a high quality service. Where areas have been identified which require action the manager has taken appropriate steps to improve the shortfalls highlighted. The home has an excellent admissions procedure. The procedure includes individuals being visited by a member of the management team and being given the opportunity to look around the home. Care staff and the management team support residents and their families through the admissions process in a positive and caring manner. Residents said the admissions procedure gave them the opportunity to get to know some of the staff and to become familiar with the home and that this made their admission a more positive experience. Residents’ needs are assessed and care staff are knowledgeable about the support individuals require. Residents are treated with respect and they are supported to maintain control over their lives. Care staff ensure that residents’ privacy and dignity are protected in the home. Care staff receive training and support to give them the skills and knowledge to continue to provide a high standard of care. Residents made many very positive comments about their lives in Maudes Meadow. Residents and their families said that visitors are made welcome in the home and they are included in decisions about the care their relatives receive. Meals are well planned and provide residents with variety and choice and a balanced diet. Residents are consulted about planned changes to the menus. The service has a clear complaints procedure. Residents say they are comfortable telling staff or a member of the management team if they are unhappy about the service provided. Care staff are clear about their responsibilities regarding protecting residents and people are safe living in the home. The home is clean and well maintained and provides a homely environment for residents to live in. Residents made positive comments about their rooms and the home. The home is well managed. The management team have good systems in place to ensure the home provides a safe environment for residents to live in.
Maudes Meadow DS0000035531.V290274.R01.S.doc Version 5.1 Page 6 There are good procedures for ensuring that residents are included in decisions about the routines in the home. 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. Maudes Meadow DS0000035531.V290274.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 Maudes Meadow DS0000035531.V290274.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): 3, 4, 5 and 6. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Admissions to the home are well managed and residents know their needs will be met by the support provided. EVIDENCE: Prospective residents needs are thoroughly assessed before they are offered accommodation in the home. Residents are visited by a member of the management team and are given the opportunity to look around the home. Staff are understanding and patient and support residents and their relatives through the process of moving into residential care. Residents were very positive about how their admission to the home was handled. Maudes Meadow does not provide intermediate care. Maudes Meadow DS0000035531.V290274.R01.S.doc Version 5.1 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): 7, 8, 9 and 10. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home provides a high standard of care which meets residents needs. Residents are treated with respect and their privacy and dignity are promoted. Medication in residents bedrooms is not stored securely and places individuals at risk of harm. EVIDENCE: Good records are kept which detail the care residents need. Care staff refer to residents’ records to inform themselves of the support individuals need. The records are reviewed regularly and are kept up to date. Residents and their families are included in developing their individual records. Residents are treated with respect and they are supported to maintain control over their lives. Residents can control their own money and have secure storage for their valuable items. Care staff take appropriate action to maintain residents’ privacy and dignity. Medication procedures are in place and are reviewed regularly. Improvements have been made to the handling of medication since the last inspection. Most of the requirements made at the previous inspection
Maudes Meadow DS0000035531.V290274.R01.S.doc Version 5.1 Page 10 have been met. Maudes Meadow DS0000035531.V290274.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents maintain control over their lives and the choices they make are respected. The home provides a nutritious diet which takes account of residents preferences. EVIDENCE: Residents are very positive about their lives in the home. Residents are supported to maintain control over their lives and the choices they make are respected. Residents’ families are made welcome in the home and they are included in decisions about their relative’s care as appropriate. Residents choose their meals from a menu. The menus offer variety and choice and have been reviewed following consultation with residents. The home provides a variety of activities. Residents choose whether to take part in the activities provided. A number of residents said they would like more activities and a greater variety of activities to choose from. Maudes Meadow DS0000035531.V290274.R01.S.doc Version 5.1 Page 12 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 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are protected from abuse and know how they can raise complaints about the services provided in the home. EVIDENCE: The home has a clear complaints procedure which is given to new residents and their families. Residents say they are comfortable telling staff if they are unhappy about the service provided. The manager is open to criticism and committed to providing a quality service. The home had received one concern from a residents relatives and this was handled properly. Care staff have received training in adult protection. All staff understand the need to protect residents and their role in this. Staff are clear about their responsibilities regarding raising concerns and know who these can be passed to. Maudes Meadow DS0000035531.V290274.R01.S.doc Version 5.1 Page 13 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, 21, 22 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is clean and well maintained. Residents live in a safe and comfortable environment which is suitable to meet their needs. EVIDENCE: Maudes Meadow is clean and well maintained. Many areas of the home used by residents have been redecorated and are very homely and attractive. Residents made positive comments about their rooms and the home. Residents choose where to spend their time, some preferring to be on their own in their bedrooms and some sitting with other residents in the lounges. Good systems are in place regarding checking water temperatures and ensuring fire safety. The manager has good systems for ensuring that areas of the home requiring attention are attended to in a timely manner. Residents have secure, lockable storage areas in their rooms to store their valuable items. Residents have appropriate aids to allow them to move around the home independently. The home is fitted with a number of adaptations to
Maudes Meadow DS0000035531.V290274.R01.S.doc Version 5.1 Page 14 maximise residents independence including grab rails, a call bell system and a passenger lift which is fitted with a seat. Residents are able to use the lift on their own and care staff assist those residents who prefer not to use the lift on their own. Maudes Meadow DS0000035531.V290274.R01.S.doc Version 5.1 Page 15 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, 28, 29 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care staff are skilled and well trained and provide a high standard of care. EVIDENCE: All the staff in Maudes Meadow work well with the residents living in the home. Care staff are knowledgeable about residents needs and provide a high standard of care. All staff treat residents with respect and take appropriate actions to protect their privacy and dignity. Care staff know residents preferences and respect these. Call bells are answered promptly and residents receive assistance in a timely manner. Staff from a registered employment agency are employed to cover short term staffing shortfalls. The manager tries to ensure that the same staff are provided from the agency so that they know the residents and the home. The agency staff say they have received a thorough induction into the home. The agency staff have developed positive working relationships with the manager and other staff in the home. The agency staff said Maudes Meadow is a good home. Staff are well trained and receive appropriate supervision. All staff said there is always appropriate management support as they need it. Maudes Meadow DS0000035531.V290274.R01.S.doc Version 5.1 Page 16 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, 32, 33, 35 and 38. 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. Residents are safe and are consulted about the care they receive. EVIDENCE: The current manager has been in post at Maudes Meadow for eighteen months and there have been demonstrable improvements to working practices in the home over this time. The manager is undertaking the Registered Managers Award. Good systems are in place to maintain a safe environment including checks that water temperatures are safe and fire safety appliances are serviced regularly. Money held on behalf of residents is stored securely with detailed records kept of all transactions. Residents have lockable storage areas for their valuable items. Residents views are sought on an ongoing informal basis and through regular, planned residents meetings.
Maudes Meadow DS0000035531.V290274.R01.S.doc Version 5.1 Page 17 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 4 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 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 X X 3 3 3 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 2 3 3 X 3 X X 3 Maudes Meadow DS0000035531.V290274.R01.S.doc Version 5.1 Page 18 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 All medicines must be stored securely. The original timescale for this requirement was 01/03/06. This timescale has been extended. Timescale for action 05/05/06 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.V290274.R01.S.doc Version 5.1 Page 19 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
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