Inspection on 21/07/05 for Mead Lodge

This inspection was carried out on 21st July 2005.

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

Mead Lodge 13/11/06

Mead Lodge 26/01/06

Mead Lodge 13/01/05

Mead Lodge 08/07/04

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

CARE HOMES FOR OLDER PEOPLE Mead Lodge Crown Road Buxton Norwich NR10 5EH Lead Inspector Pearson Clarke Announced 21 July 2005 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. Mead Lodge v232377 i55 s57375 meadlodge v232377 210705 stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Mead Lodge Address Crown Road, Buxton, Norwich, NR10 5EH 020 8501 4323 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) Hillside Commercial Ltd Mrs Anne Rosalind Gillett Care Home 24 Category(ies) of Dementia (24) registration, with number of places Mead Lodge v232377 i55 s57375 meadlodge v232377 210705 stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Twenty-four (24) Older People suffering from Dementia may be accomodated Date of last inspection 13th January 2005 Brief Description of the Service: Mead Lodge is a care home providing personal care and accommodation to 24 old people who also have dementia. The home is privately owned. Mead Lodge is located in the Norfolk village of Buxton and is within walking distance of the shops and other facilities. The service is based in an older modernised building with new extension. The home has 24 single bedrooms. All of the bedrooms have en-suite toilets. There is a fully enclosed secure garden. Mead Lodge v232377 i55 s57375 meadlodge v232377 210705 stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection of Meade Lodge was announced and was the first inspection of the home since the appointment of a new manager. The inspector was welcomed into the home by the manager and deputy. During his time in the home records were inspected and some areas of the building were looked at. Staff on duty were interviewed and one resident was spoken to. Time was also spent observing the interaction between residents and staff. The inspector received comment cards from the relatives of five residents and the views expressed have helped to form judgements. All of the residents accommodated have dementia and as such receiving their views can be problematic. In such circumstances relative comment cards are particularly important and the inspector would have liked to receive more of them. In the light of this the provider is encouraged to do everything to encourage their completion at future inspections. The inspector also talked to the district nurse who was visiting and her views are also reflected in the report. What the service does well: What has improved since the last inspection? The most notable improvements since the last inspection are in respect of the homes assessment and care planning systems. These are much improved and look likely to be far more effective. Although the new manager has not been in Mead Lodge v232377 i55 s57375 meadlodge v232377 210705 stage 4.doc Version 1.30 Page 6 post for that long it is clear that she is committed to improvement and constructive change. In this respect the process of developing staff has commenced and this will be supported through supervision and training. 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. Mead Lodge v232377 i55 s57375 meadlodge v232377 210705 stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Mead Lodge v232377 i55 s57375 meadlodge v232377 210705 stage 4.doc Version 1.30 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 standard(s) 3 The service management has recently improved its assessment and admission process, which should ensure the home can meet the needs of all people admitted into their care. EVIDENCE: Meade Lodge operates a number of respite care beds alongside its permanent provision. Particularly in relation to these beds the homes assessment process has in the recent past not been robust enough, which has resulted in some problems. This was identified as a result of a recent complaint and the inspector had asked for this matter to be addressed. At this inspection the inspector tracked progress in relation to this matter. As such the management showed improved documentation and described the process they now use for all admissions including re-admissions to the respite care beds. Although the changes made are relatively recent the system appears to be working well and if used consistently should help ensure that good admissions are made and residents will have confidence that the home can meet their needs. Mead Lodge v232377 i55 s57375 meadlodge v232377 210705 stage 4.doc Version 1.30 Page 9 Mead Lodge v232377 i55 s57375 meadlodge v232377 210705 stage 4.doc Version 1.30 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 standard(s) 7,8,9 All residents have a plan of care which guides staff in the delivery of their care needs. The home has greatly improved its medication storage arrangements and residents medication is satisfactorily managed. The home has good links with health professionals which helps ensure that residents health care needs are fully met. EVIDENCE: During the inspection the inspector looked at a sample of 6 care plans. The format for these plans has recently been fully revised and the resulting plans are a great improvement. The information held has been condensed and is now clearly presented in a way which is accessible to staff and any other interested parties. The staff on duty confirmed that they found the plans to be an improvement and could easily identify care needs and actions needed to address them. Each plan includes risk assessment and is subject to review. The care plans give a very clear record of medical interventions and indicate that appropriate help is sought whenever needed. During the inspection the inspector spoke to a district nurse who was visiting and she commended the care given in the home and spoke of the good communication from the staff and management with the nursing team. Mead Lodge v232377 i55 s57375 meadlodge v232377 210705 stage 4.doc Version 1.30 Page 11 Mead Lodge v232377 i55 s57375 meadlodge v232377 210705 stage 4.doc Version 1.30 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 standard(s) No standards were inspected on this visit. EVIDENCE: Mead Lodge v232377 i55 s57375 meadlodge v232377 210705 stage 4.doc Version 1.30 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 The homes complaints process appears to function effectively and complaints received have been dealt with in a timely and appropriate manner. EVIDENCE: The homes complaint record was inspected on the day. This record indicated that complaints had been responded to in a timely way in line with the homes procedure. Where elements of any given complaint have been upheld then action taken can be traced through the record. Mead Lodge v232377 i55 s57375 meadlodge v232377 210705 stage 4.doc Version 1.30 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 20,26 The homes main communal areas offer residents plenty of space, but would benefit from consideration as to how that space might best be used to support the needs of people with dementia. Whilst the home was clean and pleasant the completion of the installation of the homes sluice will aid the promotion of good hygiene. EVIDENCE: This inspection did not focus on the environment which is generally of a good standard. However some discussion about the lounge and dining areas took place on the day and the inspector received one comment card indicating that there were areas of the building that could be improved. From observation the homes large lounge in the new extension does not work as well as it could. The management stated that they are planning changes in the usage of communal rooms with a proper dining area being created and more thought being given to how the rooms are used , furnished and the staffing needed to support and supervise people. The inspector does not have strong views as to the best way forward, but does feel there is scope for improvement in this area and would encourage future development. Mead Lodge v232377 i55 s57375 meadlodge v232377 210705 stage 4.doc Version 1.30 Page 15 The home has not met the timescale attached to the requirement to have a sluice. However it was noted that the sluice has been fitted and it is accepted that the delay relates to waiting for the contractor to finish the work which the inspector was told will be done in the near future. On the day of inspection the television in the main lounge was working poorly and this was also raised on a comment card . The homes manager confirmed that this was also awaiting a visit from a contractor and for this reason no requirements are made. Bedrooms were not inspected on this visit, however after the inspection some comment was received indicating that some bedroom carpets would benefit from replacement and the inspector would expect the provider to review this matter. Mead Lodge v232377 i55 s57375 meadlodge v232377 210705 stage 4.doc Version 1.30 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 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) 27 When fully staffed the staffing levels are reasonable to allow for the delivery of effective care. However when sickness or holidays are not covered then the homes staff team are less effective. EVIDENCE: The inspector received five comment cards from relatives of which three indicated that they felt there to be enough staff. The other two expressed the view that this was not always the case and one raised weekends as a particular problem. The inspector discussed this with the staff on duty and with the homes management on the day and the view expressed was that unexpected sickness and uncovered holiday were where problems could occur. The manager stated that every effort was made to cover all shifts including the use of agency staff, however the homes rural setting could make obtaining such staff problematic. It is understood that the provider is considering ways to tackle these problems and given the highly dependant nature of those cared for then ensuring adequate staffing must be seen as a priority. No requirements or recommendations are made on this occasion, however provision of cover needs to be kept under review. Mead Lodge v232377 i55 s57375 meadlodge v232377 210705 stage 4.doc Version 1.30 Page 17 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) 31,32,33 The home is well managed with a strong sense of the residents interests being at the centre of the approach adopted. The manager displays leadership and commitment and as a result the home is improving. EVIDENCE: The home has a new manager who will shortly come forward for registration. She is an experienced manager having previously been registered at another service. During the inspection the inspector sought the views of the staff on duty and all felt that the new manager provided clear leadership and that they were part of an improving home. From discussion with the manager it was clear to the inspector that there is a clear agenda for change and improvement and commitment to the needs of people with dementia. Mead Lodge v232377 i55 s57375 meadlodge v232377 210705 stage 4.doc Version 1.30 Page 18 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 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 x COMPLAINTS AND PROTECTION 3 x x x x x x 2 STAFFING Standard No Score 27 2 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 3 x x 3 3 3 x x x x x Mead Lodge v232377 i55 s57375 meadlodge v232377 210705 stage 4.doc Version 1.30 Page 19 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 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 Good Practice Recommendations Mead Lodge v232377 i55 s57375 meadlodge v232377 210705 stage 4.doc Version 1.30 Page 20 Commission for Social Care Inspection 3rd Floor, Cavell House St Crispins Road Norwich NR3 1YF 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. 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