Inspection on 26/01/06 for Mead Lodge

This inspection was carried out on 26th January 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

Mead Lodge 13/11/06

Mead Lodge 21/07/05

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 Norfolk NR10 5EH Lead Inspector Mr Pearson Clarke Unannounced Inspection 26th January 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 Mead Lodge DS0000057375.V280283.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. Mead Lodge DS0000057375.V280283.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Mead Lodge Address Crown Road Buxton Norwich Norfolk NR10 5EH 020 8501 4323 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) meadlodge@clara.co.uk Hillside Commercial Ltd Position Vacant Care Home 24 Category(ies) of Dementia (24) registration, with number of places Mead Lodge DS0000057375.V280283.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 21st July 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 DS0000057375.V280283.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection of the service was unannounced although the inspector did seek written feedback from relatives and healthcare professionals prior to visiting. Responses were received from fourteen relatives and six health profesionals and these views have been used to inform judgements made on the day. The homes manager was not present and the service was represented by the provider and the deputy. The atmosphere within the home was calm and interaction between staff and service users was positive and appropriate. All areas seen were clean, comfortable and in good order What the service does well: What has improved since the last inspection? What they could do better: Mead Lodge DS0000057375.V280283.R01.S.doc Version 5.1 Page 6 The inspector feels that more attention needs to be given to the development of activity and stimulation for the client group. In this respect the use of someone with designated hours would allow for expertise to be developed and the provision of activity would not fall foul of the competing need to provide direct care to what is a very dependant group of people. The services garden area could also be developed to offer an environment that is more useable by people with dementia. 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 DS0000057375.V280283.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 Mead Lodge DS0000057375.V280283.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): EVIDENCE: These standards were not assessed on this visit Mead Lodge DS0000057375.V280283.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): 10 Service users are treated with respect and staff uphold their privacy. EVIDENCE: The homes published information, training and care plans all indicate a desire to protect privacy and treat people with respect. During the inspection the inspector observed staff at work and also interviewed staff on duty. From this he formed the opinion that the homes ethos was being translated in to practice on a day to day basis. Mead Lodge DS0000057375.V280283.R01.S.doc Version 5.1 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): 12,13,14,15 Service users are encouraged and enabled to exercise choice wherever possible. The food served is nutritious and staff help ensure that people get the food they need. The service needs to further develop the provision of meaningful activities and stimulation for service users. EVIDENCE: All service users accommodated at Mead Lodge have dementia to a degree where it compromises their ability to make meaningful choices. However staff spoken to were clear that they sought to give people choice and control wherever possible, for instance what clothes to wear on a daily basis. The views of service users relatives were sought prior to inspection and almost all were entirely happy with the service, however there was some comment regarding lack of stimulation on offer. This was explored with the staff and management of the service and whilst the inspector could see evidence of several successful social events that had taken place, the provision of day to day stimulation is patchy and could be improved. It is acknowledged that it can be more difficult to provide meaningful activity for the client group accommodated, however it is important. The service does not have anyone with designated hours for this function and as is often the case staff can find this part of their job comes second to meeting direct care needs. The inspector would recommend that consideration be given to the employment of an Mead Lodge DS0000057375.V280283.R01.S.doc Version 5.1 Page 11 activities co-ordinator who could develop expertise and both individual and group approaches to task. During the inspection the views of staff were sought about the food served and all of those spoken to felt that service users received nutritious and tasty meals. Since the last inspection the choice of food has been extended and a main dining room next to the kitchen allows for better support and supervision for service users at meal times. Staff members confirmed that they had the time to feed those who needed help and that meals were not rushed. The service has open visiting and all of the relatives whose views were sought stated that they were welcomed in to the home by the staff and management. Mead Lodge DS0000057375.V280283.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): 18 The homes policies, procedures and training help ensure that service users are protected from abuse. EVIDENCE: The service has whistle blowing and adult protection procedures and staff receive vulnerable adults training. One member of staff spoken to at inspection told of how she had reported concerns about another member of staff and that she had been fully supported in doing this. This experience was useful to the service allowing management to gain greater understanding of Norfolk Adult Protection system. Mead Lodge DS0000057375.V280283.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): 19,20,25.26 Service users enjoy well maintained clean and comfortable accommodation. EVIDENCE: Since the last inspection of the home the communal areas have been changed to allow for all meals to be taken in one place. As a result there have been new carpets in the dining room and small lounge. All areas seen by the inspector were clean with no unwanted odour and all areas were bright, warm and in good order. There are a number of visual clues around the home to help service users find toilets, bathrooms and bedrooms. The home now has a sluice room which helps deal with the laundry more effectively. Some discussion took place as to the potential to develop the homes gardens to better meet the needs of service users with dementia. As such the creation of a circular route for moving around and the use of planting and wind chimes etc which stimulates the senses would be beneficial. Mead Lodge DS0000057375.V280283.R01.S.doc Version 5.1 Page 14 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): 27,29,30 The home is normally staffed to meet need and staff training has continued to improve. The service has a safe recruitment system. EVIDENCE: During the inspection the Inspector spoke to staff and management about staffing levels at the home. Some of the feedback from relatives indicated that on occasions they felt that the home was understaffed and this point was explored. The actual staffing found on the day was judged to be reasonable by the inspector and the views of those spoken to were that there have been times in the summer months when it was not possible to cover absence, but that things were now better and that normal staffing allows for effective care delivery. The process of staff recruitment was tracked by the inspector and found to be safe with references and criminal record bureau checks being carried out as expected. Staff members expressed satisfaction with the services approach to training .A relatively newly employed member of staff described a thorough induction process and it was noted by the inspector that there had been a lot of recent training activity. The service does not meet government targets for NVQ level 2 trained staff , but will do when existing staff who are currently training have completed. The service needs to continue to increase its NVQ levels and to further develop training inputs which relate directly to dementia. Staff members observed at work displayed kindness, respect and a patient attitude to service users. Mead Lodge DS0000057375.V280283.R01.S.doc Version 5.1 Page 15 Mead Lodge DS0000057375.V280283.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): 31,35,38 The home is well managed with proper attention given to health and safety. EVIDENCE: Staff spoken to were positive in their views of the homes manager, feeling well supported and part of an improving service. The service has a policy to have minimal involvement in the financial affairs of service users and what involvement they do have is fully accounted for in records kept. General health and safety records were checked and were consistent with a culture where the health and safety of service users and staff is promoted and protected. Mead Lodge DS0000057375.V280283.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 x x x x HEALTH AND PERSONAL CARE Standard No Score 7 x 8 x 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 x 17 x 18 3 3 3 x x x x 3 3 STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x x x 3 x x 3 Mead Lodge DS0000057375.V280283.R01.S.doc Version 5.1 Page 18 Are there any outstanding requirements from the last inspection? no 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. 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 OP12 Good Practice Recommendations It is recommended that the service use designated staffing hours to offer a varied programme of stimulation and meaningful activity to service users Mead Lodge DS0000057375.V280283.R01.S.doc Version 5.1 Page 19 Commission for Social Care Inspection Norfolk Area Office 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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