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Inspection on 25/01/06 for Meadbank Nursing Home

Also see our care home review for Meadbank Nursing Home for more information

This inspection was carried out on 25th January 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Residents live in an environment, which is well maintained and meets their needs. Staff recruitment is undertaken in a manner, which protects residents from harm, with appropriate checks being carried out. Assessments of residents were noted to be thorough and care plans implemented from the information contained within the assessments.

What has improved since the last inspection?

The action plan provided by the registered person indicated that serious issues with medications found at the previous inspection have been addressed. There has been an improvement in the recording of care given, but more work is required to ensure that the skin condition of residents is recorded accurately.

What the care home could do better:

Residents need to be confident that there are clear and transparent means of communication within the home and that concerns will be acted upon at a local level. Staff must ensure that they take ownership for the work they carry out and respect the fact that Meadbank is the residents home. Staff must evidence that call bells are answered in a timely manner and residents are not placed at risk.

CARE HOMES FOR OLDER PEOPLE Meadbank Nursing Home 12 Parkgate Road Battersea London SW11 4NN Lead Inspector Janet Pitt Unannounced Inspection 25th January 2006 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 Meadbank Nursing Home DS0000019107.V282251.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. Meadbank Nursing Home DS0000019107.V282251.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Meadbank Nursing Home Address 12 Parkgate Road Battersea London SW11 4NN 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) 020 7801 6000 020 7978 5726 ANS Homes Limited Mary Ann Heavey Care Home 176 Category(ies) of Dementia (176), Mental disorder, excluding registration, with number learning disability or dementia (10), Old age, of places not falling within any other category (176), Physical disability (176), Terminally ill (176) Meadbank Nursing Home DS0000019107.V282251.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection Brief Description of the Service: Meadbank Care Centre is situated in Battersea, close to bus routes, with some parking available on site. The home provides accommodation for up to 176 residents who may require nursing care. Each resident has their own room, with ensuite facilities; there are sufficient communal spaces on each of the four floors. Additional bathroom and toilet facilities are situated at regular intervals on all the floors. There is a garden area which residents are able to access easily. A range of activities is provided and residents are able to choose how to spend their day. Meadbank Nursing Home DS0000019107.V282251.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Two inspectors undertook this unannounced inspection, which lasted for seven hours. During the course of the inspection 3 visitors and 2 residents were spoken with. Care documentation and staff files were examined. Requirements from the previous inspection and Standards not assessed were inspected. What the service does well: What has improved since the last inspection? What they could do better: Residents need to be confident that there are clear and transparent means of communication within the home and that concerns will be acted upon at a local level. Staff must ensure that they take ownership for the work they carry out and respect the fact that Meadbank is the residents home. Staff must evidence that call bells are answered in a timely manner and residents are not placed at risk. Meadbank Nursing Home DS0000019107.V282251.R01.S.doc Version 5.1 Page 6 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. Meadbank Nursing Home DS0000019107.V282251.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 Meadbank Nursing Home DS0000019107.V282251.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 Residents can be confident that their care needs will be identified on admission to the home. EVIDENCE: Residents care needs are identified prior to and on admission to the home. Social interests were noted to be recorded. There were details of care managers, next of kin and any legal status of the residents such as power of attorney. Details of past and current medical history were also recorded. Meadbank Nursing Home DS0000019107.V282251.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 and 10 Residents need to be confident that identified care needs are met consistently. Recording of care given must be accurate to make sure that risk to residents is minimised. EVIDENCE: Residents care plans were noted to lead from assessments, this enables identified care needs to be addressed. There has been some improvement in care documentation and there was good evidence of wounds being monitored. However, staff must make sure that care plans are updated when a product used to treat a wound is changed. Staff must make sure that unexplained bruising is accurately documented and accident forms completed, to make sure that there is a clear record of skin condition and risk to residents can be minimised. Risk assessments in relation to falls were in place and there was indication of checking the resident’s condition routinely if they suffered a fall. Relatives spoken with thought that care needs were being met, although there was an improvement when the key worker was on duty. Staff must make sure that care given is consistent. Meadbank Nursing Home DS0000019107.V282251.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): 14 Residents feel able to make choices about how they spend their day. Staff must evidence that call bells are answered in a timely manner to prevent residents being placed at risk of not having needs met. EVIDENCE: Visitors and residents spoken with thought their needs were met. Comments included: ‘it’s good here’ and ‘can join in activities or not’. However concerns were raised regarding the length of time that staff took to respond to call bells. Visitors and residents alleged that calls bells ring for a ‘long’ time’ before they are answered by staff. This was discussed with the management team, as it has been brought up as a concern by a complainant. At the time of inspection there was no formal monitoring system in place for response times to call bells. There must be a monitoring system in place to evidence that residents are not placed at risk and their needs are met in a timely manner. Meadbank Nursing Home DS0000019107.V282251.R01.S.doc Version 5.1 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): 16 and 18 Residents and their representatives need to be confident that they can approach the home about any concerns they have. EVIDENCE: The commission has concerns that since the previous inspection they have received three complaints and information regarding two Protection of Vulnerable Adults (POVA) investigations. The main concerns relate to one of the POVA investigations being prompted by an anonymous person and two anonymous complaints regarding one resident. The providers have been contacted to investigate in conjunction with the appropriate authorities. Information on complaints held within the home indicated that a thorough procedure is followed in response to complaints and actions and outcomes are detailed. However, residents and their representatives need to be confident that there is effective communication between them and the staff and management of the home. Since the inspection the Protection of Vulnerable Adults investigations have been concluded and were not substantiated. Meadbank Nursing Home DS0000019107.V282251.R01.S.doc Version 5.1 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 22 Residents live in an environment, which is suitably maintained with sufficient equipment available to enable staff to meet residents care needs. EVIDENCE: Residents live in a comfortable environment. A planned programme of refurbishment and redecoration is in place. The manager reported that the ground and first floor would be refurbished during February to August 2006. The electrical work on the ground floor has been completed and rewiring is taking place on the first floor. Care has been taken to maintain the safety of residents during the works. Staff spoken with indicated that they had sufficient equipment, such as hoists, to meet care needs. Meadbank Nursing Home DS0000019107.V282251.R01.S.doc Version 5.1 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): 27 and 29 There are adequate staff available to meet care needs of residents. Residents are protected from harm by the recruitment practices of the home. EVIDENCE: Residents are protected from potential harm by the recruitment process within the home. Staff files contained details of relevant checks on potential workers. Contracts of employment, job descriptions and a recent photograph of the worker were in each file examined. One contract was noted to have unequal terms of notice between employer and employee; this was shown to the administrator who rectified the information at the time. The duty rotas indicate that there are adequate staff to meet care needs, however concerns have been raised to the CSCI about visibility of staff and response times to call bells. This was discussed with manager, who reported that call bells are not logged. This needs to be further explored to make sure that residents are not placed at risk and to clarify whether calls bells are being responded to in a timely manner. (See under section Daily Lives and Social Activities also). Concerns had been raised to the CSCI about use of escorts within the home. It was clarified by the manager that when an escort is required, the unit managers are expected to cover, as they are supernumerary to the staffing levels provided. Meadbank Nursing Home DS0000019107.V282251.R01.S.doc Version 5.1 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 and 32 All staff must make sure that they are aware of how to meet the Standards and ensure that there is effective communication between all people involved with the running of the home. EVIDENCE: The registered manager indicated that she would be starting the Registered Managers Award in February 2006. Each of the four units has provision for a designated nurse manager. This was recently implemented to provide better communication between staff, relatives and their representatives, but there needs to be ownership of the work carried out in the home to make sure that this aim is achieved, as concerns have been raised regarding communication between staff and relatives. The registered manager of the home must also make sure that she is visible within the home and able to be approach by residents and their representatives if required. Consideration should be given to allocate ‘surgery’ time for this. Meadbank Nursing Home DS0000019107.V282251.R01.S.doc Version 5.1 Page 15 Meadbank Nursing Home DS0000019107.V282251.R01.S.doc Version 5.1 Page 16 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 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 X 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 2 15 X COMPLAINTS AND PROTECTION Standard No Score 16 1 17 X 18 2 3 X X 3 X X X X STAFFING Standard No Score 27 3 28 X 29 3 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 2 X X X X X X Meadbank Nursing Home DS0000019107.V282251.R01.S.doc Version 5.1 Page 17 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. 1. Standard OP7 Regulation 15 (1) & Sch. 3 12 (1) 15 (1) 13 (4) (c) Requirement The registered person must ensure that all residents have care plans reflected actual care required. The registered person must ensure that care given is consistent in quality. The registered person must ensure that the skin condition of residents is recorded accurately. The registered person must ensure that there is a monitoring system in place for call bells, to evidence that they are answered in a timely manner. The registered person must ensure that residents and their relatives are confident to discuss concerns at a local level. The registered person must ensure that there is effective communication at all levels within the home. Timescale for action 30/06/06 2 3 4 OP7 OP8 OP14 30/06/06 30/06/06 30/06/06 5 OP16 12 (5) 30/06/06 6 OP32 12 (5) 30/06/06 Meadbank Nursing Home DS0000019107.V282251.R01.S.doc Version 5.1 Page 18 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 2. Refer to Standard OP32 OP14 Good Practice Recommendations It is recommended that the registered person instigate a ‘surgery’ time to enable residents and their representatives to discuss concerns. It is recommended that the registered person considers installing a call bell system, which is electronically monitored. Meadbank Nursing Home DS0000019107.V282251.R01.S.doc Version 5.1 Page 19 Commission for Social Care Inspection SW London Area Office Ground Floor 41-47 Hartfield Road Wimbledon London SW19 3RG 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 Meadbank Nursing Home DS0000019107.V282251.R01.S.doc Version 5.1 Page 20 - 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. 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