Inspection on 17/05/05 for Meadow Acres

This inspection was carried out on 17th May 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 found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 7 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Meadow Acres 20/07/07

Meadow Acres 25/07/06

Meadow Acres 02/11/05

Meadow Acres 04/11/04

Meadow Acres 02/09/04

Meadow Acres 24/02/04

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

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

CARE HOME ADULTS 18-65 Meadow Acres 7 Crabtree Lane Harpenden Herts AL5 5TA Lead Inspector Angela Dalton Unannounced 17 May 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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. Meadow Acres I52 s19463 Meadow Acres v227605 170505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Meadow Acres Address 7 Crabtree Lane, Harpenden, Herts, AL5 5TA 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) 01582 768 098 01582 768 268 Caretech Community Service Limited CRH Care Home 6 Category(ies) of LD-6, LD(E)-6, PD-6, PD(E)-6 registration, with number of places Meadow Acres I52 s19463 Meadow Acres v227605 170505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: There are no additional conditions of registration. Date of last inspection 4 November 2004 Brief Description of the Service: Situated at the end of a private drive, Meadow Acres is a bungalow that has been extended and converted for its present use. It offers six single occupancy bedrooms, a dining room, a lounge, a multi-sensory room, two bathrooms, two toilets and a shower. There is also a kitchen, an office and a laundry. Each bedroom has a hand basin and is personalised to reflect the character of each service user.The home is surrounded by mature gardens, parts of which have been constructed to a theme. There is also a large patio area, much used by service users in clement weather.The home is located close to a local parade of shops and within walking distance of Harpenden town centre with its range of shops and amenities. Meadow Acres I52 s19463 Meadow Acres v227605 170505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. One Inspector conducted this unannounced inspection on 17th May 2005 and seven hours were spent at the home. Three of the six service users were initially at home but others returned from daycare later in the day. The Inspector spoke with staff on early and late shifts to obtain an overview of the home. Although some requirements have been made the level of care delivered was of a high quality. What the service does well: What has improved since the last inspection? Day care attendance has improved with the introduction of a full time driver. Staff recruitment has resulted in fewer agency staff being used. Previous requirements regarding maintenance issues outside the home have been met. Meadow Acres I52 s19463 Meadow Acres v227605 170505 Stage 4.doc Version 1.30 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. Meadow Acres I52 s19463 Meadow Acres v227605 170505 Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Meadow Acres I52 s19463 Meadow Acres v227605 170505 Stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,2,3,4,5 Service users have access to the necessary information to make an informed choice about their home. EVIDENCE: The most recent service user moved into the home nearly twelve months ago. It was evident that an assessment had been conducted with the opportunity to familiarise themselves with the their new home. Service users needs are frequently reviewed to ensure that staff are able to meet their needs and seek input from other professionals where necessary. Staff are able to access training to equip them for changing needs. The home manager plans to review the existing Statement of Purpose as they have been in post for less than a year. This will ensure that any changes within the home are reflected. Meadow Acres I52 s19463 Meadow Acres v227605 170505 Stage 4.doc Version 1.30 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6,7,8,9 Service users have individual care plans which ensure that full participation within the home occurs. Service users are encouraged to take risks with staff support and to be as independent as possible. EVIDENCE: Each service user has a detailed plan of care which is written from their perspective. This guides staff through each need that an individual has and how they are met. Choices are recorded and it is evident that service users are consulted about all aspects of their lives. Information is regularly reviewed to reflect any changes in service users’ requirements. A recommendation has been made to collate information to ensure that information is kept together. This will assist staff to seek clarification and review care. Service users are encouraged to take risks with staff support and to be as independent as possible. Risk assessments are in place to ensure that risks are measured but enable service users to participate in activities of their choice. Staff are aware of confidentiality and this forms part of their employment contract and is revisited in supervision. Meadow Acres I52 s19463 Meadow Acres v227605 170505 Stage 4.doc Version 1.30 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11,12,13,14,15,16,17 Service users have appropriate and fulfilling lifestyles. EVIDENCE: Staff co-ordinate outings and in house activities to ensure that service users participate in meaningful activities. Some service users attend a daycare provision but none work. The home employs a full time driver to facilitate regular outings. Service users participate fully in the community and visit local facilities. Family and friends play an important part within the home and links are supported and encouraged by staff. Staff knocked prior to entering bedrooms to observe service users’ privacy. Bedrooms are personalised and equipped with aids and adaptations to support individual needs. Staff prepare menus and a recommendation has been made to ensure that ingredients are not repeated during the same day e.g. a cooked breakfast Meadow Acres I52 s19463 Meadow Acres v227605 170505 Stage 4.doc Version 1.30 Page 11 including sausage followed by a dinner of sausage roll. Advice should be sought to ensure meals are nutritionally balanced, as vegetables did not feature every day. Lunch and dinner were observed and both meals were prepared to meet individual requirements. Staff have planted some flowers at the front of the house which service users are tending with support. Meadow Acres I52 s19463 Meadow Acres v227605 170505 Stage 4.doc Version 1.30 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18,19,20,21 Service users receive appropriate healthcare and personal support. Medication procedures require attention. EVIDENCE: Service users needs and wishes (e.g. funeral plans) are recorded in their care plan and reviewed and monitored where necessary. Other professionals, such as the Physiotherapist and Social Worker liaise closely with the home to ensure service users receive the care and support that they need. Medication amounts were not carried forward onto the current Medication Administration Record Sheet when they were checked in. Checks on amounts could not be conducted. Although there is a thermometer in the medication cupboard temperature records are not kept and correct storage temperatures cannot be assured. A requirement has been made Meadow Acres I52 s19463 Meadow Acres v227605 170505 Stage 4.doc Version 1.30 Page 13 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22,23 There is a clear and effective complaints policy. Service users are protected from abuse. EVIDENCE: The complaints policy is in a pictorial format to ensure service users can use and understand it. A recommendation has been made to update the Commission of Social Care Inspection’s details in the complaints policy. All staff have an awareness of the Whistle Blowing policy to safeguard service users from abuse. Finances are securely stored and on checking were found to be accurately recorded. Meadow Acres I52 s19463 Meadow Acres v227605 170505 Stage 4.doc Version 1.30 Page 14 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24,25,26,27,28,29,30 The premises meet the needs of service users but the garden needs attention.. Some maintenance work is required to ensure facilities are in full working order. Infection control is not adequately controlled. EVIDENCE: The home was clean and odour free providing a pleasant environment to live and work in. Some maintenance work is required to repair or replace the faulty dishwasher, repair the dripping hand basin in the kitchen, repair the broken hoist and replace the broken fridge handle on the fridge. The oven has scorch marks on the front of the door and the worktop has a circular burn mark next to the oven. The home had no supply of hand towels and the wrong order had been delivered. A supply of hand towels ensures that cross infection is minimised within the home. A requirement has been made. The gardener who worked previously at the home has retired and it is recommended that a replacement be found. Meadow Acres I52 s19463 Meadow Acres v227605 170505 Stage 4.doc Version 1.30 Page 15 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,32,33,34,35,36 Staff numbers and skills are sufficient to meet the needs of the service users. The recruitment process does not safeguard Service Users. EVIDENCE: The use of agency staff within the home has decreased, as the recent recruitment campaign for staff has been successful. Records for all staff were incomplete and validation of original documents had not occurred. A visiting therapist does not have a CRB check and service users are at risk. A requirement has been made. A member of staff has transferred within the organisation to work in the home but there is no updated description of their role. Staff files were examined and original documentation had not been seen. The current home manager has inherited paperwork. An audit will be conducted and the Commission notified of the results. A requirement has been made. Service users remain vulnerable until this assurance is provided to the Commission. Staff have ongoing training to ensure that they are equipped to meet service users’ needs. Some staff have achieved their NVQ award and the manager is working towards achieving her managers’ NVQ award. Regular one to one supervision occurs within the staff team to ensure that staff are receiving support. Meadow Acres I52 s19463 Meadow Acres v227605 170505 Stage 4.doc Version 1.30 Page 16 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37,38,39,40,41,42,43 The home is well run and is monitored by the company. The health and safety of service users is compromised. EVIDENCE: The manager is currently working towards the Registered Manager’s Award. She has yet to submit her application for registration with the Commission for Social Care Inspection and a requirement has been made. Staff confirmed that the manager was accessible and approachable. CareTech audit the home every six months to ensure that a satisfactory level of care is offered to service users. The result of their quality assurance exercise are given to the home manager and shared with the team. This ensures that all staff are aware of any improvements needed. Policies and procedures are distributed by head office and staff are invited to comment. Records checked (accident, complaint, financial, training) were found to be in good order. Fire records require a little attention as there was no record of service users having been involved in a fire drill. Fire drill records are being over written onto last Meadow Acres I52 s19463 Meadow Acres v227605 170505 Stage 4.doc Version 1.30 Page 17 years sheet and a new one is needed. There was no evidence of whether a Legionella check is necessary and the manager will explore this. The kitchen door was wedged open to provide observation and supervision of service users. A safe alternative must be employed after seeking professional advice (as opening the kitchen door may not be appropriate). Water temperatures are erratic and rise to unsafe temperatures presenting a risk of scalding. A permanent solution must be found. Meadow Acres I52 s19463 Meadow Acres v227605 170505 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 Adults 18-65 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 3 3 3 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 3 3 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 3 3 3 3 2 2 Standard No 11 12 13 14 15 16 17 3 3 3 3 3 3 2 Standard No 31 32 33 34 35 36 Score 3 3 3 2 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Meadow Acres Score 3 3 2 3 Standard No 37 38 39 40 41 42 43 Score 2 3 3 3 2 2 3 I52 s19463 Meadow Acres v227605 170505 Stage 4.doc Version 1.30 Page 19 Yes 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 YA20 Regulation 13(2) Requirement Medication must be carried forward to ensure that totals can be checked and the balance is correct. The requirement for medication to reconcile was made at the previous inspection. Equipment in the home must be maintained in good working order; The handbasin leak must be repaired, The dishwasher must be repaired or replaced, the fridge handle has broken off and must be replaced, the burnt worktop and scorched oven must be repaired. The hoist must be repaired. A spare part is on order. A supply of handtowels must be available to ensure infection control is observed. Thorough recruitment checks must be conducted. Original documents must be seen as copies are not acceptable. Visiting therapists must have a Criminal Record Bureau check conducted if they have unsupervised access to service users. Transferred staff must have a personnel file with the Timescale for action 31/05/05 2. YA24 23(2)(c) 30/06/05 3. 4. YA30 YA34 13(3) 17 (2) Schedule 4 & 19 Schedule 2 31/05/05 31/05/05 Meadow Acres I52 s19463 Meadow Acres v227605 170505 Stage 4.doc Version 1.30 Page 20 required documentation in place. 5. 6. YA37 YA41 8(1)(a) 23(4)(a) A registration application must be received by the Commission for the manager of Meadow Acre Fire drill records must reflect whether service users were involved. Records must not be over written and suitable methods must be usd to ensure that records are legible. Service users must not be exposed to unnecessary risks. The kitchen door was wedged open to provide observation and supervision of service users. A safe alternative must be employed after seeking professional advice (as opening the kitchen door may not be appropriate). Water temperatures are erratic and rise to unsafe temperatures presenting a risk of scalding. A permanent solution must be found. The manager must explore whether a Legionella check is necessary within the home. 31/05/05 31/05/05 7. YA42 13(4)(c) 31/05/05 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. 3. 4. Refer to Standard YA6 YA12 YA22 YA24 Good Practice Recommendations Care plans should collate information to ensure that relevant guidande is kept together. This would assist staff in caring for specific needs e.g. PEG feed site Menus should not duplicate ingredients on the same day. A review should be conducted to ensure all nutritional needs are met as vegetables do not feature each day. The complaints procedure should reflect up to date contact details of the Commission for Social Care Inspection. Service users should have access to a computer I52 s19463 Meadow Acres v227605 170505 Stage 4.doc Version 1.30 Page 21 Meadow Acres Commission for Social Care Inspection Mercury House 1 Broadwater Road Welwyn Garden City, Herts Al7 3BQ 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 Meadow Acres I52 s19463 Meadow Acres v227605 170505 Stage 4.doc Version 1.30 Page 22 - 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. 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