CARE HOME ADULTS 18-65
Meadow Acres 7 Crabtree Lane Harpenden Hertfordshire AL5 5TA Lead Inspector
Angela Dalton Unannounced Inspection 2nd November 2005 10:30 Meadow Acres DS0000019463.V262556.R01.S.doc Version 5.0 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 Meadow Acres DS0000019463.V262556.R01.S.doc Version 5.0 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 Adults 18-65. 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. Meadow Acres DS0000019463.V262556.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Meadow Acres Address 7 Crabtree Lane Harpenden Hertfordshire AL5 5TA 01582 768098 01582 768268 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) Caretech Community Service Limited Sheryl Ann Soen Care Home 6 Category(ies) of Learning disability (6), Learning disability over registration, with number 65 years of age (6), Physical disability (6), of places Physical disability over 65 years of age (6) Meadow Acres DS0000019463.V262556.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 17th May 2005 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 DS0000019463.V262556.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection was conducted by one Inspector between 10:30am and 1:30pm. The home was undergoing a period of transition on the day of inspection as there was building and decoration work. A stable team of staff and service users has been maintained and there have been no changes since the previous inspection in May 2005. What the service does well: What has improved since the last inspection? What they could do better:
Although service users are kept up to date on developments and changes within the home, there are no visual aids to demonstrate the choices that are available e.g. colour board to enable choice of paint colours and fabrics. The service users would benefit from a designated member of staff being allocated to organising activities as not all are in receipt of day services. Staff continue to have no computer access nor do service users. Staff are therefore unable to complete any paperwork in house and any documentation requiring typing is sent to head office. Service users would be able to access software that would convert words into pictures if a computer were available to them. Meadow Acres DS0000019463.V262556.R01.S.doc Version 5.0 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. Meadow Acres DS0000019463.V262556.R01.S.doc Version 5.0 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 Outcomes Statutory Requirements Identified During the Inspection Meadow Acres DS0000019463.V262556.R01.S.doc Version 5.0 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 the following standard(s): 1 Service users have access to the necessary information to make an informed choice about their home. EVIDENCE: The statement of purpose reflect the changes within they have moved into the users who live at Meadow is currently under review and will be amended to the premises and needs of new service users once home. There have been no changes to the service Acres since the previous inspection. Meadow Acres DS0000019463.V262556.R01.S.doc Version 5.0 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 the following standard(s): 6,8&10 Service users have individual care plans which evidence individual needs. EVIDENCE: Service user files are being reviewed by the deputy manager. Further work will be completed in the coming months as Care Tech develops Person Centred Planning. Although service users have been updated regarding developments within the home at one to one support sessions, practical participation is recommended. There are no visual aids or user friendly props to illustrate the changes to the building and décor such as photographs and theme boards with paint and fabric swatches. Meadow Acres DS0000019463.V262556.R01.S.doc Version 5.0 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 the following standard(s): 12,14&17 Structured activities would further enhance service users’ lives. Menu planning training would be of benefit to staff. EVIDENCE: The majority of service users attend day services but it is recommended that individual staff are identified to structure meaningful activities for service users who remain at home. Two service users were going out for lunch and to do some shopping to ensure time away from the disruption within the home. A recommendation has been made to seek professional input with relation to the menus. There has been some progress with the content of meals since the previous inspection but further attention is suggested as instant mash was part of the evening meal on the day of inspection. Meadow Acres DS0000019463.V262556.R01.S.doc Version 5.0 Page 11 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 the following standard(s): 20 The medication procedures require attention. EVIDENCE: Medication procedures have improved. A sample of medication records was checked and all amounts reconciled. Handwritten instructions were not signed and a requirement to implement this has been made. Meadow Acres DS0000019463.V262556.R01.S.doc Version 5.0 Page 12 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 the following standard(s): 23 Service users are protected from financial abuse. EVIDENCE: A reviewed financial monitoring system has been implemented following a theft from the home earlier in the year. Meadow Acres DS0000019463.V262556.R01.S.doc Version 5.0 Page 13 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 the following standard(s): 24, 29 Equipment is in good working order. Service users’ access to technology is impeded. EVIDENCE: Due to the ongoing building and decoration work the environment has not been fully inspected. Maintenance issues raised at the previous inspection have been resolved. Improvements are being made in communal areas of the home. A recommendation stands to purchase a computer for the home to maximise service uses’ communication and assist with staff correspondence and workload. Meadow Acres DS0000019463.V262556.R01.S.doc Version 5.0 Page 14 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 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 33, 35 Service users benefit from an established staff team. EVIDENCE: The staff team has stabilised and there has been little change within the past year. The team has a part time vacancy which the manager hopes to fill shortly. Several staff have embarked upon NVQ training and a Senior support worker is working towards qualification as an Assessor. Meadow Acres DS0000019463.V262556.R01.S.doc Version 5.0 Page 15 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 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38,42&43 Staff and service users benefit froma well managed home. EVIDENCE: The manager has successfully registered with the Commission for Social Care Inspection and meets a previous requirement made. They are currently working towards the Registered Manager’s Award. Staff confirmed that the manager was accessible and approachable. Meadow Acres DS0000019463.V262556.R01.S.doc Version 5.0 Page 16 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 X X X X Standard No 22 23 Score X 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 X 2 X 3 Standard No 24 25 26 27 28 29 30
STAFFING Score 3 X X X X 2 X LIFESTYLES Standard No Score 11 X 12 2 13 X 14 3 15 X 16 X 17 Standard No 31 32 33 34 35 36 Score X X 3 X 3 X CONDUCT AND MANAGEMENT OF THE HOME 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
Meadow Acres Score X X 2 X Standard No 37 38 39 40 41 42 43 Score 3 3 X X X 3 3 DS0000019463.V262556.R01.S.doc Version 5.0 Page 17 No 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 Handwritten medication instructions must be signed. Timescale for action 30/11/05 Meadow Acres DS0000019463.V262556.R01.S.doc Version 5.0 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 Refer to Standard YA8 Good Practice Recommendations Visual aids and user-friendly props are recommended to illustrate the changes to the building and décor such as photographs and theme boards with paint and fabric swatches. It is recommended that individual staff are identified to structure meaningful activities for service users who remain at home. Professional advice regarding menus is recommended to ensure a variety of meals are available to meet nutritional requirements. Service users should have access to a computer, which is again recommended. 2 YA12 23 4. YA17 YA29 Meadow Acres DS0000019463.V262556.R01.S.doc Version 5.0 Page 19 Commission for Social Care Inspection Hertfordshire Area Office Mercury House 1 Broadwater Road Welwyn Garden City Hertfordshire AL7 3BQ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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