Inspection on 27/01/09 for Meadow Bank Care Home

This inspection was carried out on 27th January 2009.

CSCI found this care home to be providing an Excellent service.

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

Meadow Bank Care Home 01/02/07

Meadow Bank Care Home 16/01/06

Meadow Bank Care Home 12/10/05

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Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Meadow Bank Care Home Meadow Bank Care Home 1 Bowes Terrace Dipton Stanley Co Durham DH9 9HF     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Tom Moody     Date: 2 7 0 1 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 25 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 25 Information about the care home Name of care home: Address: Meadow Bank Care Home 1 Bowes Terrace Meadow Bank Care Home Dipton Stanley Co Durham DH9 9HF 01207570508 01207570508 greynewbiggin@ic24.net Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Lifestyles - Care & Support Ltd care home 14 Number of places (if applicable): Under 65 Over 65 0 8 learning disability old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home 6 0 Meadow Bank Care Home is registered with the Commission for Social Care Inspection as a care home currently providing personal care and accommodation for up to 12 older people and people who have learning disabilities. The home is in a residential street at the end of a terrace of large, older houses. It has a ramped entrance, a lift and some ground floor bedrooms. None of the people who live in Meadow Bank at present uses a wheelchair inside, but there is enough space for visitors to move around in wheelchairs. The home encourages people to be as independent as possible and to lead full and interesting lives. The care each person gets is based on his or her individual care needs, likes and dislikes. Meadow Bank is situated in the village of Dipton, near Stanley, and there are regular buses to the larger town of Consett. The home is owned and operated by Lifestyles Care Homes for Older People Page 4 of 25 Brief description of the care home Care and Support Limited who took over the running of the home in 2005. The weekly charges for residential care range from £390.50 to £1320.00 (February 2009). Care Homes for Older People Page 5 of 25 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This inspection took place on the 27 January 2009, over a period of approximately 6 hours, although later visits were made to confirm some details arising from information received about the home. The inspection included: discussion with staff, a tour of the premises, examination of documents and records including care plans, and reading survey forms from staff, service users and visiting professionals such as doctors and social workers. The inspector met with the people that live there. The Manager, and a director of the company that manages the home, were present throughout most of the inspection and both showed a good understanding of the care needs of the people that live at Meadow Bank. Care Homes for Older People Page 6 of 25 Overall, the service provides a safe and comfortable home, staffed by people that the residents who live there have confidence in. What the care home does well: What has improved since the last inspection? What they could do better: Minor damage to decor in corridors could be improved. Some bedrooms furniture is worn and could be replaced. Timing of breakfasts may need to be revised. Care Homes for Older People Page 8 of 25 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 25 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 25 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples needs are thoroughly assessed and the home can meet those needs. They are given contracts and they are given the information they need when choosing to come into the home. People can make trial visits and stay to see if they like the home. Evidence: The providers self-assessment says that the home provides a statement of purpose. During the visit to the home the statement of purpose was seen. It is in an easy to read format and copies were in each room. The manager did say that verbal explanations were given to service users and their families. She also said clients who are thinking of coming to the home are welcome to visit and can stay overnight or for a weekend. These visits can be repeated if the service user wishes. Care plans and other documentation revealed a very thorough needs assessment, including what people wanted and liked to do. The manager did point out that most service users had been admitted as an emergency but this had been with a good Care Homes for Older People Page 11 of 25 Evidence: assessment or very shortly followed up with one. Service users who were spoken to expressed satisfaction with the way their care needs were being met and some compared their current placement favorably against previous experiences. Other service users spoke of their experiences working outside the home or attending day centers. Care Homes for Older People Page 12 of 25 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Each person has a detailed plan which explains how their care will be given and how peoples health care needs should be met. The homes policies and procedures for dealing with medication protect service users. Service users feel that they are treated with respect. Evidence: The providers self-assessment says care plans are well developed and take into account information from service users health care needs. The files of three service users were checked and these included detailed care plans. The care plans explained how their assessed needs should be met. There was evidence of a person- centered approach to planning and providing services. The planning is based on finding out what each person likes and wants to do. There is a key worker system in place and it is the key workers job to make sure that the care that service users get, meets the persons needs and that their life style suits them. Service users know this and one told me,Weve all got key workers. The records show that all service users receive annual medical reviews as well as visits Care Homes for Older People Page 13 of 25 Evidence: from dentists opticians chiropodists and other specialists. Service user said that they were looked after well and one said, Ive seen two doctors, Im not well. Another said, of the staff, They look after me. Comments from other professionals say that the home meets the health care needs of the service users. A visiting professional said, They always respond promptly to the individuals health care needs. and the local GP felt that they always met individuals health care needs. The home has policies and procedures that provide clear guidance on the safe handling of medication and when possible, enable service users to manage their own medication. Records, observation and discussions with staff showed that these guidelines are followed. Staff spoke to service users as individuals and with respect and friendliness. Staff were seen to knock on doors before entering. They asked the opinions and got permission from service users before carrying out care. Care Homes for Older People Page 14 of 25 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The homes provision matches service users recreational, social and cultural needs, and helps them maintain contact with the surrounding community. They are able to exercise choice and control over most aspects of their lives and they enjoy nutritious and appetizing food. Evidence: The home caters for older people and older people who have learning disabilities. Its approach suits people who cannot live in their own homes any longer, but who still want to lead full and interesting lives. It also suits people who have lived in other homes but are less mobile or need more staff support than they once did, to maintain some independence. There is a range of activities and opportunities available for service users. one person was going out to a bingo game in a neighboring building. One service users commented, Ive got lots of books, I do a lot of reading, another told me We grew tomatoes last year. On the day of the site visit a person from a befriending organization was taking one service users for an outing and when they returned the service user was very enthusiastic about their trip out and the meal they had enjoyed. Care Homes for Older People Page 15 of 25 Evidence: Visiting professionals have also commented that their clients are happy with the service they receive. One of the Directors of the company told me he came to the home regularly and often took service users for outings. The Manager said service users went to day centers, and places where they did part time work. One service user confirmed this, saying, I go to the Heart Foundation Charity Shop. Service users said they enjoyed these opportunities to go out into the community. One said I have a walk out when its fine. The meal that was served during the site visit looked tasty and was traditional fish, chips and mushy peas. This was followed by home made apple pie. One service user said, You get lovely meals. Staff said service users had their breakfast before the cook came on duty. This may mean they have to wait for a cooked breakfast and if they were hungry their choice may be limited to cereal. It was agreed with the Manager, and Mr Grey, that the cooks hours may be revised to allow this. Care Homes for Older People Page 16 of 25 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service users and relatives know how to raise issues and they are confident staff and managers will act on their concerns. Training and procedures ensure service users are protected and that their rights are upheld. Evidence: The home has proper policies and procdures for complaints. Staff told me they had recieved training in Protecting Vulnerable Adults (POVA) and they knew about these issues. Recruitment records show that all the right checks are carried out including Criminal Records Bureau, POVA list and previous employers references. Care Homes for Older People Page 17 of 25 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides a safe and comfortable environment with good access to almost all areas. The home is well equipped, clean and meets the current service users needs Evidence: The home is a converted house and retains this homely atmosphere. Although some corridors are narrow they do not cause problems to most service users. However, there is some damage on the walls caused by wheelchairs. The home has three levels and and two are accessible by lift. There is a short flight of stairs to accommodate one change in level. If a service users ability to climb the stairs were to get worse they would need to move to a more accessible bedroom. The home is well ventilated and warm. There was no loud noise and, although the atmosphere was calm, service users welcome visitors into their home. Showers toilets and bathrooms are a good size and fitted with rails and hoists. Temperature controls are fitted to bath and shower outlets and water temperatures are recorded. There is a good standard of equipment such as mobile and fixed hoists. A suitable call system has been installed. The bedrooms are a good size. They are well decorated and furnished to the service users taste. Some bedroom furniture was looking a little worn and damaged and it is recommended that this be replaced or refurbished. Almost every room has interesting Care Homes for Older People Page 18 of 25 Evidence: views of the surrounding area. The home has a laundry and suitable hand washing facilities for service users and staff. There were no discernible bad odours during the time of the site visit and the home was clean and tidy in all areas. Care Homes for Older People Page 19 of 25 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The staffing of the home meets service users needs. They are supported in a safe manner, by staff who are properly recruited, and have the appropriate training. Evidence: There were the right numbers of staff on duty at the time of the site visit. Service users needs were met, call buzzers were answered within a reasonable time and care was given in an unhurried manner. Staff have recieved the right training to enable them to carry out care safely. Training records confirmed this. Staff told me they received an induction and training records confirmed what they told me. Staff have NVQ qualifications and are encouraged to continue their studies and training. When staff come to work in the home all of the necessary checks are carried out before they start working. Care Homes for Older People Page 20 of 25 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is managed by an experienced person who has service users interests at heart. The home is run in the best interests of service users. They are kept safe and their welfare and rights are protected by good record keeping and the promotion of good practice Evidence: The Registered Manager is an experienced nurse and is suitably qualified. Discussions staff show that they know about the people they look after and they care about looking after them well. Visiting professionals have also commented that their clients are happy with the service they receive. Survey returns from several visiting professionals have also commented that the home is run professionally and efficiently, and that they find the manager and staff helpful. Service users were satisfied with the care in the home and said they would be happy to approach the manager or staff if they had problems. Care Homes for Older People Page 21 of 25 Evidence: Staff and relatives are also aware that the manager has an open door policy. The home has proper insurance and the certificate is displayed. Records of maintenance were available, as was the fire log and records of service users personal allowance. The manager is supported by the directors of the company and they make frequent visits. The staff who were on duty felt supported by the company and several spoke of their NVQ training. Staff have a good awareness of heath and safety and service user records contain good risk assessments, including falls. Care Homes for Older People Page 22 of 25 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 23 of 25 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 2 15 15 The manager should ensure that a late night snack is offered by all staff working a late shift. Kitchen staff hours should be revised to ensure service users are able exercise the choice to have a cooked breakfast Worn or damaged bedroom furniture should be replaced or refurbished 3 24 Care Homes for Older People Page 24 of 25 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 25 of 25 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!