Inspection on 20/07/05 for Meadow Bank House

This inspection was carried out on 20th July 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 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 House 05/07/06

Meadow Bank House 25/01/06

Meadow Bank House 10/01/05

Meadow Bank House 08/06/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE MEADOW BANK HOUSE Green Lane Bolton Lancs BL3 2EF Lead Inspector Mike Murphy Unannounced 20th July 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 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. MEADOW BANK HOUSE F56 F06 S5688 Meadow Bank House V220666 270605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Meadow Bank House Address Green Lane Bolton Lancs BL3 2EF 01204 366258 01204 366257 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) Southern Cross Healthcare Services Limited Christine Howe CRH N - Care Home with Nursing 47 Category(ies) of OP Older People - 46 registration, with number DE(E) Dementia over 65 years - 1 of places MEADOW BANK HOUSE F56 F06 S5688 Meadow Bank House V220666 270605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: That the Home is registered to provide Care with Nursing to a maximum of 47 service users to include: Up to 46 service users in the category OP (Old age not falling into any other category) One named service-user in the category DE(E) Dementia aged over 65 years) The service should employ a suitably qualified and experienced Manager who is registered with the Commission for Social Care Inspection Date of last inspection 10th January 2005 Brief Description of the Service: Meadow Bank House is situated in the Great Lever area of Bolton close to all local amenities and bus routes. It is a purpose built home providing nursing on the ground floor and residential care on the first floor to services users, over 65 years of age of either gender. There is lift access to all floors. MEADOW BANK HOUSE F56 F06 S5688 Meadow Bank House V220666 270605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was the home’s first of two annual inspections for the inspection year 2005 to 2006. The inspection took place over six hours. The inspection included discussion with residents and their supporters, a tour of the premises, inspection of care and other records maintained at the home, and discussion with staff. The home was well-managed and provided residents with a clean and comfortable environment in which to live. Residents were supported and cared for appropriately and encouraged to make personal choices and retain as much personal independence as possible. What the service does well: What has improved since the last inspection? The registered manager has reviewed and consequently changed many of the ways things are done within the home. Consequently the home is much more organised and responsive to the wishes of residents. This was clearly expressed in the comments of residents, relatives, and staff who were spoken to by the inspector. MEADOW BANK HOUSE F56 F06 S5688 Meadow Bank House V220666 270605 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 BANK HOUSE F56 F06 S5688 Meadow Bank House V220666 270605 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection MEADOW BANK HOUSE F56 F06 S5688 Meadow Bank House V220666 270605 Stage 4.doc Version 1.30 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 standard(s) 3. Standard 6 does not apply to this home. Prospective residents are appropriately assessed prior to admission. This is essential to ensure that the home is able to meet the needs of such prospective residents and assist them in choosing if the home is suitable for them. EVIDENCE: Inspection of 6 residents care records revealed that a pre admission assessment had been conducted on all 6. These assessments included consideration of prospective residents physical, psychological and social needs. The assessments had been done the home manager who is a registered nurse. These assessments were supplemented by others conducted by various health and social care professionals such as doctors, nurses and social workers. MEADOW BANK HOUSE F56 F06 S5688 Meadow Bank House V220666 270605 Stage 4.doc Version 1.30 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 standard(s) 7,8,9,10. The health and personal care needs of residents at the home were being assessed and addressed appropriately. The arrangements for the management of resident’s medicines were appropriate and staff interacted and assisted residents sensitively and appropriately during the inspection. Clearly these are important factors in ensuring residents receive appropriate care and treatment. EVIDENCE: The health care records of 6 residents who live at the home were inspected on this occasion. These were found to contain care plans that were initially based on the pre-admission assessment that is referred to earlier in this report. Care plans addressed the health, personal and social care needs of residents and were formally evaluated at least monthly. Risk assessments, that seek to protect resident’s health and safety were also recorded in respect of residents skin integrity, mobility, and nutrition (including weight monitoring) and other relevant areas and were also evaluated at least monthly. The arrangements for resident’s medicines were secure and appropriately documented. These MEADOW BANK HOUSE F56 F06 S5688 Meadow Bank House V220666 270605 Stage 4.doc Version 1.30 Page 10 arrangements are operated by senior staff at the home all of who have undergone training in the management and administration of medicines. There was however an issue regarding returning the medication of resident’s medication that is no longer required to the chemist. Clearly this needs to be resolved before such medicines accumulate. Discussion with residents indicated that staff at the home treat them with respect and seek to maintain resident’s dignity and privacy particularly when personal care is being provided. Examples of such comments are ‘ the staff are nice and kind’, ‘nothing is too much trouble’, ‘ I can go to the lounge or stay in my room as I choose’, ‘ My family can visit me at any time’. Residents also indicated in their comments, and this was supported in discussion with staff and inspection of care records, that they are able to access health care services appropriately, this included access to opticians, dentists, and chiropodists. Clearly this assists residents in maximising their health and well being. All residents were registered with a local GP. MEADOW BANK HOUSE F56 F06 S5688 Meadow Bank House V220666 270605 Stage 4.doc Version 1.30 Page 11 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 standard(s) 12,13,14,15. Social and leisure activities were in the main organised and varied providing stimulation and interests for residents. However the present arrangements are dependent of care staff devoting time to such activities. Whilst their very positive contributions are noted social and leisure activities within the home need to be more formally co-ordinated. The inspector was informed that the home is actively seeking to recruit a dedicated social/activities organiser. There were some mixed views in respect of the food provided. EVIDENCE: Discussion with resident’s indicated that they were very satisfied with the personal choices and freedom they were able to exercise. Comments regarding this included ‘I am able to choose when I get up in the morning and when I go to bed’, ‘I am able to go out with my family when I want’ and ‘I can go to my room when I want to and my privacy is respected’. Staff assisted residents appropriately and in a positive manner whilst providing care and support at the time of the inspection. Whilst positive about staff providing as much time as they can to activities, entertainments and outings provided the general view was that this needs to be more organised and led by a person specifically employed to lead such activities. In respect of food whilst some positive MEADOW BANK HOUSE F56 F06 S5688 Meadow Bank House V220666 270605 Stage 4.doc Version 1.30 Page 12 comments were made regarding the food provided for residents there was a strong consensus that menus should be more varied. The inspector was informed that a review of meals and menus was planned and that this review would be conducted in such a way as to consult residents. Both social activities and meals are important areas for residents as they are central components of how they describe their satisfaction or otherwise with a home. Staff served and assisted residents appropriately and sensitively with their lunch on the day of inspection. MEADOW BANK HOUSE F56 F06 S5688 Meadow Bank House V220666 270605 Stage 4.doc Version 1.30 Page 13 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 standard(s) 16,18. Appropriate measures have been taken to provide an environment where residents and their supporters feel comfortable with making a complaint if necessary, and to prevent residents becoming victims of abuse. These are important areas that are crucial to the protection of resident’s in a care home, many of whom are extremely vulnerable. EVIDENCE: Discussion with residents and their relatives indicated that there was a general awareness and information provided that enabled people to make a complaint if they desired. A detailed and accessible complaints procedure was in place and prominently displayed in the home, which included details of how complainants could contact the CSCI if desired. Resident’s spoken to felt comfortable and confident enough to raise a complaint if they felt it necessary to do so. Inspection of policies and procedures operated at the home, discussion with staff and inspection of staff training records indicated that staff were aware of the importance of protecting resident’s from potential abuse and how to communicate any concerns they may have in this area. MEADOW BANK HOUSE F56 F06 S5688 Meadow Bank House V220666 270605 Stage 4.doc Version 1.30 Page 14 MEADOW BANK HOUSE F56 F06 S5688 Meadow Bank House V220666 270605 Stage 4.doc Version 1.30 Page 15 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 standard(s) 19,20,21,22,23,24,25,26. The home appeared to be structurally well maintained and to provide an appropriate environment for residents to receive nursing and personal care and accommodation. EVIDENCE: An ongoing programme of refurbishment and redecoration was in operation at the time of this inspection. All areas of the home designated for resident’s use were accessible to them. Adequate and suitable WC and bathing provision was accessible to service users. 12 resident’s bedrooms were inspected on this occasion – these were clean, appropriately/adequately furnished and very personalised. However not all rooms were provided with door lock. The inspector was also informed that a programme to fit appropriate door locks to residents rooms had been started. Communal lounges and dining areas were clean, warm and appropriately furnished. However the dining furniture on the 1st floor was significantly marked in places. Appropriate aids and adaptations were in place throughout the unit that assist residents to maintain their safety and meet their physical MEADOW BANK HOUSE F56 F06 S5688 Meadow Bank House V220666 270605 Stage 4.doc Version 1.30 Page 16 needs. Individual aids and adaptations are provided following referral to the appropriate health care professional. The home was clean and free of odour at the time of this inspection. MEADOW BANK HOUSE F56 F06 S5688 Meadow Bank House V220666 270605 Stage 4.doc Version 1.30 Page 17 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,29,30. Staffing arrangements at the home appeared to be appropriately managed and suitable to meet the assessed needs of residents at the home. EVIDENCE: Inspection of staffing rotas provided by the home indicated that staffing provision at the home complied with the current minimum requirements that apply to care homes for older people. Discussion with senior staff on duty at the home indicated that they were of the view that staffing levels were appropriate to meet the dependency levels of resident’s. Inspection of 2 recently employed staff personnel files revealed that these contained an application form (including health declaration), 2 written references, a Criminal Records Bureau check (including a ‘POVA first’ check), proof of identity and evidence of induction training. However the inspector was informed that a CRB check on another existing member of staff employed at the home for some time is still outstanding. Inspection of training records demonstrated that staff at the home were provided with appropriate training in care and related issues – including NVQ MEADOW BANK HOUSE F56 F06 S5688 Meadow Bank House V220666 270605 Stage 4.doc Version 1.30 Page 18 training. The home has also been accredited to accept student nurses as part of their statutory training. MEADOW BANK HOUSE F56 F06 S5688 Meadow Bank House V220666 270605 Stage 4.doc Version 1.30 Page 19 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,33,34,35,36,37,38. The home continues to be appropriately managed at the time of this inspection. This is important as residents need to have confidence in and access to competent managers. EVIDENCE: The registered home manager is a very experienced registered nurse manager and has completed an NVQ4 in management. The registered manager is supported by 2 deputy managers. Discussions with service users within the home, their relatives, and staff employed at the home indicated that the registered manager has developed a management style that is open, supportive, positive and inclusive. Indeed the view is that the home has improved significantly and continues to do so. MEADOW BANK HOUSE F56 F06 S5688 Meadow Bank House V220666 270605 Stage 4.doc Version 1.30 Page 20 The following certificates of inspection/service records were found to be satisfactory on this occasion; electrical systems/equipment, passenger lifts/lifting equipment, gas safety, accident records/monitoring, monitoring of hot water temperatures, general and specific health and safety risk assessments, and control of clinical waste disposal. However the last servicing check for thermostatic mixer valves at the home was dated April 2004. MEADOW BANK HOUSE F56 F06 S5688 Meadow Bank House V220666 270605 Stage 4.doc Version 1.30 Page 21 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 x 14 3 15 2 COMPLAINTS AND PROTECTION 3 x x 3 3 3 3 3 STAFFING Standard No Score 27 3 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 3 3 3 3 x 3 2 MEADOW BANK HOUSE F56 F06 S5688 Meadow Bank House V220666 270605 Stage 4.doc Version 1.30 Page 22 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 9 Regulation 13 Requirement That the CSCI is informed in writing of the arrangements to dispose of residents medications that are no longer required. That the CSCI is informed in writing of action being implemented to improve the social and leisure activities for residents at the home. That the CSCI is informed in writing detailing the outcome of the review of menus provided for residents, that includes evidence that residents have been consulted in the review. That the CSCI is informed in writing regarding the progress to date of the fitting of suitable bedroom door locks (as agreed at the last inspection) That the CSCI is informed in writing that the outstanding CRB check for 1 member of staff has been completed That the registered persons submit a written action plan to the CSCI detailing planned redecoration/refurbishment within the home. That a copy of an up to date record of the servicing of F56 F06 S5688 Meadow Bank House V220666 270605 Stage 4.doc Timescale for action 30th of September 2005 30th of September 2005 30th of September 2005 2. 12 16 3. 15 16 4. 10 12 30th of September 2005 30th of September 2005 30th of September 2005 30th of September Page 23 5. 29 19 6. 19 23 7. 38 13 MEADOW BANK HOUSE Version 1.30 thermostatic mixer valves is submitted to the CSCI 2005 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 Good Practice Recommendations MEADOW BANK HOUSE F56 F06 S5688 Meadow Bank House V220666 270605 Stage 4.doc Version 1.30 Page 24 Commission for Social Care Inspection Turton Suite, Paragon Business Park Chorley New Road Horwich Bolton, BL6 6HG 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 BANK HOUSE F56 F06 S5688 Meadow Bank House V220666 270605 Stage 4.doc Version 1.30 Page 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. 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