Inspection on 25/01/06 for Meadow Bank House

This inspection was carried out on 25th January 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is 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 20/07/05

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 Lancashire BL3 2EF Lead Inspector Mike Murphy Unannounced Inspection 25th January 2006 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Meadow Bank House DS0000005688.V277217.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Meadow Bank House DS0000005688.V277217.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Meadow Bank House Address Green Lane Bolton Lancashire BL3 2EF 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) 01204 366258 01204 366257 Southern Cross Healthcare Services Limited Ms Christine Howe Care Home 47 Category(ies) of Dementia - over 65 years of age (1), Old age, registration, with number not falling within any other category (46) of places Meadow Bank House DS0000005688.V277217.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 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 20th July 2005 2. Date of last inspection 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 DS0000005688.V277217.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was the home’s second of two annual inspections for the inspection year 2005 to 2006. The inspection took place over three hours. The inspection included discussion with some residents and their relatives, a brief 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 range of social activities and outings have expanded significantly since the last inspection with the appointment of an activities co-ordinator. Consequently residents report that they are pleased with the new activities programme especially the outings. Resident’s relatives are actively encouraged to participate in all social events. The general view is also that the quality and variety of meals at the home ahs improved. Meadow Bank House DS0000005688.V277217.R01.S.doc Version 5.1 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 DS0000005688.V277217.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Meadow Bank House DS0000005688.V277217.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3,4,5. Standard 6 is not applicable to this service. Prospective residents were being 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 8 residents (4 general nursing and 4 residential) care records revealed that a pre admission assessment had been conducted on all 8. These assessments included consideration of prospective residents physical, psychological and social needs. These assessments were supplemented by others conducted by various health and social care professionals such as doctors, nurses and social workers. Discussion with 3 residents revealed indicated that they had been able to come to the home for trial visits to the home prior to their admission – and that these are actively encouraged by the home. They felt this was most useful because it made them more in control of their own lives as well as enabling Meadow Bank House DS0000005688.V277217.R01.S.doc Version 5.1 Page 9 them to make an informed choice regarding their future. Further discussion with residents also indicated that the home was meeting their needs appropriately. Comments were made by residents such ‘ they understand what needs to be done to help me’, ‘I know I am in the right place because I have got much better’. Meadow Bank House DS0000005688.V277217.R01.S.doc Version 5.1 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 and 11. The health, social and personal care needs of residents were being assessed and addressed. The arrangements for managing resident’s medicines were appropriate and residents were being treated respectfully by staff. EVIDENCE: The health care records of 8 residents who live at the home were inspected on this occasion. These contained care plans that were based on the preadmission assessment that is referred to earlier in this report. Care plans that had been developed were designed to address 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. It is noted that a new system of recording the above information has been implemented since the last inspection. This system is well organised and relevant to all aspects of resident care. The systems to manage resident’s medication were secure and appropriately documented. These arrangements Meadow Bank House DS0000005688.V277217.R01.S.doc Version 5.1 Page 11 are operated by senior staff at the home all of who have undergone training in the management and administration of medicines. Residents reported that staff treated them with respect and ensured that their dignity and privacy was maintained particularly when personal care was being provided. Examples of such comments are ‘ they are very caring’, ‘nothing is too much trouble’, ‘ I can get up when I want’, ‘ My visitors can see me when they want’. Residents confirmed that they are able to access health care services appropriately, this included access to opticians, dentists, and chiropodists. Clearly this helps to ensure residents maximise their good health. All residents were registered with a local GP. All aspects of resident’s care, including care whilst they are dying, is supervised by qualified nursing staff. Meadow Bank House DS0000005688.V277217.R01.S.doc Version 5.1 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14, and 15. Social and leisure activities were very well organised and varied providing stimulation and a wide range interests for residents. This has significantly improved since the last inspection. The prevailing view in respect of the food provided was that this has improved substantially since the last inspection. EVIDENCE: Resident’s stated they were very happy with the choices and freedom they were able to exercise in their daily life. Comments regarding this included ‘I am able to get up and go to bed when it suits me’, ‘I go out for a meal with my family’ and ‘I can go to my room when I want if I want to be on my own’. Staff assisted residents appropriately and sensitively manner at the time of the inspection. A full and varied programme of activities and outings was prominently displayed throughout the home and residents were very pleased how social activities have improved in recent months. Relatives are actively encouraged to participate in these activities and outings. Residents report that the quality and variety of the food has significantly improved over the recent period and that menus are more to their liking. Meadow Bank House DS0000005688.V277217.R01.S.doc Version 5.1 Page 13 Meadow Bank House DS0000005688.V277217.R01.S.doc Version 5.1 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18. Suitable procedures have been implemented to provide an environment where residents and their relatives 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 resident’s relatives indicated that they were aware of how to make a complaint if they wished. 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. Inspection of policies and procedures operated at the home and discussion with staff revealed 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. Staff are enabled to attend protection of vulnerable people training that is organised and provided by Bolton Social services. Meadow Bank House DS0000005688.V277217.R01.S.doc Version 5.1 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 the following standard(s): 19,20,25,26 The home was structurally well maintained and provided an appropriate environment for residents to be cared for. EVIDENCE: The home was very clean and free of malodour at the time of this unannounced inspection. A small number of resident’s bedrooms were inspected. These were found to be clean, appropriately decorated, heated and furnished, and very personalised. Communal lounge areas on both floors of the home whilst providing a generally comfortable environment for residents were in need of redecoration. The inspector was informed that this was planned for the near future. Dining areas were clean, appropriately furnished, and provide a comfortable and appropriate environment for residents to take their meals. It was noted that new dining chairs had been provided in the 1st floor dining room. Meadow Bank House DS0000005688.V277217.R01.S.doc Version 5.1 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Staffing arrangements throughout the home were appropriately managed and suitable to meet the assessed needs of residents at the home. An appropriate recruitment procedure is being operated that seeks to protect residents. Staff are also receive appropriate induction and ongoing training following their appointment. 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 the registered manager and qualified nursing staff 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. Inspection of training records demonstrated that staff are provided with appropriate training – which is conducted in the main by the registered company’s training division - in care and related issues. Whilst only 2 of the existing 17 care staff have obtained a NVQ2 qualification or above the remaining staff are registered to pursue this qualification as soon as possible. Meadow Bank House DS0000005688.V277217.R01.S.doc Version 5.1 Page 17 The home is also accredited to accept student nurses as part of their statutory training. Meadow Bank House DS0000005688.V277217.R01.S.doc Version 5.1 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,35,38. The home continues to be managed very effectively by the registered home manager. EVIDENCE: The registered home manager is a very experienced registered nurse and has completed an NVQ4 in management. Discussions with residents, their relatives, and staff employed at the home revealed that the manager has adopted a management approach that is accessible, supportive, positive and inclusive. The manager is supported in her role by senior qualified nurses and senior care staff. Records in respect of fire safety equipment, fire drills, electrical safety, gas safety, safety of lifting equipment, clinical waste (including waste medicines) removal, and the regulation of water temperatures were inspected. These were found to be satisfactory. Meadow Bank House DS0000005688.V277217.R01.S.doc Version 5.1 Page 19 The arrangements for the management of residents personal allowance monies (where these are managed by the home) were appropriately documented and regularly audited. Residents confirmed to the inspector that they were able to access monies when they required them. The inspector was informed that the arrangements in respect of the security of personal allowances was being reviewed. Meadow Bank House DS0000005688.V277217.R01.S.doc Version 5.1 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 3 3 N/a HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 2 X X X 3 X X STAFFING Standard No Score 27 3 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 2 X X 3 Meadow Bank House DS0000005688.V277217.R01.S.doc Version 5.1 Page 21 Are there any outstanding requirements from the last inspection? no STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP20 Regulation 23 Requirement That an action plan is submitted to the CSCI detailing the programme of redecoration of the communal lounges in the home. That the CSCI is informed of the outcome of the review of the security of resident’s personal allowances Timescale for action 31/03/06 2 OP35 16 31/03/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Meadow Bank House DS0000005688.V277217.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Bolton, Bury, Rochdale and Wigan Office 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 DS0000005688.V277217.R01.S.doc Version 5.1 Page 23 - 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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