Inspection on 05/07/06 for Meadow Bank House

This inspection was carried out on 5th July 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 25/01/06

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 5th July 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.V298095.R01.S.doc Version 5.2 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.V298095.R01.S.doc Version 5.2 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 www.schealthcare.co.uk 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.V298095.R01.S.doc Version 5.2 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 25th January 2006 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.V298095.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced site visit took place over a period of nearly six hours. The inspection included discussion with residents, relatives, and staff, a tour of the premises, inspection of care and other records maintained at the home, and discussion with the provider and manager. What the service does well: What has improved since the last inspection? 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 Meadow Bank House DS0000005688.V298095.R01.S.doc Version 5.2 Page 6 contacting your local CSCI office. Meadow Bank House DS0000005688.V298095.R01.S.doc Version 5.2 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.V298095.R01.S.doc Version 5.2 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): 1,2,3,4,5. Standard 6 does not apply to this service Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. No prospective residents are admitted to the home without their care and support needs being assessed appropriately. EVIDENCE: Before a resident is admitted to the home the manager who is a qualified nurse carries out an assessment of the prospective resident’s needs in consultation with the resident, their relatives and relevant health (for example doctors) and social care professionals (for example social workers). The purpose of such an assessment is to assist the prospective resident (and their relatives) in their considerations of how appropriate a placement at the home would be and enable the nurse conducting the assessment if the home will be able to meet the prospective resident’s needs appropriately. Meadow Bank House DS0000005688.V298095.R01.S.doc Version 5.2 Page 9 A statement of purpose and service users guide is provided and contains information that assists prospective residents and their supporters to make informed choices about the suitability of the home. Prospective residents are encouraged to make trial visits to the home prior to admission and all placements are formally reviewed around 6 weeks after admission. Meadow Bank House DS0000005688.V298095.R01.S.doc Version 5.2 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. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The health and personal care residents at the home receive is appropriate and is meeting the expectations of residents and their relatives. EVIDENCE: The care records of 5 residents were inspected. These contained 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 were completed in a detailed and professional way and reflected that the resident and their family had been consulted about the care to be provided.. Risk assessments, that seek to protect resident’s health and safety were also recorded in respect of residents skin integrity, mobility, and nutrition (including Meadow Bank House DS0000005688.V298095.R01.S.doc Version 5.2 Page 11 weight monitoring) and other relevant areas and were also evaluated at least monthly. All residents are registered with a local GP and it was evident that all were assisted in accessing optical, chiropody, dental, district nurses and other specialist services as they required. Relatives were strongly of the view that they were kept informed of all significant changes in their relation’s condition. The procedures for the receipt, recording, storage, handling, administration and disposal of resident’s medicines were appropriate. The qualified nursing staff and senior care staff (who have undergone appropriate training), are responsible for all aspects of managing medication in the home. Medication administration records had been completed appropriately. Discussion with residents revealed that they felt they were treated with respect and that their right to privacy was upheld. Comments made included; ‘the staff here are great and treat me very well’, ‘I am able to decide when I get up and go to bed and what I do with my day’, ‘the staff make sure you feel you are a person and not just a resident’, ‘the doctor examines me in my bedroom when he comes if I am unwell’. Meadow Bank House DS0000005688.V298095.R01.S.doc Version 5.2 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): 12,13,14,15. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to the service. Residents were of the view that they were very well supported by staff to participate in social activities and are able to retain the ability to make personal choices. There was a high level of satisfaction with meals provision at the home. EVIDENCE: Discussions with residents, staff and residents relatives indicated that residents are provided with a stimulating programme of leisure and social activities that they can participate in if they wish. A timetable of activities is prominently displayed in the home. Residents are consulted about the content of this timetable regularly and the home employs an activities organiser. The home is very well equipped with a wide variety of games, books, videos and other recreational equipment that is kept in a room reserved for leisure activities. (It is recommended that this room is provided with more storage cupboards/shelves to accommodate the large amount of equipment held – this would make this room much easier for residents to comfortably access. The leisure and social activities programme also included trips out into both the local community and the seaside. In the week before this inspection the home Meadow Bank House DS0000005688.V298095.R01.S.doc Version 5.2 Page 13 had held its annual summer fair that involved the active participation of residents, their relatives and staff. Residents spoken to felt that they were well supported both individually and as a group to engage in the activities on offer. They were also of the view that they were enabled to make as many personal choices and retain as much independence as they possibly could. But at the same time they felt supported by staff in their daily lives and felt the home was appropriately meeting their needs. Relatives consulted confirmed that they experienced no unreasonable restrictions to them visiting their relation at the home and that visits could be conducted in the privacy of the resident’s room or a quieter area of the home. The general consensus was that meals had improved both in quality and choice. Meal times are reasonable and residents were served and assisted with their lunch appropriately on the day of inspection. Menus are balanced, varied and provide choice. Residents said their likes and dislikes were taken into account and that if the menu choices provided on a particular day were not to their liking then a reasonable alternative would be provided by the home. Meadow Bank House DS0000005688.V298095.R01.S.doc Version 5.2 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. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Residents and relatives spoken to felt comfortable enough to and knew how to make a complaint if they felt it necessary. Written guidance and training arrangements ensure that staff members have a good knowledge of abuse and protection arrangements and safeguards in place to protect the welfare of residents. EVIDENCE: The complaints procedure was prominently displayed and also is available in the ‘Service users guide’ that is provided for resident’s information. Residents and relatives said that any concerns or worries brought to the manager’s attention are responded to quickly and rarely become formal complaints. A complaints log/incident log is maintained. Complaints and incidents are managed appropriately. Meadow Bank operates a protection of vulnerable adults and whistle blowing policies that seek to protect elderly people. In addition, a copy of Bolton’s Inter agency protection procedure is held on site. Staff spoken to confirmed that they had received training and were aware of the whistle-blowing policy. Appropriate pre-employment checks are conducted on all staff to help ensure that residents are being cared for by suitable staff. Meadow Bank House DS0000005688.V298095.R01.S.doc Version 5.2 Page 15 Meadow Bank House DS0000005688.V298095.R01.S.doc Version 5.2 Page 16 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): 19,20,21,22,24,26. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. The home appeared to be structurally well maintained and provides a suitable and comfortable environment for the care of residents. EVIDENCE: The home generally appeared to be in a good state of repair and employs a member of staff who deals with everyday maintenance issues. For larger building issues the home contract with appropriate builders etc. Meadow Bank was very clean and free of malodour on the day of this unannounced site visit to the home. A tour of the communal lounges and dining rooms revealed that decorating issues identified at the last inspection had in the main been addressed – only the lounge on the ‘residential’ unit remained outstanding in this respect. The inspector was informed that this was Meadow Bank House DS0000005688.V298095.R01.S.doc Version 5.2 Page 17 due to be completed soon. Communal lounges and dining areas were comfortably and appropriately furnished and equipped with televisions, videos and music centres. One communal lounge on the first floor of the home is designated as a smoking area for residents. Residents confirmed that they were able to access all communal areas of the home – a passenger lift connects the ground and first floor of the home. Appropriate bathing and shower facilities are provided. These areas were clean and appropriately adapted and equipped to meet the needs of residents who said that staff assisted them appropriately in accessing and using these areas. The home has generally been suitably adapted to meet the needs of residents in relation to specialist equipment. Individual resident’s specialist needs are met following referral of the individual resident to the relevant health care professional. Resident’s bedrooms that were inspected were very clean, suitably furnished and equipped and in some cases very personalised. All bedrooms are provided with en-suite WC and washbasin. Residents expressed their satisfaction with their bedrooms and said they (and their family) were encouraged to personalise their room. The home was well ventilated – at the time of this visit the weather was extremely hot and the manager had taken steps to try and keep the temperature of the home and residents as comfortable as possible with the extensive use of portable fans and small air conditioning units. Meadow Bank House DS0000005688.V298095.R01.S.doc Version 5.2 Page 18 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 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. Resident’s expressed the view that staff were meeting their needs appropriately. Staff are subject to an appropriate recruitment procedure that is consolidated by appropriate training when appointed. 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 management 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 3 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 and further training. NVQ 2 and 3 training in health and social care is being provided for staff. Also a wide range of appropriate and ongoing training in moving and handling, Meadow Bank House DS0000005688.V298095.R01.S.doc Version 5.2 Page 19 abuse, basic food hygiene, fire safety and other relevant topics is provided to staff at the home. The home is also accredited to accept student nurses as part of their statutory training. Meadow Bank House DS0000005688.V298095.R01.S.doc Version 5.2 Page 20 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): 31,33,34,35,36,37,38. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to the service. Meadow Bank is extremely well managed by the manger, a qualified registered nurse with many years of experience in general nursing and care of the elderly. EVIDENCE: The home manager is registered with the CSCI and is a very experienced registered nurse and has completed an NVQ4 in management. Discussion with residents their relatives and staff employed at the home indicated that the manager is very accessible, approachable, provides excellent leadership, is supportive and is very aware of what is happening in the home. She is supported in her role by her senior line manager and by two deputy home managers and staff at the home. Meadow Bank House DS0000005688.V298095.R01.S.doc Version 5.2 Page 21 A wide range of quality assurance systems are in place to ensure the home is run in the best interests of residents – these include resident/relative meetings, staff meetings, internal and external audits, and regular satisfaction surveys. Residents, relatives and staff report that the manager and her senior staff operate an ‘open door’ policy that enables people to raise and discuss any areas of concern quickly and comfortably. 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. 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 were to be imminently improved. Meadow Bank House DS0000005688.V298095.R01.S.doc Version 5.2 Page 22 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 3 X 3 3 3 N/a HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 2 3 3 X 3 X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 3 X 3 3 X 3 Meadow Bank House DS0000005688.V298095.R01.S.doc Version 5.2 Page 23 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 the CSCI is informed in writing when the communal lounge on the first floor of the home is redecorated. That the CSCI is informed in writing how the requirements/recommendations of the EHO visit of June 2006 have been addressed. Timescale for action 31/08/06 2 OP38 13 31/08/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP12 Good Practice Recommendations That consideration be given to improving the storage provision in the designated activities room to enhance residents comfort when using this room. Meadow Bank House DS0000005688.V298095.R01.S.doc Version 5.2 Page 24 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.V298095.R01.S.doc Version 5.2 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. 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. 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