Inspection on 07/02/06 for Meadow Cottage Nursing Home

This inspection was carried out on 7th February 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 found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Meadow Cottage Nursing Home 05/12/06

Meadow Cottage Nursing Home 26/09/05

Meadow Cottage Nursing Home 27/01/05

Meadow Cottage Nursing Home 10/08/04

Similar services:

Coopers Mill Ltd

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Paradise Lodge

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Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

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

CARE HOME ADULTS 18-65 Meadow Cottage Nursing Home 14 High Street Overstrand Norfolk NR27 OAB Lead Inspector Mrs Lella Andrews Unannounced Inspection 11:00a 7 February 2006 th Meadow Cottage Nursing Home DS0000015659.V271691.R01.S.doc Version 5.0 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Meadow Cottage Nursing Home DS0000015659.V271691.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Meadow Cottage Nursing Home DS0000015659.V271691.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Meadow Cottage Nursing Home Address 14 High Street Overstrand Norfolk NR27 OAB 01263 579221 01263 579315 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) Elizabeth Fitzroy Support Care Home 16 Category(ies) of Learning disability (16), Physical disability (16) registration, with number of places Meadow Cottage Nursing Home DS0000015659.V271691.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 16 people, of either sex, who have a Learning Disability or Physical Disability, may be accommodated. 26th September 2005 Date of last inspection Brief Description of the Service: Meadow Cottage is located in the village of Overstrand and provides accommodation for up to 16 service users with learning and physical disabilities. All accommodation and communal areas are on the ground floor, with administrative offices located on the first floor. The home is situated close to local amenities and has views across to the sea. The gardens are easily accessible to all service users. Limited car parking is available to the front of the building and there is ample on-road parking outside of the home. Specialised aids and adaptations have been fitted in service users bedrooms and all communal areas as necessary. Assisted bathing facilities are located throughout the building and offer choice for service users. Communal areas provide a choice of seating as appropriate. Each of the communal rooms are spacious, allowing easy access for wheelchair users. Meadow Cottage Nursing Home DS0000015659.V271691.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This Inspection was unannounced and took place between 11am and 3pm on Tuesday 7th February 2006. The Manager and deputy manager were present during the Inspection and provided information verbally and in the form of records. The Inspector spent some time with the qualified nurse on duty inspecting the medication system in use. The Inspector also spoke to another member of staff on an individual basis. The service users living at the Home have complex needs including communication difficulties and so it is not easy to gather information from them but the Inspector spent some time observing staff supporting the service users. There are currently fifteen service users living at the Home. The building is large and in need of updating. However, the organisation has plans for the service users to move so that they are able to live in smaller groups in accommodation that better meets their needs. The service users and their relatives are involved in the ongoing discussions about the future. It is not expected that anyone will move for at least another year. Only a few standards were measured on this occasion as the majority of the National Minimum Standards were measured during the previous Inspection. What the service does well: The Home provides a good standard of care to the service users who all have complex physical and learning disabilities. The staff provide a very good standard of care with regard to the service users nutritional needs. The majority of the service users have complex nutritional needs and the staff are aware of all of the individual needs. The kitchen staff and care staff work well together to ensure that individual needs are met in the most relaxed way possible. The medication is managed well and the service users receive medication in the correct way at appropriate times. The staff are enthusiastic about supporting the service users and know them well. Meadow Cottage Nursing Home DS0000015659.V271691.R01.S.doc Version 5.0 Page 6 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 contacting your local CSCI office. Meadow Cottage Nursing Home DS0000015659.V271691.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Meadow Cottage Nursing Home DS0000015659.V271691.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None of these standards were measured EVIDENCE: N/A Meadow Cottage Nursing Home DS0000015659.V271691.R01.S.doc Version 5.0 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None of these standards were measured EVIDENCE: N/A Meadow Cottage Nursing Home DS0000015659.V271691.R01.S.doc Version 5.0 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 17 Many of the service users have very complex nutritional needs and these are met by the staff team. EVIDENCE: The care plans contain detailed information about the nutritional needs of the service users. They also contain evidence of other professionals, such as the dietician and speech and language therapist, being involved in risk assessments and nutritional care plans. For some service users meal times are not easy relaxed situations due to their complex needs. Two of the service users have naso-gastric tubes and others have gastrostomy tubes. One of the service users has a condition which requires adherence to an extremely strict diet. The staff are aware of the service users needs and explained to the Inspector the individual care plans that are in place. Staff are also aware of the emotional issues which may arise due to the difficulties in eating and support the service users appropriately at mealtimes. Meadow Cottage Nursing Home DS0000015659.V271691.R01.S.doc Version 5.0 Page 11 The necessary equipment for the service users is available and each service user has their own drawer in the dining room in which their equipment and a copy of their care plan for nutrition is kept. The menu for the week is displayed on the wall in the dining room and includes the individual diets as well as a vegetarian option for each meal. Two of the staff have completed the Total Communication course and are in the process of assessing the communication needs for the service users. Staff are aware of how each service user communicates and use alternative methods as well as verbal communication. Staff were seen to spend additional time with individuals in order to offer them a choice. The deputy Manager writes an allocation of tasks for each shift and supporting the service users with nutrition is one of the tasks on this record. The Home has a commercial kitchen but there is also a kitchenette area in the dining room which the service users and care staff have access to. The staff said that the service users can choose to be involved in the preparation of snacks and cakes both in the kitchenette and the Community Resource Centre which is attached to the Home. The Home employs a cook to work in the Home for seven days per week. The main cook was not on duty on the day of the Inspection but the Inspector spoke to the relief cook who had a good understanding of the nutritional needs of the service users and explained the communication systems in place between the care staff and the kitchen staff. The Inspector was told that all staff who spend time in the kitchen have attended Food Hygiene training. The Home has a large dining room which is the “hub” of the Home with the majority of areas leading from this room. The room used to be decorated with murals but these have recently been painted white. The staff explained the current process of involving the service users in choosing a new colour for the walls. Meadow Cottage Nursing Home DS0000015659.V271691.R01.S.doc Version 5.0 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 20 Medication is well managed and provides protection for the service users. EVIDENCE: There is always a qualified nurse on duty at the Home and they are responsible for the administration of medication. The nurse on duty at the time of the Inspection explained the medication system in use. The nurse is responsible for the ordering of medication. Appropriate records are kept of medication received at the Home and that returned to the pharmacy. Medication is stored appropriately and records are kept of administration. Written guidance is available with regard to the administration of PRN (as required) medication. The care plans contain information about the medication that each of the service users is prescribed and there is evidence of reviews taking place. The nurse advised that the medication for all of the service users has recently been reviewed by the PCT pharmacist and the GP. Meadow Cottage Nursing Home DS0000015659.V271691.R01.S.doc Version 5.0 Page 13 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None of these standards were measured EVIDENCE: Although these standards were not measured the Manager said that training about the protection of vulnerable adults from abuse is now provided within the induction for new staff and that existing staff are booked to attend this training as an update. This action has been taken in response to a requirement in the previous report. Meadow Cottage Nursing Home DS0000015659.V271691.R01.S.doc Version 5.0 Page 14 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 The Home is an old building and is in need of updating but the accommodation is as homely and comfortable as possible. EVIDENCE: The building is large and, therefore, it is difficult for it to be considered homely. However, the staff work hard to ensure that it is as homely as possible. A couple of the bedrooms were seen, these are attractively decorated and furnished in very personal styles. The lounge at the end of the Home has wonderful views over the garden and the sea as there are windows on three sides. The service users have their own soft chairs which are in the lounge. The lounge is not big enough for all of the service users to use at one time. As previously mentioned, the dining room is large and is the centre of the Home. Activities other than meals take place here and it is used as the central meeting point in the Home. There is a Community Resource Centre attached to the Home and at which the service users spend some of their time. Meadow Cottage Nursing Home DS0000015659.V271691.R01.S.doc Version 5.0 Page 15 The bathrooms were all seen on the day of the Inspection. These are in need of upgrading but it is unlikely that this will be done as the service users will all be moving from the Home in the near future. The Home was clean with no unpleasant smells on the day of the Inspection. Meadow Cottage Nursing Home DS0000015659.V271691.R01.S.doc Version 5.0 Page 16 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None of these standards were measured EVIDENCE: Although these standards were not measured it was noted that staff said that they are now receiving formal supervision sessions on a regular basis. This had been a requirement in the previous report. Meadow Cottage Nursing Home DS0000015659.V271691.R01.S.doc Version 5.0 Page 17 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 39 The staff work hard to obtain the views of the service users about the service provided. EVIDENCE: As previously mentioned, the staff receive training with regard to communication and are aware of the different ways in which the service users communicate. Staff work hard to try to obtain the views of the service users so that they are able to make choices and to contribute to reviews of the service provided. Key team meetings take place at least monthly with the service user and their keyworkers to review the care plans and make any changes that are necessary to the care provided. Meetings take place informally with the service users, for example, to agree on the colour that the dining room walls should be painted. Meadow Cottage Nursing Home DS0000015659.V271691.R01.S.doc Version 5.0 Page 18 The Manager said that the organisation has a service user forum which meets regularly and is run by service users. Representatives attend from this Home and they are supported by a member of staff. Individual aspects of the service provided in the Home are measured in other ways. For example, an audit of medication is carried out monthly and there are regular health and safety checks carried out with records kept. The Manager said that the Home is using the organisations REACH standards as the formal quality assurance process. One of the standards is measured each month and the results are discussed with senior managers so that they are aware of the quality assurance outcomes. The Manager said that regular visits to the Home are carried out by the Operational Director. A requirement is made for the Commission to receive a copy of reports of the monthly visits carried out by someone in the organisation designated to do so as per Regulation 26. Meadow Cottage Nursing Home DS0000015659.V271691.R01.S.doc Version 5.0 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X X X X X Standard No 22 23 Score X X ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score X X X X X Standard No 24 25 26 27 28 29 30 STAFFING Score 2 X X X X X X LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 X 16 X 17 Standard No 31 32 33 34 35 36 Score X X X X X X CONDUCT AND MANAGEMENT OF THE HOME 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Meadow Cottage Nursing Home Score X X 3 x Standard No 37 38 39 40 41 42 43 Score X 3 X X X X X DS0000015659.V271691.R01.S.doc Version 5.0 Page 20 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 YA39 Regulation 26 Requirement It is required that monthly visits are carried out as per Regulation 26 and that a copy of the report is sent to the Commission Timescale for action 28/02/06 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 Cottage Nursing Home DS0000015659.V271691.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Norfolk Area Office 3rd Floor Cavell House St. Crispins Road Norwich NR3 1YF 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 Cottage Nursing Home DS0000015659.V271691.R01.S.doc Version 5.0 Page 22 - 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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