Inspection on 16/05/07 for Meadow Dean Residential Care Home

This inspection was carried out on 16th May 2007.

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 Dean Residential Care Home 27/02/06

Meadow Dean Residential Care Home 04/05/05

Similar services:

Springfield House

Sutton Lodge Nursing Home

The Shelley

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Meadow Dean Residential Care Home 35 Lower Road River Dover Kent CT17 0QT Lead Inspector Mrs Penny McMullan Key Unannounced Inspection 16 May 2007 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 Dean Residential Care Home DS0000061945.V336314.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 Dean Residential Care Home DS0000061945.V336314.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Meadow Dean Residential Care Home Address 35 Lower Road River Dover Kent CT17 0QT 01304 822996 F/P 01304 822996 meadowdean@btconnect.com 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) Mr Anandanadarajah Maheethan Mrs Vidya Maheethan Debra Ann Smith Care Home 26 Category(ies) of Old age, not falling within any other category registration, with number (26) of places Meadow Dean Residential Care Home DS0000061945.V336314.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 27th February 2006 Brief Description of the Service: Meadow Dean Residential Home is a large detached house, situated in the village of River. The home is registered for 26 older people and at the present time all bedrooms are being used as single rooms. Communal accommodation is located on the ground floor, and consists of three communal sitting areas, and a dining room, some bedrooms are also located on the ground floor but the majority of bedrooms are on the first floor and this floor is serviced by a passenger lift. There is a small garden area at the rear of the building, which is backed by a river. Car parking is available on the road immediately in front of the home and to the side of the home. The village of river has local shops and a public house, there is a bus service from the village into the town of Dover, and the local railway station at Temple Ewell is approximately one mile from the home. The current fees for the service at the time of the visit are £375 per week. There are additional charges for chiropidy, hairdressing, newspapers and toiletries. Information on the homes services and the CSCI reports for prospective service users/relatives will be referred to in the Service User Guide. There is also a copy on display in the entrance of the home. The email adress for the service is: www.meadowdene@btconnect.com Meadow Dean Residential Care Home DS0000061945.V336314.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report is based on evidence gained from a pre-inspection questionnaire completed by the home; comment cards received from service users, families, and visiting professionals; and a site visit of 7 hours to the home. The site visit includes talking to service users, relatives, staff, the Registered Manager, Deputy Manager; a partial tour of the building; inspection of records; and various observations. Feedback from health professionals and relatives indicate they are overall very satisfied with the service being provided. Further comments have been included in this report. What the service does well: What has improved since the last inspection? The home has re-sited the laundry facilities and purchased and a large industrial tumble drier. Two bedrooms have been completely redecorated; two new carpets and two beds have been purchased. Meadow Dean Residential Care Home DS0000061945.V336314.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. Meadow Dean Residential Care Home DS0000061945.V336314.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 Dean Residential Care Home DS0000061945.V336314.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. JUDGEMENT – we looked at outcomes for the following standard(s): 3.6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Arrangements are in place to carry out assessments of needs of service users prior to admission to the home. Standard 6 is not applicable to this home EVIDENCE: The Registered Manager and or Deputy Manager complete the pre-admission assessments for prospective service users. Care plans and joint assessments from the placing authority are also in place. People who use the service confirm they received a visit from the Manager of the home before coming to live there. One service user confirms that she had lots of paperwork when she came into the home and was offered the choice of two bedrooms. Meadow Dean Residential Care Home DS0000061945.V336314.R01.S.doc Version 5.2 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. 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 this service. The care planning system is consistent to provide staff with the information they need to meet the people who use the service health and social care needs. There are minor shortfalls in the management of the administration of medication. The home promotes people’s rights and choices. EVIDENCE: The care plans cover all aspects of health and social care. The plans are person centred and easy to understand. A key worker system is in place and staff demonstrated their awareness of peoples needs. The moving and handling risk assessments would benefit from further detailed guidelines for a Meadow Dean Residential Care Home DS0000061945.V336314.R01.S.doc Version 5.2 Page 10 safe practice of work for staff. People who use the service say they are aware of their plans but did not express an interest to look at them. Health care needs are monitored in the service user plan, clearly recording health checks, medication, medical conditions, allergies and appointments. People who use the service confirm that the home calls the GP when required and there is evidence on file with regard to visiting professionals. The people who use the service have access to dentist, optician, and chiropodist and the required equipment to support them with their health care needs is in place. Weekly exercises to music are held and many of the residents say how much they enjoy these sessions. If required the home provides an escort to accompanying service users to health appointments. One person’s medication requires to be reviewed with regard to dosage and the storage of the medication. The home is taking advice from the pharmacy or GP. A requirement has been made in this report. To minimise the risk of error a recommendation has also been made to countersign hand written entries in the mar sheets. The risk assessments for service users who self medicate require to be reviewed. Senior staff who have received appropriate training administer the medication. Feedback from people who use the service indicate that staff are polite and respectful. They confirm that their preferences are taken into consideration with regard to their daily lives. Service user comments: ‘the staff always treat me with respect, they are always polite’, ‘you can lay in and stay in bed all day if you like, you are free to do what you want to do. Staff always knock on my bedroom door before they come in’. Meadow Dean Residential Care Home DS0000061945.V336314.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home offers a good programme of activities, and links with the community are good. Service users are given every opportunity to retain independence and autonomy of their own lives. The meals in the home are good offering both choice and variety. EVIDENCE: There is a programme of activities, which include craft sessions, bingo, and exercises to music, quizzes and reminiscence. Outside entertainment is provided on a regular basis. There is Holy Communion monthly and additional church services held in the home. Service user comment: ‘ there is someone who plays keyboard, singsongs and a lady who does movement and music’ We also have bingo sessions’. Meadow Dean Residential Care Home DS0000061945.V336314.R01.S.doc Version 5.2 Page 12 Relatives say the home is welcoming and ‘you can come and go as you like, and make tea if you wish’. ‘Visitors are welcome and we can see mum in the dining room or bedroom, which is more private than the lounge’. People who use the service comments: ‘I prefer to read upstairs in my room, I don’t have to come down’, ‘I like to go to the local Abbey’. . Staff encourage and promote service users choice in all aspects of their daily lives. The people who use the service are encouraged to retain their independence and supported if required with their finances. One service user says ‘‘I can choose what time I get up and go to bed’ I get my hair done every two weeks and enjoy my bath’. Feedback from the people who use the service indicates that the home works hard to ensure they have their choice and are free to do what they wish in the home. The home has a four weekly menu in place, which is compiled with the help of the people who use the service. There is a bowl of fruit in the lounge and fruit squash is available throughout the day. Staff ask services users daily what they wish to eat and demonstrated their awareness of individual choices and diets. Service users choose where they would like to eat and the menu is varied and nutritious. Service user comment ‘we have two dishes to choose from at dimmer and can have soup or something else if we want to’. They bring biscuits with tea and there is plenty of food to eat’. Meadow Dean Residential Care Home DS0000061945.V336314.R01.S.doc Version 5.2 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. 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 this service. The clients in the home know their complaints will be listened to and acted on. Staff have a good knowledge and understanding of adult protection issues, which protect the clients from abuse. EVIDENCE: The complaints policy and procedure is given to all service users in their information pack when they come to live at the home. The home has received one complaint since the last inspection, which has been recorded and actioned. Service user surveys and discussion indicate they have no complaints but would raise any concerns with the home and know who to speak to. The majority of staff have received in house adult protection training. The Registered Manager is aware of adult protection protocols and recently referred an incident to adult protection, which was investigated and as a result was not raised as an adult protection alert. Staff demonstrated their awareness of adult protection and there are clear policies and procedures in place. Meadow Dean Residential Care Home DS0000061945.V336314.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19,21,26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The environment is maintained to a high standard, providing the clients with an attractive and homely place to live. Laundry facilities are satisfactory and policies and procedures are in place to control the risk of infection. EVIDENCE: The home has an informal maintenance programme in place, when the handyperson is on duty the Registered Manager prioritises the work to be carried out. The home need to produce a formal programme of maintenance, and keep records of work to be carried out and completed. A recommendation Meadow Dean Residential Care Home DS0000061945.V336314.R01.S.doc Version 5.2 Page 15 has not been given in this report, as it is evident that the home is well maintained this information just needs to be formalised into a plan. One service user has an interest in plants and has a small greenhouse in the garden. The lounges and dining rooms are comfortable and homely. Three people who use the service say the water flow in their rooms is not very good, and sometimes there is lukewarm water and the taps make noises. The Registered Manager is monitoring the situation and has had visits from the plumber to address this issue. The home needs to consult with the local Fire Office to review the fire risk assessment in line with the new legislation. A recommendation was made in the last report to consider turning the bathroom on the first floor into a wet room or to provide a bath. The Registered Manager has the information with regard to the refurbishment of the bathroom and is currently discussing the issue with the Registered Provider. This bathroom is not currently in use therefore the home is not using this facility to ensure that there is one bathroom/shower room for every 8 residents. The home has laundry facilities, attached to the rear of the building. The washing machine has a sluicing facility, and there are policies and procedures in place to reduce the risk of infection. People who use the service, their relatives and visitors confirm the home always smells pleasant. Meadow Dean Residential Care Home DS0000061945.V336314.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Sufficient experienced, trained and qualified staff is provided to ensure people who use the service needs are met. Recruitment polices have been consistently followed resulting in people who use the service receiving care from staff that have been fully vetted. EVIDENCE: The home is sufficiently staffed with an experienced established staff team. People who use the service, relatives and staff feel there is always enough staff on duty. People who use the services comments: The day staff are good and mostly kind’, ‘the staff are kind, they come quickly even at night time. The home has achieved over 50 of its staff qualified or on courses to qualify to NVQ level 2 and above. There is also an ongoing programme for carers to achieve this award. Staff files viewed contained all of the necessary documents, application forms, two satisfactory references, proof of identification and Criminal Records Bureau (CRB) and Protection of Venerable Adult (POVA) checks. A record of applying Meadow Dean Residential Care Home DS0000061945.V336314.R01.S.doc Version 5.2 Page 17 for POVA first checks must also be kept on file. The files would benefit from an audit to ensure that all files have the required information. The home has a detailed training matrix in place and all mandatory training is up to date or being updated. Some of the training is provided in house with a competency based structure which is linked to Skills for Care. The Registered Manager provides this training and needs to discuss with Skills for Care if she requires to be trained as a trainer for trainer. The induction is linked to Skills for Care. Staff say that any training identified to meet service needs is provided by the organisation. There is an ongoing training programme in the home and training certificates are on file. Meadow Dean Residential Care Home DS0000061945.V336314.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users benefit from a well run effectively managed home. The arrangements for service users consultation are good. Service users financial interests are safeguarded and the home is endeavouring to provide a safe environment for service users and staff. EVIDENCE: The Registered Manager Debra Smith is qualified, experienced, and competent. Feedback from service users, staff and relatives indicate she is Meadow Dean Residential Care Home DS0000061945.V336314.R01.S.doc Version 5.2 Page 19 committed to providing quality of care in the home. There is a clear management structure and staff understands their role. Staff say they are supported by the Registered Provider and Registered Manager. One staff member says ‘she is one of the best managers I have had, very fair’. A quality assurance survey has been carried out on this year. Service users, relatives, friends, and visitors from multi disciplinary teams fill in quality assurance questionnaires. Although the Registered Manager has responded to the issues raised from the survey this information is not fully recorded. The outcome of the quality assurance needs to be published and if required form part of the development plan. There is an informal development plan in place as the manager has clear direction of what needs to be achieved in the home however there is no formal written record. A recommendation has not been made in this report as the Registered Manager has actioned and responded to the outcomes of the survey and will formally implement a development plan. People who use the service have meetings every three months. There are several service users who are supported with their finances. There are sound recording systems in place to safeguard their monies, which are securely locked away in the home. Mandatory training is being provided and there is an on going training programme. The appropriate safety checks have been carried out. Although the fire testing is being recorded, the call point number is not included and fire drills are not being recorded. The fire risk assessment also needs to be reviewed in line with new fire regulations and the home needs to consult the local fire office with regard to the use of fire alarm safety devices to be fitted to individual doors. The fire door in the corridor is permanently wedged open and some of the service users sleep with their door open. A requirement has been made in this report. Environmental risk assessments in place and reviewed on a regular basis. Accidents are recorded and tracked through to the daily records with appropriate action taken. Meadow Dean Residential Care Home DS0000061945.V336314.R01.S.doc Version 5.2 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 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 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 x x x x x 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 3 x 3 x 3 x x 2 Meadow Dean Residential Care Home DS0000061945.V336314.R01.S.doc Version 5.2 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 OP9 Regulation 13(2) Requirement All medication to be stored and administered in line with the Royal Pharmaceutical Society Guidelines To review risk assessments for people who are able to self medicate their own medication 2. OP38 13 To carry out fire drills, record the call point when testing the fire points and to consult the local fire office with regard to the installation of individual fir door devices To review the fire risk assessment in line with the new fire legislation 30/06/07 Timescale for action 30/06/07 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 Good Practice Recommendations DS0000061945.V336314.R01.S.doc Version 5.2 Page 22 Meadow Dean Residential Care Home 1. 2. Standard OP9 OP21 To ensure that all hand written entries in Medical Administration Record Sheets are countersigned to minimise the risk of error A first floor bathroom needs refurbishment, to either have a fitted bath hoist, or to be made into a wet room, so that residents are able to use it. At present the home does not meet with standard 21.3, which states there should be I bathroom for every 8 residents. This recommendation is carried forward form the last inspection. Meadow Dean Residential Care Home DS0000061945.V336314.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Dean Residential Care Home DS0000061945.V336314.R01.S.doc Version 5.2 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!