Inspection on 04/05/05 for Meadow Dean Residential Care Home

This inspection was carried out on 4th May 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Meadow Dean Residential Care Home 16/05/07

Meadow Dean Residential Care Home 27/02/06

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 Home 35 Lower Road River Dover Kent CT17 0QT Lead Inspector June Davies Unannounced 04/05/05 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Meadow Dean Residential Home H56-H05 S61945 Meadow Dean Residential Home V223638 040505 Stage 3.BE.doc Version 1.20 Page 3 SERVICE INFORMATION Name of service Meadow Dean Residential Home Address 35 Lower Road, River, Dover, Kent CT17 0QT Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01304 822966 01304 822966 Mr Anandanadarajah Maheethan Debra Ann Smith CRH 26 Category(ies) of OP 26 registration, with number of places Meadow Dean Residential Home H56-H05 S61945 Meadow Dean Residential Home V223638 040505 Stage 3.BE.doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 21/12/04 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 36 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 commuanl 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.. Meadow Dean Residential Home H56-H05 S61945 Meadow Dean Residential Home V223638 040505 Stage 3.BE.doc Version 1.20 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and started at 10.55 on the 4th May 2005 and took place over 7 hours. Eight residents, four staff and the manager were able to give their views of the home. One visitor was spoken to. Seven of the residents said that they liked living in the home, all the staff felt that the home was improving in décor and provider was showing with the pre-admission as interest in the home. All residents have a care plan but it was noted that not all care plans were complete, and some pages within the care plans seen had not been written on. What the service does well: What has improved since the last inspection? What they could do better: Residents said that whilst staffing levels were good, staff chose which residents they had conversations with, and this was also observed during the visit, where staff members were assisting one resident but no interaction was taking place. Resident’s care plans need to be completed fully, reflecting information from the pre-admission assessment, and more attention paid to all personal care given to individual residents. Whilst residents said that the food had improved lately, it was noted that choices on several days during the week Meadow Dean Residential Home H56-H05 S61945 Meadow Dean Residential Home V223638 040505 Stage 3.BE.doc Version 1.20 Page 6 offered the same meat dish for example two beef dishes on the same day, rather than a beef meal and a chicken meal. The health and safety of the residents must be observed, and fire points should be checked on a weekly basis. Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Meadow Dean Residential Home H56-H05 S61945 Meadow Dean Residential Home V223638 040505 Stage 3.BE.doc Version 1.20 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Meadow Dean Residential Home H56-H05 S61945 Meadow Dean Residential Home V223638 040505 Stage 3.BE.doc Version 1.20 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3 The home ensures through pre-admission assessment that they can meet the physical and social needs of the prospective resident. EVIDENCE: Pre-admission assessment forms from Care Managers and the homes registered manager are obtained prior to any resident moving into the home. A resident said that the registered manager visited when they were in hospital, and asked questions and wrote the answers onto a form. Meadow Dean Residential Home H56-H05 S61945 Meadow Dean Residential Home V223638 040505 Stage 3.BE.doc Version 1.20 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, The care planning system is not clear and consistent to provide staff with the information they needs to meet the residents needs. EVIDENCE: During the visit four care plans were seen, none of the care plans were complete, and information that was available in some cases was confusing and contradictory to the pre-admission assessment, the daily plans of care were not completed appropriately, and in some cases there were gaps in the information, a personal care sheet within the daily plans of care was not being used to show that all personal care needs were being met, therefore requirements have been made for all care plans to be completed fully and with sufficient detail to meet the needs of the resident and at to give sufficient information to care staff. Evidence was available to show that the residents had access to a wide variety of health care professionals but the recording of these home visits or attendance at clinics was not always appropriately recorded in the correct place within the care plan. Residents spoken to during the visit stated that they had never seen their care plans, and were not aware that the care plan was reviewed regularly. During conversation the residents said that they were able to ask staff to call a doctor if they were not well. Meadow Dean Residential Home H56-H05 S61945 Meadow Dean Residential Home V223638 040505 Stage 3.BE.doc Version 1.20 Page 10 Most residents spoken to said that staff did respect their privacy when carrying out personal care. Meadow Dean Residential Home H56-H05 S61945 Meadow Dean Residential Home V223638 040505 Stage 3.BE.doc Version 1.20 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 15 The home offers the residents choice in respect of their daily living, activities and community contact. The presentation and quality of food has improved, but attention needs to be paid to the daily choices that are available to the residents. EVIDENCE: During the visit several residents were spoken to, about choices they were able to take in respect of the daily lifestyle. It was evident during conversation with the residents that they were able to have choices when to get up or go to bed, whilst some said that they liked to go to bed early. Residents said that the home employs a person to do activities with them, and all said they enjoyed the gentle exercises, some residents said that they were not interested in bingo, whilst others said they were not interested in quizzes. Outings are arranged for the residents and some of the residents said that they were looking forward to going on the blossom trail outing, which will take place in two weeks time. All residents said that the food had improved recently and that they were offered a choice, some said that they liked the cooked breakfast which was offered to them twice a week. During the visit menu’s were viewed, and while seen to be offering choice, on some occasions they were seen to offer the same meat for each choice, therefore if a resident did not like beef, on the day of the visit the two choices for that day offered minced beef Meadow Dean Residential Home H56-H05 S61945 Meadow Dean Residential Home V223638 040505 Stage 3.BE.doc Version 1.20 Page 12 based lunch. A recommendation has been made for menu’s to be revised to offer more choice on a daily basis. Meadow Dean Residential Home H56-H05 S61945 Meadow Dean Residential Home V223638 040505 Stage 3.BE.doc Version 1.20 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16, 18 The residents know their complaints will be listened to and acted on. The registered manager has ensured that the whole staff team are aware through training of the protection of vulnerable adults. EVIDENCE: During the visit it was observed that a new complaints policy and procedure was displayed in the main entrance hall. All residents spoken to said they would know how to complain to the registered manager. Two residents have made a complaint since the last inspection, and evidence was available to support these complaints which showed that the complaints had been clearly stated in writing, an investigation of the complaint had been carried out and recorded by the registered manager, but no written evidence was available of what feedback had been given to the residents and their relatives. A requirement has been made that feedback given to the complainant is appropriately recorded. A member of staff had recently attended protection of vulnerable adults training, which she explained had been carried out on two separate occasions to ensure that all staff could attend. Meadow Dean Residential Home H56-H05 S61945 Meadow Dean Residential Home V223638 040505 Stage 3.BE.doc Version 1.20 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 26 Recent investment has significantly improved the appearance of this home creating a comfortable and safe environment for those living there and visiting. EVIDENCE: During the visit it was noted that new carpets had been laid in all communal areas of the home, and that redecoration had been carried out to communal areas towards the front of the building, and in discussion with the registered manager, it was confirmed that further decoration at the rear of the building was due to take place in the next few weeks. Residents said that the areas of the home that had been decorated were now much brighter. Some residents said how much they were looking forward to spending time in the garden when the weather improves, and it was noted that access to the garden is via a ramp from the conservatory external door. The registered provider was on the premises during part of the visit, and said that he had just submitted plans to the local planning department to re-site the laundry room in an extension to the home, to provide a larger laundry space and to provide sufficient space for a tumble drier, and a recommendation has been made for the provision of the tumble drier to prevent laundry being dried in the residents communal bathroom. The feedback sheet from the local Environmental Health Meadow Dean Residential Home H56-H05 S61945 Meadow Dean Residential Home V223638 040505 Stage 3.BE.doc Version 1.20 Page 15 Inspection showed that no requirements had been made and that the officer was satisfied with environmental health issues in the home. During the visit it was noted that the staff toilet on the ground floor, did not have a splash back behind the wash basin sink, and the wall was stained, therefore a requirement has been made for a splash back to be provided behind this wash basin. Meadow Dean Residential Home H56-H05 S61945 Meadow Dean Residential Home V223638 040505 Stage 3.BE.doc Version 1.20 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 28, 29, 30 The staffing levels and qualifications of staff in the home are sufficient to meet the needs of the residents, but staff do need to update some of their mandatory training. Since the last inspection recruitment practices have improved, therefore leaving residents less at risk from abuse. EVIDENCE: Some residents spoken to during the course of the visit, said that the care staff are busy at certain times of the day, but generally they felt that there were enough staff on duty to assist them when necessary. Three weeks staff rotas were viewed, and this reflected good staffing levels in the home. The activities co-ordinator employed by the home also helps with escort duties, when a resident has a hospital appointment. The residents were unable to say which member of care staff had a qualification, but from viewing the training matrix this showed that 64 of staff have a NVQ qualification. Discussion took place with the registered manager, who stated that she ensures that thorough pre-recruitment checks are carried out on new staff, and from viewing three of the newest staff personnel files, there was good evidence of references, POVA first checks and CRB’s. On the day of the visit some of the staff on duty had completed or had some up to date mandatory training, and a requirement has been made that all staff complete mandatory training within the first six months of their employment, and keep this training updated. Meadow Dean Residential Home H56-H05 S61945 Meadow Dean Residential Home V223638 040505 Stage 3.BE.doc Version 1.20 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 33, 38 The registered manager has a good understanding of what needs to improve in the home. Actions plans are in place to ensure that the improvements take place. EVIDENCE: The registered manager, has just completed her NVQ level 4 and RMA. Evidence in the form of certification was seen for numerous work related courses that the registered manager has completed in the last two years. All the residents spoken to during the visit, said that the manager was very kind and approachable. All staff on duty were happy with the manager, and were positive about improvements being made in the home by the new registered providers. During the visit quality assurance was not looked at in detail but discussion took place with the provider and manager that monthly regulation 26 report should be made on the home by the provider and to date this has not been done, therefore a requirement has been made for regulation 26 reports to be carried out in the future. Records showed that up until three Meadow Dean Residential Home H56-H05 S61945 Meadow Dean Residential Home V223638 040505 Stage 3.BE.doc Version 1.20 Page 18 months ago the fire systems were checked weekly but there are gaps for the last three months, and a requirement has been made for regular weekly fire point checks to be made. Certificates were seen to show that all equipment in the home, had been checked and certificated by the contractors. Meadow Dean Residential Home H56-H05 S61945 Meadow Dean Residential Home V223638 040505 Stage 3.BE.doc Version 1.20 Page 19 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. Where there is no score against a standard it has not been looked at during this inspection. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 x 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 2 COMPLAINTS AND PROTECTION 3 x x x x x x 2 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 2 x 3 3 x x x x x x 2 Meadow Dean Residential Home H56-H05 S61945 Meadow Dean Residential Home V223638 040505 Stage 3.BE.doc Version 1.20 Page 20 YES 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 7 Regulation 15 Requirement The residents care plan sets out in detail the action, which needs to be taken by care staff to ensure that all asspects of the health, personal and social care needs of the resident are met. (Timescale of 30/03/05 not met. The residents care plan is completed fullyand agrees with the pre-admission assessment When complaints are investigated feedback to the complainant should be recorded Wash hand basin in ground floor staff toilet needs a splash back. (Timescale of 30/03/05 not met) All staff to receive or update mandatory training. The Registered Provider, carries out monthly Regulation 26 visits to the home, and provides a copy of their findings to CSCI. (Timescale of 14/02/05 not met) Fire points are checked and recorded weekly. Timescale for action 9/07/05 2. 3. 4. 5. 6. 7 16 26 30 33 15 22 13, 16 12 26 9/07/05 9/07/05 9/07/05 9/07/05 1/06/05 7. 38 23 1/06/05 Meadow Dean Residential Home H56-H05 S61945 Meadow Dean Residential Home V223638 040505 Stage 3.BE.doc Version 1.20 Page 21 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. 2. Refer to Standard 26 15 Good Practice Recommendations Laundry needs a tumble drier to prevent laundry being dried in the Service Users communal bathrooms. (Carried forward from previous inspection). Menu choices should offer a choice of meats, for example not two beef choices on the same day. Meadow Dean Residential Home H56-H05 S61945 Meadow Dean Residential Home V223638 040505 Stage 3.BE.doc Version 1.20 Page 22 Commission for Social Care Inspection 11th Floor, International House, Dover Place Ashford Kent TN23 1HU 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 Dean Residential Home H56-H05 S61945 Meadow Dean Residential Home V223638 040505 Stage 3.BE.doc Version 1.20 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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