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Inspection on 22/11/05 for Meadow House Residential Home

Also see our care home review for Meadow House Residential Home for more information

This inspection was carried out on 22nd November 2005.

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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

What has improved since the last inspection?

Requirements made in the previous report have been implemented. Staffing levels have been increased. The manager has included greater detail in the care plans to reflect the care routines.

What the care home could do better:

For those residents whose medication is not dispensed from the pharmacist`s monitored dosage system, there needs to be a system of recording to show when this medication should be given and by whom, as well as the date, time and signature of person administering it. A privacy lock is needed on a ground floor toilet door. The home needs to introduce a quality assurance system.

CARE HOMES FOR OLDER PEOPLE Meadow House Residential Home 47 - 51 Stubbington Avenue North End Portsmouth Hampshire PO2 OHX Lead Inspector Ian Craig Unannounced Inspection 22nd November 2005 11:00 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 House Residential Home DS0000059026.V254108.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 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 House Residential Home DS0000059026.V254108.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Meadow House Residential Home Address 47 - 51 Stubbington Avenue North End Portsmouth Hampshire PO2 OHX 023 9266 4401 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 Suresh Sudera Mr David Fuller Care Home 24 Category(ies) of Dementia - over 65 years of age (24), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (24), Old age, not falling within any other category (24), Physical disability (2), Physical disability over 65 years of age (2) Meadow House Residential Home DS0000059026.V254108.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Service users in the category PD must be at least 55 years of age. A maximum of two service users in the categories PD and PD(E) are to be accommodated at any one time. 24th May 2005 Date of last inspection Brief Description of the Service: Meadow House is three terraced properties converted into one large house that is situated in a residential street in Portsmouth. The home is registered for 24 older people and can accommodate service users who are aged 65 years or over who have a dementia and/or mental disorder. Within this total of 24, two service users with a physical disability can be accommodated. On the ground floor the home has three lounges, a dining room, a library, treatment room, laundry, bathrooms, walk-in shower and bedrooms. Further bedrooms and the office are located on the first floor. The home has a garden at the rear including a lawned area, tables and chairs plus ramped access. There is a smaller front garden consisting of shrubs and flowers. The home is close to local facilities in North End, Portsmouth where numerous shops, cinema, etc. are situated. Meadow House Residential Home DS0000059026.V254108.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The manger, Mrs. Angela Guy, assisted the inspector throughout the visit. Several residents were spoken to. This report should be read in conjunction with the previous inspection report. 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 contacting your local CSCI office. Meadow House Residential Home DS0000059026.V254108.R01.S.doc Version 5.0 Page 6 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 House Residential Home DS0000059026.V254108.R01.S.doc Version 5.0 Page 7 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): None of the standards in this section were assessed at this inspection, but were all covered in the previous report. EVIDENCE: Meadow House Residential Home DS0000059026.V254108.R01.S.doc Version 5.0 Page 8 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 and 9 Care plans have been improved and the manager is ‘open’ to discuss ways in which they can be improved further. Procedures for the handling and administration of medication are satisfactory with the exception of medication which is administered separately from the monitored dosage system. EVIDENCE: As required by the previous inspection report, the recording in the care plans has been improved to more accurately reflect the care that staff should give to the resident. The manager and inspector discussed ways in which this could be further improved. The benefits of a record of the resident’s daily care routines and personal preferences was suggested by the manager. Residents sign a document called a ‘Care Plan Agreement,’ acknowledging the content of their care plan. Assessments of need and care plans were assessed in greater detail at the previous inspection. Procedures and policies for the handling, safekeeping and administration of medication were checked. The home uses a monitored dosage system, which was being operated according to pharmaceutical guidelines. One resident has Meadow House Residential Home DS0000059026.V254108.R01.S.doc Version 5.0 Page 9 medication dispensed from a bottle supplied by a local day hospital. Procedures for this medication were not satisfactory in the following ways: • A record of the amount received into the home was not recorded • A record of the person administering the medication was not accurately maintained • Procedures for the administration of this medication were not recorded, including who should administer and the circumstances indicating the need for the medication. Meadow House Residential Home DS0000059026.V254108.R01.S.doc Version 5.0 Page 10 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): 15 The home provides a choice of food at all meal times. EVIDENCE: The previous inspection report required that residents have a choice of food for the midday meal. At this inspection it was noted that the midday meal menu was displayed in the hall and included a choice. In addition to this, staff ask residents what they would like to eat for the midday meal for the following day and record this. Residents confirmed that a choice is available for the midday meal. Comments were also made by the residents that the food is of a good quality. Meadow House Residential Home DS0000059026.V254108.R01.S.doc Version 5.0 Page 11 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 and 18 Residents are provided with a copy of the complaints procedure. The home’s management are aware of the local authority adult protection policy. EVIDENCE: The Commission were notified of an incident of oversight of the care routine for one resident. This was looked into by the local authority. Whilst this is an isolated incident, it underlines the need to ensure care plans are accurately recorded and that staff follow the care routines. Each resident has a copy of the home’s Statement of Purpose, which includes a copy of the complaints procedure. This includes details of how the Commission for Social Care Inspection can be contacted. The home has copies of the local authority adult protection procedures. The manager has booked a place on a forthcoming local authority training course entitled, ‘Adult Protection Awareness.’ The inspector and manager spent time discussing historical incidents of aggression by a resident that have since ceased. It was clear that the manager was fully aware of appropriate procedures for dealing with possible aggression. Meadow House Residential Home DS0000059026.V254108.R01.S.doc Version 5.0 Page 12 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): None of the standards in this section were assessed at this inspection. EVIDENCE: Meadow House Residential Home DS0000059026.V254108.R01.S.doc Version 5.0 Page 13 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 and 30 Staffing levels have been increased since the last inspection. There are a variety of training opportunities for staff. The inspector identified this as one of the home’s strengths. Thorough checks are made on new care staff including overseas workers. EVIDENCE: Staffing levels have been increased since the last inspection from 425 to 461 hours per week. There are now at least two staff on duty at any given time with a third person at meal times. Sufficient numbers of staff were observed to be on duty at the time of the inspection. Residents stated that the staff are helpful and kind. 50 of the care staff are qualified to NVQ level 2 and a further 2 staff have NVQ level 3 in care. Further staff will be commencing NVQ level 2 training in the near future. Newly appointed staff have an induction which is recorded. As well as the availability of NVQ training for staff, various courses are also provided, such as food hygiene training, first aid, infection control, medication awareness, dementia and moving and handling. The home maintains a record of training and there are staff training plans. Procedures for the recruitment of staff were examined for a recently appointed overseas worker. References and criminal record bureau checks had been obtained. Copies of specific documents were available verifying the person’s identity. Meadow House Residential Home DS0000059026.V254108.R01.S.doc Version 5.0 Page 14 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, 35 and 38 The home’s management are committed to improving the service. A quality assurance system is being developed. There are procedures for the safeguarding of residents’ finances. Measures are taken to ensure the health and safety of the residents’ and staff. EVIDENCE: At the time of the inspection the manager was undertaking NVQ level 4 in care and management, which includes the attainment of the Registered Manager’s Award. The manager showed a commitment to improving the service. An application for registration with the Commission has been submitted. The home is yet to implement a quality assurance system, but has sought the views of relatives and residents about the service provided. The inspector was informed that the home’s owners will be introducing a quality assurance system in the near future. Progress on the implementation of this will be checked at the next inspection. Meadow House Residential Home DS0000059026.V254108.R01.S.doc Version 5.0 Page 15 Procedures for the handling of residents’ finances were examined. Records are maintained for each resident for any amount deposited, withdrawn, as well as a corresponding balance. Any monies held are securely stored. Measures are taken to ensure adequate health and safety in the home, including training for staff in food hygiene, first aid, moving and handling and infection control. Equipment and appliances are tested by suitably qualified engineers etc. These include the fire safety equipment. The home will be carrying out its own testing of the portable electrical appliances using a testing kit. The fire log book showed that the fire safety equipment is tested and that staff receive training in fire safety and fire evacuation. Meadow House Residential Home DS0000059026.V254108.R01.S.doc Version 5.0 Page 16 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 X X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 X 9 2 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 X X X X X X X X 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 2 X 3 X X 3 Meadow House Residential Home DS0000059026.V254108.R01.S.doc Version 5.0 Page 17 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(4) Requirement For those medications administered to residents but not included in the monitored dosage system the following must be completed: • Details of the procedures, presenting symptoms etc requiring the use of medication ‘as required’ • A record of the medication received into the home • A record by the person dispensing, including the time, date and signature • Amendments to the home’s medication policy to include details of the above procedures Timescale for action 22/12/05 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 House Residential Home DS0000059026.V254108.R01.S.doc Version 5.0 Page 18 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 House Residential Home DS0000059026.V254108.R01.S.doc Version 5.0 Page 19 - 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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