Inspection on 24/05/05 for Meadow House Residential Home

This inspection was carried out on 24th 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 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 House Residential Home 29/11/06

Meadow House Residential Home 04/07/06

Meadow House Residential Home 22/11/05

Meadow House Residential Home 10/11/04

Meadow House Residential Home 28/04/04

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

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

CARE HOMES FOR OLDER PEOPLE Meadow House Residential Home 47-51 Stubbington Avenue North End Portsmouth PO2 0HX Lead Inspector Ian Craig Unannounced 24 May 2005 9:00 th 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 House Residential Home H55-H03 S 59026 Meadow House V220276 240505.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Meadow House Residential Home Address 47-51 Stubbington Avenue, North End, Portsmouth PO2 0HX 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) 023 9266 4401 ssudra@btinternet.com Mr Suresh Sudera 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 H55-H03 S 59026 Meadow House V220276 240505.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1 - Service users in the category PD must be at least 55 years of age. 2 - A maximum of two service users in the categories PD and PD(E) are to be accommodated at any one time. Date of last inspection 10/11/04 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, 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 H55-H03 S 59026 Meadow House V220276 240505.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced. Assistance was given by the home’s manager, Mrs. Angela Guy. A total of 9 residents were interviewed, as well as 3 relatives of residents. What the service does well: What has improved since the last inspection? The ground floor hall and stairwell have been redecorated. Additional activities have been provided, mainly trips out. There have been improvements to the written care plans and this needs to be developed further. The manager has attended a training course in dementia and the care of older persons. Meadow House Residential Home H55-H03 S 59026 Meadow House V220276 240505.doc Version 1.30 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. Meadow House Residential Home H55-H03 S 59026 Meadow House V220276 240505.doc Version 1.30 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 House Residential Home H55-H03 S 59026 Meadow House V220276 240505.doc Version 1.30 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) 1,2,3,4 and 5 It is clear that information is provided to prospective residents and their relatives about the service provided by the home. Relatives and prospective residents can visit the home before deciding to move in. The home is able to demonstrate that each person’s needs are assessed prior to admission, and that only those residents whose needs the home can meet are being accommodated. Following admission the home provides a contract for the resident. EVIDENCE: Relatives of residents recently admitted to the home stated that they were provided with documents and literature giving information about the services provided. These same relatives described how they were able to visit the home with the prospective resident before deciding whether or not to move in. Records were examined for those residents admitted to the home since the last inspection and included the following: • Admission form Meadow House Residential Home H55-H03 S 59026 Meadow House V220276 240505.doc Version 1.30 Page 9 • • • • Hospital discharge form Enquiry analysis form Care manager’s assessment and care plan Care plan agreement with the local authority These showed that the home assessed resident’s needs prior to admission and that assessments were obtained from the purchasing local authority. Contracts were also available for each resident: one from the local authority and another from the home. Meadow House Residential Home H55-H03 S 59026 Meadow House V220276 240505.doc Version 1.30 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8,9 and 10 Whilst there has been an improvement to the care plans these should be developed further in order to show that residents needs are addressed. The home liaises with local health services to ensure medical needs are met. Policies and procedures for administration of medication are satisfactory. Residents are treated with dignity and respect. EVIDENCE: Care plans and assessments were examined for 5 residents. These are reviewed on a regular basis. Each time an assessment or review takes place the resident is involved in this and signs an acknowledgement of this. The inspector highlighted this as an area of good practice. Care plans have been developed and each resident now has ‘Personal history profile.’ Progress has also been made to record the mental health needs of residents, such as dementia. Risk assessments are also recorded for individual residents. The care plans and risk assessments need to be developed so that care routines are accurately recorded. For instance, some entries recorded only “needs assistance” for personal care and there were similar instructions for other needs, such as lifting and handling, denture care etc. Meadow House Residential Home H55-H03 S 59026 Meadow House V220276 240505.doc Version 1.30 Page 11 Records also showed that the home effectively liaised with health professionals for specialist care such as pressure sores, and that equipment was provided to alleviate this. The attendance of district nurses at the home was recorded. More routine health needs such as eyesight and dental checks were recorded in the daily running records. The inspector suggested a monitoring format so that it would be easier to check when individual resident’s last had eyesight, dental checks etc. Procedures for the administration of medication were satisfactory with the slight exception of one recorded signature, which indicated that the manager should remind staff to sign that medication has been given immediately after the resident takes it, rather than after the staff member has dispensed all medication. Meadow House Residential Home H55-H03 S 59026 Meadow House V220276 240505.doc Version 1.30 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14 and 15 Progress has been made to develop the opportunities for activities and stimulation. Residents access the local community and links with families and friends are promoted. Choice is available in a variety of formats although this needs to be improved for the main midday meal. EVIDENCE: All the residents interviewed stated that they are content with the level of activities provided. The inspector noted that some residents liked to socialise in the lounges whilst others preferred to stay in their rooms. Residents can eat in the dining room or in their rooms. A notice board in the hall gives information about forthcoming activities, such as craft classes, theatre trips, film evenings etc. Residents stated that they had been able to decide whether or not to have a television in the lounge; they had decided against this except for film evenings. As a consequence of this residents were found to be reading and chatting in the lounges. Meadow House Residential Home H55-H03 S 59026 Meadow House V220276 240505.doc Version 1.30 Page 13 A number of residents were receiving visitors on the day of the inspection. These were mainly relatives, who reported that they are always made to feel welcome in the home. Relatives take out residents, and staff also take individuals to the local shops. The manager stated that consideration was being given to taking residents out to the seafront in the summer. For each individual resident a dated record is maintained of daily leisure, social, educational activities. The inspector viewed this as an example of good practice. The inspector observed the serving of the midday meal. The menu was displayed on the notice board. The food was plated in the kitchen and taken to residents at dining tables, which were set with tablecloths and napkins. This promoted respect and dignity for the residents. The meal looked appetising and consisted of beef stew with dumplings, boiled potatoes, two seasonal vegetables and dessert of apricot sponge with custard. For the tea time meal residents are given a choice of a number of items, which is recorded in advance by staff. A record of individual likes and dislikes are recorded. There is no direct choice of food at the midday meal and the home relies on residents to state if they don’t like the food on offer. The home should utilise a method of offering choice directly at the midday meal. All the residents spoken to stated that the food quality was either “good” or “excellent,” and that the chef is “good.” One resident stated that he/s he would\ like to be offered brown as well as white bread. Meadow House Residential Home H55-H03 S 59026 Meadow House V220276 240505.doc Version 1.30 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) None of the standards in this section were assessed at this inspection. These will be checked at the next inspection. EVIDENCE: Meadow House Residential Home H55-H03 S 59026 Meadow House V220276 240505.doc Version 1.30 Page 15 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, 20, 21, 23, 24, 25 and 26 There has been continued improvement to the home’s décor and fabric. The owners have invested in making improvements to the home. Specific areas of the home need to be prioritised for redecoration. Residents are able to personalise their bedrooms. The home was found to be generally safe, clean and hygienic. In general, bathrooms and toilets are satisfactory, although some improvements are needed. EVIDENCE: The home’s communal living spaces are of a good standard offering a choice of 3 lounges, courtyard garden areas with trees, shrubs, seating and tables. A resident described how much he/she liked the lounges for their interesting décor and ornaments. Since the last inspection the hall and stair well have been redecorated and new carpets were to be fitted shortly following the inspection. There is a plan of redecoration and refurbishment. Meadow House Residential Home H55-H03 S 59026 Meadow House V220276 240505.doc Version 1.30 Page 16 The majority of bedrooms were seen and these were also decorated to a good standard with one exception where there was damage to wallpaper and wire boxing as well as a lack of carpet on the split-level section of stairs in the bedroom. This room had an en suite bathroom where the bath panelling was damaged and in need of repair. A chest of drawers was also broken. The inspector was informed that these matters would be attended to. There is also a need for a risk assessment for the bath and stairs in the room. All bedrooms, except two, have an en suite toilet or bathroom. Residents described how they like to spend time in their bedrooms and how satisfied they are with the bedroom space. Toilets and bathrooms were clean and well maintained with the following exceptions: a suitable privacy lock with an override device is needed on a ground floor toilet and a rusting raised toilet seat frame needs to be replaced in another ground floor toilet. A staff toilet has been converted to a residents’ toilet. This needs a call point, which the manager confirmed would be fitted shortly. A new stair lift has been installed since the last inspection. The home’s office has been moved from the first floor to a ground floor area that was previously a designated library area for the residents. Meadow House Residential Home H55-H03 S 59026 Meadow House V220276 240505.doc Version 1.30 Page 17 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 Additional staff are need at weekends to ensure that residents’ needs are met. EVIDENCE: The staff rota for the week commencing 14th. April 2005 was examined. This showed the provision of 425 care staff hours, which is short of the 449.95 recommended by the Residential Forum. The home does not have to adhere to the hours set by the Residential Forum guidance as it was registered prior to 1st April 2002. However, at weekends only two staff were providing care and catering for the residents, which is wholly inadequate in view of the level of care and mobility needs. At a minimum there must be two care staff on duty with additional staff for catering. The inspector acknowledged that this shortfall was caused by staff sickness on one of the two days of the weekend. As stated in the summary all residents described the staff as having a positive attitude and to be hardworking. Staff were said to be kind and understanding. Meadow House Residential Home H55-H03 S 59026 Meadow House V220276 240505.doc Version 1.30 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 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 and 38 The manager needs to submit an application for registration to the Commission. Health and safety was not fully assessed at this inspection although it was noted that certain areas require attention. EVIDENCE: The home’s manager has delayed the submission of an application for registration with the Commission. Additional risk assessments are needed for one resident and the use of stairs and bath in his/her bathroom. Fire doors are fitted with automatic closers, one of which was not working and the door was being held open with a wedge of paper. Meadow House Residential Home H55-H03 S 59026 Meadow House V220276 240505.doc Version 1.30 Page 19 The office has been moved to the home’s library; the manager assured the inspector that this had been checked with the home’s fire safety contractor as being safe. This needs to be clarified with the fire authority. Meadow House Residential Home H55-H03 S 59026 Meadow House V220276 240505.doc Version 1.30 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 3 3 3 x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 COMPLAINTS AND PROTECTION 2 3 3 3 3 2 x 3 STAFFING Standard No Score 27 2 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x x 2 x x x x x x 2 Meadow House Residential Home H55-H03 S 59026 Meadow House V220276 240505.doc Version 1.30 Page 21 na 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 Care plans must give specific deails for staff to follow for personal care, lifting and handling, bathing etc. The home must be able to demonstrate that residents have a choice of food for the midday meal. The following must be repaired in a residents bedroom: chest of drawers, bath panelling, loose wiring and missing stair carpet. Suficient staffing must be deployed at the weekends. The homes manager must apply for registration with the Commission. Risk assessments must be carried out and recorded for the following: the use of the stairs and bath by the resident who occupies the bedroom with a staircase and bathroom. This must include any actions necessary to minimise risks. The home must liaise with the fire authority regarding the use of the library as an office as it occupies a communal hall area. Timescale for action 15th. September 2005 15th. July 2005 30th. July 2005 30th. June 2005 24th. June 2005 30th. June 2005 2. 15 and 10 16 (2) (i) 3. 19 and 24 23 (2) (b) 4. 5. 6. 27 31 38 18 (1) 9 (1) (2) 13 (4) (a) (b) (c) 7. 38 23 (4) (b) (5) 30th. June 2005 Meadow House Residential Home H55-H03 S 59026 Meadow House V220276 240505.doc Version 1.30 Page 22 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard Good Practice Recommendations Meadow House Residential Home H55-H03 S 59026 Meadow House V220276 240505.doc Version 1.30 Page 23 Commission for Social Care Inspection 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 H55-H03 S 59026 Meadow House V220276 240505.doc Version 1.30 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!