Inspection on 19/01/06 for Meadow & Ivy Cottages

This inspection was carried out on 19th January 2006.

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 no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Meadow & Ivy Cottages 08/07/08

Meadow & Ivy Cottages 26/07/06

Meadow & Ivy Cottages 03/08/05

Meadow & Ivy Cottages 25/10/04

Meadow & Ivy Cottages 06/05/04

Meadow & Ivy Cottages 04/02/04

Similar services:

22 Sandown Road

The Highlands

Dilston College Of Further Education

West View House

Prince Bishop Court

Park View (15)

Craigmore House

1 Lanark Close

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

CARE HOME ADULTS 18-65 Meadow & Ivy Cottages 39-40 Bentinck Crescent Pegswood Morpeth Northumberland NE61 6SX Lead Inspector Deborah Haugh Unannounced Inspection 19th January 2006 04:00 Meadow & Ivy Cottages DS0000000610.V276132.R01.S.doc Version 5.1 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 & Ivy Cottages DS0000000610.V276132.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Meadow & Ivy Cottages DS0000000610.V276132.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Meadow & Ivy Cottages Address 39-40 Bentinck Crescent Pegswood Morpeth Northumberland NE61 6SX 01670 - 511776 01670 511776 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) www.c-i-c.co.uk. Community Integrated Care Mrs Elizabeth Jane Costelloe Care Home 7 Category(ies) of Learning disability (7) registration, with number of places Meadow & Ivy Cottages DS0000000610.V276132.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 4 residents may also have a physical disability 2 residents may also be over the age of 65 Date of last inspection 3rd August 2005 Brief Description of the Service: Meadow and Ivy Cottages provides a home for up to seven adults with a learning disability who need residential care. Some of the residents also have physical disabilities. Nursing care is not provided. The building has the appearance of two modern semi-detached bungalows. A corridor links the bungalows internally. The design of the house is in keeping with other houses on the estate and is close to local facilities, such as the health centre and transport networks. Each bungalow has a lounge, dining kitchen and bathroom and toilet facilities. Residents can use the shared facilities in either house. The house is surrounded by large, maintained gardens, which have a summerhouse, paved areas for sitting and are easily accessible. Residents also have a mini-bus. Meadow & Ivy Cottages DS0000000610.V276132.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place on 19/01/06 at 4pm until 7pm. At the time of this inspection Christine Rowell was the senior on duty but the Registered Manager Elizabeth Costelloe, although off-duty arrived later to assist with the inspection. There were 7 service users at the time of the visit and staffing levels were checked. Time was spent looking around the home to check the cleanliness, maintenance and decoration. Service users shared their views about the home. Time was also spent observing the contact between service users and staff. Care planning arrangements were examined. Arrangements for the administration of medication, staff supervision, placement contracts, menus and quality assurance were checked. What the service does well: The Registered Manager and her team are committed to ensuring that the service users have a good quality of care and explore new experiences. People are encouraged and supported to be active both in and out of the home. Both specialist and ordinary community services are accessed. Staff demonstrated their knowledge of the people they care for. The atmosphere in the home was relaxed and there is a good rapport between service users and staff. Some of the people who live at the home have complex needs and good care planning and risk assessments are in place. Some of the service users spoke with the inspector and clearly enjoyed living at the home, explaining their interests, achievements and lifestyle. Meadow & Ivy Cottages DS0000000610.V276132.R01.S.doc Version 5.1 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Meadow & Ivy Cottages DS0000000610.V276132.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Meadow & Ivy Cottages DS0000000610.V276132.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 5 Contracts between service users, the home and placing authorities are in place, which explain service users rights and responsibilities of the home. Standard 2 was not assessed as all of the service users have lived at the home since it was opened. EVIDENCE: 5) New contracts are in place for all of the service users, which specify the main contract terms and fees. The contract also specifies the items not covered by the fee, including purchase of clothing, toiletries and dry cleaning. Contracts also identify that ‘Fees charged by external agencies for elements of your Care and Support plan’ are not included which addresses the requirement from the last inspection. Meadow & Ivy Cottages DS0000000610.V276132.R01.S.doc Version 5.1 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6 & 9 (NMS 7 was assessed and met at the last inspection) The care planning arrangements ensure that service users needs and wishes are addressed. But formal reviews must take place. Risk assessments ensure that where appropriate service users are protected from potential accidents and harm. Meadow & Ivy Cottages DS0000000610.V276132.R01.S.doc Version 5.1 Page 10 EVIDENCE: 6 & 9) The needs of service users are assessed and appropriate care plans address identified needs and wishes. The home identifies people’s strengths, likes and preferences. Care plans are documented and are in pictorial form. The ‘first person’ is used to guide staff from the service users perspective i.e. ‘I like’ Care plans are clear and link to risk assessments, which are also in pictorial form. The care planning arrangements have been reviewed and updated where needed. Key workers meet with service users each month to discuss the care plans and goals. Some of the service users are not having formal reviews of their care with external agencies such as care managers. Some care managers are telephoning the home and holding a verbal review. No minutes are available and consultation with service users is not evident. CIC are introducing Person Centred Planning and progress will be monitored at future inspections. Meadow & Ivy Cottages DS0000000610.V276132.R01.S.doc Version 5.1 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 17 (NMS 12, 13 & 15 were assessed and met at the last inspection.) Routines in the home are centred on the needs and wishes of service users Service users are provided with a nutritious, balanced and varied diet that meets their nutritional requirements. EVIDENCE: 16) Service users spoke about the activities which they like to do and their routines. People are able to be alone or mix with others. One person likes to spend time in her room and another likes to spend time with staff talking. The routines in the home are centred on the wishes and needs of the people who live there. Care plans support this person centred approach. Service users all have keys to their bedrooms. People are given their mail and where necessary staff provide support to deal with correspondence. Staff were observed to use peoples preferred name and spend time together. The atmosphere in the home was relaxed and jovial. Meadow & Ivy Cottages DS0000000610.V276132.R01.S.doc Version 5.1 Page 12 17) The evening meal was corned beef casserole and two of the service users were sitting in the kitchen enjoying the activity around them whilst tea was being prepared. The menus have been reviewed under consultation with a dietician. Copies were provided to the inspector. Where necessary individual advise is sought from dieticians. Meadow & Ivy Cottages DS0000000610.V276132.R01.S.doc Version 5.1 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 20 & 21 (NMS 19 was assessed and met at the last inspection) Service users are supported in a way that meets their needs. The systems for the storage, handling and administration of medication protect service users. Service users who become ill and age need to be supported by staff that have been appropriately trained. Meadow & Ivy Cottages DS0000000610.V276132.R01.S.doc Version 5.1 Page 14 EVIDENCE: 18) Staff were observed to provide care to service users in a sensitive and respectful manner. Care plans identify people preferences and indicators of distress where communication is complex. Staff were careful to protect peoples dignity regarding personal care. Professional advice and equipment is in place where required such as a pressure-relieving mattress, bed rails with bumpers. Risk assessments are in place completed by Occupational Therapists. 20) Medication administration concerns have been addressed since the last inspection. Two staff administer medication. The staff are required to administer a particular buccal medication. They have received training in these procedures but are still awaiting the certificates of competence from the responsible community nurse who provided and assessed the staff. 21) Appropriate steps are taken to address the care needs of service users who become ill, including ensuring that palliative care support and any special equipment is provided. A recommendation was made at the last inspection that bereavement training is provided for staff. The Registered Manager expects this training to be provided by end of January 2006. Meadow & Ivy Cottages DS0000000610.V276132.R01.S.doc Version 5.1 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): NMS 22 & 23 were assessed and met at the last inspection. EVIDENCE: Meadow & Ivy Cottages DS0000000610.V276132.R01.S.doc Version 5.1 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 (NMS 24-30 were assessed and met at the last inspection) The home is designed to meet the needs of people with learning and physical disabilities and fits in well with other houses in the neighbourhood providing service users with an attractive and homely place to live. It is a well maintained and clean home providing a safe place for people to live. EVIDENCE: 24) The shared kitchens, dining rooms and lounges are pleasant areas to use and relax in. The standard of decoration, furnishing and appliances is high. There are an appropriate number of bathrooms and toilets. The home is equipped with hoisting equipment and a tracking system for lifting people. There was evidence that as service users’ needs change the Registered Manager ensures that appropriate specialists review their need for specialised equipment. Bedrooms are individual and reflect the wishes, preferences and personality of the person living there. Keepsakes and possessions are proudly displayed and staff respect service users belongings. The home was very clean and homely. Meadow & Ivy Cottages DS0000000610.V276132.R01.S.doc Version 5.1 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 33,36 (NMS 32,34,35 were assessed and met at the last inspection) The number of staff and type of staff on duty throughout the day and night is sufficient to meet the needs of service users. Staff are supported by the Registered manager through regular supervision, which ensures that service users are cared for by competent staff. EVIDENCE: 33) On the evening of the inspection sufficient staff were on duty. Cover through the day was appropriate to peoples needs. There are a minimum of four support staff on duty between 8 am to 10 pm when the home is fully occupied. Through the night there is one waking night carer and a second carer sleeps in on the premises in case further assistance is needed. At present there exists 2.5 support worker post vacancies but recruitment is underway with a good response from interested people. 36) According to staff they receive formal supervision from the Registered Manager each month. Staff feel supported and the style of management is open and inclusive. Meadow & Ivy Cottages DS0000000610.V276132.R01.S.doc Version 5.1 Page 18 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42 The Manager provides clear leadership, which ensures that the home is well run and the staff team are fully aware of their roles and responsibilities. Quality Assurance systems ensure that the service meets the needs of the service users. Health and safety arrangements protect service users but some areas require addressing. EVIDENCE: 37) Mrs Costello has completed NVQ Level 4 in care and will complete the Registered Manager’s Qualification in June 2006. Mrs Costelloe agreed to provide CSCI with copies of certificates of qualification. 39) CIC has a quality assurance programme in place, which includes seeking the views of service users, relatives and other interested parties, to provide feedback on the quality of care provided across all the homes it runs. Meadow & Ivy Cottages DS0000000610.V276132.R01.S.doc Version 5.1 Page 19 Feedback is now given back to the homes in terms of the home and the overall performance of the organisation. 42) No hazards in the home were identified during the inspection. Risk assessments are carried out in respect of particular areas of health and safety. One issue in relation to the use of new bed rails on one service user’s bed has been addressed and updated. Service and maintenance checks are carried out and the following are in place; - Moving and handling equipment is serviced every 6 months (June and December 2005) - A Gas Landlord certificate is in place 13/05/05 - Gas Boiler service 22/09/05 - Gas Safety record of appliances 2/09/05 - Fire alarm and emergency lights service agreements last checked 12/01/06 - In–house checks of fire alarm, emergency lights, and fire extinguishers are documented at the appropriate intervals. -Staff receive fire instruction and drills every 3 months, which is recorded in staff meeting minutes, which is difficult to audit. - The Fire Risk Assessment was reviewed by the competent person 10/10/05. The following health and safety matter must be addressed; 1. Provide CSCI with an electrical wiring certificate for Meadow and Ivy Cottages. The last check was made in 2003 but a certificate was not available at the home or Head Office following the inspection. 2. Provide CSCI with proof that portable electric equipment is safe. (Previous Portable Appliance Test was completed 05/04 3. Ensure the form used to test hot water temperatures identifies which location has been checked i.e. Ivy or Meadow Cottage. 4. Fire instruction and drills for each individual staff member must be recorded in a more accessible location. Meadow & Ivy Cottages DS0000000610.V276132.R01.S.doc Version 5.1 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 N/A 3 X 4 X 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 X 23 X ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 X STAFFING Standard No Score 31 X 32 X 33 3 34 X 35 X 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 X X 2 X LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 X 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 X 3 3 2 X 3 X X 2 X Meadow & Ivy Cottages DS0000000610.V276132.R01.S.doc Version 5.1 Page 21 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA6 Regulation 15 Requirement Timescale for action 31/03/06 2. YA42 23(2) The care plan must be reviewed at the request of the service user or at least 6 monthly (involving significant professionals, and family friends and advocates as agreed with the service user. 31/03/06 The following health and safety matter must be addressed; 1.Provide CSCI with an electrical wiring certificate for Meadow and Ivy Cottages 2. Provide CSCI with proof that portable electric equipment is safe. 3. Ensure the form used to test hot water temperatures identifies which location has been checked i.e. Ivy or Meadow 4.Fire instruction and drills for each individual staff member must be recorded in a more accessible location. Meadow & Ivy Cottages DS0000000610.V276132.R01.S.doc Version 5.1 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 YA20 Good Practice Recommendations Each member of staff required to administer a buccal medication should be assessed by the responsible community nurse and certified as competent to perform this task. Provide bereavement training for staff. The Registered Manager should complete the Registered Manager Qualification and provide CSCI with copies of certificates of NVQ Level 4 in Care and the Registered Manager Qualification. 2. 3. YA21 YA37 Meadow & Ivy Cottages DS0000000610.V276132.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Cramlington Area Office Northumbria House Manor Walks Cramlington Northumberland NE23 6UR 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 & Ivy Cottages DS0000000610.V276132.R01.S.doc Version 5.1 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. 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