This inspection was carried out on 16th February 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 there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.
CARE HOMES FOR OLDER PEOPLE
Meadow Lodge Care Home 21-23 Meadow Road Beeston Rylands Nottingham NG9 1JP Lead Inspector
Dee Shelvey Unannounced Inspection 16th February 2006 10:10 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 Lodge Care Home DS0000008717.V281249.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 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 Lodge Care Home DS0000008717.V281249.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Meadow Lodge Care Home Address 21-23 Meadow Road Beeston Rylands Nottingham NG9 1JP 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) 0115 922 8406 0115 922 8406 Mr David Teece Mrs Margaret Ann Teece Care Home 25 Category(ies) of Dementia - over 65 years of age (25), Old age, registration, with number not falling within any other category (25) of places Meadow Lodge Care Home DS0000008717.V281249.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 20th September 2005 Brief Description of the Service: Meadow Lodge is situated on a main bus route, close to a railway station and one mile from Beeston Town Centre. The home is registered to care for 25 older people, including those with Dementia, in two linked adjacent houses. Accommodation is in single and double rooms and is provided on two floors with two passenger lifts. There is a large dining room and four separate lounges. The patio and gardens are pleasant and well maintained. Meadow Lodge Care Home DS0000008717.V281249.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection took place over four hours and consisted of reading documents, examining records and discussions with the manager and one member of staff. Three service users were spoken to during a limited tour of the building. 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 Lodge Care Home DS0000008717.V281249.R01.S.doc Version 5.1 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 Lodge Care Home DS0000008717.V281249.R01.S.doc Version 5.1 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): 2 The home had a satisfactory contract but this was not always issued to new residents. EVIDENCE: The case files of the two latest admissions were examined. The person funded by the local authority had a signed agreement but the person self funding did not. Statements of terms and conditions are essential to define each parties responsibilities and to clearly state what services are included in the fee. Meadow Lodge Care Home DS0000008717.V281249.R01.S.doc Version 5.1 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): 7,8,9 and 10. The service users were treated with respect, had individual plans of care and had their health needs met. The administration of medication practices do not offer sufficient protection from errors. EVIDENCE: The care plans for 4 residents were examined and they contained evidence of assessments of need, risk assessments where appropriate and referrals to health professionals as necessary. These records also showed that health needs were monitored and families kept informed. Service users and/or their families should be involved in the care planning process and there was some evidence that this occurred on occasion but there was no consistent practice. Meadow Lodge Care Home DS0000008717.V281249.R01.S.doc Version 5.1 Page 9 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): 13 Service users were enabled to maintain contact with their families and use local amenities. EVIDENCE: There was evidence in daily notes of family visits and residents could receive visitors in their rooms, the main lounge or small quiet lounge. The last residents survey indicated that not all visitors were offered a cup of tea. This was noted and remedied immediately. As daily notes monitor visitors to the home staff are able to identify service users who do not have visitors. Staff then ensure that they spend more time with these residents. Residents are accompanied to local shops and the pub. Meadow Lodge Care Home DS0000008717.V281249.R01.S.doc Version 5.1 Page 10 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): These standards were not inspected on this occasion as they were all met at the last inspection. EVIDENCE: Meadow Lodge Care Home DS0000008717.V281249.R01.S.doc Version 5.1 Page 11 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): 19 and 25. Service users live in safe, clean and comfortable surroundings. EVIDENCE: On the day of inspection the home was warm, clean and comfortable. Those service users spoken with were satisfied with the facilities. The home was looking fresh and bright as the result of refurbishment which was still underway. During the tour of the building no potential safety hazards were seen. The gardens were well maintained and some trees had been cut back to provide more natural light in the home. Meadow Lodge Care Home DS0000008717.V281249.R01.S.doc Version 5.1 Page 12 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 and 29 The service users needs were met by the numbers of staff and if followed the recruitment policy would provide protection. EVIDENCE: The staff rota was examined and was evidence of sufficient staff being on duty to meet service user need. At times of greater need i.e. during residents’ illness more staff would be provided. The staff spoken with demonstrated an understanding of the needs of the elderly and an enthusiasm for their jobs. The recruitment policy was satisfactory but was not strictly followed when a new member of staff was employed. The file contained all the necessary information, a satisfactory criminal records bureaux check but no references. This lapse may well be explained by the fact that employing new people is rare as the staff team are well established. This is of great benefit to the residents as they receive continuity of care. Meadow Lodge Care Home DS0000008717.V281249.R01.S.doc Version 5.1 Page 13 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): 33,35,37 and 38. The home is run in the best interest of service users, their rights are safeguarded and health and safety is promoted. EVIDENCE: The home seeks the views of service users by issuing questionnaires annually. The results are analysed and any problems resolved. It would be useful to expand this system to include families and visiting professionals as the more information a home has on how it’s services are perceived the better able they are to rectify problems and improve practice. The home does not have any involvement with the residents’ finances but is happy to make small payments on their account and then invoice for reimbursement. Meadow Lodge Care Home DS0000008717.V281249.R01.S.doc Version 5.1 Page 14 All the records seen were up to date and accurate with the exceptions already noted. Fire safety equipment was checked at regular intervals and fire drills held every 6 months. The home had a satisfactory health and safety policy and staff received appropriate training. The infection control policy was also satisfactory and being implemented properly. Meadow Lodge Care Home DS0000008717.V281249.R01.S.doc Version 5.1 Page 15 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 2 X X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 1 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 3 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X 3 X X X X X 3 X STAFFING Standard No Score 27 3 28 X 29 2 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 3 X 3 X 3 3 Meadow Lodge Care Home DS0000008717.V281249.R01.S.doc Version 5.1 Page 16 Are there any outstanding requirements from the last inspection? Yes 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 OP7 Regulation 15 Requirement Timescale for action 31/03/06 2. OP9 13(2) 3 OP29 19 Schedule 2 The registered person must ensure that a written plan of care is created after consultation with residents or representative. The registered person must ensure that evidence is provided to support this standard. This requirement is outstanding from 01/12/05. Med Act 1968 Misuse of Drugs 31/03/06 Act 1971 The registered person shall make arrangements for the safe administration of medicines received into the home. The practice of secondary dispensing must stop. The registered person must 31/03/06 ensure that two satisfactory written references are obtained before a new employee commences work. Meadow Lodge Care Home DS0000008717.V281249.R01.S.doc Version 5.1 Page 17 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 OP33 Good Practice Recommendations To expand the quality assurance system to include families and visiting professionals. Meadow Lodge Care Home DS0000008717.V281249.R01.S.doc Version 5.1 Page 18 Commission for Social Care Inspection Nottingham Area Office Edgeley House Riverside Business Park Tottle Road Nottingham NG2 1RT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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