CARE HOME ADULTS 18-65
Meadow View School Street Upton Pontefract West Yorks WF9 1EP Lead Inspector
Tony Railton Unannounced Inspection 30 November 2006 09:30 Meadow View DS0000006199.V321071.R01.S.doc Version 5.2 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 View DS0000006199.V321071.R01.S.doc Version 5.2 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 View DS0000006199.V321071.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Meadow View Address School Street Upton Pontefract West Yorks WF9 1EP 01977 646400 01977 658244 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) Johnston Care Limited Mrs Maureen Chappell Care Home 15 Category(ies) of Learning disability (15), Physical disability (3) registration, with number of places Meadow View DS0000006199.V321071.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. A maximum of three people with learning disabilities may also have a physical disability. 17th February 2006 Date of last inspection Brief Description of the Service: Meadow View is a registered care home for 15 adults with a mild/moderate learning disability. 13 of those service users have lived in the home for a number of years. The is situated on a housing estate in the village of Upton with good access to local bus routes to other local towns such as South Elmsall and the larger towns/cities of Wakefield, Pontefract and Doncaster. There are a number of local shops and pubs close by. Each service user has single bedroom accommodation, one of which is ensuite. There are two lounges, which have been recently re-furbished to a good standard. There is a car park to the front of the home and a rear garden for sitting out. Most service users attend a day resource, which is run and organised by the registered person whereas others are encouraged to attend college or go to the local authority day service. On 14 September the registered person said that the fees for the home are £373.00 per week and that there are no extra charges involved. Information regarding the services provided is available from the home. Meadow View DS0000006199.V321071.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced key inspection visit to the home commenced at 09.30 and ended at 13.30. During this visit there was the opportunity to talk to nearly all residents, the manager, deputy manager and 3 support workers. There was also the opportunity to look at six residents case files and six staff files including training and supervision records. The medication and financial systems were looked at and a tour of the building was also undertaken. A sample of the homes returned residents and relatives quality assurance questionnaires were seen and the minutes of residents and staff meetings. This was a positive visit to the service which continues to meet all statutory requirements and nearly all minimum standards. What the service does well:
The daily records are good and contain descriptive words to show and reflect residents’ choices, preferences likes and dislikes. The assessments, risk assessments and care plans are signed and agreed by residents. One resident said that she “has a choice” of meals and is asked what she “would like to eat”. Another said that he “chooses which clothes he wears” and what he “wants to do”. One resident said that she “likes her bedroom” and has it “how she wants it”. Another said that he “likes going to the pub” and going out with his family. Another said that he “likes cars” and “going to the shop to buy them”. One resident has certificates of achievement on her wall and these included First Aid and Food Hygiene. Another has trophies on display which he won playing Pool. Residents sign and agree the minutes of the residents meetings and most sign for their pocket monies. Records show that residents are supported to use ordinary community based healthcare and leisure services. Residents’ records and photographs show that they enjoy holidays and outings to the seaside. It was noted that all support workers with the exception of one have a National Vocational Qualification at Level 2, 3 and 4. This is to be commended as it is over and above that recommended by minimum standards. A positive relationship was observed between support workers and residents. And staff have a good insight into the needs of residents. The pre inspection questionnaire and staff records show that staff turn over is very low and discussion with staff show that they are happy, confident and feel supported in the work that they do. Meadow View DS0000006199.V321071.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. Meadow View DS0000006199.V321071.R01.S.doc Version 5.2 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 View DS0000006199.V321071.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): The standard looked at is 2. Residents’ personal and healthcare needs are fully assessed before they are admitted to the home. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Discussion with the manager and looking at six residents files at show that residents personal and healthcare needs are fully assessed before they are admitted. The new person centred documentation show that residents are fully involved in completing, agreeing and signing their assessments and care plans. One resident knew where his assessments were kept, went and got them and sat and explained what they were. Meadow View DS0000006199.V321071.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): The standards looked at are 6,7 and 9. Residents know that their changing needs and personal goals are reflected in their care plans. And they are consulted and make decisions about their lives. They are also supported to take risks as part of the living of an ordinary lifestyle. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The daily records are good and contain lots of descriptive words to reflect and show residents choices, preferences, likes and dislikes. They also reflect when residents make decisions about how they live their lives. The risk assessments show that residents are expected to take risks as part of living an ordinary lifestyle. Some residents go to the local shops by themselves and there are risk assessments to show this. The manager said that the support provided by the home is based on ordinary living principles and residents are expected to do as much for themselves as possible. Residents sign their own assessments and care plans. Most residents also sign for their reviews and for their pocket money. Meadow View DS0000006199.V321071.R01.S.doc Version 5.2 Page 10 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. JUDGEMENT – we looked at outcomes for the following standard(s): The standards looked at are 12,13,15,16 and 17. Residents are supported and encouraged to be part of the local community and to take part in ordinary community based leisure activities. Residents are offered a healthy and balanced diet. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: On the day of the visit residents were observed being offered a choice of menu. The daily records show that residents have a choice of meals. Discussion with residents’ show that they have their individual favourite menus and that they request alternatives to those offered. The minutes of the residents meetings show that menus are discussed. Residents assessments reflect their likes , dislikes , choices and preferences. One resident said that he enjoys going to the local pub. Another said that he likes cars and buys them from the shop. The daily records show that relatives visit on a regular basis and that some residents go home for alternative weekends. The returned relatives and residents quality assurance questionnaires show that they are happy with the quality of meals and activities provided.
Meadow View DS0000006199.V321071.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards looked at are 18,19 and 20. Residents are supported to use ordinary community based healthcare services. And are protected by the medicine administration systems used in the home. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A sample of six residents records including assessments, care plans and daily records show that they are supported to use ordinary community based healthcare services. However, some residents also have the support of hospital based consultants and community based learning disability nurses and specialist social workers. Examination of the medicine ordering, storage, administration and recording systems found them to be correct and safe. Meadow View DS0000006199.V321071.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 22 and 23 were looked at. Residents know that their views will be listen to and acted upon. Residents are also protected from abuse , neglect and self harm. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The pre inspection questionnaire and service history show that the home has not received any complaints since the last inspection visit. Discussion with six residents’ show that they know how to make a complaint. Discussion with four staff show that they know how to make a complaint, and a sample of the homes returned quality assurance questionnaires show that relatives know how to make a complaint. Staff training records show that they receive adult protection training. Discussion with four support workers shows that they are aware of what abuse is and how to deal with any allegations of abuse. Meadow View DS0000006199.V321071.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): The standards looked at are 24, 25,26,27,28,29 and 30. Residents live in a homely, comfortable, safe and clean environment. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A tour of the home found it to be well maintained, clean, homely and comfortable. Six residents spoken to said that they like living in the home. One said that she likes her bedroom as it is “nice”. Another said that he has “everything he needs”. Some minor remedial work was noted in the shower room and on the corridors where the wall meets the door frames. The manager said that this work has already been identified and entered in the maintenance book. It was noted that all bedrooms have a new floor covering and have been redecorated. The manager said that residents have chosen their own colour scheme. Meadow View DS0000006199.V321071.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): The standards looked at are 32,34,35 and 36. Residents’ are supported by appropriately trained, qualified and competent staff. Residents’ are also supported and protected by the staff selection and recruitment practices. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Examination of six staff records show that proper checks and references are taken up before they are employed. Training records show that all staff with the exception of one has a National Vocational Qualification at Level 2, 3 or 4. This practice is to be commended as it is over and above the recommended minimum standard. The manager said that the one remaining staff is registered on NVQ training due to start in January 2007. Staff training records and pre inspection questionnaire show that staff also receive training in First Aid, Food Hygiene, Adult Protection, Moving and Handling, Health and Safety and Behaviour management. Staff supervision records show that they appropriately supervised. Discussion with four staff found them to be happy, confident and supported in the work that they do. The minutes of the staff meetings and supervision records show that staff have the opportunity to comment on the running of the home. Meadow View DS0000006199.V321071.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): The standards looked at are 37,39 and 42.Residents benefit from living in a well run home where they know they have a say in how the home runs. The health safety and welfare of residents and staff are promoted and protected. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: During this visit residents were observed setting the tone of the home and driving what happened to them. A positive relationship was observed between staff and residents, and staff responded positively to residents’ requests. The minutes of the residents meetings along with the returned quality assurance questionnaires and daily records show that residents views are listed to and acted upon. The daily records contain descriptive words to show and reflect residents’ choices, preferences and any decisions they make about how they live their lives. The pre inspection questionnaire, fire and maintenance records show that they health, safety and welfare of residents and staff are promoted and protected. Meadow View DS0000006199.V321071.R01.S.doc Version 5.2 Page 16 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 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 2 28 2 29 3 30 3 STAFFING Standard No Score 31 X 32 4 33 X 34 3 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 X 3 X X 3 X Meadow View DS0000006199.V321071.R01.S.doc Version 5.2 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. Standard Regulation Requirement Timescale for action 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 YA28 Refer to Standard YA27 Good Practice Recommendations The minor remedial work to the skirting / floor covering in the shower room should be carried out as soon as is practicable. The minor decoration on the corridors where the walls meet the door frames should be carried out as soon as is practicable. Meadow View DS0000006199.V321071.R01.S.doc Version 5.2 Page 18 Commission for Social Care Inspection Brighouse Area Team First Floor St Pauls House 23 Park Square Leeds LS1 2ND National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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