Inspection on 13/05/08 for Meadow View Care Centre

This inspection was carried out on 13th May 2008.

CSCI found this care home to be providing an Good service.

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 View Care Centre 20/06/07

Meadow View Care Centre 14/12/06

Meadow View Care Centre 02/12/05

Meadow View Care Centre 20/06/05

Meadow View Care Centre 09/03/05

Meadow View Care Centre 15/09/04

Meadow View Care Centre 03/02/04

Meadow View Care Centre 16/07/03

Extracts from inspection reports are licensed from CQC, this page was updated on 28/09/2008.

CARE HOMES FOR OLDER PEOPLE Meadow View Care Centre Wharrage Road Alcester Warwickshire B49 6QY Lead Inspector Jo Johnson Unannounced Inspection 13th & 22nd May 2008 09:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Meadow View Care Centre DS0000043254.V365700.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 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 View Care Centre DS0000043254.V365700.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Meadow View Care Centre Address Wharrage Road Alcester Warwickshire B49 6QY 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) 01789 766739 01789 763440 info@prime-life.co.ukwww.prime-life.co.uk Prime Life Ltd Mrs Melanie Oliver Care Home 42 Category(ies) of Dementia - over 65 years of age (25), Old age, registration, with number not falling within any other category (42) of places Meadow View Care Centre DS0000043254.V365700.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users Service users placed in the bungalows must be assessed by social services and the Registered Manager as suitable for the bungalow style of living and not have primary diagnosis of dementia. Service users in the bungalows must have one member of staff available at all times, this member of staff clearly identified on the staff duty rota. 20th June 2007 2. Date of last inspection Brief Description of the Service: Meadow View Care Centre is a purpose built care home, situated in the town of Alcester. Meadow View can accommodate up to 42 older people including 25 older people in the dementia care category. The service provider offers long and short-term accommodation and services associated with meeting the personal care needs of service users in the above categories. The accommodation is on one level in two wings. The complex also includes several privately owned bungalows and a separate annex called Poppies. All clients are offered single bedroom accommodation with en-suite toilet and shower facility. Meadow View is spacious with a long wide corridor leading from the entrance to the communal and accommodation areas. The communal areas consist of a large lounge dining room with two smaller sitting rooms off the main room plus a lounge, which is based at the far end of a corridor. There are also seating areas in the corridors. The gardens are landscaped and very attractive and can be accessed by wheelchairs. The care centre is registered to provide personal care services only. The visiting district nurses treat residents needing nursing care. All placements at the Meadow View Care Centre are contracted through Warwickshire Social Services. Meadow View Care Centre DS0000043254.V365700.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. The focus of inspections undertaken by us is upon outcomes for people who live at the home and their views of the service provided. This process considers the home’s capacity to meet regulatory requirements, minimum standards of practice; and focuses on aspects of service provisions that need further development. This report uses information and evidence gathered during the key inspection process, which involves a visit to the home and looking at a range of information. This includes the service history for the home and inspection activity, notifications made by the home, information shared from other agencies and the general public and a number of case files. The acting manager supplied the commission with an AQAA (Annual Quality Assurance Assessment). Information from this has been used to make judgements about the service, and have been included in this report. Surveys were sent to ten people who live at the home and ten staff. Seven surveys from people and their relatives and four staff surveys were returned. The findings of these surveys have been included in the report. This was the home’s first key inspection of 2008/2009. The inspection visit was unannounced (we did not let the home know that we were coming) and took place on 13th May between 12.45 pm and 3pm and on 22nd May between 8.45am and 4pm. The inspection involved; • Two hours sitting with and observing people in the dining room/lounge watching to see how people were treated and looked after. These observations were used alongside other information collected to find out about the care they get from staff. Speaking with 10 people who live at the home. Observations of and talking with the people who live at the home and the staff on duty and the acting manager. Four people were identified for close examination by reading their care plan, risk assessments, daily records and other relevant information. This is part of a process known as ‘case tracking’, where evidence is matched to outcomes for people. • • • Meadow View Care Centre DS0000043254.V365700.R01.S.doc Version 5.2 Page 6 • A tour of the environment was undertaken, and home records were sampled, including staff training and recruitment, health and safety, and staff rotas. What the service does well: What has improved since the last inspection? All of the requirements from the previous inspection have been met. Arrangements have been made to ensure prospective residents have a full assessment of their needs and abilities recorded before they move into the home. Systems are now in place to identify any risk to the health or well being of people living in the home and it now includes details of how any identified risk can be reduced. Meadow View Care Centre DS0000043254.V365700.R01.S.doc Version 5.2 Page 7 Arrangements are now in place for all staff to have training in recognising and responding to abuse. Accurate records of the staff duty rota are now kept showing which staff are on duty at any time during the day and night and in what capacity. Records now show the actual hours worked by each staff member in the care home. Staff hours undertaken in Meadow View Bungalows Domiciliary Care service are not reflected as staff hours in the care home. Arrangements have been made for all staff to have up to date mandatory training in Fire Safety and Manual Handling. Systems are now in place to ensure that all parts of the home to which residents have access are so far as reasonably practicable free from hazards to their safety. Unnecessary risks to the health and safety of residents have been identified and as far as possible eliminated. 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 Meadow View Care Centre DS0000043254.V365700.R01.S.doc Version 5.2 Page 8 contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Meadow View Care Centre DS0000043254.V365700.R01.S.doc Version 5.2 Page 9 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 View Care Centre DS0000043254.V365700.R01.S.doc Version 5.2 Page 10 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Quality in this outcome area is good. People who are considering moving into the home benefit from having their care needs assessed so that they can be sure the home can meet their needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Surveys from people and their relatives tell us that they had enough information before moving into the home. Comments included, ‘the manager was very informative about all the details and information about the home’. Meadow View Care Centre DS0000043254.V365700.R01.S.doc Version 5.2 Page 11 None of the people spoken with were able to give information about their experiences of moving into the home or looking at the home due to their cognitive impairments due to dementia or short-term memory loss. The manager told us that people and or their families come and visit the home before making a decision about moving in. There was evidence on all four files read that information is sought by the home from care management assessments, and where appropriate, other health professionals. One person who was staying at the home has regular respite stays throughout the year. There was evidence that their assessment and care plan had been reviewed and updated during their current stay. The manager undertakes a pre admission assessment before determining whether they can meet someone’s needs. A fuller assessment, risk assessments and a social history are completed with people as soon as they move in. From this a care plan is developed. This was seen for the people case tracked. The care records and surveys completed by people and their relatives tell us that they have a contract. Meadow View Care Centre DS0000043254.V365700.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10 Quality in this outcome area is good. People are treated respectfully, and can be assured that their care plans are going to be continually updated if they experience any changes in their health or mental needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Each person had a care plan, daily records and monitoring records. Care plans were based on information gained during the initial care needs assessment and were developed as staff got to know the individuals. All of the people had tissue viability, nutritional, falls and moving and handling risk assessments and management plans in place. Meadow View Care Centre DS0000043254.V365700.R01.S.doc Version 5.2 Page 13 There is new care planning system in place at the home and people all had a new style care plan. The acting manager is now involving the care workers in the review and development of care plans with people and their families. Care staff spoken with told us that they felt more involved and have a better understanding of the needs and plans of the people they were supporting. This is good practice. The staff surveys show that that they ‘usually’ have up to date information about the needs of people they care for. One survey included the comment, ‘care plans are updated monthly so we can find out if any needs have changed. We have handovers when we changeover of staff’. There was evidence in care plans of improved care practices at the home. People are weighed monthly and the manager now collates this information to ensure that people are referred to the GP if they lose weight over a two-month period. A GP referral had been made that week for one of the people whose care records were seen. The new care plans are more person centred and focus on people’s strengths and abilities. Two of the four care plans included incorrect or out of date information about people. This means that staff do not have the right information to be able to care for people properly. For example: • One care plan included a letter from the community dentist that stated that they had a fractured jaw following a fall and needed a soft diet and needed to be followed up. There was no evidence of any follow up on the issue and the subsequent hospital visit. Following discussion with the acting manager, it became clear that the individual was confused and gave wrong information to the dentist and did not have a fall or fractured jaw but did not wish to open their mouth to be examined. None of this information was available in the care records. The individual did not recall the visit to the dentists when asked. • One other person’s care plan also included a letter from the dentist requesting that the individual’s dentures and mouth be cleaned twice a day. The care plan referred to teeth and not dentures. The plan had not been amended to detail the directions of the dentist. Meadow View Care Centre DS0000043254.V365700.R01.S.doc Version 5.2 Page 14 • This person is partially sighted and the plan specified that staff should ensure that they wear their glasses at all times. During both visits the individual was not wearing glasses and was observed to move around the home freely and even look at a newspaper and photographs during a reminiscence session. If the person is now choosing not to wear glasses, this should be reflected in their care plan. Surveys from people and their relatives show that they ‘usually’ receive the care and support they need. Comments included, • ‘Sometimes it’s difficult to find someone who is in charge’, • ‘The care is very good no problems’, • ‘Mum needs help with getting dressed, showered or bathed and with her laundry I’m not sure she gets this help every day. Changing of her bed varies should be every week but sometimes isn’t’. People were generally well groomed and cared for. A relative spoken with said that staff always take care to make sure their relative is well dressed and their appearance is cared for. However, one person had faeces smeared on their walking frame and we noted this before lunch. The acting manager was informed but the individual came into the dining without being checked by staff. This person’s monthly care plan review had identified that they needed to be checked more frequently as they were not managing their colostomy bag due to short term memory loss. The care plan had not been updated to reflect this change nor were staff checking them more frequently. The acting manager ensured that staff cleaned the frame immediately after lunch when the person returned to their room. There was very little personal history or information available about people. There was a short ‘profile’ section in the care plan and this was only briefly completed in two of the care plans seen. It is very important when people have dementia or are confused that there is a full life history so that staff can understand the person as an individual and their way they live their life. People’s preference of gender of carer for personal and intimate care is not sought during the assessment or care planning process. This information should be sought so that people preferences for personal and intimate care can be met. The wording in the assessment format assumes that all people have a ‘marital’ status. The use of the term ‘partner’ should be considered so that people’s individual important relationships are acknowledged. Meadow View Care Centre DS0000043254.V365700.R01.S.doc Version 5.2 Page 15 Discussion with the acting manager, staff, surveys from relatives, observation of care plans and daily records showed that people living in the home have access to other health professionals such as GP, dietician, dentist and specialist consultants and chiropodist. One survey included the comment ‘my mother has to hospital every six months for her check up and the staff at the home always take her and look after her well’. The medication systems and administration at the home are well managed. Medication policies and procedures are safe, with medication being stored safely, labelled correctly and administered safely. All of the medication records and controlled drugs records seen were correct. The community pharmacist visited the home the week before the inspection and completed an audit and gave the acting manager advise on recording ‘as needed’ paracetamol. The acting manager had implemented this. Staff observed had good relationships with the people living at the home and were patient and encouraging. People with dementia freely approached staff and staff gave them reassurance when needed. Staff spoken with had a good understanding of recognising people as individuals, respecting their privacy and dignity and they were knowledgeable about them as a person. They were observed to be relaxed with people. They reassured people by talking quietly, touching and holding them when they were upset. Staff also smiled, danced and had fun with people during both visits to the home. Staff respected people’s privacy and dignity, by knocking on their doors and offering personal care discreetly and in private. Peoples’ surveys show that staff treat them well and that carers listen and act on what they say. Meadow View Care Centre DS0000043254.V365700.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Quality in this outcome area is excellent. People living in the home are supported to maintain their independence, contact with important others and lifestyle, which enhances their quality of life. This judgement has been made using available evidence including a visit to this service. EVIDENCE: During the inspection, there were a number of visitors and those spoken with said that they are welcomed and that staff are approachable. One relative said, “Glad to see lots of activities going on it’s what people need. All the staff are very approachable I know most of them”. The home provides a programme of activities with at least one planned group activity each day. During the inspection visits, staff played croquet in the garden with people, did reminiscence sessions, did gardening, danced, listened to music, petted the home’s cats and rabbit with people. Meadow View Care Centre DS0000043254.V365700.R01.S.doc Version 5.2 Page 17 Daily newspapers are delivered to the home and staff spend time going through these with people during both visits people clearly enjoyed this daily living activity. There were many items around the home for people to pick up and there were things to do. People were observed carrying and interacting with dolls, drinks, laundry and food. Surveys from people and relatives show that there are ‘usually’ or ‘sometimes’ activities arranged by the home that they can take part in. Comments included ‘mum enjoys the activities and generally joins in’. People spoken with and observed got up and spent their time how and where they chose. The two-hour observation session started towards the end of lunchtime. One the whole staff interacted in a positive way with people and in return, people’s moods were relaxed and positive. The people observed, were a majority of the time, engaged in activities either with staff or by themselves. One person was observed to look at the paper, another cleared the table and floor of crumbs and another chatted with other people and staff. One person slept for some of the time but when woke interacted with staff and us with smiles and chatting. The full cooked meal of the day is now served in the early evening and there is a light lunch of sandwiches, salads or hot snacks. People observed ate well at lunchtimes and staff said that people seemed to prefer their cooked meal at night. This change means that people who do not like to get up early do not have their breakfast and lunch too close together. People were given verbal or visual choices when they were asked what they wanted to eat. There is a new menu that has photographs of all the meals provided so that it easier for people to make their choice. There is a café area in the home and some people chose to eat their meals in this area. There is fridge with a glass door with cold drinks, crisps and other snacks in. There are also bowls of fresh fruit around the home. People were observed to help themselves to snacks, sweets, fruit and drink throughout the inspection visits. This is good practice. Meadow View Care Centre DS0000043254.V365700.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16,17,18 Quality in this outcome area is good. Complaints procedures make sure that peoples, relatives and representatives concerns and complaints are listened to and acted upon. A staff team who have a good knowledge of how to respond to any suspicion of abuse and to keep people safe from harm support the people living at the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a formal complaints policy which is accessible to people and their families. People are encouraged to raise their concerns with the manager. Information on how to make a complaint is kept by the visitors’ book and posters around the home give further information. Surveys from people and their relatives show that they know who to speak to if they are not happy and know how to complain. One visitor spoken with knew how to complain and who to speak to if they had any concerns. Staff spoken with and surveys show that they know what to do if a service user or relative or friend has concerns about the home. Meadow View Care Centre DS0000043254.V365700.R01.S.doc Version 5.2 Page 19 There has been one complaint made to the commission since the last inspection. This related to one person’s visitors and decisions made by the individual’s family and the home. The organisation investigated the complaint appropriately. A record of complaints received by the home is kept along with the action taken by the home regarding each issue raised. One complaint was identified in a survey from a relative; it was regarding the fitting of an automatic door closure and the organisation’s slow response. The complaint was looked at during the inspection and the acting manager confirmed that there had been a delay in the response to the individual from the organisation. The automatic door closure had been delivered to the home that week and was due to be fitted within the next few days. Staff have attended training in the Protection of Vulnerable Adults (POVA) so that they are aware of the different ways vulnerable people are at risk of abuse, and would know how to respond. Staff spoken with had a good understanding of how to recognise and report any allegations of abuse. Since the last key Inspection, there have been three referrals for investigation under Adult Protection Procedures, which have been led by Social Services with the co-operation of the service. All referrals related to the risk of harm to people because of the challenging behaviour of other people living at the home. Strategies were immediately introduced to reduce the risk to other people. Unfortunately, this resulted in the home acknowledging they could no longer meet the needs of the person with challenging behaviour and an alternative placement was arranged. The acting manager and staff had limited knowledge, understanding or the implications of the Mental Capacity Act, which was fully implemented on 1st October 2007. The acting manager had some information packs about the new act. The staff should have information and or training on the Mental Capacity Act. This is so they can understand the importance of the new legislation and the impact that it will have on the people living at the home who may have previously been assessed as not having capacity to make decisions about their lives. Meadow View Care Centre DS0000043254.V365700.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 26 Quality in this outcome area is good. The home is maintained and furnished so that people live or stay in a homely, clean, comfortable environment. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The large reception area in Meadow View is bright and welcoming, visitors can only access the building if a staff member opens the door to them. The building surrounds a central garden which is attractively landscaped with seating and a pond with water feature. The garden can be accessed through several doors into it. Meadow View Care Centre DS0000043254.V365700.R01.S.doc Version 5.2 Page 21 The differing designs of communal spaces in the home create a variety of atmospheres so people living in the home can choose to use an area that suits how they feel and where they feel most comfortable. There are two seating areas off the reception area and one of these recreates a cosy ‘sitting room’ area with a fireplace as a focal point and fibre optic lighting; the other features leather sofas and coffee tables and has a contemporary, ‘coffee shop’ feel to it. There is one large dining area which is bright and airy, but quite functional. Off the dining area is one space that is used as a craft area and has a small kitchenette in it. This has recently been improved as an activity area with games, tactile things and music. In another area there is a small lounge with a television, armchairs and contemporary sideboards. There is good signage around the home and there are tactile boards on the walls for people to touch and feel. In a wide space where the corridors join is a small seating area with bistro type tables and chairs that has a ‘café’ feel to it. Finally, there is another good-sized lounge and dining area with sofas, dining furniture and a kitchenette. This conservatory type room is quite homely. Some people are accommodated in ‘Poppies’, a separate building that can only be accessed through the central garden area. ‘Poppies’ has been converted from its previous use as a day centre and provides bedrooms, a small lounge, kitchen and bathroom. There is the facility to accommodate a married couple or partners in the bungalows that are part of the home’s registration. At the time of the inspection visits, no one was staying or living in these bungalows. People were observed to walk all around the home and garden quite freely. People socialised with other people and staff whenever they chose. Some people chose to spend their time in their bedrooms. Each resident is accommodated in single rooms with ensuite facilities. Each room has it’s own front door and a back door leading to a walkway that goes around the building. We looked at some of the bedrooms of the people involved in case tracking. They were clean and well furnished. The rooms were personalised with their own belongings. People’s bedroom doors cannot be left open, whilst the individual is in their room, without them propping open the door with a stool or wedge. This has Meadow View Care Centre DS0000043254.V365700.R01.S.doc Version 5.2 Page 22 been a long-standing issue at the home for a number of years and the subject of a recent complaint. During the inspection, there were seven rooms with stools propping open the bedroom doors. From discussion with the acting manager and staff and observation people like to be able to see what is going on whilst they are sat in their bedrooms. Automatic door closures should be provided for the people who are routinely propping open their doors with stools as they present a trip hazard. Since the last inspection, the acting manager has introduced a daily plan for staff so that staff are responsible for the people who live or are staying in specific areas and rooms. All of the environmental risks identified at the last inspection have been assessed and minimised where possible. Systems are in place for the management of dirty laundry and control of infection. Protective clothing such as plastic gloves and aprons were available and hand-washing facilities were available. Surveys from people and relatives show that the home is ‘usually’ fresh and clean. Comments included: • ‘Sometimes at the weekend the beds are not made up’ • ‘The staff do a fairly good job though I would like to see some spring cleaning going on, pulling out the furniture and hoovering, this hasn’t been done since mum moved in’. Meadow View Care Centre DS0000043254.V365700.R01.S.doc Version 5.2 Page 23 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Quality in this outcome area is good. The people living in the home are protected by robust recruitment practices and supported by a skilled, competent and managed staff team. This judgement has been made using available evidence including a visit to this service. EVIDENCE: During the inspection, there were 35 people in total at the home. 33 were permanently living there and two people were staying for respite care. There was only one person living in the domiciliary care bungalows. This person does not need any personal care support and staff were only taking over meals for this individual. This means that the staff member allocated to the bungalows was spending a majority of their time as part of the home’s staff compliment. From discussion with the acting manager and from four weeks rotas seen the usual staffing compliment is: • 8am – 2pm is six care staff (plus one allocated to the bungalows) • 2pm – 8pm is six care staff (plus one allocated to the bungalows) • 8pm – 8am is two care staff (plus one allocated to the bungalows) Meadow View Care Centre DS0000043254.V365700.R01.S.doc Version 5.2 Page 24 Since the last inspection, the way that the staff are deployed has changed. At the start of each shift staff are allocated to work with people in specific bedrooms. From discussion with staff and the acting manager, this seems to be working better with staff knowing whom they are responsible for. These daily planning records were seen and the manager said that it was assisting with monitoring care practices in the home. The duty rota now reflects the hours people work, in what capacity and the daily planner shows who they are working with. During the inspection, there were enough staff to meets the needs of the 35 people living or staying at the home. Staff surveys tell us that there are ‘usually’ enough staff to meet the individual needs of the people at the home. The surveys from people and their relatives tell us that that staff are ‘usually’ available when they need them. The surveys also tell us that staff listen and act on what people say. Comments included: ‘no complaints staff are very good’ and ‘usually it depends who is on duty’. Four staff files were seen including the most recently recruited staff. The files were well organised. Two of the four files included evidence of CRB (Criminal Records Bureau) checks and PoVA (Protection of Vulnerable Adults) checks. The organisation faxed over the other two CRB and POVA checks for the other two staff by the end of the inspection. Evidence of these checks had not been sent to the home although the files indicated that they had been received. Staff surveys and staff spoken with show that that checks such as CRB and references were carried out before they started work. From the AQAA (Annual Quality Assurance Assessment) completed by the manager, the training programme and discussions with staff there is a comprehensive training programme in place that focuses on mandatory training and the specific needs of the people living at the home. Staff training matrix shows that staff complete an induction programme and receive mandatory training including food hygiene, Equality and Diversity, fire safety, first aid, and adult protection, Control of Substances Hazardous to Health (COSHH) and moving and handling. All staff complete a dementia awareness training course. Staff spoken with and surveys show that they are given training that is relevant to their role. The induction programme seen and staff spoken with and surveys show that that they had an induction that covered everything the needed to know to do the job. Meadow View Care Centre DS0000043254.V365700.R01.S.doc Version 5.2 Page 25 There is an active NVQ programme and over 50 of staff have achieved or are working towards level 2 or above. Meadow View Care Centre DS0000043254.V365700.R01.S.doc Version 5.2 Page 26 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35,38 Quality in this outcome area is good. People benefit from living in an improving home. People and others are able to express their views to the acting manager and these are listened to and acted upon. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The acting manager has worked at Meadow View since it opened in 2003, as both senior carer and deputy manager. She is in the process of applying for registration with us. Meadow View Care Centre DS0000043254.V365700.R01.S.doc Version 5.2 Page 27 During the visit staff appeared confident in their roles, the home was relaxed and people appeared at ease and comfortable. Staff spoken with commented positively about the style of management and leadership from the acting manager, their job role and the people living at the home. The management approach of the home creates an open, positive and inclusive atmosphere and the acting manager communicated a clear sense of direction. The personal monies of people living in the home are kept securely in separate bags and accurate records of income and expenditure are kept. Receipts for transactions are now kept. The organisation undertook a Quality Assurance exercise in May 2006. There is a large poster in the main entrance that gives their own ‘star’ rating and assessment. However, this is now out of date and the organisation has not completed any further quality assurance exercise since that date. It is recommended that this be taken down as it also tells people that we have rated the home as ‘poor’ or ‘level 1’ and that is not the home’s current rating. The AQAA (Annual Quality Assurance Assessment) told us that the organisation complete quality assurance assessments. The frequency of the organisation’s quality assurance assessment should be reviewed so that it is up to date and reflects the home’s status with us. The acting manager has started to develop her own internal quality assurance programme that includes surveys. The acting manager has also produced a plan for the home. She told us that she was going on quality assurance training the week after the inspection. Information provided before the inspection, by the acting manager in the AQAA (Annual Quality Assurance Assessment) shows that relevant Health and Safety checks and maintenance are being carried out at the home. A number of Health and Safety records were checked, including the fire safety log. These records showed that health and safety matters are well managed. Meadow View Care Centre DS0000043254.V365700.R01.S.doc Version 5.2 Page 28 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 18 3 x X x x x x 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 x 3 x x 3 3 3 Meadow View Care Centre DS0000043254.V365700.R01.S.doc Version 5.2 Page 29 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP7 Regulation 15 (1)(2)(b) Requirement Care plans must be up to date, include correct information and describe the actions staff are to take to meet peoples’ assessed needs. This is so staff know what care and support people require to make sure that their changing needs are met. Timescale for action 01/09/08 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 OP7 Good Practice Recommendations Personal profiles in care plans and or ‘Life History’ books should be developed that include details and photographs of their ‘history’ such as family, friends, where they have lived, pets, work etc. These profiles or life history books will assist staff to have a greater understanding of them as an individual. People’s preference of gender of carer for personal and intimate care should be sought so that people preferences DS0000043254.V365700.R01.S.doc Version 5.2 Page 30 2 OP10 Meadow View Care Centre 3 4 OP10 OP19 for personal and intimate care can be met. The use of the term ‘partner’ should be considered so that people’s individual important relationships are acknowledged. Automatic door closures should be provided for the people who are routinely propping open their doors with stools as they present a trip hazard. The poster with the organisation’s own ‘star rating’ be taken down. This is because it is out of date and gives inaccurate information about our rating of the home. The frequency of the organisation’s quality assurance assessment should be reviewed so that it is up to date and reflects the home’s status with us. 5 6 OP33 OP33 Meadow View Care Centre DS0000043254.V365700.R01.S.doc Version 5.2 Page 31 Commission for Social Care Inspection West Midlands West Midlands Regional Contact Team 3rd Floor 77 Paradise Circus Queensway Birmingham, B1 2DT 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 © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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