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Inspection on 27/07/05 for Meadow View Care Centre

Also see our care home review for Meadow View Care Centre for more information

This inspection was carried out on 27th July 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

What has improved since the last inspection?

The wood and glass in the area surrounding the indoor fishpond has been replaced and this makes it a pleasant and safe area for service users and their families to sit in when visiting the home. Further staff have achieved an NVQ qualification and the home have now almost reached the 50% of staff that must have an appropriate qualification by 2005.

What the care home could do better:

The care delivered is not reflected in the service users care plans as they have not improved since the last inspection. Service users must have their needs reassessed particularly if they are returning back into the home to ensure their care needs can be met at all times. The home does not provide enough activities to ensure that service users can choose what they would like to do or if they prefer to go out and records relating to the activities need to be improved. The home must address the health and safety issues that have been highlighted. All fire prevention checks must be carried out as stated within the fire log book and staff must have further instruction and guidance on everyday health and safety practice within the home.

CARE HOMES FOR OLDER PEOPLE Meadow View Care Centre Kibblesworth Gateshead Tyne and Wear NE11 0YJ Lead Inspector Eileen Hulse Unannounced 27 July 2005 8:45am The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Meadow View Care Centre B52 B02 S63769 Meadow View V225480 27 Jul 2005 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Meadow View Care Centre Address Kibblesworth Gateshead Tyne and Wear NE11 0YJ 0207 0343220 none none European Care (England) Limited Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Prospective Manager Mr Joe Patterson Care home only 22 Category(ies) of DE(E) Dementia - over 65 (21) registration, with number SI(E) Sensory Impair over 65 (3) of places MD(E) Mental Disorder -over 65 (2) Meadow View Care Centre B52 B02 S63769 Meadow View V225480 27 Jul 2005 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 14/12/04 Brief Description of the Service: Meadow View is a large, grand older building which has been converted for use as a care home with an extension to the rear. It is sited in the pretty rural village of Kibblesworth. It provides 21 places for older people who require assistance with personal care needs. It does not provide nursing care. At this time most of the people who live there have dementia care needs. All the bedrooms are single and well decorated and 6 of the bedrooms have en-suite facilities. The home also provides a good choice of sitting areas for the people who live there, and it enjoys extensive mature gardens and an indoor patio area with fishpond. There are local shops, public house and a bus route a short walk from the home. Meadow View Care Centre B52 B02 S63769 Meadow View V225480 27 Jul 2005 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place on the 27th July 2005 by one inspector (Eileen Hulse), it was un-announced and was carried out as part of the annual inspection programme. It took 9hrs 45mins to complete that included 2hrs to prepare for the inspection. The focus of the inspection was to gain insight into the quality of life and services received by service users who live in the home. Time was spent chatting with service users and talking with the Manager and staff who were on duty, inspecting some records including care plans, risk assessments, medication, complaints and POVA policies and procedures. The Inspector had a lunchtime meal with service users in the dining room and a tour was made of the premises. What the service does well: Service users spoken with throughout the inspection were very positive about the home and the staff team. Comments they made included: • • • • ‘The girls are really canny’ ‘I have made a lot of friends here’ ‘It’s nice to get out, I like to walk in the gardens’ ‘The staff are fantastic they do a wonderful job’ Relatives and visitors to the home were also positive and all said it was a ‘friendly home’ and that ‘nothing was too much trouble for the staff’. The home is well decorated and pleasantly furnished and staff have created a friendly, homely atmosphere. What has improved since the last inspection? The wood and glass in the area surrounding the indoor fishpond has been replaced and this makes it a pleasant and safe area for service users and their families to sit in when visiting the home. Further staff have achieved an NVQ qualification and the home have now almost reached the 50 of staff that must have an appropriate qualification by 2005. Meadow View Care Centre B52 B02 S63769 Meadow View V225480 27 Jul 2005 Stage 4.doc Version 1.40 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Meadow View Care Centre B52 B02 S63769 Meadow View V225480 27 Jul 2005 Stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Meadow View Care Centre B52 B02 S63769 Meadow View V225480 27 Jul 2005 Stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3 Pre-admission assessments are completed by both the home Manager and the Care Manager to ensure the needs of service users are identified and can be met by the home. However, re-assessments following a short stay away from the home are not completed and therefore there is no assurance that care needs will be met. EVIDENCE: The home have good pre-admission assessments within the care plans for all service users living in the home that are detailed to ensure the care needs can be met. The assessments detail the person’s social care, how the care needs will be met and what levels of staff support the service user requires. However, during the inspection, observation was made of staff having difficulty in trying to support a service user who had recently been returned home following a short stay in hospital. The persons needs had changed prior to hosp discharge and due to no assessment being carried out and no guidance available for staff to follow, it was evident the home could not meet the needs. Meadow View Care Centre B52 B02 S63769 Meadow View V225480 27 Jul 2005 Stage 4.doc Version 1.40 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, 9 and 10 Every service user has an individual plan of care but little improvement has been made to the content of the records, they are not fully completed and therefore, do not ensure the care needs of service users are identified and met at all times. However, the healthcare needs of service users is not consistent and not always met. Inspection of the medication records and observation of service users receiving their medicines indicated that the arrangements in place are generally satisfactory and this helps to ensure service users are given medication safely. EVIDENCE: Meadow View Care Centre B52 B02 S63769 Meadow View V225480 27 Jul 2005 Stage 4.doc Version 1.40 Page 10 A sample of care plans were examined and varying levels of information are included within the care plans particularly in areas regarding personal care needs. Some of the information is out of date and they do not always include the likes/dislikes, evaluations and do not give descriptive detail to guide the practice of staff and some of the entries made on the monitoring sheets is very repetitive and does not help to give a good overall evaluation. Not all of the care needs are identified, therefore, more detail needs to be included to ensure the care needs are met at all times and that the care is consistent. On the day of the inspection, one service user was poorly in bed. The staff were given no instruction on how to care for this person and no information or monitoring was carried out in relation to the care that was required, there was also no guidance for staff included within the plan of care. Out of 3 care plans examined, only one service user had received the services of a chiropodist. Inspection of the medication records evidenced that a record is kept of medications when they are prescribed, administered and disposed of. A drug round that was completed by two members of staff was observed and the practice was found to be satisfactory. Records showed that the medication prescription and instructions on the current months’ Medicine Administration Record (MAR) sheets, were legible and well maintained. Meadow View Care Centre B52 B02 S63769 Meadow View V225480 27 Jul 2005 Stage 4.doc Version 1.40 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 14 and 15 The home do not have an activities co-ordinator trained in organising activities specifically for people with dementia and the activities that are organised by the staff in the home are repetitive and lack variation and records kept were poor. Although the lunchtime meal was pleasant, a number of concerns regarding the mealtime arrangements were evident that do not promote the choice, dignity and safety of the service users. EVIDENCE: On the day of the inspection there were no activities taking place and service users either dozed in armchairs or wandered aimlessly around the building. A monthly activity list on the wall was not dated and detailed activities such as exercises, sing a longs and ball games but these were repeated several times over the course of a month. The activity records are poor and do not give sufficient information, they fail to detail which service users were asked to take part in an activity, which service users refused or how meaningful the chosen activity was. The records were out of date the last entry was dated Monday 5th July 05 and activity entries included service users who had received a bath, those who had washed their hair and service users who had had their nails cut. Meadow View Care Centre B52 B02 S63769 Meadow View V225480 27 Jul 2005 Stage 4.doc Version 1.40 Page 12 The inspector shared a lunchtime meal with service users. All the service users had their lunch in one dining room instead of the usual two rooms. This compromised the safety of service users as chairs were sticking out from under the tables and a number of walking frames were next to chairs making it difficult for service users to get to the tables and making limited space. The tables were set with placemats, tablecloths and condiments, however, no serviettes were available and service users used the tablecloths to wipe their hands on. It was a two course meal comprising of a choice of mixed grill or fish fingers, peas and chips with yogurt or trifle for sweet. The meal was hot, tasty and well cooked with good-sized portions, however, no choice was given to the amount or type of food presented on the plates. Service users chatted with each other throughout the meal and were given sufficient time to sit and enjoy their meal without being hurried. Service users made statements about the meals they receive and comments made included: • • ‘I eat all of my meals’ ‘We are well done to in here’ Service users were asked if they required an apron to protect their clothes and those who required help to eat their meals were given help in a dignified and respectful manner with staff sitting next to them. However, one service user was given a soft diet that looked unappetizing and not at all appealing, the dinner was mashed and because of peas on the plate, the dinner was green. One service user waiting for a second yogurt was told by a member of staff ‘you only get one’ the inspector intervened and the service user was given another one. Cold juice drinks only were offered with the lunch. Meadow View Care Centre B52 B02 S63769 Meadow View V225480 27 Jul 2005 Stage 4.doc Version 1.40 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 and 18 The home has a comprehensive Complaints Procedure that is included within the Statement of Purpose and policies and procedures on the protection of vulnerable adults that ensures the safety of service users from abuse at all times. EVIDENCE: Service users and relatives spoken to during the inspection stated that they know who to raise and complaints or concerns with and that they feel comfortable about doing so. All relatives who were spoken to indicate they have not felt the need to complain at any time and were positive about the home and it’s staff. All staff working in the home have received POVA training from the former company who owned the home. Staff have also completed POVA training with Gateshead Council and the council’s policies and procedures are in place for staff to refer to should they suspect a case of abuse. POVA guidelines and contacts have been made available to all staff employed in the home. Meadow View Care Centre B52 B02 S63769 Meadow View V225480 27 Jul 2005 Stage 4.doc Version 1.40 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19 The home is clean, well decorated and generally well maintained EVIDENCE: All areas of the home used by service users are decorated to a good standard and are provided with good quality furnishings and carpets. An on-going redecoration programme ensures that the home maintains this standard. The home is warm and cheerful and offers pleasant accommodation for the people who live here. Meadow View Care Centre B52 B02 S63769 Meadow View V225480 27 Jul 2005 Stage 4.doc Version 1.40 Page 15 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 29 and 30 Staffing levels were found to be adequate on the day of the inspection, however, on checking the staff rota it appears this level of staffing is not always maintained. The home has two waking night staff on duty every night and a management on call arrangement is in place, which appears to work well. The procedures for the recruitment of staff are robust and provide the safeguards to offer protection to people living in the home. EVIDENCE: All staff are employed using the home’s recruitment policy and procedures based on equal opportunities that is based in accordance with the code of conduct set by the General Social Care Council. This ensures that the home follows the recruitment process and that all the necessary checks are carried out that includes references and Criminal Records Bureau checks. Part of the interview process requires that prospective staff are required to produce either a passport or a driving license which contains a photograph and two references one of which must be from a former employer. Meadow View Care Centre B52 B02 S63769 Meadow View V225480 27 Jul 2005 Stage 4.doc Version 1.40 Page 16 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 38 There is a Health & Safety policy statement in place and risk assessments are carried out for all procedures carried out within the home to ensure a safe environment. However, some monthly fire checks were found to be out of date and some care practice needs to be addressed. EVIDENCE: Meadow View Care Centre B52 B02 S63769 Meadow View V225480 27 Jul 2005 Stage 4.doc Version 1.40 Page 17 All staff receive the mandatory training appropriate to Health & Safety. However, records provided evidence that some fire checks were not being kept up to date, they included fire fighting equipment which recorded months 3,4 and 6 no checks were carried out and the emergency lighting was last tested 19 April 05. All fire checks must be carried out at the required times by the home. During the inspection, at different times, two members of staff were observed to walk backwards whilst assisting service users. This is dangerous practice and must stop immediately. Meadow View Care Centre B52 B02 S63769 Meadow View V225480 27 Jul 2005 Stage 4.doc Version 1.40 Page 18 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 2 x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 1 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 1 13 x 14 2 15 2 COMPLAINTS AND PROTECTION 3 x x x x x x x STAFFING Standard No Score 27 2 28 x 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x x x x x x x 2 Meadow View Care Centre B52 B02 S63769 Meadow View V225480 27 Jul 2005 Stage 4.doc Version 1.40 Page 19 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. 2. 3. 4. 5. 6. 7. 8. 9. Standard 3 7 8 12 14 15 27 28 34 Regulation 14 15 12 16 12 12 18 18 25 Requirement All service users must have detailed assessments prior to returning to the home The individual care plans must be completed in sufficient detail to guide the practice of staff Healthcare needs of service users must be addressed at all times Detailed records must be maintained regarding activities held within the home Service users must be given choice regarding their meals The dining arrangements must be reviewed Staff hours should be as stated by the previous registering authority 50 of care staff must hold a qualification by 2005 Accounting and financial records to ensure the viability of the service must be made available for inspection as stated in The Care Homes Regulations 2001 All service users must have individual personal allowance books as per the guidelines of the Data Protection Act Monthly fire checks must be B52 B02 S63769 Meadow View V225480 27 Jul 2005 Stage 4.doc Timescale for action Immediatel y 1 Nov 05 Immediatel y 1 Nov 05 Immediatel y 1 Nov 05 Immediatel y 2005 1 Nov 05 10. 35 20 1 Nov 05 11. 38 23 Immediatel Page 20 Meadow View Care Centre Version 1.40 carried out 12. 38 13 y The practice of staff must be Immediatel addessed to enable them to work y safely 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 12 Good Practice Recommendations The home should consider employing an activities coordinator. Meadow View Care Centre B52 B02 S63769 Meadow View V225480 27 Jul 2005 Stage 4.doc Version 1.40 Page 21 Commission for Social Care Inspection Baltic House Port of Tyne, Tyne Dock South Shields NE34 9PT 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 View Care Centre B52 B02 S63769 Meadow View V225480 27 Jul 2005 Stage 4.doc Version 1.40 Page 22 - 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. 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