Inspection on 15/03/06 for Meadow View Care Home

This inspection was carried out on 15th March 2006.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Meadow View Care Home 16/08/07

Meadow View Care Home 05/09/06

Meadow View Care Home 26/09/05

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Meadow View Care Home Rear Of 1072 Manchester Road Castleton Rochdale Lancashire OL11 2XJ Lead Inspector Diane Gaunt Unannounced Inspection 15th March 2006 09:15 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 Home DS0000063310.V269776.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Meadow View Care Home DS0000063310.V269776.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Meadow View Care Home Address Rear Of 1072 Manchester Road Castleton Rochdale Lancashire OL11 2XJ 01706 711620 01706 711157 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) East and West Health Care Limited Mrs Pushpa Sundramoorthy Care Home 39 Category(ies) of Past or present alcohol dependence (1), Old registration, with number age, not falling within any other category (38) of places Meadow View Care Home DS0000063310.V269776.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum of 39 service users to include: up to 38 service users in the category of OP (Older People) and 1 named service user in the category of A (Alcohol Dependent). Registration will revert to 39 service users in the category of OP once the named service user is no longer accommodated at the home. The service should employ a suitably qualified and experienced Manager who is registered with the Commission for Social Care Inspection. Staff must be provided with relevant information regarding alcohol dependency and treatment related to the service user’s specific needs. 26th September 2005 2. 3. Date of last inspection Brief Description of the Service: Meadowview Care Home is a purpose built residential home providing accommodation and personal care to 39 resdients on both a permanent and respite stay basis. A small number of day care places are also available. Twenty four hour care is provided. All rooms are single although four bedrooms have inter-connecting doors which may be locked if not occupied by couples. A passenger lift is provided to the 1st floor. The home is situated approximately half a mile from Castleton which has a variety of shops and other community facilities. A large garden is provided to the rear. There is level access to the front door and good car parking facilities. Meadow View Care Home DS0000063310.V269776.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. A regulatory inspector and a pharmacist inspector visited the home. The home had not been told beforehand that the inspectors would visit. The pharmacy inspector spent 7 hours at the home inspecting arrangements for medication. The regulatory inspector spent 8½ hours home looking at the building and paperwork about the running of the home and the care given. In order to find out more about the home the inspectors spoke with seven residents, one senior carer, four care assistants, the cook, five relatives, a GP, an aromatherapist, a District Nurse, the deputy manager and the registered manager. Three requirements listed at the end of the report had not been fully met since the last inspection. What the service does well: What has improved since the last inspection? The ground floor bathroom had been tiled and a number of bedrooms redecorated. Trees had been cut down in the garden to allow more light into rooms. The mobile hoist had been inspected to make sure it was safe to use. A fire lecture had been held so staff knew what to do if there was a fire Some staff had had training in health and safety training and how to make sure residents were safe and free from harm at the home, although not all staff had attended. Bedroom door keys were available in bedrooms unless residents had said they did not wish to have them. Detailed food/fluid intake monitoring charts were in use. Meadow View Care Home DS0000063310.V269776.R01.S.doc Version 5.1 Page 6 Staff were appropriately alerting the District Nurse if there were any areas of concern and passing on clear messages from the District Nurse so all staff knew what care to offer people the District Nurse visited. Staff were only employed after the home had got two written references and Criminal Records Bureau checks to make sure staff were suitable to work with residents. Staff had begun to include residents and relatives when they checked whether the care they were giving was what was needed and wanted. What they could do better: The manager must make sure that care managers and CSCI are told of incidents between residents which put them at risk of harm. Training in how to keep residents safe and free from harm must be provided for those staff who haven’t had it. Staff should be given written terms and conditions of employment within 8 weeks of starting work. The manager must make sure that care plans describing what help residents need are written for everyone who lives at Meadowview. They must include all the action staff need to take to meet residents’ needs and include a record of advice given by other professionals e.g. GP. More residents and relatives should be invited to talk to staff about the care plan every 6 months to make sure it records the care they want and need. The manager should check regularly to make sure senior staff are doing what they are supposed to do when writing care plans and giving out medicine and tablets. A number of changes must be made to how staff give out medicines and tablets, how they keep an accurate record of what medicines and tablets are in the home and what medicines and tablets they have given to residents. They must also make sure all medicines and tablets are stored safely. The home must introduce a system to find out what residents, relatives and other interested people think about the home and plan changes as a result of this information. This will make sure the home is run in the best interests of people living there. A maintenance and renewal plan should be written for the home and a copy given to the manager and CSCI. This should include plans to replace furniture etc.. Security at the home should be reviewed. Meadow View Care Home DS0000063310.V269776.R01.S.doc Version 5.1 Page 7 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 Home DS0000063310.V269776.R01.S.doc Version 5.1 Page 8 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 Home DS0000063310.V269776.R01.S.doc Version 5.1 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None of these standards were inspected on this occasion. EVIDENCE: Meadow View Care Home DS0000063310.V269776.R01.S.doc Version 5.1 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8 and 9 Residents’ health, personal and social care needs were not always set out in an individual plan of care which could result in staff being inconsistent in their approach. Health and personal care needs were met. There were deficiencies in the handling and recording of some medication that must be addressed to ensure safe administration. EVIDENCE: Six resident files were inspected. Of these, three did not have a care plan and one had an incomplete plan. Of the two that had care plans one had been signed by the resident and had been regularly reviewed –although there was no evidence of resident/relative involvement in the review. The other two care plans showed no evidence of resident or relative involvement. Completed care plans encompassed health and personal care needs and recorded action to be taken to meet the needs. They would benefit from expansion with regard to social care needs and the information used to advise activity plans. The two plans had been reviewed by staff on a monthly basis. Plans inspected by the pharmacist did not include healthcare plans where carers were involved in monitoring blood glucose level for residents with diabetes. Meadow View Care Home DS0000063310.V269776.R01.S.doc Version 5.1 Page 11 Files recorded involvement of GP, District Nurse and other healthcare professionals, but one was incomplete with regard to GP advice about a change in medication. All the issues above have been raised before at the home and initial action taken to remedy them, but the action had not been maintained. Risk assessments were held with care plans and were regularly reviewed, but were not always signed by the resident and/or their relative. Risk assessments with regard to nutrition and skin care were routinely completed and food/fluid intake charts were appropriately introduced and kept. Residents were weighed monthly and their weights monitored. One resident had pressure sores and discussion with the District Nurse indicated that staff were providing appropriate care. Comment was also made that staff communication both between themselves and the District Nurses had improved and a positive working relationship formed. Appropriate referrals were made by staff to District Nurses. A visiting occupational therapist provided fortnightly exercises, staff could further contribute to residents’ healthcare by providing additional exercise on a more regular basis. Observation showed that personal care and hygiene needs were met at the home. This was supported by discussion with residents and relatives. Those interviewed said staff generally responded quickly to call bells. Residents and relatives considered both health and care needs were met. Residents said the home called their GP when they needed them and the services of opticians, dentists, chiropodist and audiologist were accessed as and when necessary. Medication policies and procedures had been implemented but should be reviewed and expanded in accordance with current guidance. One resident was supported to self-administer an inhaler but a written assessment had not been completed. Trained care staff administered all other medication. Most medication was supplied in a Monitored Dosage System (MDS) with pre-printed Medication Administration Records (MAR). Medication within the MDS appeared to be given correctly, but it was not possible to confirm the correct administration of medicines in traditional containers (boxes and bottles) because the medication audit trail was incomplete. Records of medication received at the home and of medication leaving the home were not maintained and there were some ‘blanks’ and, conversely, some ‘extra’ signatures in the MARs. Where it was advised that verbal dose changes had been received from the prescriber these were not always documented. The management of medication brought in by respite care residents needs to be reviewed in accordance with current guidance. These records were poorly Meadow View Care Home DS0000063310.V269776.R01.S.doc Version 5.1 Page 12 maintained and medication for one respite care resident was administered from an unlabelled ‘dosette’. The medication storage was generally orderly but controlled drugs were not inside the controlled drug cupboard and when the inspector arrived at the home the storage room was observed to be unlocked. A fuller report providing more detail of concerns identified regarding medication administration is available from CSCI on request. Meadow View Care Home DS0000063310.V269776.R01.S.doc Version 5.1 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Social activities which residents enjoyed were provided on both an individual and group basis. Visiting arrangements at the home were informal and family and friends were encouraged to maintain contact promoting personal relationships. Residents were able to exercise choice and control over their lives. A wholesome appealing diet was provided in pleasing surroundings at times convenient to residents. EVIDENCE: Activities were arranged for each weekday and residents spoken with said they enjoyed some of these. In addition, some enjoyed other pursuits, reading the daily paper, knitting, watching TV and video’s, going out. On occasion musical entertainment was also provided. Staff provided some activities e.g. bingo, manicures, cards and karaoke afternoons although they were not regular nor recorded. The manager may wish to introduce an activities record in order to monitor participation in activities and introduce new ones to further stimulate residents. Two care plans inspected recorded some of the residents’ past interests, comment regarding their development is made in the health and personal care section above. The home had an open visiting policy and relatives interviewed said they were made to feel welcome and ‘at home’. They were usually offered a hot drink during their visit. Residents could see their visitors wherever they wished, either in the lounges, dining rooms (outside of mealtimes) or their bedrooms. Meadow View Care Home DS0000063310.V269776.R01.S.doc Version 5.1 Page 14 Residents went out with relatives as and when they wished and the inspector was informed that in the summer months staff took residents out to the local pub or garden centre. Religious services were not held at the home, although representatives of two Christian faiths visited residents regularly to serve communion. The choices residents made each day varied, dependent upon their mental frailty but residents who were able generally chose what time to get up, go to bed, what clothes to wear, what to eat, where to spend their day and whether or not to participate in activities. There was evidence of each of these choices being made on the day of inspection. The manager had information regarding local advocacy services available in the office and a poster regarding an advocacy contact (CareAware) was displayed. One resident managed their own money, others had passed the responsibility to relatives, solicitors or the manager. All those spoken with were happy with the arrangements in place. Menus inspected were seen to provide a nutritious and varied diet over a 3 week period. Two hot choices of meal were served each lunchtime and 2 or more choices at teatime. Whilst main meals were balanced and nutritious desserts were often stodgy, a sponge pudding being provided at lunchtime most days. The cook may wish to reduce the number of stodgy desserts when next reviewing the menu. Fruit was occasionally served as a dessert e.g. bananas and custard, apple crumble, prunes and custard but fresh fruit was not offered as a snack. Food served during the inspection was sampled, it looked, smelt and tasted appetising and was hot when served. Suitable provision was made for those needing special diets i.e. diabetic and soft diets. Staff gave appropriate assistance to those needing it. Supplementary drinks were provided for those in need of them and their use had proved to be effective. Monitoring of food intake was detailed for those who were unwell or had poor appetites. Residents were seen to enjoy the food and were heard to make positive comment. Residents spoken with about the food said it was very good and ‘suited them’. One resident described it as ‘excellent’. Meadow View Care Home DS0000063310.V269776.R01.S.doc Version 5.1 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 Appropriate systems were in place to protect residents from abuse, but reporting procedures were not always followed, putting residents at risk. EVIDENCE: A procedure for responding to allegations of abuse was available as was the Rochdale Inter-agency Protection of Vulnerable Adults (POVA) procedure. Significant improvement was noted with regard to staff training and the majority, although not all, had received training in this area. Some staff interviewed were not familiar with the term ‘whistleblowing’ although they said they would report concerns if another staff member was abusive to residents. It was noted from reading the incident book that incidents between residents which put their safety at risk were not always reported to care managers for investigation and protection of residents. Neither were they reported to CSCI. Outstanding requirements are in place with regard to both notification procedures. For the safety of residents the manager must take the responsibility for reporting incidents to all care managers or duty social workers immediately they occur. Meadow View Care Home DS0000063310.V269776.R01.S.doc Version 5.1 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 A safe, clean, pleasant, hygienic and well-maintained building was provided for residents. Whilst significant improvement had been made, the environment remained in need of further action with regard to safety, maintenance and cleaning. Hygiene practices were of a satisfactory standard. EVIDENCE: The home was safe, adequately maintained, and clean. Level access was provided along with a passenger lift and handrails in corridors. Everyone spoken with thought the home was a safe place to live and work in. Residents and relatives spoke positively about the cleanliness, one resident described the home as ‘spotless’. Staff expressed some concerns about the security of the home as items had been stolen from the staff room and kitchen in recent months. There was no planned maintenance and renewal programme at the home although it was noted bedrooms were decorated cyclically and/or as they became empty. A maintenance worker was employed and the inspector was informed that small repair jobs were completed quickly. There was no planned Meadow View Care Home DS0000063310.V269776.R01.S.doc Version 5.1 Page 17 replacement of furnishing and fittings, although the manager said she was due to order a number of overchair tables. It was noted some easy chairs and commodes in bedrooms were due for replacement. These should be included in the maintenance and renewal programme. Since the last inspection the ground floor bathroom had been tiled and a number of bedrooms redecorated. A number of trees had been cut down in the garden to allow more light into rooms. The mobile hoist had been inspected. Grounds were seen to be safe, tidy and accessible. Residents said they looked forward to sitting outside in the good weather. Neither the Environmental Health Department nor Greater Manchester Fire Officers had visited the home since the last inspection. Greater Manchester Fire Officers are due to inspect in 2007 as the home is on a 4 yearly inspection programme. Residents spoken with were pleased with their individual rooms and there was evidence they had brought in a number of personal possessions to make them feel more homely. All bedrooms were fitted with door locks and lockable storage space to ensure resident’s valuables were kept safe. Staff had a master key, which could be used to gain access in an emergency. Door keys were seen to be hung in the bedrooms and a minority of residents said they used them. An infection control policy was in place and staff spoken with described safe infection control practice. There was no malodour in the home. Disposable gloves and aprons were provided for staff use when assisting with personal care. Different coloured disposable aprons were used when staff were serving food. Liquid soap and paper towels were provided in communal areas. Although this was not available in bedrooms where staff were assisting with personal care, staff said they would go to the sluice or the nearest bathroom to wash their hands. The manager may wish to consider providing staff with an alcohol based cleaning gel for use at these times, or to provide liquid soap and paper towels in all areas where staff assist with personal care. Satisfactory practice was in place with regard to disposal of clinical waste. The laundry was sited away from the food preparation area and was seen to be clean and orderly. Sufficient and suitable equipment was provided and laundry was attended to efficiently. Meadow View Care Home DS0000063310.V269776.R01.S.doc Version 5.1 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 28, 29 and 30 Staff had basic training but needed additional input to ensure their competence. Safe recruitment and selection procedures were in place. EVIDENCE: Of four senior carers and fourteen care assistants, three seniors and one carer had an NVQ level 3 and two carers had an NVQ level 2. A senior and 2 carers were nearing completion of NVQ level 3 and five carers were taking NVQ level 2. When these carers complete their courses the home will have achieved over 50 trained care staff. In addition to the above, the deputy manager was nearing completion of NVQ level 4 in care and the assistant manager had achieved NVQ level 4 and the Registered Manager’s Award. Inspection of three files of the most recently recruited staff showed that Criminal Records Bureau (CRB) or Protection of Vulnerable Adults 1st (POVA) checks were taken up prior to appointment, along with two written references. The manager said she explored gaps in employment during recruitment interviews but no written evidence was available of this practice. Staff received a copy of the General Social Care Council Code of Practice on appointment. When beginning work they initially shadowed experienced staff until deemed competent. Contracts were not issued within 8 weeks of employment. New staff received an in-house induction and some, but not all staff had attended a Learn Direct one day induction course. This was not always achieved within the first 6 weeks of employment however. New common induction standards were discussed with the manager who intended to Meadow View Care Home DS0000063310.V269776.R01.S.doc Version 5.1 Page 19 implement them for new starters in place of previous induction/foundation standards. Improvement was noted with regard to provision of health and safety training, only two staff had not attended infection control training but this had been discussed as part of induction prior to places being booked on courses. In interview these staff showed an understanding of the application of infection control practices. The manager should ensure that the minority of staff not undertaking NVQ training achieve competence with regard to the SkillsforCare common induction standards. In addition to required training, the home had provided training in catheter care for six staff and had accessed a distance learning course on dementia care which the deputy, assistant manager and two seniors carers were undertaking. Additionally, senior staff had undertaken training in risk assessment and the assistant manager had attended courses in leadership skills and time and stress management. Residents and relatives were complimentary about the staff, describing them as ‘the best’, ‘really good’, ‘wonderful’ and ‘attentive’. One resident said she hadn’t been happy with one staff member’s manner, she had discussed this with the manager and there had been no problems since. Some residents commented that they were always busy and didn’t have much time to spare. Staff interviewed said they found the evening shift particularly demanding as the number of residents living at the home had recently increased, as had the dependency of some. The manager agreed to review the rota in consultation with senior staff. Meadow View Care Home DS0000063310.V269776.R01.S.doc Version 5.1 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33 and 35 Whilst the home operated adequately, the service would benefit from more management monitoring, review and staff supervision. The home occasionally reviewed aspects of its performance through formal consultation, but the process was not thorough, nor based on seeking residents’ views. Residents’ financial interests were safeguarded. EVIDENCE: The registered manager is a registered nurse who has had experience and training in 1st and middle line management within the NHS. She holds a degree in health studies, a diploma in counselling and a clinical teaching certificate. She does not hold the Registered Manager’s Award (RMA) but at the time of the inspection was on a Coaching and Mentoring Course. Management tasks were delegated to the deputy manager, assistant manager and senior carers. The deputy manager was nearing completion of NVQ level 4 in care and the assistant manager had completed both this and the RMA. During this inspection significant shortfalls were noted with regard to care planning and medication management. The manager should ensure that she Meadow View Care Home DS0000063310.V269776.R01.S.doc Version 5.1 Page 21 more closely monitors areas of delegated responsibility. It was also noted that despite previous requirement, CSCI were not always informed of notifiable incidents with regard to residents. The home had the Investors in People Award which had been renewed in August 2005, but a formal quality assurance and monitoring system was not in place. Systems for seeking feedback on the service were limited to annual residents meetings and 6 monthly staff meetings. A resident/relative satisfaction questionnaire had been devised but was not used in a planned way to influence the running of the home. Resident/relative involvement in writing and reviewing care plans had improved since the last inspection but was not universally applied. Staff performance was supervised on a quarterly basis, and annual appraisals were held. Supervision sessions did not include discussion of the home’s aims and objectives and staff training needs however. The responsible individual conducted regular visits to the home as required by Regulation 26 of the Care Homes Regulations 2001. Residents, relatives and staff said the manager was accessible on a daily basis and would listen and address matters raised. There was no current annual development plan at the home. Action to implement all requirements identified in CSCI reports was not taken within agreed timescales. East & West Healthcare acted as corporate appointee for two residents, upon their request. Relatives and solicitors acted on behalf of others, although the home remained responsible for monies left at the home by relatives for residents’ use. Records and monies held in respect of three residents were inspected and seen to be in order. There was evidence of regular audit. The manager illustrated her pro-active approach to one resident’s money management needs. Meadow View Care Home DS0000063310.V269776.R01.S.doc Version 5.1 Page 22 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 X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 1 8 3 9 1 10 X 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 X 17 X 18 1 2 X X X X X X 3 STAFFING Standard No Score 27 X 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 X 3 X X X Meadow View Care Home DS0000063310.V269776.R01.S.doc Version 5.1 Page 23 Yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP7 Regulation 15 Requirement Care plans must be written and regularly reviewed for every resident no matter what their status. The registered person must ensure that accurate records of medication administration are maintained. Timescale for action 30/04/06 2 OP9 17(3)(a) 15/03/06 3 OP9 12(1)(b) The registered person must 15/03/06 ensure that medication is not given other than in accordance with the prescriber’s instructions. The registered person must audit 31/03/06 the management of respite care medication with consideration to current guidance. The registered person must ensure that records of medication received into and leaving the home are maintained. The registered person must ensure that all selfadministration is assessed and DS0000063310.V269776.R01.S.doc 4 OP9 13(2) 5 OP9 13(2) 31/03/06 6 OP9 12(1)(b) 31/03/06 Meadow View Care Home Version 5.1 Page 24 reviewed. 7 OP9 17(1)(a) Sch3 The registered person must ensure that individual healthcare plans are developed where carers are involved in monitoring blood glucose levels for diabetic residents. The registered person must review and implement the medication policies and procedures. The registered person must ensure that medicines are always securely stored: • The medication room must be locked when unattended • Controlled drugs should be in the CD cupboard. • 31/03/06 8 OP9 13(2) 24/04/06 9 OP9 13(2) 15/03/06 10 OP18 13 Care managers must be informed of any incident which places a service user at risk of harm in the home. (Previous timescale of 31/10/05 not met) All staff must receive training in the Protection of Vulnerable Adults. (Previous timescale of 31/01/06 not met) The manager should ensure that staff not undertaking NVQ training achieve competence with regard to SkillsforCare common induction standards. The provider must ensure there is an effective quality assurance and quality monitoring system based on seeking the views of service users. CSCI must be informed of all notifiable incidents within 24 hours of their occurrence. DS0000063310.V269776.R01.S.doc 15/03/06 11 OP18 13 30/04/06 12 OP30 18 30/06/06 13 OP33 24 31/08/06 14 OP38 37 15/03/06 Meadow View Care Home Version 5.1 Page 25 (Previous timescale of 31/10/05 not met) 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 Reviews should be held with service users and/or their representatives on a 6 monthly basis and the record signed by service users/representatives to show their agreement. Handwritten MAR entries should be signed, checked and countersigned. A procedure for recording verbal dose changes should be implemented. The record of GP visits should be kept up-to-date. The provision of ‘blank’ MAR templates should be discussed with the supplying pharmacist. The temperature of the medication refrigerator should be recorded. A maintenance and renewal plan should be written and copies forwarded to the manager and CSCI. The responsible individual should review security arrangements at the home. Terms and conditions of employment should be issued to staff following 8 weeks of employment in keeping with employment law. The manager should ensure that she monitors more closely areas of responsibility delegated to senior staff. 2 3 4 5 6 7. 8 9 OP9 OP9 OP9 OP9 OP9 OP19 OP19 OP29 10 OP31 Meadow View Care Home DS0000063310.V269776.R01.S.doc Version 5.1 Page 26 Meadow View Care Home DS0000063310.V269776.R01.S.doc Version 5.1 Page 27 Commission for Social Care Inspection Bolton, Bury, Rochdale and Wigan Office Turton Suite Paragon Business Park Chorley New Road Horwich, Bolton BL6 6HG 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 Home DS0000063310.V269776.R01.S.doc Version 5.1 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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