Please wait

Please note that the information on this website is now out of date. It is planned that we will update and relaunch, but for now is of historical interest only and we suggest you visit cqc.org.uk

Inspection on 11/12/06 for Meadow View Nursing Home

Also see our care home review for Meadow View Nursing Home for more information

This inspection was carried out on 11th December 2006.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 7 statutory requirements (actions the home must comply with) as a result of this inspection.

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

Residents needs are assessed prior to their admission to the home and forms the basis for the planning of care. Care plans are generally good and underpin the care that is given. Residents are supported to participate as much as possible in making choices about their lives. Staff work well together and work hard for the benefit of residents. A generally comfortable and well furnished environment is provided with aids and adaptations suited to the needs of residents.

What has improved since the last inspection?

A letter of confirmation that residents assessed needs can be met within the home is now being sent out prior to the admission of residents. Some improvements have been made to the environment including some general redecoration and the repair of kitchen flooring. Care records are continually being improved to underpin the care that is given.

What the care home could do better:

Some of the requirements from previous inspection visits have not been met, these relate specifically to training and to the environment of the home. Some progress has been made and the timescales have been extended to take account of this. Staffing levels are expected to be improved as a matter of urgency to ensure that all of the needs of residents are met including social activities. Staff continue to say that there is an adverse effect on the care of residents when staffing levels are consistently inadequate.

CARE HOME ADULTS 18-65 Meadow View Nursing Home Church Lane Calow Chesterfield Derbyshire S44 5AG Lead Inspector Marie Bonynge Unannounced Inspection 11 December 2006 10:30 th Meadow View Nursing Home DS0000002064.V313273.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Meadow View Nursing Home DS0000002064.V313273.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Meadow View Nursing Home DS0000002064.V313273.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Meadow View Nursing Home Address Church Lane Calow Chesterfield Derbyshire S44 5AG 01246 270235 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) Enable Care & Home Support Limited Neil Blake Care Home 24 Category(ies) of Learning disability (24) registration, with number of places Meadow View Nursing Home DS0000002064.V313273.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 19th December 2005 Brief Description of the Service: Meadow View is situated approximately two miles from the centre of Chesterfield in a residential area near to local amenities and public transport. Meadow View provides personal and nursing care and accommodation for 24 adults with learning disabilities. The home comprises four bungalows, each accommodating six residents. The bungalows are linked, although each has its own separate facilities. All the residents have single, ground floor bedrooms and shared lounge / dining rooms. There are garden and patio areas to the rear of the bungalows. The fees for this home were not provided. Meadow View Nursing Home DS0000002064.V313273.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over one day in December 2006 and covered the late morning, lunchtime and afternoon. Many of the home’s residents have communication difficulties therefore during this visit the Inspector spent time observing the care of residents, the daily routines and the quality of the interaction between staff and residents. Discussions were held with the registered manager and staff. Other inspection methods used included the examination of the care records of 3 residents selected as part of case tracking, medication systems, staff training and a brief tour of the building to assess the general cleanliness and hygiene of the home. 10 CSCI resident surveys were sent out, none of these were completed due to the complex needs of the residents. 10 requirements were made at the last inspection visit in December 2005, 5 of which have been met and the timescale has been extended for the remainder to take account of some of the relevant training having been completed. A letter of serious concerns was sent to the provider regarding unsatisfactory staffing levels and the impact this had on residents. What the service does well: What has improved since the last inspection? A letter of confirmation that residents assessed needs can be met within the home is now being sent out prior to the admission of residents. Some improvements have been made to the environment including some general redecoration and the repair of kitchen flooring. Care records are continually being improved to underpin the care that is given. Meadow View Nursing Home DS0000002064.V313273.R01.S.doc Version 5.2 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 Nursing Home DS0000002064.V313273.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Meadow View Nursing Home DS0000002064.V313273.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents and their representatives can be confident that full assessment information is obtained in order to provide a basis for care planning, and assist in ensuring that their needs are met. EVIDENCE: Most of the residents at Meadow View have lived in the home for many years. There has been one new admission in the last year. The files of 3 residents were examined as part of the case tracking process including the most recently admitted resident. Assessments were completed for these residents prior to their admission to the home and have been updated when the persons needs have changed. Meadow View Nursing Home DS0000002064.V313273.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans are generally good and underpin the care that is given. Residents are supported to participate as much as they are able to in making choices about their lives. EVIDENCE: Resident care plans were in place for each of the 3 residents selected for case tracking purposes. These were person centred and detailed how the person preferred their care to be delivered. This was based on the knowledge that staff had of the person and included the input of the resident where possible. The care plans identified individual needs, the preferences of each person and detailed the necessary action to be taken by staff to meet those needs. Staff used the care plans to implement the plan as everyday working documents. Risk assessments were in place that supported residents to pursue independent lifestyles within a risk management framework. Meadow View Nursing Home DS0000002064.V313273.R01.S.doc Version 5.2 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16, 17 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Staff strive to provide suitable activities and recreational pastimes, however shortages in staffing levels do not always ensure fulfilling lifestyles for residents. EVIDENCE: Staff said that problems continued to present themselves regarding being able to provide social activities for residents because the home had often been understaffed. On this visit 4 residents were not able to attend the day centre because there was no driver or member of staff to stay with residents at the centre. (See staffing section for further comments about staffing). It was also said that there were limited numbers of minibus drivers and this also had an impact on the ability of residents to attend outside activities. Sometimes the staff who were employed specifically for assisting residents to go out were used to cover staff shortages as on this occasion. Meadow View Nursing Home DS0000002064.V313273.R01.S.doc Version 5.2 Page 11 Family links and friendships both inside and outside the home were supported and encouraged. Daily logs demonstrated that family and friends are welcomed. A sample of menus was provided that were varied and balanced, alternatives were often cooked if residents wanted something different. Staff in each of the bungalows were responsible for the preparing of meals and these were taken in the dining areas of each of the properties. Meadow View Nursing Home DS0000002064.V313273.R01.S.doc Version 5.2 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Personal and healthcare support is provided in the way in which residents prefer and is determined by the care plan. The medication systems in place assist in safeguarding residents in respect of the safe handling and administration of medication. EVIDENCE: Personal support was provided in accordance with the care plan. Discussions with staff indicated that they were familiar with the needs and preferences of residents and had developed appropriate and supportive relationships with them, particularly through key working. Every effort is made to accompany residents to appointments or as on this occasion to stay with a resident who was in hospital but was disturbed and needed additional support from people that they knew. This however, had an impact upon the staffing levels of the home. Regular healthcare checkups and appointments were planned including access to the dentist, chiropodist and optician. Records were clearly documented with appropriate follow up action being taken. Meadow View Nursing Home DS0000002064.V313273.R01.S.doc Version 5.2 Page 13 Medication systems were generally in good order with a treatment and storage room being used for bungalows 1 and 2 and 3 and 4. The Medication Administration Records were completed and a record of staff signatures was kept for those staff administering medication. There were no residents in the home who were assessed as being able to administer their own medication and risk assessments had been completed accordingly. This served to assist in safeguarding residents. Meadow View Nursing Home DS0000002064.V313273.R01.S.doc Version 5.2 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff training, policies and procedures were in place that assisted in the promotion and protection of residents’ rights. EVIDENCE: A complaints procedure was in place. No complaints have been received by the home or by the CSCI in relation to this home since the last inspection. Policies and procedures regarding safeguarding adults assisted in the protection of residents. There have been 2 safeguarding adults referrals since the last inspection. One involving an allegation against a member of staff was investigated and reported on to the social services department and one is under investigation at the moment. The service has followed the appropriate procedures and worked with the local social services in accordance with the guidelines. Staff have accessed training regarding safeguarding adults although this is not always updated. A recommendation is made in respect of this. Some staff had accessed training in dealing with challenging behaviour in response to a requirement from the last two inspection reports, however additional staff need to complete this training. The requirement has been carried forward with an amended timescale. Meadow View Nursing Home DS0000002064.V313273.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. A homely, comfortable and personalised environment is provided with aids and adaptations that meet the needs and lifestyles of those residents accommodated. EVIDENCE: The 4 bungalows were generally clean, tidy and free from offensive odours. The bungalows were well decorated and maintained and work has been done to meet with the requirements from previous inspections. 4 requirements have been met in respect of: • Keeping the walls and ceiling in the kitchen of bungalow 2 clean • In repairing the torn fly screen and flooring in the kitchen of bungalow 4 • In repairing the cupboard doors and drawer fronts in the kitchens of bungalows 3 and 4 • Completing a risk assessment for the wooden flooring in bungalows 3 and 4. • The flooring in the bathroom of bungalow 3 has not been repaired or replaced although the work for this was planned. A requirement has been carried forward and the timescale extended in this area. Meadow View Nursing Home DS0000002064.V313273.R01.S.doc Version 5.2 Page 16 • Work has been completed on the patio area of bungalow 1, however it has not taken place regarding bungalow 2. This requirement has been carried forward. The communal space was generally well furnished although the dining table in bungalow 3 was a trestle table and there were not enough chairs for all of the residents to sit down at the table. A requirement has been made in respect of this. Meadow View Nursing Home DS0000002064.V313273.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34, 35 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. The home is not always appropriately staffed in accordance with residents needs and staff are not always adequately trained to care and support the resident. This has potential risks for residents and staff. EVIDENCE: Staffing rotas, discussions with staff and direct observation indicated that the home was not always being staffed according to the numbers and dependencies of residents. There were 24 residents accommodated on this visit including one resident who was in hospital but requiring a member of staff to be with them due to their needs. All of the residents were assessed as having high level dependency needs, both physical needs, challenging behaviour and a resident with mental health needs. One resident was ill on this visit and waiting to be seen by a doctor. Some residents had not been able to attend a day centre because there were not enough staff to provide a driver and an escort. This had happened on 2 previous occasions. A resident from bungalow 3 was moved to bungalow 2 for safety reasons as an incident had occurred with another resident. It was reported that this resident needed one to one support for some periods of time, particularly when aggressive and agitated. A number of accidents were Meadow View Nursing Home DS0000002064.V313273.R01.S.doc Version 5.2 Page 18 recorded in the accident book relating to this resident. One to one support was not being provided due to the level of staffing. The residents in bungalow 3 were assessed as having challenging behaviour needs. It was observed that staff worked hard to meet the needs of residents, however they were also required to go shopping, attend to the laundry, cook and assist with the feeding of some residents. One nursing assistant was unable to attend epilepsy training to cover the shortfall in the afternoon. These issues were raised as a serious matter with the manager and a letter of serious concerns has been sent to the provider requiring urgent action to be taken and to provide an action plan to the CSCI. A requirement has been made in respect of this area. Staff were not always adequately trained to meet the needs of residents particularly with regard to challenging behaviour, moving and handling and infection control. A requirement has been made in respect of this at 2 previous inspections and is carried forward on this occasion. Recruitment procedures are established in this service, pre inspection information indicates that these procedures are followed for example with regard to obtaining CRB checks prior to the recruitment of staff. Meadow View Nursing Home DS0000002064.V313273.R01.S.doc Version 5.2 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 42 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. This home is run with the health, safety and welfare of residents and staff generally being promoted, however there are deficits in staffing and gaps in training that may compromise this. EVIDENCE: The registered manager has been in post for more than 2 years and is a registered nurse for people with learning disabilities. Some recruitment has taken place to fill the staff vacancies, however advertisements have not gone out for some of the posts. This aspect of the home is organised by the provider. An established quality assurance system is in place that involves resident questionnaires and an audit of the service. Regular monthly provider visits take place and regulation 37 notices are sent to the CSCI. This assists in the self monitoring and review of the service. Meadow View Nursing Home DS0000002064.V313273.R01.S.doc Version 5.2 Page 20 Although there is a training programme, not all of the mandatory training has taken place including moving and handling, challenging behaviour and infection control. This cannot always ensure the health and safety of residents and staff. Particularly where there are a number of residents with challenging behaviour and complex needs. Pre inspection information indicates that compliance with relevant legislation is taken seriously and the maintenance of the building is kept up to date. Meadow View Nursing Home DS0000002064.V313273.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 2 33 1 34 3 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 2 13 2 14 3 15 X 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 2 X 3 X X 2 X Meadow View Nursing Home DS0000002064.V313273.R01.S.doc Version 5.2 Page 22 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 YA24 Regulation 23(2)(b) Requirement The flooring in the bathroom of bungalow 3 must be repaired or replaced. Original timescales 30/11/05 and 31/03/06. The patio areas outside bungalow 2 must be suitable for, and safe for use by service users. Original timescales 31/12/05 and 31/03/06. Suitable dining furniture must be provided that meets with the assessed needs of residents. At all times suitably qualified, competent and experienced persons must be working at the care home in such numbers as are appropriate for the health and welfare of servce users. Infection control training must be provided for staff by way of the rolling training programme arrangements to ensure that staff receive periodic updates. Original timescales 01/12/04 and 31/03/06. Staff who require must undertake relevant and recognised training in respect of DS0000002064.V313273.R01.S.doc Timescale for action 31/03/07 2. YA24 23(2)(o) 31/03/07 3. 4. YA24 YA33 23 (2) 18 1 a 31/03/07 18/12/07 8. YA30 13(3) 18(1) 31/03/07 9. YA32 13(4) 18(1) 31/03/07 Meadow View Nursing Home Version 5.2 Page 23 non-physical and physical interventions for dealing with challenging behaviours. Original timescale 28/02/04 and 31/03/06. 10. YA35 18(1)(c) Staff must receive regular training in safe moving and handling. Original timescale 31/03/06. 31/03/07 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 YA23 Good Practice Recommendations All staff should receive regular updates in safeguarding training. Meadow View Nursing Home DS0000002064.V313273.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT 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 Nursing Home DS0000002064.V313273.R01.S.doc Version 5.2 Page 25 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!