Inspection on 19/12/05 for Meadow View Nursing Home

This inspection was carried out on 19th December 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 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 10 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Meadow View Nursing Home 01/04/10

Meadow View Nursing Home 27/01/09

Meadow View Nursing Home 10/10/08

Meadow View Nursing Home 12/08/08

Meadow View Nursing Home 17/10/07

Meadow View Nursing Home 11/12/06

Meadow View Nursing Home 24/08/05

Meadow View Nursing Home 31/01/05

Meadow View Nursing Home 08/09/04

Similar services:

Hillside

Applegarth

122 Scorer Street

Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

Hunter`s Lodge

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

CARE HOME ADULTS 18-65 Meadow View Nursing Home Church Lane Calow Chesterfield Derbyshire S44 5AG Lead Inspector Rose Veale Unannounced Inspection 19th December 2005 10:15a Meadow View Nursing Home DS0000002064.V270796.R01.S.doc Version 5.0 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.V270796.R01.S.doc Version 5.0 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.V270796.R01.S.doc Version 5.0 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) Derbyshire 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.V270796.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 24th August 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. Meadow View Nursing Home DS0000002064.V270796.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced. There were 24 residents accommodated in the home on the day of the inspection. The manager and staff were spoken with during the inspection. Care records, staff duty rotas and records of staff training were examined. The kitchens and communal areas of each bungalow were seen. What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Meadow View Nursing Home DS0000002064.V270796.R01.S.doc Version 5.0 Page 6 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.V270796.R01.S.doc Version 5.0 Page 7 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 The care records had improved since the last inspection with assessment information regularly reviewed to ensure that residents’ needs were being properly met. EVIDENCE: The care records of three residents were examined. The assessment information was detailed and comprehensive. Assessments, including risk assessments and moving and handling assessments had been reviewed and updated in the last six months. None of the records seen had a copy of a letter to the resident / their representative confirming that the home was able to meet the needs of the resident. This was a requirement at the previous two inspections and has been carried forward in this report. Meadow View Nursing Home DS0000002064.V270796.R01.S.doc Version 5.0 Page 8 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 and 7 Individual care plans were clear, detailed, and regularly reviewed to ensure residents’ needs were properly met. Residents’ personal preferences and choices were respected. EVIDENCE: Each of the care records seen had a care plan. The care plans were detailed and clearly described the action required by staff to ensure residents’ needs were met. All of the care plans seen had been reviewed and updated in the last six months. There was evidence that care plans were reviewed when there was a change in the resident’s condition. For example, one care plan had been reviewed very recently to include the care needed by a resident following hospital treatment. The care records contained comprehensive information about the personal preferences, likes and dislikes of residents. Staff spoken with were knowledgeable about residents’ needs and preferences. Staff spoken with were clearly aware of respecting residents’ preferences and choices in their daily lives. Meadow View Nursing Home DS0000002064.V270796.R01.S.doc Version 5.0 Page 9 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, 14 and 17 Since the last inspection, no further progress had been made in providing a programme of appropriate activities, in and out of the home, to ensure fulfilling lifestyles for residents. Residents enjoyed a varied and flexible menu in pleasant surroundings. EVIDENCE: Staff spoken with said that there were problems with providing social activities for residents because the home was often understaffed, (see Staffing section, Standards 31-36). Records were kept of activities for each resident. Some residents had been unable to go out of the home in the two weeks before the inspection and staff said this was due to lack of staff. There were staff specifically employed for assisting residents to go out – ‘mobility’ staff. The manager said that there should have been approximately 20 hours per bungalow for mobility staff, but with staff shortages these staff were often used to cover care shifts and so the mobility hours were lost. Each of the four bungalows catered separately for residents’ meals. Staff working in each of the bungalows were responsible for devising menus, doing Meadow View Nursing Home DS0000002064.V270796.R01.S.doc Version 5.0 Page 10 the weekly shopping, and cooking each day for residents. Nutritional assessments were completed for residents to ensure all their dietary needs were met. The menus seen appeared varied and balanced. There were good stocks of food in each of the kitchens seen. Residents appeared to enjoy their meals and staff assisted residents to eat as necessary. The staff of one bungalow had devised a Christmas menu including some traditional and some more unusual meals. The menu was presented in an attractive way. Meadow View Nursing Home DS0000002064.V270796.R01.S.doc Version 5.0 Page 11 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 20 Residents were protected by the practices in place in the home for the administration of medication. EVIDENCE: Medication in the home was administered by the nurses on duty. There were no residents in the home assessed as able to administer their own medication. Medication was securely stored. The Medication Administration Records, (MARs), were checked and were correctly completed. The ordering, receipt and disposal of medication records were seen and were satisfactory. Meadow View Nursing Home DS0000002064.V270796.R01.S.doc Version 5.0 Page 12 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: These standards were not assessed at this inspection. However, a requirement made at the last two inspections regarding training for staff in dealing with challenging behaviour was followed up. It was found that some, but not all staff requiring it had received this training. The requirement has been carried forward in this report. Meadow View Nursing Home DS0000002064.V270796.R01.S.doc Version 5.0 Page 13 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 The home was generally clean and reasonably well maintained. However, there were outstanding maintenance issues to be addressed to ensure a safe and pleasant environment for residents. EVIDENCE: At the previous inspection, several issues were identified regarding the environment of the home and requirements were made to address these. Most of these requirements had not been met and have been carried forward in this report. Meadow View Nursing Home DS0000002064.V270796.R01.S.doc Version 5.0 Page 14 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 33 and 35 Staffing levels at the home were not always adequate to meet the needs of the residents. There were some gaps in staff training, potentially affecting resident care and staff competency. EVIDENCE: At the previous inspection it was noted that staffing levels were not always sufficient to fully meet the needs of residents. At this inspection it was clear that no progress had been made and that the home was often understaffed. This was evidenced from staff rotas seen, from talking to the staff and the manager, and from the residents care records which noted when residents were unable to go out of the home due to a lack of staff. Staff spoken with were unhappy about the continued understaffing as they were sometimes working with one or two staff per bungalow, instead of three, on morning or afternoon shifts. Staff spoken with said the situation was causing low morale amongst staff. Staff spoken with said they were covering the hours needed by working overtime. One new care worker had started in November 2005. The manager said that five other new staff had been appointed but were awaiting pre-employment checks before they could start. It was not clear whether these new appointments would fill all the care hours needed. It was noted that a nurse working full-time had been moved to another home and the hours had not been replaced, causing difficulty in covering nurse shifts. Meadow View Nursing Home DS0000002064.V270796.R01.S.doc Version 5.0 Page 15 From the rotas seen, it was noted that the staffing levels were sometimes below the guidance of the Residential Forum. The Residential Forum guidance calculates the staffing levels required against the assessed dependency of the residents. For the 24 high dependency residents at Meadow View, the Residential Forum guidance was for a total of 10 care staff, (not including nurses), on duty for the morning and afternoon shifts. On the days when the home was fully staffed this requirement was exceeded as there were a total of 12 care staff on duty. When the home was understaffed, there were sometimes a total of 8 or 9 care staff on duty. Care staff at Meadow View were responsible for preparing meals, shopping for food and cleaning materials, doing the laundry, and some cleaning in addition to the care of the residents. Staff spoken with said their workload was manageable when there were three care staff on duty in each bungalow, but that it was difficult when they were understaffed. An Immediate Requirement was left on the day of the inspection for the staffing levels to be addressed urgently by the providers. Staff training records were seen. The records showed that the majority of staff had received fire safety training regularly up to date, including twice yearly training for staff working nights. Basic food hygiene and first aid training were up to date for the majority of staff. Most of the staff were overdue for moving and handling training updates. Staff spoken with said that training dates were offered, but when they applied there were no places left, or they could not attend because of lack of staff cover at the home. Some staff working with residents with challenging behaviour had not had relevant training. Staff spoken with said they enjoyed the training they had received and had found it useful and relevant to their work. Meadow View Nursing Home DS0000002064.V270796.R01.S.doc Version 5.0 Page 16 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): EVIDENCE: These standards were not assessed at this inspection. Meadow View Nursing Home DS0000002064.V270796.R01.S.doc Version 5.0 Page 17 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X 2 X X X Standard No 22 23 Score X 2 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 X X X Standard No 24 25 26 27 28 29 30 STAFFING Score 2 X X X X X X LIFESTYLES Standard No Score 11 X 12 2 13 2 14 X 15 X 16 X 17 Standard No 31 32 33 34 35 36 Score X X 2 X 2 X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Meadow View Nursing Home Score X X 3 X Standard No 37 38 39 40 41 42 43 Score X X X X X X X DS0000002064.V270796.R01.S.doc Version 5.0 Page 18 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 YA2 Regulation 14(1)(d) Requirement The Registered Person shall not provide accommodation to any service user at the home unless it has been confirmed in writing to the service user that, having regard to their assessment, the care home is suitable for the purpose of meeting the service users needs in respect of their health and welfare. Original timescale 31/03/2005 The walls and ceiling in the kitchen in bungalow 2 must be kept clean. Original timescale 31/10/05 The torn fly screen and flooring in the kitchen of bungalow 4 must be repaired or replaced. Original timescale 30/11/05. The cupboard doors and drawer fronts in the kitchens of bungalows 3 and 4 must be repaired or replaced. Original timescale 30/11/05 The flooring in the bathroom of bungalow 3 must be repaired or replaced. Original timescale 30/11/05 A risk assessment must be made DS0000002064.V270796.R01.S.doc Timescale for action 31/03/06 2. YA24 23(2) (b) (d) 23(2)(b) (c) 23(2)(b) (c) 31/01/06 3. YA24 28/02/06 4. YA24 31/03/06 5. YA24 23(2)(b) 31/03/06 6. YA24 13(4)(a) 31/01/06 Page 19 Meadow View Nursing Home Version 5.0 (c) 7. YA24 23(2)(o) 8. YA30 13(3) 18(1) 9. YA32 13(4) 18(1) 10. YA35 18(1)(c) regarding the wooden flooring in bungalows 3 and 4, including the action to be taken to prevent slips and falls. Original timescale 31/10/05 The patio areas outside bungalows 1 and 2 must be suitable for, and safe for use by service users. Original timescale 31/12/05 Infection control training must be provided for staff by way of the rolling training programme arrangements to ensure that staff receive periodic updates. Original timescale 01/12/04 Staff who require must undertake relevant and recognised training in respect of non-physical and physical interventions for dealing with challenging behaviours. Original timescale 28/02/04 Staff must receive regular training in safe moving and handling. 31/03/06 31/03/06 31/03/06 31/03/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard YA6 YA24 Good Practice Recommendations The date of admission should be included on the front sheet of service users files A general upgrade and refurbishment of the kitchen areas should be considered to improve the facilities Meadow View Nursing Home DS0000002064.V270796.R01.S.doc Version 5.0 Page 20 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.V270796.R01.S.doc Version 5.0 Page 21 - 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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