Inspection on 10/05/05 for Meadow View Nursing & Residential Home

This inspection was carried out on 10th May 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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 Nursing &... 12/08/08

Meadow View Nursing &... 16/10/07

Meadow View Nursing &... 06/06/06

Meadow View Nursing &... 11/10/05

Meadow View Nursing &... 13/10/04

Meadow View Nursing &... 23/04/04

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 Finlay Avenue Penketh Warrington WA5 2PN Lead Inspector John Mills Unannounced 10 May 2005 09:15 th The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Meadow View F51 F01 S59120 Meadow View V225694 100505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Meadow View Address Finlay Avenue Penketh Warrington WA5 2PN 01925 791180 01925 728730 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Ashberry Healthcare Limited Angela Phillips Care Home with Nursing (N) 41 Category(ies) of Old age, not falling within any other category registration, with number (OP) 41 both of places Meadow View F51 F01 S59120 Meadow View V225694 100505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. No more than 41 Service Users, within the category of old age (OP) may be accommodated 2. The attached schedule of requirements must be met within the stated timescale. Date of last inspection 13 October 2004 Brief Description of the Service: Meadow view is a 41 bedded care home catering for elderly service users. Located in Penketh, a suburb of Warrington. The home is on a main bus route and is located within easy access to shops, churches and a library. The home is of a single storey design with 41 single rooms, lounge, two dining areas, conservatory, laundry and hairdressing salon. There is a small secluded garden to the front of the building and several smaller sitting areas located around the building each within the enclosed perimeter of the home. A Registered General Nurse is on duty at all times to meet the needs of the resients in receipt of nursing care. Meadow View F51 F01 S59120 Meadow View V225694 100505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. One inspector carried out this inspection over 6 hours on 10th May 2005. During this inspection the inspector spoke with 10 service users, one visiting relative, one visiting social worker and three district nurses. Conversations were also had with eight members of staff including housekeeping, care and nursing staff. The inspection was carried out with the support of the manager. During the inspection 16 of the identified 20 core standards were assessed together with 6 of the remaining 18 standards. The inspection included the reading of three resident’s care plans, the examination of records relating to health and safety and a tour of the home. What the service does well: What has improved since the last inspection? Tissue viability care and the care of pressure sores has improved, this has been supported with the purchase of two profiling beds and three pressure relieving mattresses. Bedrooms have been decorated and new sinks provided in two additional bedrooms. Meadow View F51 F01 S59120 Meadow View V225694 100505 Stage 4.doc Version 1.30 Page 6 Formal staff supervision is taking place for all staff every two months. What they could do better: The completion of the redecoration of the home must proceed in a structured manner. NVQ training to achieve a minimum of 50 of care staff with this award must be undertaken. Planned training of all staff should be undertaken. A formal quality assurance processes should be developed, this should include palliative care training for nursing staff. Requirements and recommendations are made within this report asking the provider to address these matters. 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 F51 F01 S59120 Meadow View V225694 100505 Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Meadow View F51 F01 S59120 Meadow View V225694 100505 Stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3 & 6 Potential residents have their needs assessed before moving into the home and family members discuss with senior staff how these identified needs will be met. Only those people whose needs are in keeping with the skills and knowledge of staff working within the home are admitted. EVIDENCE: The care plans belonging to a recently admitted resident contained detailed pre-admission assessments. These had been undertaken by a senior nurse from the home and a standard social services assessment where necessary had been provided to the manager. This resident said that his daughter had visited the home on his behalf whilst he was in hospital waiting to be admitted and had discussed his needs and what the service could provide to meet those needs. This service does not provide intermediate care. Meadow View F51 F01 S59120 Meadow View V225694 100505 Stage 4.doc Version 1.30 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, & 10 Care plans are maintained to a good standard and there is consistency in the dating of assessments and the carrying out of regular reviews. The complex and various needs of residents are identified within the care plans. EVIDENCE: Three residents’ case files were examined and each contained detailed care plans that identified emotional, social and physical needs. These plans were up to date and were being regularly reviewed by senior staff. Residents or relatives had contributed to the development and content of these plans and had been involved in the reviewing of these plans and had signed to confirm this. Where a significant risk had been identified this was included within the care plans and actions identified to minimise or help the person were also recorded within the plan. Meadow View F51 F01 S59120 Meadow View V225694 100505 Stage 4.doc Version 1.30 Page 10 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14 & 15 Social activities and meals are well managed, creating and providing daily variation for people living within the home. Families regularly visit the home providing residents with opportunities to maintain family links. Residents have opportunities to maintain links with local churches and clergy that allow them to exercise their faith. EVIDENCE: Residents said that they had been given choices regarding how they organised their day. This was specifically in regard to going to bed, where they spent the day and what they did with their time. On the afternoon of the inspection staff were seen playing a game of bingo with residents in the main sitting room. Residents were taking part and were enjoying this activity, laughing and joking with staff. The son of one resident said that he was free to visit the home at any time and spent many hours most days visiting his mother. During the afternoon other relatives were seen visiting the home. Meadow View F51 F01 S59120 Meadow View V225694 100505 Stage 4.doc Version 1.30 Page 11 One resident was being taken by her family to the local Catholic Church to celebrate Mass. There are also regular visits to the home by the Eucharistic Minister who provides Holy Communion to residents. Meadow View F51 F01 S59120 Meadow View V225694 100505 Stage 4.doc Version 1.30 Page 12 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) None of these three standards or their outcomes were assessed at this inspection. EVIDENCE: Meadow View F51 F01 S59120 Meadow View V225694 100505 Stage 4.doc Version 1.30 Page 13 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20, 22, 23, 24, 25 & 26 Improvements have been made to the décor and furnishings. Residents live in a comfortable and pleasant home. The manager has responded positively to previously identified requirements and recommendations. Residents live within a safe and well maintained home. EVIDENCE: Redecoration of residents’ bedrooms and of corridors has taken place since the last inspection. There is a large lounge near the main dining room and other seating areas located around the home and in the gardens surrounding the home. Adaptations such as grab rails and ramps have been provided to assist people with physical disabilities. Hosts and other equipment are provided to assist staff in the safe moving of residents. Residents’ bedrooms have been re-decorated with their choice of colours. A new resident said that he had already brought things in from home and had arranged with the handyman to hang pictures and shelves in his room. Meadow View F51 F01 S59120 Meadow View V225694 100505 Stage 4.doc Version 1.30 Page 14 Previously identified work in bedrooms had been attended to since the last inspection. The home was clean and free from any unpleasant odours. Three cleaners were working together on the morning of the inspection. Meadow View F51 F01 S59120 Meadow View V225694 100505 Stage 4.doc Version 1.30 Page 15 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 28, & 30 The existing vacancies for qualified nurses continue to have an impact on the work of the manager and limit her ability to work outside of direct care. Staff are provided with a good range of training opportunities covering both mandatory areas and developmental subjects. Residents benefit from a home with adequate staffing levels and well informed and knowledgeable staff. EVIDENCE: Examination of the staffing rota confirmed that minimum staffing levels of two nurses and seven care staff are maintained from 8.00 to 14.00 and one nurse and seven care staff from 14.00 to 20.00. By night there is one nurse and four care staff on duty. In addition to these direct care staff there are housekeeping staff with specific responsibilities for, the laundry, the kitchen and general cleaning. The manager said that two nurses have been recruited and are to start work when their registrations have been confirmed by the Nurses and Midwives Council, until then the manager and other nurses are working additional shift to maintain appropriate staffing levels. All nurses within the home are actively undertaking ongoing professional development to satisfy the registration requirement of the Nursing & Midwifery Council. Meadow View F51 F01 S59120 Meadow View V225694 100505 Stage 4.doc Version 1.30 Page 16 Eight care staff have achieved NVQ level 2 in care. Additional training is provided by the manger or senior staff and by external training agencies. Meadow View F51 F01 S59120 Meadow View V225694 100505 Stage 4.doc Version 1.30 Page 17 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 33, 37 & 38 Residents live in a well managed service providing them with a good degree of safety and security. The manager needs to confirm her competence in her role by undertaking NVQ level 4 in management. EVIDENCE: The manager of the home is an experienced nurse and has previously managed a care home. The manager has not yet commenced NVQ 4 in management and this is an outstanding expectation from previous reports. There is no formal quality assurance system in place, residents or their relatives have no structured means of informing the manager of their views or satisfaction. Records relating to the management of a safe home were checked and the management of Fire Safety, Moving & Handling, Hot Water, COSHH, Food and Kitchen equipment were properly maintained. Meadow View F51 F01 S59120 Meadow View V225694 100505 Stage 4.doc Version 1.30 Page 18 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 4 COMPLAINTS AND PROTECTION 3 3 x 3 3 3 3 2 STAFFING Standard No Score 27 2 28 3 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x x 2 x 2 x x x 3 3 Meadow View F51 F01 S59120 Meadow View V225694 100505 Stage 4.doc Version 1.30 Page 19 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 31 Regulation 18 Requirement Timescale for action 1/9/05 2. 33 24 The registered person ensure that the manager undertake NVQ Level 4 in management (Timescale of 1/1/05 not met) The registered person must 1/9/05 ensure that an effective quality assurance system must be implemented (Timecale of 1/1/05 not met) 3. 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 27 Good Practice Recommendations Additional nurseing staff should be employed at the earliest date possible to avoid relying on the manager and other nurses working additional shifts. Meadow View F51 F01 S59120 Meadow View V225694 100505 Stage 4.doc Version 1.30 Page 20 Commission for Social Care Inspection Unit D, Off Rudheath Way Gadbrook Park Northwich CW9 7LT 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 F51 F01 S59120 Meadow View V225694 100505 Stage 4.doc Version 1.30 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. 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. 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