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Inspection on 11/10/05 for Meadow View Nursing & Residential Home

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

This inspection was carried out on 11th October 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.

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

The atmosphere at the home was warm and welcoming. The home was clean and hygienic. The home has a regular group of staff that have worked at the home for some time and they are aware of the needs of the residents. Staff were friendly and attentive to the residents and had a good knowledge of the residents needs and the character and history of the residents in their care. The home manager is experienced and competent.

What has improved since the last inspection?

Trained staff have been employed to enable the manager to spend more time in a managerial capacity. There have been no other significant improvements to record since the last inspection.

CARE HOMES FOR OLDER PEOPLE Meadow View Nursing & Residential Home Meadow View Nursing and Residential Home Finlay Avenue Penketh Warrington Cheshire WA5 2PN Lead Inspector Joan Adam Unannounced Inspection 09:00 11 October 2005 th 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 Nursing & Residential Home DS0000059120.V257142.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 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 Nursing & Residential Home DS0000059120.V257142.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Meadow View Nursing & Residential Home Address Meadow View Nursing and Residential Home Finlay Avenue Penketh Warrington Cheshire WA5 2PN 01925 791180 01925 728730 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) Ashberry Healthcare Limited Angela Phillips Care Home 41 Category(ies) of Old age, not falling within any other category registration, with number (41) of places Meadow View Nursing & Residential Home DS0000059120.V257142.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. No more than 41 Service Users, within the category of old age (OP) may be accommodated The attached schedule of requirements must be met within the stated timescale 10th May 2005 Date of last inspection 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. Meadow View Nursing & Residential Home DS0000059120.V257142.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place over a two-day period by one inspector. A tour of the home was carried out and care records, fire records and staff personnel files were inspected. The service history of the home and the previous inspection report were read in preparation for the inspection. Four of the staff on duty, eight residents and two relatives were spoken with. What the service does well: What has improved since the last inspection? Trained staff have been employed to enable the manager to spend more time in a managerial capacity. There have been no other significant improvements to record since the last inspection. Meadow View Nursing & Residential Home DS0000059120.V257142.R01.S.doc Version 5.0 Page 6 What they could do better: Care plans in general at the home are detailed but one plan of care looked at did not fully document the progress of a pressure sore to enable staff to monitor the improvement or deterioration of the wound. The home does not employ an activities co-ordinator and although some social activities take place they are limited and the home would benefit from a more structured approach. A formal quality assurance processes should be developed, this should include palliative care training for nursing staff. This is an outstanding requirement from the last two inspections and a short period of time will be given to enable the proprietor to meet this standard. The manager should achieve NVQ level four in management. This is an outstanding requirement from the last two inspections and a short period of time will be given to enable the proprietor to meet this standard. The leaking roof should be repaired as soon as possible to enable the health, safety and wellbeing of the residents to be maintained. The storage of commode chairs in one of the bathrooms should be addressed to enable residents to use the bath. Some of these chairs require replacing, as they are broken. 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 Nursing & Residential Home DS0000059120.V257142.R01.S.doc Version 5.0 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 Outcomes Statutory Requirements Identified During the Inspection Meadow View Nursing & Residential Home DS0000059120.V257142.R01.S.doc Version 5.0 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 the following standard(s): These standards were assessed and met at the last inspection. EVIDENCE: Meadow View Nursing & Residential Home DS0000059120.V257142.R01.S.doc Version 5.0 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 the following standard(s): 7,8,9,10 Care plans in general at the home are detailed but one plan of care looked at needed more information with regard to the progress of a pressure sore. Staff members working at the home are aware of the needs of the residents. Medication is being properly managed to protect the residents living at the home. Residents are treated with dignity. EVIDENCE: Care plans for four residents were examined. The care plans at the home are detailed and identify areas of need such as hygiene, psychological needs, swallowing difficulties and tissue viability which states the type of mattress required and gives instruction to staff as to the prevention of pressure sores. Dental assessment forms, nutritional assessments and risk assessments for bed rails, risk of falls, maintaining a safe environment and moving and Meadow View Nursing & Residential Home DS0000059120.V257142.R01.S.doc Version 5.0 Page 10 handling are completed on all residents. Relatives had signed risk assessments. One care plan for a resident with pressure sores detailed what treatment was being given, how often the dressing required changing and recorded input from the district nursing service. However, the care plan did not describe the grade, size, colour and depth of the pressure sore to enable staff to assess the progress of the wound. Comments from residents included “staff are ok”, “staff are lovely”,“ I like living here” All residents were complimentary about the food. Staff were observed to speak to the residents in a courteous manner and were seen to knock on doors before entering bedrooms or bathrooms. Medication recording, management and storage were inspected. All medication administration records were completed correctly and medicines were stored securely. Meadow View Nursing & Residential Home DS0000059120.V257142.R01.S.doc Version 5.0 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,15 Social activities take place at the home but these are limited at present and are not recorded. Relatives are welcome at any time and residents have contact with the local community in which they live. Residents receive wholesome meals. EVIDENCE: Care staff organise the activities at present, as the home does not employ an activities organiser. Activities on offer are bingo, dominoes and indoor bowls, which are carried out by the care staff. The activities taking place are not recorded and one resident said they “get a bit fed up.” Activities do take place, however they are limited and the home would benefit from a more structured approach. Three ladies spoken with said that they liked getting their hair done and the hairdresser visits once weekly. Two residents were sat in the garden at the front of home enjoying a cigarette and staff were seen to take them cups of tea and biscuits. Meadow View Nursing & Residential Home DS0000059120.V257142.R01.S.doc Version 5.0 Page 12 A menu is in place, which offers choice and residents said that the food is good. Meadow View Nursing & Residential Home DS0000059120.V257142.R01.S.doc Version 5.0 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 The policies, procedures and management at the home protect the residents from abuse. Complaints at the home are dealt with in accordance with the company’s complaints policy and residents and relatives know who to raise concerns with. EVIDENCE: A policy on the protection of vulnerable adults is in place. Members of staff spoken with confirmed that they were aware of the policy. Staff have received training in adult protection and this was recorded in the staff training files. A copy of the complaints procedure is displayed in the entrance hall and the service users guide. One complaint has been made to the home since the last inspection. This has been dealt with appropriately. Residents and relatives spoken with said they have no complaints and were aware of whom to speak to if they were unhappy with any aspects of care. Meadow View Nursing & Residential Home DS0000059120.V257142.R01.S.doc Version 5.0 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,21,26 Some areas of the home require attention to ensure that residents live in a safe and well-maintained environment Some items of equipment need to be replaced to maintain the safety of the residents. The storage space within the home needs to be assessed to enable all bathrooms to be used by the residents. EVIDENCE: The home has been redecorating some bedrooms but at the present time this redecoration has had to be stopped as the roof at the home has been leaking. There is evidence of extensive water damage along the corridors and in some bedrooms. The proprietor has had some estimates on the cost of repair, however, work has not yet commenced. Meadow View Nursing & Residential Home DS0000059120.V257142.R01.S.doc Version 5.0 Page 15 Bedrooms are well personalised with ornaments and pictures brought in by the residents. The home was clean and free from odours on the day of inspection. One bathroom at the home had commode chairs stored making it difficult to use the bathroom. The manager said that the home had limited storage space. Some of the commode chairs were broken and need to be replaced. Meadow View Nursing & Residential Home DS0000059120.V257142.R01.S.doc Version 5.0 Page 16 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): 27,29 Residents’ benefit from a service that provides adequate staffing levels and well-informed and knowledgeable staff. EVIDENCE: The staffing numbers at the home are adequate to meet the needs of the residents. Trained nurses are on duty twenty fours hours a day supported by care staff. Duty rotas were seen and agreed staffing levels were being maintained. Staff spoken to were aware of the needs of the residents in their care. A number of staff had worked at the home for some time and had a good relationship with the residents. The staff were aware of the different personalities of the residents. The records of two recently appointed staff contained appropriate information to ensure that the residents are protected. Meadow View Nursing & Residential Home DS0000059120.V257142.R01.S.doc Version 5.0 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 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): 31,35 The management of the home maintains the safety of the residents living there. The manager needs to confirm her competence in her role by undertaking NVQ level 4 in management. EVIDENCE: The fire log was checked and staff training had taken place in fire safety procedures. The manager at the home is experienced and competent however she 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 Meadow View Nursing & Residential Home DS0000059120.V257142.R01.S.doc Version 5.0 Page 18 satisfaction. This is an outstanding requirement from the last two inspection reports. Residents’ monies are stored individually and records of accounts are stored on the computer. A printed copy is available for each resident. Meadow View Nursing & Residential Home DS0000059120.V257142.R01.S.doc Version 5.0 Page 19 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 2 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 x 14 x 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 2 x 2 x x x x 2 STAFFING Standard No Score 27 3 28 x 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 x 3 x x x x 3 Meadow View Nursing & Residential Home DS0000059120.V257142.R01.S.doc Version 5.0 Page 20 Are there any outstanding requirements from the last inspection? yes 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 relating to the management of pressure sores must include details about the grade, size, colour and depth of the pressure sore. The roof at the home must be repaired to maintain the health and safety of then residents. Suitable provision is made for storage of equipment. Broken commode chairs must be replaced. Timescale for action 31/10/05 2 3 4 5 OP19 OP22 OP22 OP31 23 23 23 18 31/12/05 31/12/05 31/12/05 6 OP33 24 The registered person ensure 30/11/05 that the manager undertake NVQ Level 4 in management (Timescale of 1/1/05 and 1/09/05 not met) The registered person must 30/11/05 ensure that an effective quality assurance system must be implemented (Timescale of 1/1/05 and 1/09/05 not met) Meadow View Nursing & Residential Home DS0000059120.V257142.R01.S.doc Version 5.0 Page 21 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 OP12 Good Practice Recommendations Social activities should be more structured. Meadow View Nursing & Residential Home DS0000059120.V257142.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Northwich Local Office 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 Nursing & Residential Home DS0000059120.V257142.R01.S.doc Version 5.0 Page 23 - 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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