Inspection on 16/10/07 for Meadow View Nursing & Residential Home

This inspection was carried out on 16th October 2007.

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 but made no statutory requirements on the home.

Other inspections for this house

Meadow View Nursing &... 12/08/08

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

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

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

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 Nursing & Residential Home Finlay Avenue Penketh Warrington Cheshire WA5 2PN Lead Inspector June Shimmin Unannounced Inspection 16 October 2007 10:00 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.V353080.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 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.V353080.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Meadow View Nursing & Residential Home Address Finlay Avenue Penketh Warrington Cheshire WA5 2PN 01925 791180 01925 728730 bsamuel@ashberry.net 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 vacant post 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.V353080.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home with nursing: Code N, to people of the following gender: Either. Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category: Code OP The maximum number of people who can be accommodated is: 41. Date of last inspection 12th September 2007 Brief Description of the Service: Meadowview provides accommodation and care for 41 older people. It is in Penketh, a suburb of Warrington in Cheshire. The home is on a main bus route and close to shops, churches and a library. The home is a single storey building with 41 single rooms, lounge, two dining areas, conservatory, laundry and hairdressing salon. There is a small secluded garden at the front of the building and several smaller sitting out areas around the building. The weekly fee payable at the home ranges from £326 to £414.41. Further details regarding fees are available from the manager. Meadow View Nursing & Residential Home DS0000059120.V353080.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced visit took place on the 16 October 2007 and lasted six hours. A CSCI pharmacy inspector accompanied the lead inspector. Four short, focussed inspections have been carried out at this home since the last main inspection. One was to follow up the progress of the home towards meeting requirements. Two were to follow up issues relating to medication and one was a thematic inspection. This thematic inspection looked at the quality of care people with dementia experience when living in care homes, focussing on ‘dignity’ as an important part of people’s quality of life. Because people with dementia are not always able to tell us about their experiences, we used a formal way to observe people in the thematic inspection to help us understand. We call this the Short Observational Framework for Inspection (SOFI). This involved us observing 5 people who live in the home for 2 hours and recording their experiences at regular intervals. This included their state of well being, and how they interacted with staff members, other people who use services, and the environment. The visits were just one part of the inspection. Other information received about the home was also looked at. Before this visit the home manager had completed a questionnaire to provide up to date information about Meadowview. CSCI questionnaires were also given and sent to people living in the home, families, and health and social care professionals such as social workers and doctors to find out their views. During the visit various records and the premises were looked at. A number of people who live at the home and their relatives were spoken with and they gave their views about Meadowview. What the service does well: Staff working at Meadowview are highly regarded. A relative wrote, “they have some lovely staff” and a doctor, “compared with many homes we have no problem with them.” People have their needs assessed before moving into the home so that they know their needs can be met at the home. People are given information about the home so that they know what facilities the home will provide. Meadow View Nursing & Residential Home DS0000059120.V353080.R01.S.doc Version 5.2 Page 6 Nursing staff refer people to a number of health professionals for further advice regarding their care to make sure their health care needs are met properly. The standard of catering is good with plenty of variety so that people are well nourished. Meadowview is free from odours and measures are in place so any potential infection is controlled. Safe systems are in place to make sure that people’s money is managed properly. What has improved since the last inspection? What they could do better: Care plans and risk assessments should cover all identified needs so that people know they are receiving the level of care they need. Medicine management needs urgent improvement so that people living in the home receive their medicines safely as prescribed. More activities need to be provided so that all people living in the home have access to social activities which meet their needs. One relative commented, “the residents need to be stimulated more often”. All staff should undertake training in adult protection so that they know how to recognise abuse and what to do if they suspect someone is being abused. Senior management of the organisation should visit the home every month to monitor how it is performing and give guidance to the manager about any areas that need to be improved. All people working at the home should undergo training in fire safety and fire drills so that they know what to do in the case of a fire. Meadow View Nursing & Residential Home DS0000059120.V353080.R01.S.doc Version 5.2 Page 7 Staff should undertake training on person centred care so that care is not task orientated and people receive care that is tailored to their individual needs. Various improvements should be carried out so that the home provides a comfortable and pleasant living environment for people living there. Special consideration should be given to monitoring the noise levels in communal areas so that people can enjoy areas of the home that are quiet other than going to their own bedroom. All necessary documentation relating to recruitment should be obtained so that people living in the home are protected from possible harm or poor practice. 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. The summary of this inspection report can be made available in other formats on request. Meadow View Nursing & Residential Home DS0000059120.V353080.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Meadow View Nursing & Residential Home DS0000059120.V353080.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Meadowview gives people information so that they can decide if the home will meet their needs. An assessment of people’s needs is carried out before they move into the home to make sure their needs can be met there. EVIDENCE: People are given enough information to help them decide if the home will meet their needs. Information given to people about the home was person-centred in content and referred to people as individuals with specific wishes and choices. The guide also stated that the person’s privacy, dignity and the right to confidentiality would be respected. There was a reference to advocacy services if needed. During the thematic inspection the initial assessments of two people were seen. There was very little information about the person’s life history, social care needs and significant events in their lives which might have an impact on Meadow View Nursing & Residential Home DS0000059120.V353080.R01.S.doc Version 5.2 Page 10 their future care. The manager said that they were hoping to introduce life histories and acknowledged the importance of this information in the care of people with or without dementia. During the inspection visit the assessment of someone admitted to the home as an emergency was seen. There was sufficient information about the person’s physical care needs but little about the person’s life history or social care needs. Meadowview does not provide intermediate care so standard 6 does not apply. Meadow View Nursing & Residential Home DS0000059120.V353080.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Records and care practices are inconsistent so people living in the home may not be provided with appropriate care and treatment. Medicines are not handled properly so the health of people who live at the home is being put at risk. EVIDENCE: The care plans for three people who live at the home were looked at. For one person there were only two care plans and no risk assessments. There were no care plans for a number of identified needs so that staff might be unaware of the care to be provided to this person or of any risks relating to their care. The actions identified to be taken in both plans indicated that there was insufficient understanding of appropriate approaches to manage care. For instance, one plan said that the person was confused but did not detail how this presented and what actions should be taken by staff to minimise the impact of this confusion. The other plan referred to the person being vocally and physically aggressive but the care plan did not identify what actions should Meadow View Nursing & Residential Home DS0000059120.V353080.R01.S.doc Version 5.2 Page 12 be taken to manage this behaviour. There was a reference in one care plan to the privacy and dignity of the person. Neither care plan referred to the person’s social needs or made the link between stimulation and managing behaviour and preventing boredom and isolation. There was also no reference to choice in the care plan or of people’s preferences in relation to various aspects of their daily lives such as time of getting up or going to bed or where or how they preferred to spend their day. There are company procedures for managing medicines. The findings of this inspection show that staff are not following them. Medicines records were poor. There was a list of staff who are authorised to give medicines that was not up to date. When no printed instructions were supplied hand written records made by staff were not always clear and complete. Some records had been made carelessly; for example, a resident’s co-codamol painkillers were packed in twos in the blister system. If only one tablet was given the record of the wasted tablet was recorded paracetamol. Also there was a record of giving morphine on the reverse side of the printed record with no explanation. There were records entered on the wrong date; some had been corrected by adding arrows but these were not all clear. In the records of giving medicines there were 29 unexplained gaps and some examples of using the open omit code “F” without the reason the medicine was not given. When staff were given the discretion to give doses of medicines according to need (like painkillers and laxatives) the dose given was not recorded. Also records of using thickeners were meaningless, recorded four times a day when in practice they are used far more frequently. When giving residents their medicines staff did not take enough care. For example, on seven records of giving antibiotic courses the quantity recorded given did not agree with the amount supplied. This may result in the infection not clearing up properly. Residents prescribed blood-thinning medicines were not always given the correct dose. One resident was prescribed a liquid sedative medicine. More of this liquid had been used than had been recorded as given. Another resident was being given only three doses a day of a painkiller prescribed four times a day. The time to give one resident’s afternoon dose of a water tablet had been changed from midday to 22:00 hours. This medicine is active in the body for 6 hours and may have caused the resident to need the toilet into the early hours of the morning. Another resident had a note that co-codamol painkillers were to be reviewed as a stronger medicine was required. Then the co- codamol was recorded as out of stock and homely remedy paracetamol, a weaker painkiller, was given. There were no problems with the handling and recording of controlled drugs. Meadow View Nursing & Residential Home DS0000059120.V353080.R01.S.doc Version 5.2 Page 13 The room used to store medicines was not well organised. Heavy boxes of thickeners were stored above head height. There were a few items that were old or date expired and staff could not easily find medicines they needed for residents. There were six oxygen cylinders. Only one resident was prescribed oxygen. There was a pile of medicines that were reported to be waste. The records of waste medicines were not dated or clear. Meadow View Nursing & Residential Home DS0000059120.V353080.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The limited provision of social and leisure activities means that some people are at risk of not being stimulated and becoming socially isolated. EVIDENCE: In the last month a person has been employed to provide activities at the home. The manager provided a diary of these activities, which indicated that the activity coordinator works three days a week. There is good evidence that some people are receiving one to one quality time with the activity coordinator but this does not include all people living in the home because of lack of available hours. Examples of group activities include film shows, card and ball games and gentle exercise to music. The activity coordinator has also set up a shop so that people can purchase small items independently without having to go to a local shop or request items from family or visitors. The activity coordinator has also started to collect objects for a memory box for several people so that it will help them remember significant events in their lives. She has started to compile life Meadow View Nursing & Residential Home DS0000059120.V353080.R01.S.doc Version 5.2 Page 15 histories for people so that staff will have more in-depth knowledge about the person they are caring for. Staff at the home also organise seasonal celebrations such as Bonfire night and a fair was held in the summer to raise funds for the home. The home produces a newsletter and a copy of the October newsletter was pinned to the notice board. There was no arranged social activity on the day of the inspection. A relative commented about the lack of activities in the home, “more activities as there never seems to be anything going on, just people sat around”. During the thematic inspection there were three TV sets on in the main lounge areas making noise levels quite high. At the follow up only one TV set was on but music was playing quite loudly so it would be difficult to have a conversation with someone else in the main lounge area. Relatives said that they were made to feel welcome by staff and that the quality and variety of meals was good. During the thematic inspection it was noted that the lunch was unhurried. There was evidence that people were offered a choice of meal and staff knew what people wanted to eat. There were enough care staff available to help people who were unable to feed themselves and this assistance was given in a manner that preserved the dignity of people living in the home. People were encouraged to feed themselves wherever possible and plate guards were provided so that food would not slide off the plate. Care plans did not indicate whether people had choice in their daily lives. For instance, there was no reference to people’s choices about where they spent their day, what they preferred to wear or eat and their previous lifestyle so that care was not person centred or tailored to the individual. The manager wrote that people of differing faiths are given the opportunity to practice their chosen religion. A local minister visits regularly for a service and priests visit to provide Holy Communion. Meadow View Nursing & Residential Home DS0000059120.V353080.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Although Meadowview has a complaints procedure, a lack of training in adult protection may put people at risk of harm if staff do not take the right actions. EVIDENCE: Meadowview has a complaints procedure, which is displayed in the reception area of the home. Relatives said they were aware of the procedure and would contact the manager or a senior staff member if they had any concerns. However, a review of complaints received by the manager indicated that at least one complaint should have been referred to Social Services under adult protection procedures. The manager confirmed that although she had undertaken training in adult protection most staff had not done so. This may put people living in the home at risk if staff do not understand what constitutes abusive behaviour. Since the inspection visit a complaint has been received by the CSCI about contracts and the manager has been asked to supply the CSCI with a response to this complaint. Meadow View Nursing & Residential Home DS0000059120.V353080.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 22 and 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Meadowview is well maintained but a lack of quiet space and outside spaces for people to sit may adversely affect people’s quality of life. EVIDENCE: The manager said that a number of improvements have been made to the building since the last inspection. The reception area, lounge and dining room have been redecorated and there is new flooring in these areas. All corridors have been redecorated and new flooring is to be provided in the corridors. There are three new armchairs. During a tour of the building no odours were noticed and effective measures are in place to control the possible spread of infection in the home. It was noticed however, that apart from the small garden at the entrance to the home all other garden areas were overgrown, littered with varying degrees Meadow View Nursing & Residential Home DS0000059120.V353080.R01.S.doc Version 5.2 Page 18 of rubbish and were therefore not pleasant places for people living in the home to use. Meadowview does not have a gardener. The manager had received one complaint about the decoration of the home. Internally there is limited space for people seeking somewhere quiet to sit. One relative commented that people either had to go their own room or the dining room, which is interconnected with the three lounges. The manager said that a grant had been received and that the money was to be used to build a conservatory, which would hopefully provide a quiet area. During a tour of the home it was also noted that there was limited storage space so that bathrooms were cluttered with a variety of equipment. A number of armchairs were quite shabby in appearance. One person commented about a lack of showers but the manager wrote that there are plans to convert an existing bathroom into a shower room. Meadow View Nursing & Residential Home DS0000059120.V353080.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Staffing levels appear to be adequate and recruitment practices are generally robust but not all staff have received relevant training so that people may not be receiving care from staff with sufficient knowledge and skills. EVIDENCE: Although staffing levels appeared adequate during the inspection written feedback from one relative indicated that there may not always be enough staff on duty to meet the needs of all people living in the home. The recruitment records of two staff members were seen. In one case these were satisfactory but for one person there was only one reference available and no evidence of previous qualifications that the person claimed on the application form to have achieved. This means that people may not be protected from possible poor practice as recruitment procedures have not been sufficiently thorough. Only four care staff have achieved NVQ 2 in care and a further three staff are working towards this award. This means that not many care staff may have sufficient knowledge or skills to care for people. During the thematic inspection it was noticed that many of the interactions between staff and people living in the home were task orientated so that people’s physical care Meadow View Nursing & Residential Home DS0000059120.V353080.R01.S.doc Version 5.2 Page 20 needs were being met but there was little social interaction. The feedback from relatives was positive and comments such as, “the home has some very good staff” were made. Meadow View Nursing & Residential Home DS0000059120.V353080.R01.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36 and 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home is quite well managed but some issues need to be addressed so that people living in the home are safe. EVIDENCE: The manager is a registered nurse and has eighteen years of experience in care of older people. She has worked at the home for eighteen months and has been acting manager for three months. She is well respected by staff and showed that she is keen and enthusiastic about improving standards at the home. The manager is hoping to start the registered manager’s award so that she will have a qualification that is relevant to her role. Meadow View Nursing & Residential Home DS0000059120.V353080.R01.S.doc Version 5.2 Page 22 A clinical lead nurse has also been appointed to support the manager in her management role and ensure that she has sufficient time to devote to this role. However, this person has not yet started working at the home. The manager has started the process to become registered with the CSCI. A safe system is in place to ensure that small amounts of money brought into the home for relatives are well managed. Visits by senior management members have not always been carried out every month as required by law so that quality assurance mechanisms are not sufficiently robust. The Director of Operations wrote in the April 2007 visit that issues relating to medication would be followed up within three weeks but there were no further records to show if this happened. An issue that should have been reported to the CSCI was not communicated so that matters adversely affecting the wellbeing of people in the home were not made known to the CSCI. The manager completed written information about the home before the inspection. However, this was only partially completed in relation to maintenance issues and the manager was unsure of the whereabouts of some of the documentation as a result of the changeover from the previous manager. Documents relating to the testing of portable electrical appliances and fire alarm and emergency lighting servicing were seen and were up to date. A fire risk assessment had been reviewed in August 2007. However, as there was not a training matrix it was difficult to establish if staff had undertaken mandatory training in various subjects without going through individual training files. The manager acknowledged that no staff had received supervision so that people may not receive the guidance they need to perform their role. There was no evidence of recent training in fire safety and although fire drills had been held monthly until May 2007 none had been held since. This means that people living in the home may not be safe. There was only one record of the emergency lighting being tested in September 2007. The records of several staff members indicated that they had not attended recent updates in safe moving and handling so that people are put at risk of unsafe moving procedures. The manager said that several staff were attending a course arranged by social services and that a further training course was to be arranged for the end of November 2007. Meadow View Nursing & Residential Home DS0000059120.V353080.R01.S.doc Version 5.2 Page 23 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 3 X 2 X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 1 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 2 2 X 2 X X X 3 STAFFING Standard No Score 27 3 28 2 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 X 3 2 X 2 Meadow View Nursing & Residential Home DS0000059120.V353080.R01.S.doc Version 5.2 Page 24 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 OP9 Regulation 13(2) Requirement Action must be taken to ensure that the receipt, disposal and administration of medicines are documented by clear, contemporaneously made, signed and dated records. (Previous timescales of 01/07/06, 07/04/07 and 18/04/07 not met.) Action must be taken to ensure that medicines are safely administered to the residents by checking that the doctor’s directions are clearly explained on the records and that staff are rigorously following those directions. Steps must be taken to ensure the safekeeping and safe handling of medicines by reorganising the medicine storage room so that old and unfit items are disposed of and that residents are not left without medicines because they cannot be found. All staff must undertake training in adult protection so that they can recognise abuse and know DS0000059120.V353080.R01.S.doc Timescale for action 17/10/07 2 OP9 13(2) 17/10/07 3 OP9 13(2) 31/10/07 4 OP18 13(6) 31/10/07 Meadow View Nursing & Residential Home Version 5.2 Page 25 5 OP30 18(1)(a) 6 OP33 26 7 OP38 23(4)(e) what to do about it. Action must be taken to ensure that staff who handle medicines are competent to do so by regular training and supervision. Monthly visits must be made by a representative of the registered provider to monitor standards of care at the home. All people working in the home must take part in fire drills at least twice a year so that everyone in the home is protected if a fire breaks out. 31/10/07 31/10/07 31/10/07 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 OP3 Good Practice Recommendations Assessments should include information about a person’s current and previous social, religious and cultural needs together with details of their family and social relationships so that carers can understand the person’s unique life history in order to provide sensitive and appropriate care. Care plans for communication and aggression should include effective strategies for the management of these needs so that people receive appropriate care. Care plans should include the social and spiritual care needs of residents so that these needs are identified and met. Care plans should be provided for all identified needs so that people receive appropriate care. Risk assessments should be provided for all identified care needs so that people are protected and receive the care they need. The individual social care needs of people living in the home should be recorded together with activities they have taken part in so that the home can demonstrate that their social care needs have been identified and met. Evidence should be recorded of people’s preferences and choices in relation to their daily lives to make sure that the DS0000059120.V353080.R01.S.doc Version 5.2 Page 26 2 3 4 5. 6 OP7 OP7 OP7 OP7 OP12 7 OP14 Meadow View Nursing & Residential Home 8 9 10 OP19 OP20 OP22 11 12 13 14 15 16 OP28 OP29 OP30 OP36 OP38 OP38 care people receive is person-centred. The external areas of the home should be improved so that people can enjoy the gardens. There should be a review of the way shared living spaces are used so that people can enjoy social interaction of their choice without the interference of excessive noise. Items should not be stored in bathrooms and the provision of storage space should be reviewed so that people living in the home have easy access to toilets and bathrooms at all times. A minimum of 50 of care staff should achieve NVQ 2 so that they have the knowledge and skills to perform their role. There should be two references on file for all staff and evidence of qualifications achieved. Staff should be given training in dementia and the management of challenging behaviour so that they can manage the care of all people living in the home. Care staff should receive formal recorded supervision at least six times a year so that they are given guidance and support in their role as a carer. All staff working at the home should undertake an annual refresher training session in fire safety so that people in the home are protected. All staff working in the home should undertake an annual refresher training session in safe moving and handling so that people being moved are safe from possible injury. Meadow View Nursing & Residential Home DS0000059120.V353080.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Northwich Local Office Unit D Off Rudheath Way Gadbrook Park Northwich CW9 7LT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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. 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