Inspection on 06/06/06 for Meadow View Nursing & Residential Home

This inspection was carried out on 6th June 2006.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

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

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

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 Meadow View Nursing and Residential Home Finlay Avenue Penketh Warrington Cheshire WA5 2PN Lead Inspector John Mills Key Unannounced Inspection 6th June 2006 09:30 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.V290962.R01.S.doc Version 5.1 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.V290962.R01.S.doc Version 5.1 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.V290962.R01.S.doc Version 5.1 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 11th October 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.V290962.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Two regulatory inspectors conducted this unannounced site visit on 6th June 2006 over a period of six and a half hours. Feedback was given the following day to the manager and the owner of the home. Records were inspected and staff practice was observed. Discussion took place with residents, visitors and staff. A tour of the building was made during visit. The manager confirmed that the fees within this home are £444 pw for nursing service users and £316 pw for non-nursing. This information is made know to prospective clients on inquiry and confirmed within the formal contract of residency. Each of the six requirements made at the previous inspection have either been met or are in the process of being met. Additional requirements in relation to care planning, the management of medicines and the registration of a manager are made within this report. What the service does well: What has improved since the last inspection? Meadow View Nursing & Residential Home DS0000059120.V290962.R01.S.doc Version 5.1 Page 6 The new manager is developing a clear managerial role and starting to remove herself from the direct care role of a named nurse. Care plans continue to make sustained progress in their structure content and relevance to direct care practices. The employment of an activities co-ordinator has made significant changes to the daily routines of residents. The overall maintenance and decoration of the home, both communal areas and resident’s bedrooms is being progressed. The manager has developed and implemented a formal Quality Assurance system. A training programme and schedule has been developed and started to be implemented. 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 & Residential Home DS0000059120.V290962.R01.S.doc Version 5.1 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.V290962.R01.S.doc Version 5.1 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): 1,2,3,4 & 5 The quality rating for this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users and their relatives are given appropriate advice upon which to make decisions regarding accessing this service. The assessment of need completed before residents move into the home, to ascertain if their needs can be met, is being undertaken by the new manager of the service. This person was previously a senior nurse within the home and as such is suitably qualified and experienced to undertake this role. EVIDENCE: Meadow View does not provide intermediate care facilities and standard 6 is not applicable. Conversations with two visiting relatives confirmed that they had been provided with information about the home prior to making a decision regarding accessing this service. They also confirmed that they had been given an Meadow View Nursing & Residential Home DS0000059120.V290962.R01.S.doc Version 5.1 Page 9 opportunity to visit the home on their relatives’ behalf. They also confirmed that a standard contract of residency had been provided. Conversations with these relatives and with service users indicated that they were satisfied that the service was able to meet their needs and those of their relatives. On examination of the Statement of Purpose it was identified that it did not identify the present management structure neither did it include the range of qualifications held by staff. The care record belonging to a recently admitted resident contained detailed pre-admission assessments. This had been undertaken by the manager of the home and a standard social services assessment had been provided to the manager. Meadow View Nursing & Residential Home DS0000059120.V290962.R01.S.doc Version 5.1 Page 10 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 The quality rating for this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Care plans are generally 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 not always fully identified within the care plans. Greater consistency is need in the recording of the administration of medication EVIDENCE: The care records of four service users were examined and each contained detailed care plans that identified emotional, social and physical needs. There were inconsistencies in the development of one care plan where new needs had arisen, staff had not developed addition care plans in response to those changes. See Requirement No 1. Meadow View Nursing & Residential Home DS0000059120.V290962.R01.S.doc Version 5.1 Page 11 These plans were being regularly reviewed by senior staff including the present manager. The manager had not developed a process for auditing the evaluation of care plans care plans as a specific responsibility within her role as manager. See Recommendation No 1. The information contain in care plans for wound management lacked specific detail and clear instructions for nurses. This information is contained in evaluation documentation. See Requirement No 1. There was evidence to confirm that residents have continued access to and receive services from external health professionals. These include, Chiropodists, Dentist, Opticians, Nutritional/dietetic staff, Continence Advisors and Tissue Viability specialists. Medication is managed according to the home’s policy and procedures for receipt, storage and administration. There were absences in the regular signing of medication given or omitted. See Requirement No 2. The observed behaviour of staff towards residents and conversations with care staff evidenced an understanding of the principles of care. Residents were observed to be cared for with a high degree of respect, an understanding of their need for privacy and dignity. Meadow View Nursing & Residential Home DS0000059120.V290962.R01.S.doc Version 5.1 Page 12 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): 12,13,14 & 15 The quality rating for this outcome area is good. This judgement has been made using available evidence including a visit to this service. 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. EVIDENCE: The home now employs an activity co-ordinator who works 3 days each week from 9.00 – 2.00. There is a programme of planned activities organised around small groups of residents. Additional support continues to be provided by care staff. Relatives were seen to be visiting throughout the day, these visitors were able, if desired, to meet in private within residents bedrooms or in a quite part of the home. Residents confirmed that they were able to make choices within their daily routines, this included times of retiring t night and getting up in the morning, Meadow View Nursing & Residential Home DS0000059120.V290962.R01.S.doc Version 5.1 Page 13 where they took their meals and where the chose to spend their time during the day. Residents spoken with were positive about the food provided, describing a good range of choices and a high standard of catering. Specific dietary needs are catered for and staff were seen to assist frailer residents in a patient and supportive manner. Meadow View Nursing & Residential Home DS0000059120.V290962.R01.S.doc Version 5.1 Page 14 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 quality rating for this outcome area is good. This judgement has been made using available evidence including a visit to this service. 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 copy of the complaints procedure is displayed in the entrance hall and the service users guide. Three complaints have been made to the home since the last inspection. This has been dealt with appropriately and in accordance with the home’s policy and procedure. 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. 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 are to receive training in adult protection and this was recorded in the staff training record. Meadow View Nursing & Residential Home DS0000059120.V290962.R01.S.doc Version 5.1 Page 15 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): 19,23,24 & 26 The quality rating for this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a home that is safe and well maintained, there is a commitment to improve the appearance of the physical environment. Staff are aware of and capable of fulfilling their responsibilities in maintaining a safe environment. EVIDENCE: The tour of these premises evidenced that there has been a systematic programme of redecoration and refurbishment taking place since the previous inspection. On the day of this site visit the entrance hall was being re-papered. Bedrooms and corridors on the “A” unit have been redecorated and re-carpeted and the remaining areas of the home are scheduled for similar attention. Meadow View Nursing & Residential Home DS0000059120.V290962.R01.S.doc Version 5.1 Page 16 There are plans and programmes inn place to confirm the commitment to sustain this programme. See Requirement No 3 . Bedrooms viewed were personalised and included TVs and radios. There were no obvious odours evident throughout this visit, staff spoken with were aware of proper and safe procedures to manage soiled lined and control the risk of cross infection. There was suitable equipment to assist staff in this responsibility, these included a sluicing machine, appropriate clothing and facilities to assist safe disposal of linen materials and dressings. Meadow View Nursing & Residential Home DS0000059120.V290962.R01.S.doc Version 5.1 Page 17 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): 27,28,29 & 30 The quality rating for this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service users in this home benefit from a service that is provided through a team of care & nursing staff that is knowledgeable, motivated and that have access to a range of appropriate training opportunities. 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. Four staff were interviewed and confirmed their knowledge of the needs of service users, safe working practices, positive management and supervision and a commitment to ongoing training and development. A training record for 2006 and a training programme for the next year was provided by the manager to support this commitment. Newer members of staff had during the change of managers only received a formal induction and as yet no structured training programme. Meadow View Nursing & Residential Home DS0000059120.V290962.R01.S.doc Version 5.1 Page 18 Examination of staff records evidenced a robust and proper recruitment process, new members of staff are only appointed after a formal application has being received, two written references are obtained together with an enhanced disclosure from the Criminal Records Bureau. Meadow View Nursing & Residential Home DS0000059120.V290962.R01.S.doc Version 5.1 Page 19 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): 31,33,35,36,37 & 38 The quality rating for this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a well managed service providing them with a good degree of safety and security. EVIDENCE: The manager of the home is a qualified general nurse and has worked in the home as a senior nurse for more that 2 years. There is a stated commitment from the manager to commence her NVQ Level 4 in management in July 2006. The manager has also started the process of registration with CSCI. See Requirement No 4. Meadow View Nursing & Residential Home DS0000059120.V290962.R01.S.doc Version 5.1 Page 20 Throughout the day residents visitors and staff were observed to be interacting in a positive and open way. The relationship between staff both between peers and those of different grades was positive, respectful and supportive. The manager has continued to develop a Quality Assurance system using a Satisfaction Survey. The records of finances belonging to service users held by the home were viewed and found to be correct and in order. There is a structured process of formal supervision in place for all staff working within the home. The manager has in the newness of her role reviewed and re-written, where necessary, all the policies and procedures used within the home over the last two months. Records relating to safe working practices, maintenance of equipment and the recoding of all accidents are properly maintained. Meadow View Nursing & Residential Home DS0000059120.V290962.R01.S.doc Version 5.1 Page 21 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 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X 3 3 X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 3 3 3 Meadow View Nursing & Residential Home DS0000059120.V290962.R01.S.doc Version 5.1 Page 22 Are there any outstanding requirements from the last inspection? No 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 The registered person must ensure that care plans contain all information necessary to guide and direct care practices The registered person must ensure that all staff who administer medication record that procedure accurately on medication record sheets The registered person must ensure that the programme of re-decoration and refurbishment is progressed to its conclusion The registered person must ensure that the manager makes an application to register with CSCI Timescale for action 31/07/06 2 OP9 13 01/07/06 3 OP19 23 30/11/06 4 OP31 8 01/09/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Meadow View Nursing & Residential Home DS0000059120.V290962.R01.S.doc Version 5.1 Page 23 1 OP7 The registered person should develop a process to adequately audit the care plans of service users and their monthly reviews by nurses within the home. Meadow View Nursing & Residential Home DS0000059120.V290962.R01.S.doc Version 5.1 Page 24 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.V290962.R01.S.doc Version 5.1 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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