Please wait

Please note that the information on this website is now out of date. It is planned that we will update and relaunch, but for now is of historical interest only and we suggest you visit cqc.org.uk

Inspection on 22/09/06 for Meadow View Residential Home

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

This inspection was carried out on 22nd September 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 found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

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

What has improved since the last inspection?

Arrangements for the safe storage of service users medicines has been made. All of the required safety certificates are now available.

What the care home could do better:

CARE HOME ADULTS 18-65 Meadow View Residential Home 2 Kestrel Rise Halstead Essex CO9 2TU Lead Inspector Neal Cranmer Final Unannounced Inspection 22nd September 2006 09:30 Meadow View Residential Home DS0000062773.V302275.R01.S.doc Version 5.2 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 Residential Home DS0000062773.V302275.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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Meadow View Residential Home DS0000062773.V302275.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Meadow View Residential Home Address 2 Kestrel Rise Halstead Essex CO9 2TU 01787 479172 01787 472532 www.meadowviewres.co.uk 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) Miss Isabel Mutendadzamera Mrs Ayshea Jannette Hutchison Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Meadow View Residential Home DS0000062773.V302275.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Persons of either sex, under the age of 65 years, who require care by reason of a learning disability (not to exceed 3 persons) 21st February 2006 Date of last inspection Brief Description of the Service: The home is a detached three bedroom service set in a residential area of Halstead in Essex, close to local amenities and on a local bus route to the town centre. The home provides a service to people who have a learning disability. The home provides accommodation on two levels, with service users’ bedrooms all being on the first floor. The home benefits from a small-enclosed garden area. The fees for the home are £662.00 per week, and additional charges are made for the Following: • Chiropody • Hairdressing • Toiletries • DVDs • Cigarettes. This information was taken from the homes Pre-inspection questionnaire submitted. Meadow View Residential Home DS0000062773.V302275.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection to the home, the first for the inspection year 2006/2007, which took place over one day in September 2006, lasting 5.75 hours. The inspection took place in the company of both the registered provider and manager. At the time of the inspection two service users were in residence. The inspection process included: discussion with both service users, the proprietor and registered manager. A tour of the premises was undertaken, which included the communal areas and garden During the course of the inspection a range of documentary evidence was also sampled. On the day of the inspection twenty-one of the forty three standards were inspected, of these one was exceeded, fifteen were considered meet, three were nearly meet, two were major shortfalls. What the service does well: What has improved since the last inspection? Arrangements for the safe storage of service users medicines has been made. Meadow View Residential Home DS0000062773.V302275.R01.S.doc Version 5.2 Page 6 All of the required safety certificates are now available. What they could do better: • • The registered manager needs to be supported to undertake their N.V.Q level 4 in care. All staff must be provided with fire safety training as a matter of urgency. The home recruitment practice requires tightening up, to adequately safe guard service users. A process for reviewing the quality of the homes service provision needs to be developed. • • 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 Residential Home DS0000062773.V302275.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Meadow View Residential Home DS0000062773.V302275.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2. Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to the service. Service users are only admitted to the home following the completion of a comprehensive pre-admission needs assessment. EVIDENCE: Discussion took place with the registered manager about the home admission process. The admission assessment for the service users most recently admitted to the home was viewed, the assessment was well detailed covering the following areas: • Personal profile/contact points • Previous history • Clinical diagnosis • Dietary preferences • Personal hygiene needs • Educational needs • Family contact • Any identified behavioural difficulties. This pre admission assessment was then used to generate the service users plan of care. Meadow View Residential Home DS0000062773.V302275.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 &9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Service users needs and personal goals are reflected well in their care plans, which are generated from the assessment of need. Service users are supported by the care team to make decisions about their everyday lives. Service users are supported to take risks in their everyday lives, as part of developing an independent lifestyle. EVIDENCE: The care plan sampled was comprehensively detailed and as mentioned above had been generated from the homes own pre-admission assessment, the plan clearly identified the nature of need, it then went on to clearly and concisely identify the support that was required, by whom and when. Each service user has a designated key worker and co-key worker. The care plans were seen to have been developed alongside the service users, and the written records showed that they were regularly kept under review, daily records pertaining to the care plans were maintained clearly and concisely. Meadow View Residential Home DS0000062773.V302275.R01.S.doc Version 5.2 Page 10 One of the two service users residing at the home has an advocate, and the registered manager spoke of pursuing advocacy service for the other service user. Both service users have their own cash withdrawal cards and take responsibility with support for managing their own finances. Money held by the home on behalf of the service users is held in individual purses, which are kept in petty cash tins, which are kept in a locked filing cabinet. Records are kept of all service users financial transactions, and those checked on the day of the inspection were in order. Risk assessments sampled were well detailed, clearly identifying the nature of the risk, adverse effects and measurements in place to minimise the level of risk, review dates were set and attached to each assessment was a sheet to be signed of by each member of the care team to confirm their awareness. Risk assessments were in place for the following: • Accessing money • Accessing the kitchen • Bathing • Accessing stairs and steps • Consuming alcohol • Smoking The manager provided evidence of information that had been given to staff on risk assessing. The home has in place a policy for responding and dealing with unexplained absences. Meadow View Residential Home DS0000062773.V302275.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 &17. Quality in this outcome area was good. This judgement has been made using available evidence, including a visit to the service. Service users are supported to take part in activities that are age and peer appropriate. Discussion with service users indicated that they are supported to take part in community based activities. Service users are well supported to maintain links with their families. The daily routines of the home are designed so as to promote independence; service users had free access to all areas of the home. Service users are provided with a healthy and wholesome diet, and are actively involved in the planning preparation and purchasing of food stocks. EVIDENCE: During discussion with one service user about educational and occupational activities they spoke of attending college two full days a week where they join in a class on skills for live, the same service user also spoke of attending cookery classes and a horticultural class, the service user was seen and spoken to just prior to leaving to attend one of their college classes. Meadow View Residential Home DS0000062773.V302275.R01.S.doc Version 5.2 Page 12 The other service user spoken with spoke of their intention to commence a course at the local college on motor mechanics (something which they appeared to be very keen on) however to date the course has not been able to commence due to lack of numbers. Both service users spoken with spoke of accessing the local community for a range of community-based activities, some of which are listed below: • Shopping • Visiting the local pub • Going for meals out • Going swimming • Trips to the cinema • Going bowling. The home has access to its own people carrier. At present service users are not accessing public transport, although in discussion with the registered manager agreement was reached that there is no real reason why they could not do so, the home is situated close to a bus route. The home has an open door policy on the receiving of visitors, and both service users spoke of being free to choose where they received their visitors, both service users are supported to maintain links with their close families. The daily routines of the home are designed to enable service users to maximise their independence, service users were seen and heard being supported to do things for themselves with encouragement e.g. make drinks, prepare snacks. Service users were seen to have unrestricted access to all areas of the home, and interactions between staff and service users were seen and heard to be positive and respectful. Menus continue to be planned week by week in consultation with service users, menus are provided in alternative formats as are shopping lists, service users spoke of assisting with food shopping, and of helping to plan the shopping list, a copy of a list one of the service users had made was shown to the inspector, the list was very comprehensive and showed a varied and quite nutritious choice. The home works proactively with service users to facilitate ways in which to enable them to take the lead in food preparation. Meadow View Residential Home DS0000062773.V302275.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 &20. Quality in this outcome area was good. This judgement has been made using available evidence, including a visit to the service. Service users health care needs are well met, the needs of the service users are such that they require little or no assistance with personal care. Medication procedures are safe and well managed. EVIDENCE: Each service user is registered with a General practitioner, records showed that service users healthcare needs are regularly kept under review, and included details of appointments, outcomes of appointment, any follow up action that maybe required following the appointment and the signature of the member of staff supporting the service user. Records showed that the following healthcare professionals were providing input into the home: • General practitioners • Dentists • Chiropodists • Opticians. Records showed that service users are supported to attend outpatient appointments. Meadow View Residential Home DS0000062773.V302275.R01.S.doc Version 5.2 Page 14 All medication is dispensed via a Measured Dosage System (MDS) for which all staff barring one have been trained, the training for this member of staff has been scheduled. The home does not hold any medicines which full with the controlled medicines act. Medication not used is returned to pharmacy via a returns book. Medication records examined were found to be in order; each file had a photograph of each member of staff trained with a sample of their signature. Medication is currently stored in a locked filing cabinet, although individual cabinets are in the process of being purchased and fitted in each service users room. Meadow View Residential Home DS0000062773.V302275.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 &23. Quality in this outcome area was good. This judgement has been made using available evidence, including a visit to the service. Service users are supported to make complaints, and the home responds to complaints made following the appropriate procedures. The homes procedures for protecting service users from harm and or abuse a robust. EVIDENCE: The home has a Complaints Procedure which is comprehensively detailed, there have been no complaints made in respect of the service since the previous inspection, service users appear well versed in how and who to complain too, should they have any concerns about any aspect of their care delivery. Since the previous inspection there has been the need for one adult protection referral, this was well managed, with all appropriate actions being taken with quick timescales. All staff working at the home have been trained in Adult protection. Meadow View Residential Home DS0000062773.V302275.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 &30. Quality in this outcome area was good. This judgement has been made using available evidence, including a visit to the service. Service users are supported in an environment that is homely, comfortable and safe. The home is kept clean, and was free of any unpleasant smells or odours. EVIDENCE: The premises is in keeping with the local community, being situated just outside the town and the local amenities, close to a bus route. Furnishings and fittings in the home were modern and were of a good quality, the home is laid out comfortably and was bright and airy, on the day of the inspection the home was free of any unpleasant odours. The laundry facility is situated immediately off the kitchen, however the home has in place a policy for dealing with dirty laundry, which legates the need for soiled or dirty laundry to be taken through the kitchen area. The homes washing is done at night. Staff are provided with Personal protective equipment e.g. gloves/aprons. The laundry has hand-washing facilities and the walls and floors are semipermeable, and therefore easily cleanable. Meadow View Residential Home DS0000062773.V302275.R01.S.doc Version 5.2 Page 17 Meadow View Residential Home DS0000062773.V302275.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 &35. Quality in this outcome area was poor. This judgement has been made using available evidence, including a visit to the service. Service users are supported by a team of staff who knowledgeable about their needs. The homes recruitment practice requires tightening up to ensure that it adequately safe guards service users interests. Although all staff had received induction, gaps noted in the training of staff were such that they could place both service users and staff at risk of potential harm. EVIDENCE: The home employs five care staff, two of who are qualified at N.V.Q level 2 in care, in addition one member of the care team holds a Diploma in Health and Social Care. The home does not employ any carers under the age of eighteen. Three staff files were sampled in respect of the homes recruitment practice, the following observations were made: • Two of the files did not have copies of the application form on file • Only one of the three files had two references on file, each of the other two only had one. Meadow View Residential Home DS0000062773.V302275.R01.S.doc Version 5.2 Page 19 Other than the above two points the staff employment records were in order, the homes recruitment practice requires some tightening up to ensure that it adequately protects service users. All of the staff files sampled showed that staff had received induction, and there was evidence of other relevant training having been undertaken by staff, however there was no record of any of the staff having received any level of training in fire awareness, this was discussed with both the registered provider and manager, and largely came down to the cost burden for a small home, whilst this was recognised as a difficulty the registered person never the less must make provision for staff to receive training as a matter of urgency in this important area, to safe guard the needs of both service users and staff. Meadow View Residential Home DS0000062773.V302275.R01.S.doc Version 5.2 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 &42. Quality in this outcome area was poor. This judgement has been made using available evidence, including a visit to the service. The home is managed by an experienced and competent manager, who holds an appropriate management qualification. The home does not yet have in place a process for reviewing and keeping under review the quality of its service provision, which is underpinned by the views of service users. The health and safety of service users is potentially in jeopardy due to the care staff having not received any fire safety training. EVIDENCE: The registered manager has significant previous experience in the care sector, and holds the N.V.Q level 4 registered managers award, although not yet the level 4 care award, this was identified as a further need during discussion with both the provider and manager. The registered manager has overall responsibility for the day-to-day running of the home. Meadow View Residential Home DS0000062773.V302275.R01.S.doc Version 5.2 Page 21 The home does not have in place a formal process for reviewing and keeping under review the quality of its service provision, which is underpinned by the views of service users. Advocates are involved in the home, and weekly key worker meetings are held, both provider and manager are aware of the need to develop a process, and have given a commitment to address this matter. The following safety certificates were viewed in respect of the homes safe working practices: • Gas installation certificate • Electrical installation certificate • Record of inspection for smoke detectors. All of which were in order. The home has four persons trained in first aid. It was as mentioned before of particular concern that staff have not had any training in fire awareness. Meadow View Residential Home DS0000062773.V302275.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 2 35 1 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 2 X 2 X X 1 X Meadow View Residential Home DS0000062773.V302275.R01.S.doc Version 5.2 Page 23 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 YA34 Regulation 19, (Schedule 2). Requirement The registered person must ensure that in respect of persons working at the home all of the documentary evidence specified under Regulation 19, Schedule 2 of the Care Homes Regulations is maintained. The registered person must ensure that all staff receive the appropriate training necessary to enable them to carry out their roles safely and effectively. (this relates specifically to the need for all staff to receive fire safety training). The responsible person must ensure that staff receive the necessary training to enable them to carry out their roles effectively. This relates specifically to the need for the registered manager to be qualified at NVQ Level 4 in care. The previous timescale set of the 31/08/06 was not met. The registered person must make provision for the home to have a process by which to DS0000062773.V302275.R01.S.doc Timescale for action 31/12/06 2. YA35 18 (i) 30/11/06 2. YA37 18 (ci) 31/12/06 3. YA39 24 31/12/06 Meadow View Residential Home Version 5.2 Page 24 review and keep under review the quality of the home’s service provision. The previous timescale set of the 31/08/06 was not met. 4. YA42 23 The registered person must make provision to ensure that safe working practices at the home are maintained. This relates specifically to the need to ensure that all staff working at the home receive fire safety training. 30/11/06 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 Residential Home DS0000062773.V302275.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Colchester Local Office 1st Floor, Fairfax House Causton Road Colchester Essex CO1 1RJ 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 Residential Home DS0000062773.V302275.R01.S.doc Version 5.2 Page 26 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!