CARE HOMES FOR OLDER PEOPLE
MEADOWBANK 44 Braywick Road Maidenhead Berkshire SL6 1DA Lead Inspector
Katy Brown Unannounced 8 July 2005 @ 11:30 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. MEADOWBANK H52-H01 S11310 Meadowbank V234121 080705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION
Name of service Meadowbank Address 44 Braywick Road Maidenhead Berkshire SL6 1DA 01628 781186 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Meadowbank Care Home Limited Mrs Caroline Li Care Home 16 Category(ies) of Older Person OP registration, with number of places MEADOWBANK H52-H01 S11310 Meadowbank V234121 080705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: None Date of last inspection 04/03/05 Brief Description of the Service: Meadowbank cares for 16 older people. It is set in a residential area close to the train station, local amenities and the town centre. The home is on two floors and there is a passenger lift in place. There is a variety of aids and adaptations around the building to allow residents to move about more independently and there is a spacious garden that the residents can, and do use. The home has fourteen single bedrooms and one shared room. There are five bedrooms that have shower and toilet en-suite facilities. There are three toilets and one bathroom on the ground floor and two toilets and bathrooms on the first floor. MEADOWBANK H52-H01 S11310 Meadowbank V234121 080705 Stage 4.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection took place over five hours. There have been no additional visits made to the home since the last inspection. A tour of the premises took place and staff records, residents’ care records and health and safety records were inspected. Four of the staff on duty, eight of the sixteen residents, and two visitors were spoken to. What the service does well: What has improved since the last inspection?
There is a board in the lounge area that displays the day and date and also the lunch menu for the day. This is in large print, to enable the residents to read and understand it more clearly.
MEADOWBANK H52-H01 S11310 Meadowbank V234121 080705 Stage 4.doc Version 1.40 Page 6 There is also a poster that tells the residents, who is the senior member of staff that is in charge of the home during the morning, afternoon and evening shifts and it also says who is the named person responsible for first aid during the shift. The amount of training provided to staff has increased, which will ensure that the residents’ receive a good level of care, and all staff receive supervision to enable them to be clear about the things they are doing. 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. MEADOWBANK H52-H01 S11310 Meadowbank V234121 080705 Stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection MEADOWBANK H52-H01 S11310 Meadowbank V234121 080705 Stage 4.doc Version 1.40 Page 8 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 2, 3, 4, and 5 Significant progress has been made to improve the admission and care planning process for residents’ living at the home. This now gives residents greater assurance that their care needs will be met. EVIDENCE: Two residents’ that were spoken to said that they were provided with an opportunity to visit the home prior to their admission and that a representative from the home visited them to discuss their needs. They had been given a copy of the service users guide, which informed them of the services provided and information about the terms and conditions of the home. Individual records are kept for each resident and an inspection of the records for four residents, confirmed that they had completed care needs assessments in place. Two relatives that were spoken to confirmed that they had been involved in their relative’s admission process. MEADOWBANK H52-H01 S11310 Meadowbank V234121 080705 Stage 4.doc Version 1.40 Page 9 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7 and 9 The residents health, personal and social care needs are clearly identified and the residents that take medication are protected by the homes policies and procedures and care practices. EVIDENCE: Individual plans of care are available for all the residents. The plans of care for four residents’ living at the home were detailed and contained information about their healthcare needs, dietary requirements, personal care needs, likes and dislikes and hobbies and interests. It was noted however; that not all the staff keep a record of the outcome of health related visits. This makes it difficult to track, whether all of the identified health needs of the residents are being met. Discussion with the residents’ and their visitors indicated that the needs of the residents were being met and clear plans and guidance for managing risks are in place. The staff at the home that administer medication to the residents have all received training and medication administration policies and procedures are in place to provide support to staff. The pharmacist has recently visited the home and raised concern at the number of errors found on the medication
MEADOWBANK H52-H01 S11310 Meadowbank V234121 080705 Stage 4.doc Version 1.40 Page 10 administration record. The manager has addressed these concerns with the staff. MEADOWBANK H52-H01 S11310 Meadowbank V234121 080705 Stage 4.doc Version 1.40 Page 11 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 15 The menu planning process reflects the preferred choices of the residents and meals provided at the home are varied, well balanced and nutritious. EVIDENCE: Residents that were spoken to said that the food at the home tastes delicious and that there is always enough to eat. Two choices of meals are on the menu and the cook will make an alternative if requested. There is a notice board in the lounge area that informs the residents of what day and date it is and also what the choices of meal are. The residents’ said that their preferred meals are included in the menu planning process and that a vegetarian option is always available. The residents said that they could eat their meals in the dining room, the lounge or their own rooms. One resident said that sometimes they get too much food to eat. The residents are provided with beverages throughout the day and sweets and fresh fruit are available in the lounge area. MEADOWBANK H52-H01 S11310 Meadowbank V234121 080705 Stage 4.doc Version 1.40 Page 12 MEADOWBANK H52-H01 S11310 Meadowbank V234121 080705 Stage 4.doc Version 1.40 Page 13 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 Residents and relatives are confident that their complaints will be taken seriously and investigated properly. EVIDENCE: Residents and relatives that were spoken to said that although they had not made a complaint, they would feel comfortable if the need arose. They said that they believed that their complaint would be taken seriously. Four residents said, “I know that if we made a complaint, the manager would listen to us and make changes.” All the residents have a copy of the complaints procedure and the staff keep a record of complaints that are made. The progress of the complaints are difficult to track however, as staff do not record all the details about the complaint or what action has been taken. The CSCI has not received any complaints in respect of this service MEADOWBANK H52-H01 S11310 Meadowbank V234121 080705 Stage 4.doc Version 1.40 Page 14 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 and 25 Residents are able to be as independent as possible, while living in an environment that is safe for them. EVIDENCE: Residents that were spoken to said that they have been provided with walking frames to help them walk independently. Two residents said that they have been provided with specialist cutlery to assist them when eating meals as they have difficulty with their hands. All the toilets, bathrooms and residents’ bedrooms have call alarms in place and residents confirmed that staff do respond to these calls and that they are not waiting for lengthy periods of time. The home is well lit to enable residents to see where they are going and emergency lighting is in place in the event of a fire or power cut. MEADOWBANK H52-H01 S11310 Meadowbank V234121 080705 Stage 4.doc Version 1.40 Page 15 MEADOWBANK H52-H01 S11310 Meadowbank V234121 080705 Stage 4.doc Version 1.40 Page 16 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 28, 29 and 30 The procedures for the recruitment of staff are robust and provide safeguards for the residents. Staff do receive induction and training and obtain qualifications that enable them to provide a good service to the residents living at the home. EVIDENCE: Most of the staff have now been enrolled on courses to obtain national qualifications that are specific to the provision of care. Staff confirmed that these qualifications help them provide a better service for residents. The member of staff most recently recruited at the home confirmed that all the necessary recruitment checks had been completed prior to her employment and that she had received an induction. Staff that were spoken to, confirmed that they receive mandatory training that helps them meet the needs of the residents and that they also complete refresher courses. Staff have been provided with certificates that identify the training that they have completed and the manager is in the process of arranging a number of training courses for staff. A member of staff, who holds a first aid qualification, is now scheduled to work each shift and a poster that is provided for the residents identifies whom this named individual is. MEADOWBANK H52-H01 S11310 Meadowbank V234121 080705 Stage 4.doc Version 1.40 Page 17 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 36 and 38 The manager ensures that the safety and welfare of both residents’ and staff is met through supervision and the health and safety maintenance checks for equipment used at the home. EVIDENCE: Staff that were spoken to, confirmed that they do receive supervision from the manager of the home. All staff have individual supervision records and the content of supervision includes the residents’ care needs and staff training and development. Inspection of records indicated that regular tests to fire equipment, electrical equipment and gas appliances have been carried out and that equipment maintenance checks are also completed. A record of all accidents and injuries to residents and staff is kept at the home. Staff also confirmed that fire instruction takes place.
MEADOWBANK H52-H01 S11310 Meadowbank V234121 080705 Stage 4.doc Version 1.40 Page 18 MEADOWBANK H52-H01 S11310 Meadowbank V234121 080705 Stage 4.doc Version 1.40 Page 19 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 3 3 3 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 x 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 3
COMPLAINTS AND PROTECTION x x x 3 x x 3 x STAFFING Standard No Score 27 x 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x x x x x x 3 x 3 MEADOWBANK H52-H01 S11310 Meadowbank V234121 080705 Stage 4.doc Version 1.40 Page 20 No 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 Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard 8 16 Good Practice Recommendations That a record is kept of the outcome of health related visits. That the manager and staff record the date of complaints that are made, the contact details for the complaintants and the nature of the complaint and the action that has been taken. MEADOWBANK H52-H01 S11310 Meadowbank V234121 080705 Stage 4.doc Version 1.40 Page 21 Commission for Social Care Inspection 2nd Floor, 1015 Arlington Business Park Theale Berkshire RG7 4SA National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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