Inspection on 25/05/05 for Meadowbank Nursing Home

This inspection was carried out on 25th May 2005.

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

Meadowbank Nursing Home 11/06/09

Meadowbank Nursing Home 20/06/07

Meadowbank Nursing Home 17/05/06

Meadowbank Nursing Home 26/10/05

Meadowbank Nursing Home 13/10/04

Meadowbank Nursing Home 28/04/04

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 Meadowbank Nursing Home Meadow Lane Clayton Green Bamber Bridge, Preston PR5 8LN Lead Inspector Vivienne Morris Unannounced 25 May 2005 9:30am 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 Nursing Home F57 F08 S25569 Meadowbank Nursing Home V229373 250505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Meadowbank Nursing Home Address Meadow Lane Clayton Green Bamber Bridge Preston PR5 8LN 01772 626363 01772 698044 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) BUPA Care Homes Mrs Bernadette Maclean Care Home with Nursing 120 Category(ies) of DE Dementia (60) registration, with number OP Old Age (60) of places PD Physical Disability (1) Meadowbank Nursing Home F57 F08 S25569 Meadowbank Nursing Home V229373 250505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: This home is registered for a maximum of 120 service users to include: 1) Up to 30 service users requiring nursing care in the category OP – Old Age, not falling within any other category. 2) Up to 60 service users requiring personal care in the category OP – Old Age, not falling within any other category. 3) Up to 60 service users in the category DE Dementia (aged 50 years and above). 4) One named female service user in the category PD aged 62 years and above. This condition will no longer apply should the service user no longer reside at Meadowbank Nursing Home or, due to advancing age, fall into the category OP. 5) The registered provider must, at all times, employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. 6) Staffing must be provided to meet the dependency needs of the service users at all times and will comply with any guidelines which may be issued through the commission for Social Care Inspection regarding staffing levels in care homes. Date of last inspection 13 October 2004 Brief Description of the Service: Meadowbank Nursing Home is situated in Bamber Bridge close to the motorway network, easily accessible by road and public transport. The home provides care for up to 120 persons within four 30-bedded single storey homes, set amongst well-established, landscaped gardens. Enclosed sensory gardens are also available. Care is provided for the frail elderly, those suffering from physical disabilities and persons requiring care associated with a diagnosis of dementia. All private accommodation is in single, fully furnished bedrooms. Although there are no en-suite facilities provided, toilets and bathing facilities are conveniently located throughout the home. Each house has pleasantly decorated spacious lounges and dining areas, although service users are able to dine within their private accommodation, if they so wish. The laundry services and kitchen facilities are centrally located within the administration block and main reception area. Meadowbank Nursing Home F57 F08 S25569 Meadowbank Nursing Home V229373 250505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was conducted over one day during May 2005 by three regulatory inspectors from the Commission for Social Care Inspection. The inspection process focused on the outcomes for people living at the home. During the course of the inspection service users, relatives and staff were spoken to, relevant records and documentation were examined and a tour of the premises took place, when a random selection of private accommodation was viewed and all communal areas and service areas were seen. The Commission for Social Care Inspection had received four complaints since the previous inspection, which were referred back to the provider for investigation. The concerns raised in these complaints were in relation the weight loss of a service user, care issues, insufficient review of care plans and no involvement of representatives in care planning process, lack of communication with representatives, lack of dignity for a service user, theft of service user’s ring, staffing issues, service users not being regularly bathed, lack of activities and stimulation, lack of interaction with service users by staff, service users unable to follow religious observance, lack of residents meetings, inappropriate storage of equipment, cleanliness and hygiene issues, inappropriate behaviour by staff and poor English skills of some staff. The outcome of the providers investigations resulted in some elements being upheld, others partially upheld and some not upheld. Other elements remained unresolved. The Commission for Social Care Inspection investigated one additional complaint received since the previous inspection. The concerns raised by this complainant were in relation to the weight loss of a service user, which was upheld and the restriction of preferred snack food, which was not upheld. What the service does well: The health, safety and welfare of those who live and those who work at the home was protected by ensuring that all equipment and systems were appropriately serviced and maintained. Three of the four houses provided a clean, tidy and pleasant smelling environment for people to live. The grounds of the home were very well maintained providing pleasant surroundings for those who live at the home, including secluded sensory gardens. Meadowbank Nursing Home F57 F08 S25569 Meadowbank Nursing Home V229373 250505 Stage 4.doc Version 1.30 Page 6 The home was conducted in a manner that respected the privacy and dignity of those who lived there. What has improved since the last inspection? 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 Nursing Home F57 F08 S25569 Meadowbank Nursing Home V229373 250505 Stage 4.doc Version 1.30 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 Nursing Home F57 F08 S25569 Meadowbank Nursing Home V229373 250505 Stage 4.doc Version 1.30 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) 3. The pre admission procedure was inconsistently applied so that people coming to live at the home could not be sure that their needs had been fully assessed and understood. EVIDENCE: The standard of pre admission work carried out at Meadowbank varied between units so that the quality of needs assessments was inconsistent. For those residents placed by social services care management summaries gave a clear picture of identified need and how those needs were to be met. Pre admission assessments carried out by the home were less detailed and sometimes most of the information had been gathered on admission to the home not before. Assessments carried out by the home did not involve residents or a representative. The home should not be providing accommodation to residents unless their needs have been fully assessed so that both parties can be sure the home is able to meet their needs and residents or a representative have been given the opportunity to be involved in the process. Meadowbank Nursing Home F57 F08 S25569 Meadowbank Nursing Home V229373 250505 Stage 4.doc Version 1.30 Page 9 When asked, the manager and staff said that a trained member of staff usually undertook the assessments so that prospective residents could be assured that an appropriately trained person had conducted the assessment process. As occasionally the home accepts emergency admissions, an emergency admissions policy should be implemented to incorporate details, as identified within standard 5.3 of the National Minimum Standards for Older People so as to ensure that these residents are provided with relevant information and sufficient details are obtained so that adequate care may be provided. Meadowbank Nursing Home F57 F08 S25569 Meadowbank Nursing Home V229373 250505 Stage 4.doc Version 1.30 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 standard(s) 7, 8 and 10 The care planning process was not thorough enough to ensure the needs of residents were consistently met. Risk assessments were not detailed enough to ensure the safety of residents. EVIDENCE: Care records seen showed that each resident had a plan of care drawn up using information from pre admission assessments. The standard of care planning varied between the units and needs to be improved in some areas as good record keeping is an important tool in promoting high quality care. Although staff were able to discuss individual needs and how the home met those needs this was not reflected in the care records. Care plans were sometimes too brief and instructions for staff not specific enough to help the care process and promote the welfare of residents. One resident was very thin and frail, weighing less than 30 kilograms. Staff discussed her needs and how they were managing her medical condition but the care records did not support this and there was no evidence to show that advice had been sought from the Meadowbank Nursing Home F57 F08 S25569 Meadowbank Nursing Home V229373 250505 Stage 4.doc Version 1.30 Page 11 Doctor or dietician. It is essential that specialist advice is sought when required. Risk assessments, particularly those relating to the use of bed rails were also too brief and need to be improved to ensure the continued safety of residents. When asked about care they received there was a mixed response. Comments included, “Yes I am happy with the care and staff treat me well”. “‘I have only had one bath in three weeks, and ‘I don’t get a proper wash just a lick’. Some people living at the home had not been involved in the compilation of their care plans and when asked did not know what a care plan was. People living at the home say staff maintained their dignity and treated them respectfully. They commented, “staff always knock before they come in my room” and “they shut the door while they wash and dress me”. Staff were able to discuss how they respected the privacy and dignity of the people they cared for. They said, “we take people to their own rooms to be washed and changed; “ We shut the door and keep the curtains closed”. Induction records showed that staff received instruction about how to make sure that residents’ right to privacy and dignity were upheld. Staff on Sabrina House were particularly good at finding out exactly what residents wanted and how much they could do for themselves so they could encourage their ability to self-care and make decisions. Meadowbank Nursing Home F57 F08 S25569 Meadowbank Nursing Home V229373 250505 Stage 4.doc Version 1.30 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 standard(s) 12 and 15 The home did not provide sufficient stimulation and activities for those who lived there. The food served was sometimes of a poor standard. Therefore, those who lived at the home did not consistently receive a nutritious and wholesome diet. The privacy and dignity of residents was respected at all times. EVIDENCE: A daily programme of routine activities was in place, although this was not produced in clear print and was not up to date. Therefore, those living at the home could not easily identify current activities being provided and so were unable to plan their day accordingly. Some residents felt that little activity was provided, although Bingo and painting sessions were available, one service user stated ‘there are not a lot of activities in the day time, I think it would be better for there to be a hobby therapist on each unit’ and another commented, ‘all the nurses are very good, and the place is spotless as you can see, but they should do more to stimulate people, that’s not good enough really’. Service users were seen being offered a choice of where they preferred to eat their lunch. Staff were seen to be knocking on service users’ bedroom doors before entering. Service users confirmed that they were able to make decisions in relation to their life style and that staff respected their privacy and dignity and one service user commented, “staff are very nice and respect me”. Meadowbank Nursing Home F57 F08 S25569 Meadowbank Nursing Home V229373 250505 Stage 4.doc Version 1.30 Page 13 Other comments from residents included, “some staff are fine”, “The manager of the unit is lovely” and ‘ I had my hair done last week, they come every week’. It was noted that visitors were made welcome and were able to meet with those who lived at the home in any of the communal areas or in private, if they so preferred. The menu was seen to offer a good choice of meals for each sitting, and individuals preferences were recorded in the kitchen so preferred dishes could always be provided. The head of the kitchen also had an efficient system for checking with the service users about the meals that were served to ensure people got the opportunity to have meals they enjoyed. Specialised diets were provided as required, liquidised diets were well presented and the dining areas were pleasantly arranged. Feedback from those who lived at the home and those who worked at the home was mixed. All those spoken to felt that the food was of a good standard when two of the three chefs were on duty. However, when one particular chef was on duty the food was poor. This issue was discussed with the registered manager. On the day of the inspection the food was seen to be well presented and staff were seen to be assisting residents with their meals in a respectful and courteous manner, although aids were available to assist service users to be as independent as possible during meal times. One service user said ‘ food is often cold, and the tea is like brown water’. Others said ‘ by and large the food is not too bad, though some days are better than others’. Staff felt that the quality and presentation of meals on some occasions was a problem. Meadowbank Nursing Home F57 F08 S25569 Meadowbank Nursing Home V229373 250505 Stage 4.doc Version 1.30 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 standard(s) 18. The written policies of the home did not ensure that service users were adequately protected from abusive situations. EVIDENCE: A policy was seen to be in place at the home for responding to suspicion or evidence of abuse or neglect, including whistle blowing. However, this was not in line with the Department of Health guidance ‘No Secrets’. The current written procedure indicated that the registered manager would investigate any allegations of abuse and would choose which external bodies to inform of any allegations, which did not include the Commission for Social Care Inspection. This issue remains outstanding from the previous inspection and needs to be addressed as a matter of urgency. The home’s policies and practices regarding service users’ money and financial affairs were in accordance with standard 18 of the National Minimum Standards for Older People, demonstrating that monies belonging to service users was protected. Service users money was securely retained. However, service users were not able to access their own money during the evenings or at weekend. This remains as an outstanding issue, and action is needed to ensure service users have full access to their own money at any time. The policies of the home precluded staff involvement in assisting in the making of or benefiting from service users’ wills. Meadowbank Nursing Home F57 F08 S25569 Meadowbank Nursing Home V229373 250505 Stage 4.doc Version 1.30 Page 15 Staff spoken to were aware of the procedure which they should follow in the event of any suspicions of abuse. Meadowbank Nursing Home F57 F08 S25569 Meadowbank Nursing Home V229373 250505 Stage 4.doc Version 1.30 Page 16 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) 19, 22, 23, 24 and 25. The home was maintained to an acceptable standard both internally and externally, ensuring adequate safety for those living at the home. Systems for the control of infection were in place. EVIDENCE: Sabrina House This house was well presented. The lounge area had been redecorated, and new furnishings provided. Individuals living in the house were seen to be accessing the facilities freely, using a range of chairs and seats in the communal areas. Bedrooms were clean and provided a comfortable, pleasant space for individuals, who had their own possessions, such as pictures around them. The kitchen and bathrooms were clean, and provided soap and towels as needed. Bathrooms were well signed with symbols to make them easy to locate. Meadowbank Nursing Home F57 F08 S25569 Meadowbank Nursing Home V229373 250505 Stage 4.doc Version 1.30 Page 17 The external grounds were well maintained and a pleasant patio area, with a focus on providing sensory stimuli, was available to the rear of the building which staff said individuals enjoyed sitting out on in the nice weather. Staff said ‘the place is kept clean and the domestic’s work well’ Ribble House The bedrooms in this house well presented, and provided a modern lino type flooring with rugs for those who wanted them. People had their own possessions around them and rooms looked individual and were set to best suit the service user. The large lounge/dining area was being used by service users who were either watching TV, sitting chatting, or sitting in quiet areas reading. Others were sat in their own rooms, and they confirmed that they were free to access areas of the home as they wished. Bathrooms were clean and well stocked with soap, towels and toilet tissue and offered service users a choice of bathing in a shower or bath. Service users said ‘ its well presented, clean and comfortable here’. Some attention needed to be paid to the security of the building as some windows were not restricted and could allow access into or from the building. Beech House On the day of the visit to this unit there was a strong smell of urine throughout the building, and so service users were not offered a pleasant environment to be in. Cleaning staff were seen to be working hard in the unit, but there were a number of areas that needed attention, specifically carpets through the unit that were marked and stained. Bedrooms had been moved around to ensure individuals had a bedside unit by their bed, but in most cases this resulted in the nurse call button not being accessible when in bed. The furniture in bedrooms was starting to look worn. Service users were seen to be accessing areas of the house freely, and the lay out of building ensured people could move about as they wished in a secure environment. A board had been erected in the lounge, which included information about the day, date and weather, providing individuals with a point of reference and promoting orientation skills. Meadowbank Nursing Home F57 F08 S25569 Meadowbank Nursing Home V229373 250505 Stage 4.doc Version 1.30 Page 18 Willow House This house had not been re-furbished but every effort had been made to offer a pleasant environment. Items such as book cases and display cabinets were placed in the corridors making the place look more homely. Rooms were generally well presented, though some furniture would benefit from being updated. Some new easy chairs had been provided in the lounge area and service users said they were ‘very nice’. Some service users had keys to their rooms and felt this was good to help them have privacy in the home. Bathrooms were clean and well presented, offering the choice of baths and showers to the service users. General There was only a limited number of bedrooms with locks, though individuals had devised ways to stop others going in their rooms. All service users should be offered the option of a lock if they want one to offer them some privacy. There continued to only be a small number of adjustable beds through the home, and this was limiting to some service users who would benefit from a fully adjustable bed. Radiators throughout the home were not guarded and guaranteed ‘low surface temperature’ radiators had not been installed. Therefore, this could in certain situations cause a hazard to individuals. Outside areas of the home were well cared for, and provided a pleasant outlook from the units. Works were being done to make a safe garden for the units, so everyone could have the opportunity to enjoy the outside spaces safely. Meadowbank Nursing Home F57 F08 S25569 Meadowbank Nursing Home V229373 250505 Stage 4.doc Version 1.30 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 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) 27 and 29 The recruitment process was thorough enough to ensure the continued protection of those living at the home. The skill mix of and the number of staff on duty was sufficient to ensure the needs of residents were met. EVIDENCE: A recorded staff rota was in place on all four houses, demonstrating which staff were on duty at any time of the day or night. There were 93 people living at Meadowbank at the time of the inspection. Staffing levels were calculated in accordance with the minimum requirements of the previous regulating bodies. Staffing levels should be determined according to the dependency needs of people living at the home to ensure that assessed needs are fully met. Three of the houses were in general pleasant smelling. However, there was a strong unpleasant odour on Beech House. This needs addressing as a matter of urgency. A thorough recruitment procedure was being followed at the home, and all information gathered about staff, such as their employment references and CRB disclosures, were seen on individual staff files. Staff said they had an interview before they started at the home and had to obtain a CRB disclosure. Meadowbank Nursing Home F57 F08 S25569 Meadowbank Nursing Home V229373 250505 Stage 4.doc Version 1.30 Page 20 One service user said, ‘All the nurses are very good’, another said, ‘ the nurses are superb, all in their lovely uniforms’. (Both service users referred to all staff as ‘nurses’) Meadowbank Nursing Home F57 F08 S25569 Meadowbank Nursing Home V229373 250505 Stage 4.doc Version 1.30 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 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) 38 The home ensures safe working practices and ensures the health and safety of service users and staff. EVIDENCE: Relevant service certificates and maintenance records were examined, which showed that all equipment and systems had been serviced regularly in order to protect the health, safety and welfare of residents and staff. A variety of detailed risk assessments had been conducted in order to identify any areas of risk. Hot water was being delivered at safe temperatures, substances hazardous to health were seen to be appropriately stored and the security of each house was satisfactory, in order to protect those who lived and worked at the home. Health and safety policies and procedures were in place and a record of accidents was maintained. Staff training was provided in relation to health and Meadowbank Nursing Home F57 F08 S25569 Meadowbank Nursing Home V229373 250505 Stage 4.doc Version 1.30 Page 22 safety issues and staff had been appropriately inducted into the role they were to perform so that service users needs could be appropriately met. Staff spoken to confirmed that core training was compulsory and some specialist training had also been provided, although it was felt that additional training would be useful in relation to the medical and psychological conditions of people currently living at the home. Staff spoken to stated that the manager of the home is very supportive and provides sufficient training. Meadowbank Nursing Home F57 F08 S25569 Meadowbank Nursing Home V229373 250505 Stage 4.doc Version 1.30 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 2 x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 x 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 x 14 x 15 2 COMPLAINTS AND PROTECTION 2 x x 2 3 2 2 x STAFFING Standard No Score 27 2 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x 2 x x x x x x x 3 Meadowbank Nursing Home F57 F08 S25569 Meadowbank Nursing Home V229373 250505 Stage 4.doc Version 1.30 Page 24 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 3 Regulation 14(1)(a, c) Requirement Timescale for action 31.07.05 2. 7 3. 8 4. 8 5. 9 The home must not provide accommodation to residents unless they have been fully assessed and involved in the assessment process. (Timescale of 30.11.04 not met) 15(1) A written plan of care that clearly shows how a residents needs in repsect of his health and welfare are to be met must be in place. The plan must give clear instructions for staff to follow and be specific to individual needs. Residents or a representative must, wherever possible, be involved in the care planning process. (Timescale of 5.11.04 not met) 13(4)(c ) Risk assessments relating to the use of bedrails must include the reason for their use, the risks associated with their use and management strategies to remove or reduce the risk. 24(1)(a,b) A system for reviewing and improving the quality of care provided must be established and maintained, including seeking specialist advice when necessary. 13(2) The manager must ensure that F57 F08 S25569 Meadowbank Nursing Home V229373 250505 Stage 4.doc 31.07.05 31.07.05 30.09.05 15.07.05 Page 25 Meadowbank Nursing Home Version 1.30 6. 12 7. 18 8. 31 records be kept of all medication received, administered (including creams) and leaving the home. Administration records must be signed contemporaneously and refusals documented. (Timescale of 19.11.04 not met). 16(2)(m)( The registered person must 31.08.05 n) consult service users about their social interests, and make arrangements to enable them to engage in local, social and community activities. The registered person must consult service users about the programme of activities arranged by the care home 13(6) The written policies and 15.07.05 procedures of the home must clearly identify the correct procedure to be followed in the event of any allegations of abuse. (Timescale of 20.11.04 not met). 9(1)(c)(i)( A skeleton file must be retained 30.09.05 ii) in the home to demonstrate that the registered manager is qualified, competent and experienced to run the home and to meet its stated purpose, aims and objectives. This information may be retained in the form of duplicate basic documents or a checklist. (Timescale of 31.01.05 not met) 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 5 Good Practice Recommendations An emergency admissions policy should be implemented to incorporate details, as identified within standard 5.3 of the National Minimum Standards for Older People. F57 F08 S25569 Meadowbank Nursing Home V229373 250505 Stage 4.doc Version 1.30 Page 26 Meadowbank Nursing Home 2. 3. 4. 5. 7 8 9 12 Trained nurses should be aware of the guidelines for record and record keeping produced by the Nursing and Midwifery Council. The home should obtain a copy of the advice booklet on the safe use of bedrails issued by the medical devices agency. A second member of staff should witness all hand written entries on MAR charts. It is recommended that the activities programme be written in a clear format and kept up to date, so that service users are able to easily identify the activities to be provided. A satisfactory standard of food should be consistently served. Service users should be able to have access to their own money at any time. The large windows at the end of the corridors on each house should be restricted from opening fully, to prevent injury to service users. Where nurse call leads are not provided in service users’ private accommodation, then individual risk assessments should be conducted to demonstrate that such provision would create a potential hazard. Bedside cabinets and nurse call leads should be accessible by the service users when in bed, unless individual risk assessments suggest otherwise. (Beech House) Doors to service users’ private accommodation should be fitted with locks suited to service users’ capabilities and accessible to staff in emergencies, unless risk assessments and care records demonstrate that this may create a hazard for service users’, in which case the agreement of service users or representatives should be obtained. Each service user should be provided with the key to their locked facility within their bedroom, unless the reason for not doing so is explained in the care plan. Pipe work and radiators should be guarded or have guaranteed low temperature surfaces. The levels of care staff on duty should be calculated in accordance with the dependency levels of service users, in accordance with the Department of Health guidance. 6. 7. 8. 9. 15 18, 35 19 22 10. 24 11. 12. 24 27 Meadowbank Nursing Home F57 F08 S25569 Meadowbank Nursing Home V229373 250505 Stage 4.doc Version 1.30 Page 27 Commission for Social Care Inspection Levens House Ackhurst Business Park Foxhole Road Chorley PR7 1NW 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 Meadowbank Nursing Home F57 F08 S25569 Meadowbank Nursing Home V229373 250505 Stage 4.doc Version 1.30 Page 28 - 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!