Inspection on 28/07/05 for Meadowbrook Care Centre

This inspection was carried out on 28th July 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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

Meadowbrook Care Centre 30/11/06

Meadowbrook Care Centre 07/12/05

Meadowbrook Care Centre 05/01/05

Meadowbrook Care Centre 01/09/04

Meadowbrook Care Centre 25/05/04

Meadowbrook Care Centre 22/03/04

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Ashcroft Hollow Nursing Home

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Meadowbrook Care Centre Twmpath Lane Gobowen Oswestry, Shropshire SY10 7AH Lead Inspector Patricia Scott Unannounced 28 July 2005 09:20 th 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. Meadowbrook Care Centre E56 E01 S22262 Meadowbrook V 241840 UI 280705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Meadowbrook Care Centre Address Twmpath Lane Gobowen Oswestry Shropshire SY10 7AH 01691 653000 01691 662927 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) Four Seasons Healthcare Sheridan Lesley Chetwin Care Home with Nursing (N) 80 Category(ies) of 41 x Old age, not falling within any other registration, with number category (OP) of places 18 x Physical disabilitiey (PD) 21 x Dementia (DE) Meadowbrook Care Centre E56 E01 S22262 Meadowbrook V 241840 UI 280705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home must comply with the minimum Staffing Notice issued with the National Care Standards Commission in April 2003. 2. 3. The home may accommodate a maximum of 80 service users. The home may accommodate a maximum of 62 Older Persons of whom up to 21 may have Dementia, in the specified unit for that category of service user. The home may accommodate a maximum of 18 Younger Adults with a Physical Disability in the specified unit. 4. Date of last inspection 5th January 2005 Brief Description of the Service: Meadowbrook Care Centre was designed and built as a single storey care home and opened in 1992. The centre is divided into four separate care units comprising eighty one beds. The service is designed to meet the needs of elderly mentally infirm, frail elderly and younger physically disabled people. The home is owned and operated by Four Seasons Healthcare and is situated in Gobowen, near the town of Oswestry. Since August 2004 the home has been managed on a day to day basis by Sheridan Chetwin. Meadowbrook Care Centre E56 E01 S22262 Meadowbrook V 241840 UI 280705 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on the 28th July 2005 and commenced at 09.20. The National Minimum Standards for Care Homes for Older People focus on achievable outcomes for service users – that is the impact on the individual of the facilities and services of the home. Evidence was looked for that the standards were being met and a good quality of life enjoyed by service users through: • Discussions with service users, families and friends, staff and managers. • Observation of daily life in the home • Scrutiny of written records (including care plans for 4 service users). The statement of purpose was used to assess how far the home’s objectives to be able to meet service user requirements and expectations were being met. Reports regarding an overview of the conduct of the home are sent to CSCI on a monthly basis by a representative of Four Seasons Healthcare. These, as well as the risk assessment from the last inspection were taken into account to determine the core standards focused on and depth of inspection. The commission does not have any concerns with this home. What the service does well: The ethos of the deputy manager and staff is such that they take into account the whole needs of the individual and their family and friends. The home is registered for 3 client groups and staff provide appropriate health and personal care for each very professionally and do it well. Communication between staff and service users about their care needs is very good. After appropriate risk assessment, service users are not discouraged or unduly restrained from undertaking activities solely for fear that for example, they may hurt themselves. Service users living in care are often vulnerable both physically and emotionally and the management ensures that staff are recruited with the ability to carry out personal services for people sensitively and tactfully. The recruitment of good staff is critical to the running of care homes and the management at Meadowbrook undertake this carefully. Meadowbrook Care Centre E56 E01 S22262 Meadowbrook V 241840 UI 280705 Stage 4.doc Version 1.40 Page 6 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. Meadowbrook Care Centre E56 E01 S22262 Meadowbrook V 241840 UI 280705 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 Meadowbrook Care Centre E56 E01 S22262 Meadowbrook V 241840 UI 280705 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) 1,3, The home provides an up to date statement of purpose and service users guide that is clearly written so that prospective service users have the information they need to make an informed choice about where to live. Pre-admission needs assessments are thorough ensuring that service users who move into the home are assured that their needs will be met. EVIDENCE: The statement of purpose and service users guide have been updated for 2005. The information provides details of needs assessment to be conducted prior to admission and examination of care plans on the units confirmed that this process had been carried out. Meadowbrook Care Centre E56 E01 S22262 Meadowbrook V 241840 UI 280705 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) 7,8,10 The health needs of service users are very well attended to with evidence of good liaison with other health care professionals thus, service users can be assured of appropriate treatment of their health problems. Personal care support in the home is provided in such a way as to promote and protect service users’ privacy, dignity and independence in their daily life. There is a clear, consistent care planning system in place to adequately provide staff with the information they need to satisfactorily meet service users needs. EVIDENCE: The care of 8 service users was case tracked. Care plans were seen and where appropriate service users were spoken with and their bedrooms seen. Staff spoken with on the units talked about the care people receive which mirrored the content of the plans. Staff were very knowledgeable about the client group they were caring for on this shift and approached them respectfully and spoke to them in a dignified manner. Service users on all units Meadowbrook Care Centre E56 E01 S22262 Meadowbrook V 241840 UI 280705 Stage 4.doc Version 1.40 Page 10 showed signs of well being by their relaxed manner, being allowed by the staff members to show their emotions and being able to assert their own wishes e.g. they chose where to sit, whether they wanted the television on or whether they wished to speak with the inspector. From case files seen it is evident that staff restore dignity where it has been lost prior to living at Meadowbrook. Care plans looked at were consistently completed and had all the useful information in them that is necessary to enable a care worker to provide the right care for that individual in a way that meets their wishes and preferences. Ascertaining such information can be difficult when an individual has dementia or mental health problems and records provide evidence of consultation with families and other supporters. The information that was read showed that individuals receive the level of care which their own situation requires. Regular monitoring and review of a service user’s condition takes place to ensure that the correct treatment and care is being given. Evidence was seen of the improvement of pressure ulcers on a service user admitted to the home from hospital. Meadowbrook has scored a 4 for standard 8. This is because there is health information which is positively beneficial for service users that is displayed on notice boards in reception area. Service users can read this at their leisure. Meadowbrook Care Centre E56 E01 S22262 Meadowbrook V 241840 UI 280705 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) 12, Staff have an excellent understanding of the service users support and leisure needs and use this to assist them to exercise choice and control in their lives. EVIDENCE: Individuality is maintained as service users have their own rooms, places to withdraw to from busy active communal areas, opportunities to prepare food and drink for themselves and choice over when they get up and go to bed. Breakfast was still being provided at 10.40hrs for those who had wanted to get up later this morning. 2 activity co-ordinators work in the home. All service users receive a copy of the forthcoming programme of activities for the week which are also were displayed on each unit and in reception. A book club, daily papers and mobility news are available in reception. The home held a fete recently and raised money for charity. They also had a cheese and wine evening. Meadowbrook Care Centre E56 E01 S22262 Meadowbrook V 241840 UI 280705 Stage 4.doc Version 1.40 Page 12 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) These standards were not assessed at this inspection. EVIDENCE: Meadowbrook Care Centre E56 E01 S22262 Meadowbrook V 241840 UI 280705 Stage 4.doc Version 1.40 Page 13 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) 19,26 The standard of the environment within this home is good providing service users with an attractive and homely place to live. EVIDENCE: A general tour of the bedrooms and communal spaces demonstrated that the home is purposely designed with lounges and dining areas and courtyard gardens. These were all in a good state of repair and comfortably furnished. It is easy for service users, elderly frail or those with dementia to find their way around the building. Service users can participate in the hubbub of daily life or retreat to one of the quieter lounges. There are few ‘dead ends’ and most corridors lead out into a lounge area that enable service users to mix with each other if they wish to. The garden areas are safe and accessible to all. The Jacuzzi is not working and there is no Physiotherapist to make use of the other equipment (although the home are advertising). Meadowbrook Care Centre E56 E01 S22262 Meadowbrook V 241840 UI 280705 Stage 4.doc Version 1.40 Page 14 Discussions with the deputy manager identified that one bedroom is being used as a shower room. It is hoped by staff that this will be changed back to a bedroom and staff toilet converted to a shower room. If a further five bedrooms currently used for elderly frail service users were registered as YPD then this would provide a dedicated unit for this client group with increased communal space. The home could improve the facilities and services for the younger disabled category and the Local Authority if the provider takes staff views and expertise into account. Laundry facilities appeared satisfactory with the exception of the lack of a designated hand washing basin. This has been a requirement of the previous inspection that had not been actioned. Meadowbrook Care Centre E56 E01 S22262 Meadowbrook V 241840 UI 280705 Stage 4.doc Version 1.40 Page 15 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) 27,29 The arrangements for the induction and training of staff are good with the staff demonstrating a clear understanding of their roles. There is a good match of well-qualified staff offering consistency of care within the home. EVIDENCE: The home demonstrated that its recruitment procedures are carried out through staff files examined. These were in excellent order. Relevant training has been provided and staff spoken with confirmed this. Staff observed carrying out their duties were seen to be responsive and understanding of individuals wishes and needs. The nursing and care staff deployed today gave the cover required to meet the home’s stated aims. Meadowbrook Care Centre E56 E01 S22262 Meadowbrook V 241840 UI 280705 Stage 4.doc Version 1.40 Page 16 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) 32,38 The manager is supported well by the deputy manager in providing clear leadership in her absence and demonstrating an awareness of her roles and responsibilities. EVIDENCE: The monthly report into the conduct of the home stated that all health and safety checks are in place and up to date, such as; fire book, water temperatures, accident book. At the time of this inspection it was considered that standard 38 was met and no potential hazards were identified. The home has three stand-aid hoists but only two are working. It is considered that three are required for the needs of service users accommodated in the home and the dementia unit staff should not have to go to other units to Meadowbrook Care Centre E56 E01 S22262 Meadowbrook V 241840 UI 280705 Stage 4.doc Version 1.40 Page 17 ‘borrow’ one as 5 people regularly require this type of moving and handling aid. A stand-aid hoist must be in situ on the dementia unit. Satisfactory statements of health and safety are in place and all individual risk assessments have been reviewed and amended as necessary. Meadowbrook Care Centre E56 E01 S22262 Meadowbrook V 241840 UI 280705 Stage 4.doc Version 1.40 Page 18 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 N/A 3 N/A N/A N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 9 N/A 10 4 11 N/A DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 N/A 14 N/A 15 N/A COMPLAINTS AND PROTECTION 3 N/A N/A N/A N/A N/A N/A 2 STAFFING Standard No Score 27 3 28 N/A 29 3 30 N/A MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score N/A N/A N/A N/A 4 N/A N/A N/A N/A N/A 3 Meadowbrook Care Centre E56 E01 S22262 Meadowbrook V 241840 UI 280705 Stage 4.doc Version 1.40 Page 19 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. 2. 3. Standard 26 38 Regulation 13(3) 13(5) Requirement Provide a hand wash facilities in the laundry Provide a stand-aid hoist in the dementia unit. Timescale for action 30/8/05 30/8/05 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. 3. Refer to Standard 19 19 32.5 Good Practice Recommendations To work towards making the therapy room a useable facility for service users. To work towards providing a multi-sensory facility To consider increasing the YPD category by 5 to provide a dedicated facility to this group. Meadowbrook Care Centre E56 E01 S22262 Meadowbrook V 241840 UI 280705 Stage 4.doc Version 1.40 Page 20 Commission for Social Care Inspection 1st Floor, Chapter House South Abbey Lawn SHREWSBURY SY2 5DE 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 Meadowbrook Care Centre E56 E01 S22262 Meadowbrook V 241840 UI 280705 Stage 4.doc Version 1.40 Page 21 - 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. 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