Inspecting for better lives Random inspection report
Care homes for older people
Name: Address: Meadowcare Home 2-3 Belvedere Road Westbury Park Bristol BS6 7JG The quality rating for this care home is: The rating was made on: new service which has yet to be given a quality rating A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed inspection. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Odette Coveney Date: 3 0 1 0 2 0 0 8 Information about the care home
Name of care home: Address: Meadowcare Home 2-3 Belvedere Road Westbury Park Bristol BS6 7JG 01179730174 01179739919 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Meadow Care Homes Ltd care home 34 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category 34 0 Over 65 0 34 Conditions of registration: The registered person may provide the following category of service only: Care home with nursing - Code N to service users of either gender whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category (Code OP) Dementia (Code DE) The maximum number of service users who can be accommodated is 34. Date of last inspection Brief description of the care home Meadow Care Home opened in the summer of 2008. It is a 34 bed registered care home, with nursing support for people over the age of 50 years of age. The home is located near to Clifton and the main Bristol city centre shopping centre. There are good bus routes and the home is within close walking distance to Park Street which has a broad range of shopping and facilities. Care Homes for Older People Page 2 of 11 Care Homes for Older People Page 3 of 11 What we found:
This was an unannounced random site visit. Meadowcare was registered with The Commission for Social Care Inspection in July 2008 and is registered to provide care and personal support to 34 older people who have a diagnosis of a dementia. The purpose of this visit was to review information that had been forwarded to us by a healthcare professional. The visit also enabled us to review the service being provided to people living at the home and to look at the outcomes for people who live at Meadowcare Home. The healthcare professional had raised a number of concerns to us in writing and highlighted areas for review such as staffing levels, healthcare support , care planning assessment and the environment in which people live. In order to fully investigate all of the issues which had been raised to us we spent time with the manager of the service, we spoke to people who live and work at the home and we also spoke with visitors who were at the home at the time of our visit. We focused on the care records for one person and sampled the records for two other people who live at the home. There were ten people living at the home at the time of our visit. We reviewed a number of documents required for the running of a care service and these included care records, risk assessments, duty rotas, staff recruitment records, medication records, healthcare records, accident reports and fire safety records. We found that although information was in place to support people living at the home this was limited to task orientated information with very little other information to demonstrate that the person had been consulted about about their support requirements. We were also concerned that there was no evidence to show that specialist services had been involved to advise and provide guidance for the complex needs of one of the individuals who live at the home. Furthermore factors associated with risk, including manual handling and protection of peoples rights had not been fully explored or recorded. The building is well decorated, however the home must take action to ensure that the home is well maintained and suited for its intended purpose, aids and furnishings must be provided as individuals assessed needs dictate. What the care home does well:
The service is still evolving and the service is still in its infancy. The manager demonstrated a clear understanding of the needs and wishes of people who are living at the home. The manager was aware of his role and responsibilities and confirmed to us that he had submitted an application to The Commission for Social Care Homes for Older People
Page 4 of 11 Care Inspection in order to be registered as the manager of the service. Care plans are in plans and record well how people are supported with the physical aspects of their care, however, improvement is needed in this area to fully demonstrate that the individual was involved in the process and to also ensure that all aspects of the persons care have been fully explored and recorded. When we spoke with the cook he was able to inform us of the personal preferences of people who live at the home, the cook knew about individuals special dietary requirements, menu choices are provided. The cook gave us good examples of how individuals needs are met at the home. The premises are comfortable with generally good quality furnishings and fittings in place. There is good disabled access into the home and also to reach the rear garden. This ensures that those with limited mobility are not further hindered. What they could do better:
In order to demonstrate that people have had all areas of their care, including emotional wellbeing fully evaluated and to also fully ensure that the best interests, wishes and choices of individuals have been fully considered. It is required that for the one person identified during this visit appropriate specialists are contacted in order that a mental capacity assessment is undertaken to evidence that decisions made are done so in that persons best interests. Individual plans of care for those living at the home must be more person centered and show that people have been consulted and involved with the decision making process on how they wish their care to be provided. In order to show that those living at the home are not restricted with their freedom of movement within the home and their rights are not limited or ignored it is required that all areas of potential risk are fully evaluated and recorded. Consideration must be given to the appropriate use of key pad entry and exit systems which are in place on each floor to ensure that peoples freedom of movement are not restricted. In order to show how individuals are supported with their moving and handling transfers manual handling risk assessments must be completed. The assessments must include information about the assistance and possible equiptment that individuals may require and how this will be provided. Accident reports were in place and were generally well completed and contained all of the required information, however, for one person we saw that there was no detail about an accident which had occurred, improvement is required for the recording of incidents to demonstrate what action has been taken by the home to prevent further re occurrence and show that a full investigation of the incident had taken place. In order to demonstrate that the provider is committed to provide a well maintained environment which is suited to meet the needs of people living at Meadow Care home the provider must arrange for suitable rails to be fitted in bathroom, toilet and en suite areas. Care Homes for Older People Page 5 of 11 Also attention must be given to the stair carpet which has lifted. Attention should also be given to the radiator which is leaking on the ground floor stairwell. The furnishings of the home are of a good standard, however we noted that one person was sitting in a chair which was not appropriate for their needs and attention must be given to ensure the appropriate furniture is provided. The home has some pictures in corridors however there was a lack of soft furnishings such as plants, ornaments, clocks and nick naks, it is recommended that these are provided in order to provide a more homely environment for people in which to live. We saw that the home have a large conservatory to the rear of the house, this provides additional communal lounge space for those who at the home, we also noted that there were no curtains or blinds in this area. This conservatory is overlooked by the houses to the rear of the property, the registered person should make suitable arrangements to ensure privacy for service users who use this area. We reviewed staffing levels and were satisfied with the current levels of qualified nursing and care staff at this time. The manager was reminded of his responsibility to ensure that appropriate numbers of staff are on duty to meet the assessed needs of people living in the house. We reviewed duty rotas which showed us who was on duty each day, however these must specify the actual hours worked. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 2. Care Homes for Older People Page 6 of 11 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These requirements were set at the last inspection. They may not have been looked at during this inspection, as a random inspection is short and focussed. The registered person must take the necessary action to comply with these requirements within the timescales set.
No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 7 of 11 Requirements and recommendations from this inspection
Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours.
No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set.
No. Standard Regulation Requirement Timescale for action 1 7 12 Specialist support services must be requested for one individual who lives at the home. This is to ensure that this person has had an assessment of their mental capacity undertaken and to demonstrate that any decisions made have been done so through consultation and in line with the individuals assessed needs. 24/11/2008 2 7 15 The registered person must 24/11/2008 consult with the service user and should incorporate within the plan individuals wishes, preferences and choices. This is to evidence that individuals have been asked their opinion about how they wish their care to provided and to develop care plans in order that they are more person centered, rather than task orientated. 3 19 13 The registered person must 24/11/2008 give consideration to the use Care Homes for Older People Page 8 of 11 of key pad systems within the home. This is to evidence that people are not being restricted in their ability to move freely around the home. 4 19 23 The registered person must 24/11/2008 ensure that attention is given to the stair carpet which has lifted. This is to demonstrate that the registered person is committed to providing a well maintained environment. 5 22 23 The registered person must provide rails in those areas identified during this site visit, this includes all bathroom areas, all individuals en suite facilities and toilet areas. This is to enable people to maintain their independence and to ensure that equipment is provided by the home in line with individuals assessed needs. 6 24 16 The registered person must 24/11/2008 provide a bedroom chair which is appropriate to meet the needs of the service user identified during this visit. This is to ensure that people have appropriate, safe seating provided. 7 25 23 Attention must be given to the leaking radiator pipe on the ground floor stairwell. This is to demonstrate that the registered person is 24/11/2008 24/11/2008 Care Homes for Older People Page 9 of 11 committed to providing a well maintained environment. 8 38 17 The registered person must ensure that accident reports are fully completed. This is to record accurate information about how incidents have occurred and what action has been taken to prevent further re occurrence. 9 38 13 The registered person must 24/11/2008 ensure that manual handling risk assessments are in place for all who live at the home. This is to record how individuals will be supported in a safe manner, it will outline individuals needs, staff support and any equipment which is needed. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service.
No. Refer to Standard Good Practice Recommendations 24/11/2008 1 19 The home should take action to make the accommodate provided more homely and provide items such as clocks, plants and nic nacks. The home should take action to make the conservatory area more private by fitting blinds or curtains to this area. The duty rotas for staff must clear show the times that staff start and finish work. 2 3 20 27 Care Homes for Older People Page 10 of 11 Reader Information
Document Purpose: Author: Audience: Further copies from: Inspection Report CSCI General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 11 of 11 - 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!
