Inspection on 21/06/05 for Meadowcroft

This inspection was carried out on 21st June 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Meadowcroft 06/03/07

Meadowcroft 23/02/06

Meadowcroft 15/11/04

Meadowcroft 22/07/04

Similar services:

Snydale Care Home

Abbey The

Larchfield Manor

Hawkhills

Beeches The - North Yorkshire County Council

The Grove Waltham

Carentan House

Ravensworth Lodge

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

CARE HOMES FOR OLDER PEOPLE Meadowcroft 289 Rooley Lane Bradford West Yorkshire BD5 8LG Lead Inspector Carol Haj Najafi Announced 21 June 2005 st 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. Meadowcroft J52 J03 S33608 Meadowcroft V225275 210705 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Meadowcroft Address 289 Rooley Lane, Bradford BD5 8LG 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) 01274 733561 01274 725574 City of Bradford Metropolitan District Council, Department of Social Services Care home only 33 Category(ies) of Old age (33) registration, with number of places Meadowcroft J52 J03 S33608 Meadowcroft V225275 210705 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 15 November 2004 Brief Description of the Service: Meadowcroft is a large purpose built care home operated by Bradford Local Authority. It is situated approximately three miles from the city centre and is located near to a social services area office. There are no amenities nearby and although there is a bus service along the main road it is a good walk down to the home. Limited parking is available at the front of the building for the use of visitors.The accommodation is provided on the ground floor in single rooms. Access is available to all parts of the home for all service users and equipment for the disabled has been provided as required. The home provides intermediate care and has a rehabilitation gymnasium and activity kitchen. Meadowcroft J52 J03 S33608 Meadowcroft V225275 210705 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. One inspector carried out this announced inspection between 9.30am and 6.00pm. The purpose of the inspection was to ensure the home was operating and being managed to a satisfactory standard. The inspector spoke to residents, visitors, a healthcare professional, staff members and the acting manager. Records were inspected including resident’s pre admission assessments, health assessments, daily records, staff training and recruitment records. A pre inspection questionnaire was sent into the Commission before the inspection. Service users and relatives returned a lot of comment cards which gave views of the home. The home does not have a registered manager in post. What the service does well: What has improved since the last inspection? What they could do better: The home provides a lot of different services to people with very different needs. This has caused some difficulties for some service users, and must be looked at to see how it can be improved. Service users are encouraged to do things for themselves but this is often inconsistent; the home should review how it promotes independence to make sure it is done in the best way for each individual. Before service users move into the home they should have an Meadowcroft J52 J03 S33608 Meadowcroft V225275 210705 Stage 4.doc Version 1.30 Page 6 opportunity to find out about the home. Service users whose needs cannot be met must not be admitted. Bradford social services need to look at how service users will receive any interest for their individual savings and provide individual statements to service users. Requirements and recommendations identified at this inspection can be found at the end of this report. 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. Meadowcroft J52 J03 S33608 Meadowcroft V225275 210705 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 Meadowcroft J52 J03 S33608 Meadowcroft V225275 210705 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, 4 & 5 Residents are assessed before admission but the home does not use this information to ensure they can meet their needs. This has resulted in people staying at the home whose needs are not met. Many different services are being provided in the home, which has caused dissatisfaction with some service users. EVIDENCE: The home offers a range of services including respite, short stay, assessment, interim, rehabilitation, and emergency admissions. Five day care places for people from the community are also provided. The home no longer admits long stay admissions although three long stay service users live there. There are different admission’s processes depending on the type of stay. Some admissions are linked to health care, others are done in conjunction with social workers. The inspector focussed on respite admissions at this inspection. Two service users who had recently been admitted to the home had preadmission assessments in their files. The acting manager confirmed that social work assessments are always received before residents move into the home, and service users are encouraged to visit the home. Alternatively staff will visit service users in their own home although this has been difficult due to transport problems. Meadowcroft J52 J03 S33608 Meadowcroft V225275 210705 Stage 4.doc Version 1.30 Page 9 A service user who recently moved into the home for a short stay said they did not visit the home or have an opportunity to speak to anyone from the home before admission. No record of any visit or communication with the service user was recorded in their file. Another service user recently admitted to the home was under the age of 65; the acting manager confirmed this was not an emergency admission. An application should have been made to the commission before this admission took place. The placement was not successful and caused some difficulties. Concerns were expressed by a number of service users, staff and management regarding the different types of services that are provided at Meadowcroft. Some service users said they are unhappy that there is a constant turnover of service users moving in and out of the home, staff acknowledged this was very difficult for long stay service users. Comments from service users included, ‘the staff are nice but they are doing more hospital work now’, ‘too many people are trying to do too many jobs’, ‘I’m worried about all the changes, they do things differently-it’s not the same since the ones are coming into here from hospital’. Services users are admitted for different reasons; some require rehabilitation therefore independence must be encouraged and others need a rest. Three of the four units provide respite beds although the different units have different routines, one unit has a dining room and service users are expected to assist with serving meals and clearing tables, staff wait on service users from the other units, this again has also caused upset for some service users. Staff said the organisation had been looking at the future of Meadowcroft for the past two years, and discussions regarding a change of service had taken place but no decision had been made. Service users confirmed they had been worried for ‘a quite a while about the changes.’ Meadowcroft J52 J03 S33608 Meadowcroft V225275 210705 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) 8 & 10 The health care needs of all service users are met. Assessments need to be completed to identify healthcare risks to service users. Good care is provided and service users are respected. EVIDENCE: Service users receiving short stay or respite care arrange healthcare themselves although the home supports service users with appointments if required. Staff and a district nurse said the health care needs of long stay service users are met. Regular health checks are arranged, and health care professionals are consulted at appropriate times. The district nurse said the home provides good care and staff and health care professionals work together well, as a team. Nutritional and pressure care assessments have not been carried out for any service users. The manager has the relevant assessment forms and is in the process of giving this information to the management team. Service users confirmed that staff knock on doors before entering a room and respect privacy when giving personal care. Staff induction includes respect and good principles of care. Staff described good care practice and felt that it is an area where they performed well. Meadowcroft J52 J03 S33608 Meadowcroft V225275 210705 Stage 4.doc Version 1.30 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 & 13 A good activities programme is provided. Generally independence is encouraged but not in a consistent or flexible way; this can leave service users feeling confused and not meeting their expectations. Family and friends are encouraged to visit and made to feel very welcome. EVIDENCE: Service users said they enjoy the different activities that are provided. Group activities are arranged in the dining area which also caters for day centre service users. An activity worker is employed to work in the unit; service users praised the activity worker for providing quality and varied activities. They said activities are organised regularly and there are opportunities to go out into the community. Respite service users spoke of friendships and said they looked forward to their stays at the home. When planning respite care careful consideration is given to friendships and service user compatibility. The home has a bar, which is very popular with service users and visitors, and provides an excellent social facility. Sadly, due to licensing laws the bar is closing in August. This facility will be missed. Some concerns were raised about how independence is promoted. Service users said ‘some staff help you but some won’t, we have to do a lot more than we used to’. Staff confirmed that there were inconsistencies in staff approaches and some staff encourage independence more than others. The acting manager said that some service users were not happy with changes that had been introduced to promote independence, even though this had taken place over two years ago. Meadowcroft J52 J03 S33608 Meadowcroft V225275 210705 Stage 4.doc Version 1.30 Page 12 Service users and visitors confirmed that family and friends can visit at any reasonable time. Relatives said they were made welcome and informed about any issues or concerns. Meadowcroft J52 J03 S33608 Meadowcroft V225275 210705 Stage 4.doc Version 1.30 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 The acting manager deals effectively with complaints and ensures service users are listened to. The recording of complaints is good. EVIDENCE: The manager discussed the complaints process, and explained how formal complaints and general concerns are dealt with. She had a good understanding of the procedure and strategies for managing complaints effectively. Service users said they discuss concerns with staff or the manager, and understood they could make formal complaints if they are unhappy with the service. One complaint has been received at the home in the last twelve months; this was investigated thoroughly and records were detailed. Meadowcroft J52 J03 S33608 Meadowcroft V225275 210705 Stage 4.doc Version 1.30 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) 19, 20, 21, 22, 23, 24, 25 & 26 The home is clean, tidy and pleasantly decorated. Service users are usually given keys to their room but not always. EVIDENCE: The inspector visited all areas of the home except the intermediate care unit. The home was clean, tidy and well organised. All units have recently been decorated and new furniture, carpets, and furnishings have been ordered. Service users and staff were pleased with the new décor and said this has greatly improved the environment. Furniture, carpets and furnishings are well worn and everyone is looking forward to items being replaced. Bedrooms are personalised for long stay service users. Appropriate laundry facilities are provided and control of infection systems are in place. Service users are given the option of having keys to their room and a key to a lockable draw. However, a service user recently admitted to the home was not given a key, they kept their own medication which was left on a dressing table. As the room was left unlocked this presented a risk to other service users. Meadowcroft J52 J03 S33608 Meadowcroft V225275 210705 Stage 4.doc Version 1.30 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, 28, 29 & 30 The staff team are friendly and well liked by service users and visitors. New staffing arrangements will improve service provision. The recruitment process is robust, and training programmes are varied and staff have a lot of opportunities to attend. The staffing rota does not provide an accurate picture of when all staff have worked at the home. EVIDENCE: The commission received fifteen comment cards from service users and relatives/visitors. The cards were very positive about the home and praised staff. Comments included ‘staff are always pleasant and efficient, staff are five star- keep up the good care, staff are excellent in their approach’. Service users and visitors described staff as friendly and caring. However, some concerns were raised about shortages of staff. Staff confirmed that staffing levels have been an issue, and said when only three care staff are working on a shift it is very difficult to complete some tasks. The acting manager said Bradford social services had confirmed that staffing levels have been reviewed, and an agreement for additional care staff had been agreed. This will result in a minimum of four care staff working on shift during the day. The staffing rota does not include some management hours and therefore it is not possible to establish from the rota all the staff that have been on duty. Staff recently employed at the home described a thorough recruitment and induction process. Staff records confirmed that all the necessary documentation had been obtained. Meadowcroft J52 J03 S33608 Meadowcroft V225275 210705 Stage 4.doc Version 1.30 Page 16 Staff have attended training courses which cover health and safety areas and good care practice; these include medication, slips, trips & falls, person centred care, first aid and fire training; 75 of care staff have completed NVQ level 2, which is a good achievement and exceeds the national minimum standards Meadowcroft J52 J03 S33608 Meadowcroft V225275 210705 Stage 4.doc Version 1.30 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) 32, 35, 37 & 38 The temporary management arrangements are working well but it is important to look at long-term arrangements. Service users are not receiving the full amount of interest on their savings that they would receive if their savings were held in a bank or building society, therefore losing out financially. The health and safety of service users and staff are protected. EVIDENCE: There is no registered manager at the home. An acting manager has been in post since February. A health care professional said the home has strong leadership, and the high standards of care are generated from the management team. Staff said the home had run smoothly, and there was consistency and continuity during the recent change in management. As highlighted earlier in the report uncertainty about the future of the home has created anxiety. Permanent management arrangements should be put in place as soon as possible to eliminate further concerns. Meadowcroft J52 J03 S33608 Meadowcroft V225275 210705 Stage 4.doc Version 1.30 Page 18 Service users or relatives are responsible for managing individual finances. Bradford social services is the corporate appointee for two service users who need help with their finances. Service users who have savings with Bradford social services do not receive any interest for the first £500. This does not comply with the regulations or guidance published by the Commission for Social Care Inspection. Individual statements identifying transactions and balances have not been issued to service users. Transactions for monies held in the home are recorded and receipted. Two staff sign for monies received but currently service users are not involved in this process. Monies held in the home were counted and the amount held corresponded with the financial records. Daily records contain good information and are detailed. Records are stored securely. The pre inspection questionnaire confirmed that policies and procedures are available and regular maintenance and health and safety checks are completed at the home. Meadowcroft J52 J03 S33608 Meadowcroft V225275 210705 Stage 4.doc Version 1.30 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 x x 3 2 2 x HEALTH AND PERSONAL CARE Standard No Score 7 x 8 2 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 x 15 x COMPLAINTS AND PROTECTION 3 3 3 3 3 2 3 3 STAFFING Standard No Score 27 2 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 3 x x 2 x 3 3 Meadowcroft J52 J03 S33608 Meadowcroft V225275 210705 Stage 4.doc Version 1.30 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 4 Regulation 12 Requirement The registered provider must review service provision to ensure the home has the capacity to meet the assessed needs of service users admitted to the home. The registered provider must ensure service users admitted meet the homes registration category. The registered manager must ensure nutritional, continence, and tissue viablility assessments are carried out. The registered provider must enable service users to make decisions with respect to the care they are to receive, daily routines and independence. The registered provider must ensure service users can access lockable facilities. The registered provider must ensure the staff rota contains all hours worked within the home The registered provider must ensure staff are working in such numbers that are appropriate for the health and welfare of service users. The registered provider must J52 J03 S33608 Meadowcroft V225275 210705 Stage 4.doc Timescale for action 30th September 2005 2. 3 14 31st July 2005 31st August 2005 30th September 2005 31st July 2005 31st July 2005 30th September 2005 30th Page 21 3. 8 14 4. 12 12 5. 6. 7. 24 27 27 13 17 18 8. 35 20 Meadowcroft Version 1.30 demonstrate how each individual service user will receive any interest applicable to their individual savings. September 2005 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 5 35 35 Good Practice Recommendations The registered provider should give prospective service users an opportunities to meet staff in their own home or at Meadowcroft before admission. The registered provider should provide regular individual financial statements for savings held on behalf of service users. The registered provider should encourage service users to sign for money they receive. Meadowcroft J52 J03 S33608 Meadowcroft V225275 210705 Stage 4.doc Version 1.30 Page 22 Commission for Social Care Inspection Aire House Town Street Rodley Leeds LS13 1HP 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 Meadowcroft J52 J03 S33608 Meadowcroft V225275 210705 Stage 4.doc Version 1.30 Page 23 - 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!