Inspection on 30/09/08 for Meadowcroft

This inspection was carried out on 30th September 2008.

CSCI found this care home to be providing an Good service.

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 13/10/06

Meadowcroft 24/02/06

Meadowcroft 25/08/05

Meadowcroft 15/03/05

Meadowcroft 19/08/04

Meadowcroft 12/02/04

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

Extracts from inspection reports are licensed from CQC, this page was updated on 30/01/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Meadowcroft Towersey Road Thame Oxfordshire OX9 3NN     The quality rating for this care home is:   two star good service 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. Lead inspector: Marie Carvell     Date: 3 0 0 9 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought 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 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) 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. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Meadowcroft Towersey Road Thame Oxfordshire OX9 3NN 01844212934 01844215630 manager.meadowcroft@osjctoxon.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Sylvia Kay Cann Type of registration: Number of places registered: The Orders Of St John Care Trust care home 40 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category physical disability Additional conditions: The maximum number of service users to be accommodated is 40. The registered person may provide the following category/ies of service only: Care home only - (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Dementia (DE) Old age, not falling within any other category (OP) Physical disability (PD). Date of last inspection Brief description of the care home Meadowcroft was opened in 2008, replacing the previous care home on the same site.It is situated in a quiet residential area near to the centre of the market town of Thame, and is close to local services - a health centre, community hospital, shops, library, pubs, clubs and churches. The home is registered to provide accommodation and personal care for up to forty older people. The home is not registered to provide Care Homes for Older People Page 4 of 26 40 0 40 Over 65 0 40 0 Brief description of the care home nursing care. Meadowcroft is owned and managed by the Order of St John Care Trust, which is a charitable organisation that also owns home in Wiltshire and Linconshire. The fees for this service range from 505.00 pounds per week to 700.00 pounds per week. Items not covered within the fees include hairdressing, podiatry, newspapers and magazines, toiletries and contributions to some outings and activities. Care Homes for Older People Page 5 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This inspection of the service was an unannounced Key Inspection. We arrived at the service at 10.45am and was in the service until 5.15pm. It was a thorough look at how well the service is doing. It took into account detailed information provided by the manager in December 2007, and any other information that we have received about the service since the last inspection in October 2006. We asked the views of the people who use the service and other people seen during the inspection or who responded to surveys sent out. Five service users and two members of staff responded to surveys sent out. We looked at how well the service was meeting the standards set by the government Care Homes for Older People Page 6 of 26 and have in this report made judgements about the standards of the service. We toured the building, examined records including case tracking five service user files and met with service users. We also spent time with the manager and staff on duty. In addition we observed how care was being delivered to service users and joined service users in one unit for lunch. At the last inspection, one requirement was made that the manager ensures that a full employment history is obtained from new workers and that gaps in employment history are checked. This has been complied with. Feedback was given to the manager, Sylvia Cann during the inspection. What the care home does well: What has improved since the last inspection? What they could do better: 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 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 26 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users are provided with sufficient information about the home, to make an informed choice about moving in. Service users are assessed prior to admission to ensure that the home can effectively meet their care needs. Evidence: All prospective service users are provided with information about the home, including the homes brochure and a copy of the last inspection report. Oxfordshire Social Services have a block contract with the home for twenty three beds, including one bed used for service users requiring respite care. All prospective service users are assessed before being offered a place in the home. Service users and their representatives are encouraged to visit the home, meet other service users and the staff team, before deciding whether to move into the home for a trial period. Service users spoken to and comments made on service user surveys confirmed this. Care Homes for Older People Page 10 of 26 Care Homes for Older People Page 11 of 26 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care plans need to be developed to include emotional, psychological and social care needs. The health care needs of service users are fully met. Medication administration records, storage and administration were seen to be well maintained. service users feel that they are treated with dignity and respect. Evidence: Care plans are drawn up from the pre-admission assessment and agreed and signed by the service user and their representative, if appropriate. Care plans are reviewed on a regular basis and any changes are recorded. Information regarding health and personal care is well documented however, no information is recorded about how the emotional, psychological or social care needs of the service user are identified or met. The activity organiser records information about social activities and hobbies. This information needs to be incorporated into the care plan. The manager has confirmed that this will be addressed within the next twelve weeks. Service user files are well Care Homes for Older People Page 12 of 26 Evidence: organised and contain appropriate information regarding risk assessments include the involvement of health care professionals, such as the falls specialist. The health care needs of service users are met by three local GP practices and a range of health care professionals visit the home as required. From evidence seen and discussion with service users, staff on duty and the manager, the health care needs of service users are fully met. The manager expressed her satisfaction of the service provided and felt that she had a good working relationship with GPs and the district nursing team. Medication is administered by staff who have received appropriate medication training from a pharmacist. Medication administration records were seen to be well maintained, with no obvious gaps in recordings. Appropriate medication storage is provided and is secure. Service users are able to take responsibility for their own medication, following a risk assessment. Service users were complimentary about the care provided, the facilities and the building. Comments included the staff are wonderful, always cheerful, nothing is too much trouble, the staff look after us really well. The home has a key worker system in place and both service users and staff were clear about this role. Staff were observed addressing service users by their preferred term of address and interacting with them in a respectful and professional manner. There is a good rapport in the home between service users, relatives and the homes staff team. As in many other care homes, there is a wide range of racial, ethnic and faith backgrounds represented within the staff team compared with the current service users. from discussion with the manager and staff on duty, we consider that the home is able to provide a service to meet the needs of individual service users of various religious, racial or cultural needs. Care Homes for Older People Page 13 of 26 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users are encouraged to make choices and to remain independent for as long as possible. There is a wide range of activities in place to meet the social needs of service users. Service users are provided with a varied, nutritious and wholesome diet. Evidence: Information about weekly activities is displayed throughout the home. An activities organiser is employed for thirty hours per week, these hours will be increased as additional beds are registered. Several volunteers assist with fund raising and activities in the home. Four of the surveys completed by service users felt that there were always activities arranged that they could take part in, one service user felt that this was only sometimes the case. Service users are encouraged to maintain contact, as far as possible with the local community. Many service users have friends and family who are able to visit on a regular basis. The home has use of a minibus. The mobile library and hairdresser visit regularly. Religious ministers visit weekly. The home has recently been named as the Mayors charity of the year. Service users confirmed that routines in the home are flexible and they are able to spend the day as they choose. We joined service users in one unit for the midday meal, there is always a choice of dishes offered and this is recorded. Menus evidenced that a varied, nutrious and wholesome Care Homes for Older People Page 14 of 26 Evidence: diet is provided. The meal was tasty, hot and attractively serviced. Staff were observed to assist service users in a discreet and dignified manner. Surveys completed by two service users confirmed that they always enjoyed the meals served, two usually enjoyed the meals and one service user sometimes enjoyed the meals. Care Homes for Older People Page 15 of 26 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has a comprehensive complaint procedure in place. Policies and procedures are in place to protect service users from abuse. Evidence: There is a comprehensive complaints procedure in place and this is displayed in the entrance hall. In the last twelve months two complaints have been received by the home. Service users said that they knew how to make a complaint and if they had any concerns, would speak to either Sylvia Cann or a member of staff. All service users said that they were confident that their concerns would be taken seriously and acted upon. Since the last inspection, the Commission has not received any information regarding complaints about this service. All staff receive training in the homes policies and procedures for protecting service users from abuse and the homes whistle blowing policy, this was confirmed by staff on duty and training records. Training is provided during staff induction and then updated on a regular basis. The home has a copy of the Oxfordshire safeguarding adults procedures. No safeguarding adult referrals or safeguarding adult investigations have taken place in the last twelve months. No referrals have been made for inclusion on the POVA (Protection of Vulnerable Adults) list. Care Homes for Older People Page 16 of 26 Care Homes for Older People Page 17 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides safe, well maintained and spacious accommodation for service users. The home was found to be clean, hygienic and free from unpleasant odours. Evidence: The home is purpose built and was opened in June 2008, replacing the previous home on the site. This is the first phase of a larger home and consists of forty beds, an additional thirty one beds are due for completion by April 2009. The location and layout of the building is suitable for its stated purpose. Service users expressed their satisfaction of the premises and facilities. Communal areas of the home are comfortable and well furnished. Throughout the home are quiet areas for service users to use, including a designated smoking room. In addition to several sitting rooms there is a large communal room, used for activities and functions. There is a licensed bar, facilities for making beverages and snacks, a wide screen television, music system and a computer for service user use. Currently service users have limited access to outdoor space, due to the building work taking place. This was not raised as a concern by any service users, who said that with the colder weather approaching was not a problem. Several service users said that Care Homes for Older People Page 18 of 26 Evidence: they enjoyed watching the building work and had felt involved throughout the building work so far. Hot water outlets in bedrooms and bathrooms are maintained at recommended safe temperatures. All windows are fitted with window restrictors and radiators are covered. A call alarm in installed throughout the home. All bedrooms are for single occupancy and have en-suite shower rooms, complete with washbasin and toilet, appropriate aids and adaptations are in place to assist with maintaining the service users independence and dignity. Bedrooms are a reasonable size and are able to accommode wheelchairs and aids to assist with daily living with ease. Service users are encouraged to personalise their bedrooms. Most service users have a television set and some had a private telephone line. Communal bathrooms and toilets are fitted with appropriate aids and adaptations, to help maintain independence. All areas of the home were seen to be clean, well maintained and free from unpleasant odours. From discussion with members of the housekeeping staff on duty, it was evident that they take pride in maintaining high standards of cleanliness throughout the home. The laundry is well equipped. All housekeeping and laundry staff have received training in COSHH, infection control and health and safety. Policies and procedures are in place. Staff are provided with protective clothing, such as disposable aprons and gloves. Care Homes for Older People Page 19 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff recruitment procedures are robust and protect service users from possible harm. staffing levels appear adequate to meet the current needs of the service users. Staff are well trained. Evidence: From discussion with the manager Sylvia Cann, staff on duty, duty rosters and direct observation, staffing levels appear to be adequate for the current service users. Comments made on one staff survey stated that staff shortages are a problem at times, causing staff to be tired and stressed, this was discussed with Sylvia Cann. The home currently has vacancies for part time care assistants, receptionist and maintenance person. Several registered nurses are in post in preparation for the home being registered to provide nursing care. Until registration has been completed, the nurses are working as team leaders. Sylvia Cann has agreed to provide appropriate name badges, to clarify their current role for service users, staff and visitors to the home. Registered nurses cannot practice as nurses in care homes that are not registered with the Commission to provide nursing care. Members of staff are encourage to undertake NVQ ( national vocational qualification ) training. It is anticipated that the majority of care staff will have completed this training shortly. Care Homes for Older People Page 20 of 26 Evidence: From examination of five staff files, discussion with the manager and staff on duty, the home has robust recruitment procedures. Staff files evidenced that documentation required is obtained and that all staff undertake a formal interview, undertaken by two senior members of staff. All members of staff undertake induction training, appropriate to their role once in post, complete mandatory training and specialist training, as appropriate. OSJCT has its own training centre that provides a high standard of training both in house and external to the home. There is a staff training and development plan in place and evidenced that regular updating of skills is provided to all staff. The two surveys completed by members of staff confirmed that they had received relevant training for their role. Staff spoken to were positive about training opportunities available and felt that this gave them confidence in carrying out their duties and assisted with career advancement within the trust. Staff spoken to during the inspection expressed their satisfaction of working in the home, felt that the working conditions were good, felt well supported and that they contributed positively to the daily live of the service users. Communication systems appear to be well organised, with staff handovers taking place at the start of each shift. Staff meetings take place and staff feel that morale in the home is good. All grades of staff were observed to be professional in their approach to service users, to colleagues and to their work. Care Homes for Older People Page 21 of 26 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users benefit from a well managed home. Evidence: Sylvia Cann is a experienced and well qualified manager, having completed NVQ level four in Health and Social Care and the Registered Managers Award. She has been in care home management since 1999 and the manager of Meadowcroft since May 2008. The manager is supernumery to the homes staffing levels are is supported by an experience head of care and administrator. In discussion with service users and staff on duty all expressed the view that the home was well managed and run in the best interests of service users. Service users expressed their satisfaction of the management style of Sylvia Cann and said that she was approachable and was always accessible, she regularly works in the home, providing direct care to service users at times of staff shortages and as a means of monitoring care practices in the home. Care Homes for Older People Page 22 of 26 Evidence: Procedures are in place for dealing with service users monies and valuables held in safekeeping. From discussion with the manager and examination of a sample of financial records, it was evidenced that records are well maintained. Regular auditing of accounts takes place. All staff receive formal, planned supervision every two months from either a senior member of staff or the manager. A sample of supervision records were seen to be well maintained, actions agreed, recorded and signed by the supervisor and supervisee. Sylvia Cann said that she encourages feedback from service users, members of staff and visitors to the home. Because the home has an open door policy, people are encouraged to speak to the manager or a senior member of staff without having to make an appointment. Quality assurance systems are in place and the manager/head of care undertake regular audits. Evidence was available to demonstrate how the views of service users are obtained to measure the homes success in meeting the aims, objectives and statement of purpose. Reports written by a cluster manager, who is also a registered manager of another OSJCT home, completes a written report on behalf of the provider, following a monthly unannounced visit to the home, these were available for examination. A sample of records relating to health, safety and welfare were examined and found to be up to date and well maintained. Policies and procedures are in place and are reviewed on a regular basis. Care Homes for Older People Page 23 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 24 of 26 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 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 Care Homes for Older People Page 25 of 26 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 26 of 26 - 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!