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Inspection on 17/04/08 for Meadowcroft, Minehead

Also see our care home review for Meadowcroft, Minehead for more information

This inspection was carried out on 17th April 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

There is a relaxed friendly atmosphere at Meadowcroft. Some people have lived there for some time and the home continues to provide excellent support. Social care and living an active supported daily routine are part of the home`s ethos. The environment is comfortable but and smart and maintained to a high standard. People who live at the home are able to personalise their rooms to reflect their individual tastes. Access to community social and leisure pursuits is easy due to the home`s town location. Mrs Cliffe and Mr Clarke have a thorough knowledge of the people who live at the home. When combined with their experience this enables them to minimise possible troubles between people and promote a positive social environment. The range of educational and leisure activities offered to the people who live in the home is diverse and purposeful. There is a real effort to offer people a weekly programme that suits them. People are encouraged to maintain contact with family and friends. People living at the home are able to choose when they want to mix with others and when they would like to spend time alone. Interaction observed between people living in the home was warm and friendly. Information in the home is well organised, making records easily assessable and auditable.

What has improved since the last inspection?

At the last inspection no requirements or recommendations are made. The proprietors described improvements to the environment made as part of an on-going process.

What the care home could do better:

The home will access the latest guidance on Fire Risk Assessment and implement it.

CARE HOME ADULTS 18-65 Meadowcroft The Parks Minehead Somerset TA24 8BU Lead Inspector Shelagh Laver Unannounced Inspection 17th April 2008 14:00 Meadowcroft DS0000016182.V362486.R01.S.doc Version 5.2 Page 1 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 Meadowcroft DS0000016182.V362486.R01.S.doc Version 5.2 Page 2 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 Adults 18-65. 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 DS0000016182.V362486.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Meadowcroft Address The Parks Minehead Somerset TA24 8BU 01643 702106 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) alisonjcliffe@hotmail.com Ms Alison Jane Cliffe Mr Lee James Clarke Ms Alison Jane Cliffe Care Home 4 Category(ies) of Learning disability (4), Physical disability (4) registration, with number of places Meadowcroft DS0000016182.V362486.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Registered for 4 Persons in categories LD and PD Date of last inspection 28th June 2006 Brief Description of the Service: Meadowcroft is a large detached house situated not far from the centre of Minehead. The home is registered with the Commission for Social Care Inspection to provide personal care to 4 adults, between the ages of 18 & 65 years, with learning disabilities and/or a physical disability. The home is not registered to provide nursing care. Residents live with the providers as part of the family. The home does not employ staff. All residents are accommodated in comfortable single bedrooms and have access to all communal areas. The home has a people carrier, which provides transport for service users. Meadowcroft also benefits from a very large garden, which is enjoyed by all. The registered providers are Alison Cliffe and Lee Clarke. The registered manager is Alison Cliffe. Meadowcroft DS0000016182.V362486.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. The focus of this inspection visit was to inspect relevant key standards under the CSCI ‘Inspecting for Better Lives 2’ framework. This focuses on outcomes for service users and measures the quality of the service under four general headings. These are - excellent, good, adequate and poor. The inspector has found that on this visit the overall quality of the service is good. This key inspection commenced on 17th April when contact was made with Mr Clarke. The visit to the home was made on 21st April at 2pm in order to meet the three people who were living at the home. The visit took place between three and five pm. There is currently one vacancy and the admission procedures were discussed. The proprietors Mrs. Cliffe and Mr. Clarke were at the home and assisted with the inspection. No additional staff are employed at this family run business and the proprietors provide care based on best practice guidelines in a comfortable setting. The inspector met with the three people who lived in the home when they returned from their day time activities. In the short time spent having a cup of tea in the sitting room with them they were confident, cheerful and relaxed. They spoke with enthusiasm about the activities of the week, parties attended and holidays enjoyed. They appeared to be in very good health, looked fit and were smartly dressed. In conversation it was clear that they had made choices about the clothes they wore and the things they did. Records were examined during the inspection for two people. These included care and support plans, medication administration records and medication storage, and the home’s Statement of Purpose. An Annual Assessment of Quality Assurance had been completed prior to inspection. The inspector spoke with the care manager for two of the people who live in the house. She was able to confirm that Meadowcroft provided “excellent” care and that health monitoring was very good. Communication was very good. Any day to day issues could be quickly discussed and appropriate action taken. Two comment cards were received from relatives that were positive. What the service does well: Meadowcroft DS0000016182.V362486.R01.S.doc Version 5.2 Page 6 There is a relaxed friendly atmosphere at Meadowcroft. Some people have lived there for some time and the home continues to provide excellent support. Social care and living an active supported daily routine are part of the home’s ethos. The environment is comfortable but and smart and maintained to a high standard. People who live at the home are able to personalise their rooms to reflect their individual tastes. Access to community social and leisure pursuits is easy due to the home’s town location. Mrs Cliffe and Mr Clarke have a thorough knowledge of the people who live at the home. When combined with their experience this enables them to minimise possible troubles between people and promote a positive social environment. The range of educational and leisure activities offered to the people who live in the home is diverse and purposeful. There is a real effort to offer people a weekly programme that suits them. People are encouraged to maintain contact with family and friends. People living at the home are able to choose when they want to mix with others and when they would like to spend time alone. Interaction observed between people living in the home was warm and friendly. Information in the home is well organised, making records easily assessable and auditable. What has improved since the last inspection? What they could do better: The home will access the latest guidance on Fire Risk Assessment and implement it. Meadowcroft DS0000016182.V362486.R01.S.doc Version 5.2 Page 7 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. The summary of this inspection report can be made available in other formats on request. Meadowcroft DS0000016182.V362486.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Meadowcroft DS0000016182.V362486.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. People are admitted to the home only following a full assessment that involves the person to be admitted and all interested parties. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There is a vacancy in the home and one person is being considered for admission. The registered manager described the detailed process. There is written information available about the home. There have been meetings with the care manager of the person. The family have visited the home. The person has been to the home for a meal and will spend a night in the home before moving in. As well as being sure that the home can meet the needs of the new person care is taken to ensure that the three people who live in the home will be able to live with the newcomer. Written contracts were seen in peoples’ files. Individual care plans and documentation were seen in peoples files showing consultation and agreement. Meadowcroft DS0000016182.V362486.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6 7 9 Quality in this outcome area is good. Care plans reflect peoples’ current needs, interests and aspirations. There is a commitment to developing service user’s independence and choice within a risk assessment framework. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The care documentation of two people who live in the home was seen. Records were clear and well written giving a good account of the needs and interests of people. Talking to people who live in the home it was evident that they had made choices about how they spend their week. There is a risk assessment in the files that identifies everyday risks. There are no daily records kept but key events are recorded. There are regular reviews and plans are up-dated as needed. Meadowcroft DS0000016182.V362486.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12 13 14 15 16 17 Quality in this outcome area is excellent. People enjoy an active social life that includes meeting with friends outside of the home and outings with the providers. Meals are nutritious and balanced and offering a healthy varied diet. This judgement has been made using available evidence including a visit to this service. EVIDENCE: From the records available and from talking to the registered manager it was clear that people had an individual and varied programme of activities. Each person is consulted on how they spend their days and there are regular opportunities for review. The home has taken time to research and evaluate the facilities and opportunities available for people in the local community. People attended a local Day Centre and access choices there. People could access sporting activities and further education courses that gave them the opportunity to do cooking and life skills. At weekends there is a chance to go to the sports centre to do exercise classes. One person is a volunteer for the National Trust and talked enthusiastically about her work of growing things. Meadowcroft DS0000016182.V362486.R01.S.doc Version 5.2 Page 12 People are interested in drama and attend a local group. There is a social club and parties. People stay at home if they are unwell or occasionally tired. When discussing and arranging changes of activity the person is fully involved and time is taken to explain what is entailed so that they have a realistic view of whether it will suit them or not. People sometimes spend time with the home proprietors going shopping or making visits. There is an annual holiday and people were able to talk about trips to Tunisia, Egypt and Spain. Links with family and friends are encouraged. The home provides support and transport to enable service users to maintain these links. When the proprietors take an annual holiday people leave the home and spend time away from each other. This was seen as a positive move. It gives everyone time away from each other and people enjoy the arrangements made for them each year. Meal planning is undertaken in the manner of family homes. There is no fixed menu and meals are planned on a daily basis. People spoken to confirmed they enjoyed the meals. There is an emphasis on healthy and sensible eating that has paid dividends for the health of all at Meadowcroft. Meadowcroft DS0000016182.V362486.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18 19 20 Quality in this outcome area is good. The health and personal care needs of service users are met with good multidisciplinary working taking place. The management of medicines is safe. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People receive individual personal support in appropriate degrees to maintain their dignity and independence. People appeared to be positively healthy. Exercise is encouraged in everyday life and people clearly benefit from the encouragement to walk and eat healthily in the home. There is consideration of peoples physical and emotional health needs. People are supported to visit General Practitioners when needed. There are links to appropriate consultants or specialist services. People visit dentists and chiropodists when needed. At a previous inspection the Commission wrote to G.P surgeries providing medical support to the home there were three responses received giving an overall positive opinion of the service at Meadowcroft. Meadowcroft DS0000016182.V362486.R01.S.doc Version 5.2 Page 14 People receive help with medication when needed. A consideration of selfmedication has been made but this is currently not appropriate for people. A record of medication is kept. If it is ever necessary to keep controlled drugs in the home the storage arrangements should be changed. Meadowcroft DS0000016182.V362486.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 23 Quality in this outcome area is good. Service users are encouraged to air their views both in the home or to families/placement care managers. The proprietors are aware of their responsibilities in protecting people. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Peoples’ views are listened to and acted upon. There is a zero tolerance policy in the home regarding bullying between people. This is signed and each persons file. There is a complaints policy available. The up-dated Safeguarding Adults in Somerset policy has been accessed. The home has received no complaints since the last inspection and in this time no complaints or concerns have been raised directly to the Commission with regard to the service. The home’s complaint’s procedure is written in both English and Somerset Total Communication symbols and is displayed in service user’s rooms. The proprietors employ no staff and do not use volunteers. Financial record keeping on behalf of service users by the providers were inspected and clear records were maintained. Meadowcroft DS0000016182.V362486.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 30 Quality in this outcome area is good. The standard of the environment is high, providing residents with attractive, safe and clean surroundings. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Meadowcroft is an established and well maintained family home. The premises are comfortable bright and cheerful. The home is very clean and well maintained. There are two sitting rooms that enable people to make choices about which television programmes are watched. The communal kitchen/dining room is furnished and equipped to high standard. Individual rooms are comfortable and reflect peoples interests. Currently two people share one bathroom however there are other toilet facilities. Meadowcroft DS0000016182.V362486.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32 Quality in this outcome area is good. Service user’s needs are met by the owners who are caring and experienced. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home does not employ staff. This is a conscious decision made by the providers to enable service users to live in a family environment. The providers have renewed their enhanced CRB disclosures in June 2006. This is good practice. Both providers have experience in caring for younger adults with learning disabilities and have undertaken some training, for example total communication, physical intervention, first aid, moving and handling essential food hygiene and health and safety, in order to meet the needs of the residents. Meadowcroft DS0000016182.V362486.R01.S.doc Version 5.2 Page 18 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. The home is managed well with clear records maintained. Health and safety in the home is carefully managed. People benefit from the conscientious and informed management of the service. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The registered owners have many years experience of working with younger adults and managing a home however neither have formal care management qualifications for example NVQ 4 or the Registered Managers Award. Mrs. Cliffe trained and practiced as an occupational therapist prior to being a care homeowner. Both proprietors have undertaken regular periodic training for managerial, healthcare or behavioural management of the home and service users. Meadowcroft DS0000016182.V362486.R01.S.doc Version 5.2 Page 19 The home does not have a formal quality assurance system in place but consult with service users daily and care managers at planned reviews. The environment is maintained appropriately with safety risk assessed and controlled in the home. Fire alarms are tested weekly and service users participate in fire drills. The home has current public liability insurance. Meadowcroft DS0000016182.V362486.R01.S.doc Version 5.2 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 Standard No Score 1 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 X 35 X 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X X X X 3 X Meadowcroft DS0000016182.V362486.R01.S.doc Version 5.2 Page 21 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Meadowcroft DS0000016182.V362486.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection South West Colston 33 33 Colston Avenue Bristol BS1 4UA National Enquiry Line: 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 © 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 DS0000016182.V362486.R01.S.doc Version 5.2 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!