CARE HOME ADULTS 18-65
Meadowcroft Meadowcroft The Parks Minehead Somerset TA24 8BU Lead Inspector
Dee McEvoy Unannounced Inspection 27th February 2006 10:00 Meadowcroft DS0000016182.V282154.R01.S.doc Version 5.1 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.V282154.R01.S.doc Version 5.1 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.V282154.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Meadowcroft Address Meadowcroft 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) 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.V282154.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: 1. Registered for 4 Persons in categories LD and PD Date of last inspection 10th October 2005 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 providers have plans to provide an additional lounge area for residents. 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.V282154.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was a short unannounced inspection following the good outcomes found at the last inspection on 10 October 2005, this report should be read in conjunction with the last report in order to fully appreciate the service offered at Meadowcroft. National Minimum Standards, which have been met at the previous inspection on 10 October 2005, were not inspected on this occasion. This inspection focussed on key National Minimum Standards, which had not been inspected at the previous inspection or those, which were the subject of previous requirements and/or recommendations. There were three residents living at the home at the time of this inspection; the inspector met and spoke with one. The other residents were undertaking activities outside of the home. The inspector was at the home for just under three hours. During that time the inspector looked around the home, which was extremely clean and comfortable. A number of records were inspected, including residents’ care notes. Feedback was also received from one care manager with responsibility for two residents living at the home. What the service does well: What has improved since the last inspection?
One recommendation was issued at the last inspection. In response to that recommendation a copy of local guidelines for adult protection has been obtained by the home and the providers have familiarised themselves with local adult protection procedures in order to ensure residents are protected from harm. Meadowcroft DS0000016182.V282154.R01.S.doc Version 5.1 Page 6 Since the last inspection work has finished to provide an additional lounge area for residents. The inspector was told that residents were using and enjoying the room. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Meadowcroft DS0000016182.V282154.R01.S.doc Version 5.1 Page 7 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.V282154.R01.S.doc Version 5.1 Page 8 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): This was not inspected on this occasion; relevant key standard was met at the previous inspection. EVIDENCE: Meadowcroft DS0000016182.V282154.R01.S.doc Version 5.1 Page 9 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6&9 The standard of care planning and risk assessment and management were good, ensuring residents’ individual needs are understood and met. EVIDENCE: One care plan was looked at on this occasion. The care plan contained good detail and direction on how to meet the residents’ needs. Risk assessments were good, identifying hazards to the resident, for example crossing roads or using the kitchen and the action to be taken to reduce risks. The resident spoken with said they were aware of their ‘file’ and was completely happy with the care and attention provided. Meadowcroft DS0000016182.V282154.R01.S.doc Version 5.1 Page 10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These standards were not inspected on this occasion; relevant key standards were met at the previous inspection. EVIDENCE: Meadowcroft DS0000016182.V282154.R01.S.doc Version 5.1 Page 11 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 20 The management of residents’ medicines is generally good. EVIDENCE: Two residents are assisted to manage their medicines. Evidence of annual medication reviews by G.Ps was seen. Medication is stored in a locked cupboard, accessed only by the providers. Clear records are kept of residents’ current medication and daily records are kept of when medicines are administered and by whom. Meadowcroft DS0000016182.V282154.R01.S.doc Version 5.1 Page 12 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 23 Well informed and proactive providers protect residents from abuse or harm. EVIDENCE: Since the last inspection the providers have obtained and familiarised themselves with Somerset’s Adult Protection multi-agency policy and practice guidelines. The providers work closely with care managers if any concerns arise and one care manager was confident in the providers ability to liaise and act appropriately, the inspector was told, “Communication with the home is excellent”. Residents have access to advocates at the local day centre to ensure that they have someone other than the providers to act in their interests. Meadowcroft DS0000016182.V282154.R01.S.doc Version 5.1 Page 13 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30 The standard of the environment is high, providing residents with attractive, safe and clean surroundings. EVIDENCE: The inspector looked at communal areas, such as the kitchen, sitting rooms, bathroom and office, as well as one resident’s bedroom. Since the last inspection work on a second sitting room has been completed providing residents with an alternative space for watching TV or entertaining visitors. The resident spoken with was happy with the accommodation provided and one care manager described the environment as “lovely”. The standard of cleanliness throughout the home was high. There is a domestic laundry area, which suits the requirements of the home. The providers were aware of how to deal with any soiled or infected linen, although this was not a problem currently. Meadowcroft DS0000016182.V282154.R01.S.doc Version 5.1 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 & 35 Residents’ needs are well met by the owners who are caring and experienced. EVIDENCE: The home does not employ staff. This is a conscious decision made by the providers to enable residents to live in a family environment. The providers have enhanced CRB disclosures but were to renew these shortly as the last checks were undertaken three years ago. This is commended as good practice. Both providers have experience in caring for younger adults with learning disabilities and have undertaken some training, for example total communication, in order to meet the needs of the residents. One care manager felt that both providers had the skills to meet the residents’ individual needs, the inspector was told, “Alison and Lee manage challenging behaviour brilliantly. I wouldn’t hesitate to place people at Meadowcroft.” Both providers have an up to date first aid certificate, manual handling, and health and safety certificates. A refresher course for food hygiene was booked for early in March. Meadowcroft DS0000016182.V282154.R01.S.doc Version 5.1 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37 & 39 The home is well managed and residents are involved in the development of the service. However formal quality assurance is less well addressed. EVIDENCE: One care manager expressed complete confidence in the management of the home, saying, “Alison and Lee are very professional.” The registered owners have many years experience of working with younger adults and managing a home however neither have formal qualifications for example NVQ 4 or the Registered Managers Award. This was discussed with them at the inspection and they were asked to consider further training in order to maintain the high standards and good practice at the home. Undertaking periodic training specific for management responsibilities will update knowledge, skills and competencies. The home does not have a formal quality assurance system in place but one resident confirmed that they were consulted on a daily basis regarding their preferences and always kept informed of changes. The providers told the inspector that ‘feedback’ was actively sought from residents and the daily
Meadowcroft DS0000016182.V282154.R01.S.doc Version 5.1 Page 16 routine of the home was centred on the residents’ needs and preferences. Formal quality assurance systems will ensure that the views of family, advocates and others, for example care managers and G.Ps, are sought on how the home is achieving goals for the residents. Meadowcroft DS0000016182.V282154.R01.S.doc Version 5.1 Page 17 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 X 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 X 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 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 X X X X LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 X 16 X 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X X 3 X 2 X 2 X X X X Meadowcroft DS0000016182.V282154.R01.S.doc Version 5.1 Page 18 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 YA39 Regulation 24 Requirement The registered person shall establish and maintain a system for reviewing at appropriate intervals and improving the quality of care provided at the care home. The registered person shall supply a report to the Commission in respect of any review of the quality of care provided at the care home, and also make a copy available to residents. Timescale for action 31/07/06 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. Refer to Standard YA37 Good Practice Recommendations The providers need to demonstrate that they have undertaken periodic training to update knowledge, skills and competencies, particularly in relation to the management of the home. Meadowcroft DS0000016182.V282154.R01.S.doc Version 5.1 Page 19 Commission for Social Care Inspection Exeter Suites 1 & 7 Renslade House Bonhay Road Exeter EX4 3AY National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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