Inspection on 15/08/06 for Meadowfield House

This inspection was carried out on 15th August 2006.

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

Meadowfield House 08/11/05

Meadowfield House 16/08/05

Meadowfield House 18/01/05

Meadowfield House 28/09/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Meadowfield House Meadowfield Close Fulwood Preston Lancashire PR2 9ER Lead Inspector Ms Susan Dale Unannounced Inspection 10:00 15 August 2006 th X10015.doc Version 1.40 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 Meadowfield House DS0000032674.V303613.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 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. Meadowfield House DS0000032674.V303613.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Meadowfield House Address Meadowfield Close Fulwood Preston Lancashire PR2 9ER 01772 563002 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) alison.walker@careservices.lancscc.gov.uk Lancashire County Care Services Alison Walker Care Home 43 Category(ies) of Dementia (18), Old age, not falling within any registration, with number other category (11), Physical disability (14) of places Meadowfield House DS0000032674.V303613.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The service should employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection Service users in the physical disability category may only be accommodated in the two designated 8 and 6 bedded units, which must not accommodate any service user under the age of 55 years The home is registered for a maximum of 43 service users to include: Up to 11 service users in the category of old age, aged over 65 years (OP) Up to 18 service users in the category of dementia (DE) Up to 14 service users in the category of physical disability (PD) 8th November 2005 3. Date of last inspection Brief Description of the Service: Meadowfield House is a Direct Service Organisation managed by Lancashire County Care Services. The accommodation is situated in Fulwood, a residential suburb to the north of Preston; a good range of shops is located close by and a bus route into the centre of town. Meadowfield House provides personal care to older people of both sexes, and specialist care to older persons suffering from dementia. Rehabilitative care is provided to service users with a physical disability over the age of 55 years. The accommodation is purpose built on two levels and designed to accommodate people living in groups of nine in selfcontained units. Two of the self-contained units have been adapted as Rehabilitation Units, designed to provide short-term care enabling service users to return to their own homes as soon as possible. A Day Care service is also provided in close proximity to the main building however, this is not subject to the regulatory process. All the bedrooms are single and contain a hand basin. Each unit has a living area with a comfortable lounge and a small kitchen area for use by the service users. Currently the home is undergoing a major refurbishment programme and parts of the home are inaccessible. Meadowfield House DS0000032674.V303613.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and the focused mainly on key standards. The inspector was able to speak to service users and staff and examine various records. Comment cards were provided to service users, relatives/friends and health professionals prior to the inspection. 7 comment cards were returned from service users/relatives and 2 were from general practitioners, all the responses were very positive, the results were taken into account as part of the inspection. A tour of the premises took place. What the service does well: What has improved since the last inspection? A new summary sheet for each service user is kept in a loose-leaf file that provides up to date information to staff as they come on duty. In the corridor a display board is dedicated to the Commission for Social Care Inspection providing leaflets and information about the regulatory process. Meadowfield House DS0000032674.V303613.R01.S.doc Version 5.2 Page 6 The manager of the home is now responsible for the rehabilitation units in place of the Team Leader who was previously in charge. The registered manager also now oversees the medication provided on the rehabilitation units. According to the registered manager there will be an opportunity to build up a closer relationship with the District Nurses as each nurse is allocated to an individual home and a file with all the case notes is available within the home. All staff have been placed on standard contracts working 8.00 am till 3.30 pm and 3.30 pm till 10.00 pm. Staff have been very helpful in thinking of new activities and one of them has recently introduced a candyfloss machine that has been a hit with the service users. Service users are also benefiting from a hand massage that was monthly but now takes place every two weeks. For service users who have to stay in bed an idea was put forward for a wind chime or mobile to be hung above the bed and when the home is refurbished one of the plans is for a room that provides sensory experiences. The number of staff with an NVQ qualification has risen to 30 staff out of a total of 45, 4 more staff are to commence NVQ training on the 28th August 2006. This means that the home has met the required standard for staff holding an NVQ qualification. 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. Meadowfield House DS0000032674.V303613.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection Meadowfield House DS0000032674.V303613.R01.S.doc Version 5.2 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 the following standard(s): 3&6 The quality in this outcome group was good. This judgement has been made using available evidence including a visit to this service. Prospective service users are assessed in order to ensure that the services provided meet their needs. Intermediate care is provided in a way that assists service users to maximise their independence and move on where appropriate. EVIDENCE: Major changes are taking place within the home and work has commenced on the building; according to the registered manager the refurbishment programme will not be completed until December 2007. Relatives of service users are kept informed by telephone of the details as they progress and they are able to liaise with the service users over any choices they may have over, for example, colours on the walls. Records belonging to service users were examined and the details showed that a comprehensive assessment had been undertaken prior to admission. All areas of physical and emotional requirements are assessed and any risks are examined and recorded. There are no new service users being admitted to the home on a permanent basis whilst the home is undergoing refurbishment. Meadowfield House DS0000032674.V303613.R01.S.doc Version 5.2 Page 9 New paperwork with regard to the assessment of new service users will be put in place when new service users are to be re-admitted. A new summary sheet for each service user is kept in a loose-leaf file that provides up to date information to staff as they come on duty. In the corridor a display board is dedicated to the Commission for Social Care Inspection providing leaflets and information about the regulatory process. In the intermediate units service users are assessed by a team of professionals who decide whether service users will benefit from short-term care that will enable them to move back to their own homes. Meadowfield House DS0000032674.V303613.R01.S.doc Version 5.2 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 the following standard(s): 7, 8, 9 & 10 Quality in this outcome group was good. This judgement has been made using available evidence including a visit to this service. A comprehensive care plan is produced that meets all physical/health and emotional requirements and appropriate medication policies and procedures are in place. EVIDENCE: Care plans seen provided a clear picture about the needs of each individual service user and risks had been identified. Reviews of the care plan are now taking place every month. There was evidence that the service user or their representative had been involved in the compilation of the care plan and any subsequent review or risk assessment. The records showed that prompt action had been taken with regard to the service users health and that specialist medical, nursing, dental and chiropody services had been sought appropriately. Service users are allowed to see the G.P. of their choice and have access to hearing and sight tests according to need. Nutritional requirements are recorded at the initial assessment and a record kept of any weight gain or loss and fluid charts are maintained for certain service users who are at risk. Meadowfield House DS0000032674.V303613.R01.S.doc Version 5.2 Page 11 Two comment cards were returned from General Practitioners who confirmed that the home worked in partnership with them and the management /staff demonstrated a clear understanding of the care needs and managed the medication appropriately. The medication records seen were complete and signed for at the time of administration. Handwritten records are checked and pharmacy labels are not being used, the details on them are handwritten on the medication record. All staff have recently been invited to undertake training in the provision of medication and several staff have taken this up. Whoever is on senior duty monitors the provision of medication and the registered manager also now oversees the medication provided on the rehabilitation units. According to the registered manager there will be an opportunity to build up a closer relationship with the District Nurses as each nurse is allocated to an individual home and a file with all the case notes is available within the home. Staff were observed to treat service users with respect and dignity and comment cards returned from service users confirmed that staff treated them well and their privacy was respected. A relative made the following comment: “Everything is fine here and we couldn’t wish for better care for our mother, nothing is ever too much trouble.” At the initial assessment a recording is made of individual requirements including the service users’ preferred form of address. Service users open their own mail and have access to a telephone. Meadowfield House DS0000032674.V303613.R01.S.doc Version 5.2 Page 12 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 the following standard(s): 12, 13, 14 & 15 Quality in this outcome group was good. This judgement has been made using available evidence including a visit to this service. Appropriate activities are in place according to the needs and capabilities of the service users. Contact is maintained with family, friends and the local community. EVIDENCE: The routines of daily living are flexible according to need and that activities are arranged around the capabilities of the individual service user. At the initial assessment a recording is made of hobbies and interests and service users are encouraged to continue any interests as much as possible. Staff have been very helpful in thinking of new activities and one of them has recently introduced a candyfloss machine that has been a hit with the service users. Service users are also benefiting from a hand massage that was monthly but now takes place every two weeks. For service users who have to stay in bed an idea was put forward for a wind chime or mobile to be hung above the bed and when the home is refurbished one of the plans is for a room that provides sensory experiences. Up to date information about activities is circulated verbally and displayed on a notice board. The majority of permanent service users are very frail an unable to participate in outings or certain activities. Service users in the intermediate Meadowfield House DS0000032674.V303613.R01.S.doc Version 5.2 Page 13 unit are able to visit the local community and have handicraft instruction. Activities provided generally include Bingo, Sing Along, Nail Care and a Mobile Shop. A drinks trolley is provided at social occasions; there is a party at Christmas and Halloween and singing groups are provided at Bank Holidays. Local schools visit the home on such occasions such as Harvest Festival. In the corridor of the home there was a display of photos depicting service users in Easter Bonnets and obviously having a good time with the staff. A comment from a service user in the rehabilitation unit: “they are very helpful especially the exercise class.” “Enjoy bingo and sing-a-long nights.” A relative commented that her mother, “Likes singing and going to church.” And also with regard to the staff “They have been very helpful.” Visitors are able to visit the home at any time and comment cards confirmed that they are able to see service users in private. One visitor commented on how she loved coming to the home to visit her friend and was always made to feel welcome. Representatives from various Churches visit the home on a regular basis. Service users are encouraged to handle their own financial affairs for as long as possible and information has been provided about how service user can obtain an external agent/advocate who will act in their interests. Service users may bring their own personal belongings into the home and the home have a policy and procedure on the service users rights to look at their own personal records. At the initial assessment a recording is made about any dietary requirements, likes and dislikes. Meals are taken in the individual units that ensure a homely setting for smaller numbers of service users. Service users confirmed that the meals are “excellent” and one service user commented on the high quality of the meals and how much he looked forward to the meals provided. The chef was spoken to and she was preparing for a ‘field kitchen’ that was to replace the existing kitchen whilst the refurbishment programme took place. Concerns were raised about the lack of kitchen help and this is a particular problem for the chef that has been raised before. Currently the number of service users is low but, the chef is concerned that when the number of service users is increased she may find it difficult too maintain standards. Both the registered manager and the area manager have been made aware of her concerns. Meadowfield House DS0000032674.V303613.R01.S.doc Version 5.2 Page 14 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 the following standard(s): 16 & 18 Quality in this outcome group was good. This judgement has been made using available evidence including a visit to this service. There is an appropriate procedure for dealing and recording any concerns about the care and facilities of the home. Polices and procedures are in place for protecting service users from abuse. EVIDENCE: The home has an appropriate policy and procedure for complaints and the details are publicised within the Statement of Purpose and Service Users’ Guide. There have been no complaints received by the Commission for Social Care Inspection. A service user in the rehabilitation unit commented that the officer in charge was always available for any concerns. Procedures are in place for safeguarding service users from any harm. Training has been provided to staff with regard to Adult Abuse and in the handling of any physical or verbal aggression. Policies and procedures are in place to ensure the safety of any financial records or money belonging to service users. The home has a safe for the storage of any valuables or money. Staff are not allowed to assist service users with regard to any legal documents. Meadowfield House DS0000032674.V303613.R01.S.doc Version 5.2 Page 15 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 the following standard(s): 19 & 26 Quality in this outcome group was good. This judgement has been made using available evidence including a visit to this service. The home is clean and well maintained. All areas of the home including service users’ personal accommodation are safe, clean and comfortable. EVIDENCE: A tour of the premises took place and all areas and bedrooms seen were clean and comfortable. Some parts of the home were not accessible; the home is undergoing major refurbishment and will not be completed until December 2007 at the earliest. The home is divided into separate units each with its own lounge and dining room. There are two rehabilitation units each with its own dedicated accommodation separate from the rest of the home. The large lounge on the ground floor is generally used for training purposes or activities. Because of the recent hot weather an air conditioning unit has been purchased for one of the units. Meadowfield House DS0000032674.V303613.R01.S.doc Version 5.2 Page 16 The premises were clean and hygienic and free from offensive odours. Meadowfield House DS0000032674.V303613.R01.S.doc Version 5.2 Page 17 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 consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 Quality in this outcome group was good. This judgement has been made using available evidence including a visit to this service. The staffing levels have been improved and there are sufficient staff for the number of service users and to cover their care needs. A suitable recruitment procedure is in operation and training is provided to staff that ensures they are competent and able to meet the needs of the service users. EVIDENCE: No new staff have been recruited but some staff have been re-allocated from other local authority homes in the area. The staffing rotas have been adjusted to ensure that adequate staffing levels are maintained at peak times. All staff have been placed on standard contracts working 8.00 am till 3.30 pm and 3.30 pm till 10.00 pm. Overall, staff appeared happy with the changes to their contractual hours. The manager of the home is now responsible for the rehabilitation units in place of the Team Leader who was previously in charge. The training of staff is given a high priority and the number of staff with an NVQ qualification has risen to 30 staff out of a total of 45, 4 more staff are to commence NVQ training on the 28th August 2006. This means that the home has met the required standard for staff holding an NVQ qualification. Along with the new staff contracts, all staff now have to be willing to undertake an NVQ qualification. Other recent training includes, Customer Care, Food Hygiene, First Aid, Moving and Handling, Abuse Training, Safe Handling of Meadowfield House DS0000032674.V303613.R01.S.doc Version 5.2 Page 18 Medication and Dementia. Future training planned is Fire Safety, IT and the 4day First Aid training. Meadowfield House DS0000032674.V303613.R01.S.doc Version 5.2 Page 19 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 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38 Quality in this outcome group was good. This judgement has been made using available evidence including a visit to this service. The home is well run and service users benefit from the services provided by the staff. Service users are also protected by the policies and procedures operating within the home. EVIDENCE: The manager of the home has an appropriate qualification; many years experience in care and the management of staff within a residential setting and has been recently registered with the Commission for Social Care Inspection. Both staff and service users are benefiting from the support of the manager and the new ideas that she has introduced. There are several quality monitoring systems in operation within the home. Questionnaires are sent out twice a year from Headquarters; the results are analysed and then returned to the home for any action required. A Meadowfield House DS0000032674.V303613.R01.S.doc Version 5.2 Page 20 questionnaire is also provided to new service users or their relatives shortly after they commence with the home in order to see if they have been satisfied with the process. In the Rehabilitation Unit, questionnaires are sent out once the service user has returned to their own home to see if the temporary stay within the home has helped in their circumstances. The home has a `Complaints, Compliments and Comments’ leaflet, prominently displayed and available for any visitor to the home. Records are kept of financial transactions and personal allowances on behalf of service users. The home has a safe to secure articles of value belonging to service users and an inventory is taken of the contents. Policies and procedures are in place with regard to Health and Safety. The assessment and care planning process takes into account any risks that may be encountered by staff in their care of service users and staff are routinely sent on training and updated training on safe working practices. The manager is currently analysing any potential risks to service users, staff and any visitors to the home connected with the major refurbishment of the home. Meadowfield House DS0000032674.V303613.R01.S.doc Version 5.2 Page 21 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Meadowfield House DS0000032674.V303613.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? No 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. 1 Refer to Standard OP15 Good Practice Recommendations Consideration should be given to providing a kitchen assistant when the number of service users are increased. Meadowfield House DS0000032674.V303613.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection North Lancashire Area Office 2nd Floor, Unit 1, Tustin Court Port Way Preston PR2 2YQ 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 Meadowfield House DS0000032674.V303613.R01.S.doc Version 5.2 Page 24 - 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. 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