Inspection on 16/08/05 for Meadowfield House

This inspection was carried out on 16th August 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Meadowfield House 15/08/06

Meadowfield House 08/11/05

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 Sue Dale Announced 16 August 2005 10:00 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Meadowfield House F57 F09 S32674 Meadowfield V202118 160805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Meadowfield House Address Meadowfield Close, Fulwood, Preston, Lancashire, PR2 9ER Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01772 563002 karen.mason@careservices.lancscc.gov.uk Lancashire County Care Services Mr Alan Charles Ridd Care Home 43 Category(ies) of Dementia (18), registration, with number Old age, not falling within any other category of places (11), Physical disability (14) Meadowfield House F57 F09 S32674 Meadowfield V202118 160805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. Staffing to be provided in accordance with the residential forum staffing guidance by April 2004. 2. The service should at all times, employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. 3. 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. 4. 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) Date of last inspection 09/02/05 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. The home has a garden, accessible to service users providing a safe pleasant environment to sit out on sunny days. Meadowfield House F57 F09 S32674 Meadowfield V202118 160805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was announced and the inspector was able to examine various staffing and service user records as well as speak with the registered manager, care staff and all the service users. Comment cards were sent out prior to the inspection to service users, relatives/visitors, health professionals and general practitioners; their comments have been taken into account as part of the inspection process. 3 Comment cards were received from service users, 1 from a relatives/visitor and 3 from general practitioners. What the service does well: What has improved since the last inspection? There have been no obvious improvements from the last inspection other than the new manager has structured the procedures to be taken by the staff in the morning routines and the staff have commented that this has been beneficial. The manager also intends to alter the paperwork relating to assessment and care planning and this should be in evidence by the next inspection. Meadowfield House F57 F09 S32674 Meadowfield V202118 160805 Stage 4.doc Version 1.40 Page 6 Staff have received additional training including Dementia Reminiscence and are encouraged and supported to attend training on various subjects. 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 F57 F09 S32674 Meadowfield V202118 160805 Stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Meadowfield House F57 F09 S32674 Meadowfield V202118 160805 Stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 3 & 6 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: The documentation detailing the service provided by the home has not been up-dated to include the current service provided by the home. The home is due to be refurbished in the near future and it is understood that the documentation, the Statement of Purpose and Service User Guide, will be updated at that time. 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 have been no new service users requiring permanent care admitted to the home for some time as the home is due to be re-furbished. Changes are to be made to the assessment paperwork in order Meadowfield House F57 F09 S32674 Meadowfield V202118 160805 Stage 4.doc Version 1.40 Page 9 to improve the procedure and become more user friendly; the new manager hopes to have the new paperwork available for the next inspection. 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 F57 F09 S32674 Meadowfield V202118 160805 Stage 4.doc Version 1.40 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8, & 10 A comprehensive care plan is produced that meets all physical/health and emotional requirements. 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. Any significant changes are recorded on a daily basis on the back page of an individual file. 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 F57 F09 S32674 Meadowfield V202118 160805 Stage 4.doc Version 1.40 Page 11 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. 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. Comment cards returned from General Practitioners confirmed that medical examinations take place in private; there are no shared rooms. Meadowfield House F57 F09 S32674 Meadowfield V202118 160805 Stage 4.doc Version 1.40 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 standard(s) 12, 13, & 14 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. 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 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. Meadowfield House F57 F09 S32674 Meadowfield V202118 160805 Stage 4.doc Version 1.40 Page 13 Visitors are able to visit the home at any time and comment cards confirmed that they are able to see service users in private. 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. Meadowfield House F57 F09 S32674 Meadowfield V202118 160805 Stage 4.doc Version 1.40 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 standard(s) The standards were not assessed at this inspection. EVIDENCE: Meadowfield House F57 F09 S32674 Meadowfield V202118 160805 Stage 4.doc Version 1.40 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 standard(s) The standards were not assessed at this inspection. EVIDENCE: Meadowfield House F57 F09 S32674 Meadowfield V202118 160805 Stage 4.doc Version 1.40 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 28, 29 & 30 There are inadequate staffing levels for the requirements of the service users cared for in the category of Old Age and Dementia; there are adequate staffing levels in the Intermediate units. A suitable recruitment procedure is in operation that ensures the protection of vulnerable people and training is provided to staff that ensures they are competent and able to meet the needs of the service users. EVIDENCE: Staff were spoken to who care for the service users who require permanent care and are categorised as suffering from Dementia. The staff are concerned and state that there are insufficient staffing levels particularly in the morning. The needs of the very frail service users and their need for constant attention means that staff are struggling to provide adequate care. A member of the Domestic staff stated that she had helped provide care to service users as necessary because there was no alternative. The issue of staffing levels was discussed with the manager who has only recently been appointed to Meadowfield and it was agreed that although staffing levels meet minimum previous local authority guidance, it was insufficient because of the dependency levels of the current service users. The manager has already made some improvements to the morning routines and staff spoken to confirm that they feel confident in her approach with regard to staffing. There is a requirement for a minimum of 5 care staff to be on duty in the mornings instead of the current 4 care staff. Staffing levels have been an Meadowfield House F57 F09 S32674 Meadowfield V202118 160805 Stage 4.doc Version 1.40 Page 17 issue at Meadowfield previously and comment cards received from relatives at the current and previous inspections have expressed their concerns in this area. The geographical nature of the home with individual units means that a staff member in one unit could not be physically present in another unit where assistance may be required. There was evidence that the home has an appropriate policy and procedure with regard to the recruitment of staff and correct recruitment procedures are in operation. NVQ training is continuing and 36 care staff have an NVQ level 2 qualification. Staff training meets National Training Organisation Targets with regard to Induction and Foundation Training. All staff are provided with training in `Moving and Handling’; Food Hygiene; Safety Compliance and First Aid. Staff have also received training in Adult Abuse; Care of the Dying; Dementia and Aggressive Behaviour; Hoist Training; and Working with Mental Illness/Dementia. A comprehensive draft-training programme has been devised and all staff receives in excess of three paid days training per year. Meadowfield House F57 F09 S32674 Meadowfield V202118 160805 Stage 4.doc Version 1.40 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32 & 38 The home is well run and service users benefit from the services provided by the staff. Both service users and staff benefit from the health and safety policies operating within the home. EVIDENCE: The current manager is new, having transferred from another home belonging to Lancashire County Care Services. She has considerable experience in the provision of care and the management of staff. An application form has been received to register the manager through the Commission for Social Care Inspection. Several quality-monitoring systems are 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 questionnaire is also provided to new service users or their relatives shortly Meadowfield House F57 F09 S32674 Meadowfield V202118 160805 Stage 4.doc Version 1.40 Page 19 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. 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. 12 staff hold a current First Aid Certificate. Meadowfield House F57 F09 S32674 Meadowfield V202118 160805 Stage 4.doc Version 1.40 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 2 x 3 x x 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 x COMPLAINTS AND PROTECTION x x x x x x x x STAFFING Standard No Score 27 2 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x x 3 3 x x x x x 3 Meadowfield House F57 F09 S32674 Meadowfield V202118 160805 Stage 4.doc Version 1.40 Page 21 Yes 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 1 Regulation 4 Requirement The registration details and Statement of Purpose are required to be updated with the current services provided by the home. Written information must be provided stating that the required documents will be provided to the Commission when the refurbishment of the home is due to commence. Outstanding from last inspection on 09/02/05. The staffing levels need to be increased to meet the needs of service users within the category of DE - Dementia Timescale for action Immediate 2. 27 18 By 30/09/05 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 28 Good Practice Recommendations Training of care to NVQ level 2 should continue. Meadowfield House F57 F09 S32674 Meadowfield V202118 160805 Stage 4.doc Version 1.40 Page 22 Commission for Social Care Inspection Unit 1, Tustin Court Portway 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 F57 F09 S32674 Meadowfield V202118 160805 Stage 4.doc Version 1.40 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. 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