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Inspection on 02/08/07 for Meadows Sands Care Home

Also see our care home review for Meadows Sands Care Home for more information

This inspection was carried out on 2nd August 2007.

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.

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

The home provides a comfortable, safe and homely environment for people to live in. The care home is very well managed. Residents have detailed care plans, which enables staff to know how residents needs are to be met. Staff, are well trained and supported by the registered manager and have a sound knowledge of resident`s needs. The staff team work well together and have established a good working relationship with the community health care teams and local GPs.

What has improved since the last inspection?

The Proprietors have carried out work to improve the environment of the care home. A number of new Carpets have been fitted. Areas of the home have been decorated. New equipment has been purchased. Maintenance has been completed to the roof of the care home. Care records and care plans have been improved and now exceed the National Minimum Standards. Activities are well organised and answer the needs and choices of residents. Staff are receiving supervisions. A lockable facility is now provided for residents in their bedroom.

What the care home could do better:

The use of the curtained toilets on the corridor leading to the office should be assessed and changes made so that people`s privacy and dignity is assured. This is especially important for those using wheelchairs and hoists.

CARE HOMES FOR OLDER PEOPLE Meadows Sands Care Home 98 South Parade Skegness Lincs PE25 3HR Lead Inspector Ken Hague Key Unannounced Inspection 2nd August 2007 08:30 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 Meadows Sands Care Home DS0000002552.V347981.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. Meadows Sands Care Home DS0000002552.V347981.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Meadows Sands Care Home Address 98 South Parade Skegness Lincs PE25 3HR 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) 01754 762712 marina@meadowssands.co.uk Accredited Care Limited Marina Prescott Care Home 26 Category(ies) of Dementia - over 65 years of age (26), Old age, registration, with number not falling within any other category (26) of places Meadows Sands Care Home DS0000002552.V347981.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered to provide personal care for service users of both sexes whose primary needs fall within the following categories:Old age, not falling within any other category (OP) (26) Dementia - over 65 years of age (DE[E]) (26) The maximum number of service users to be accommodated is 26. 2. Date of last inspection 3rd August 2006 Brief Description of the Service: Meadow Sands Care Home is situated on the sea front at the Southern end of Skegness. There are public car parking facilities to the front of the home and three car park spaces to the rear of the home for staff. The home has no garden but seating is available at the front of the building and there is a park across the road. The bedrooms are situated on three floors accessible by stairs or a passenger lift. There are communal lounges and dining facilities on the ground floor. At the time of the inspection the home confirmed that the weekly fees ranged from £335 - £415 depending on the residents assessed needs. Additional charges are made for services such as chiropody, hairdressing and toiletries. Information about these costs as well as the day-to-day operation of the home, including a copy of the last inspection report, can be found in the reception area or from the home’s office. The home has a statement of purpose and service user guide, which sets out resources and services offered, by the care home. These documents are made available to all new potential residents. Meadows Sands Care Home DS0000002552.V347981.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over 6 hours. The registered manager was provided with feedback at the end of the inspection. The main method of inspection used was called ‘case tracking’ which involved selecting three residents and tracking the care they receive through the checking of their records, discussion with them and the staff, and where more appropriate observation of interaction between staff and residents and related care practices. A sample of care records was inspected. Three members of staff were interviewed and the opinions of four residents were sought. An (AQAA) Annual quality assurance assessment was completed by the care home and sent to the Commission for Social Care Inspection prior to the site visit. This is a selfassessment document completed by the providers of the care home. It sets out evidence from the provider to demonstrate that they are meeting the Care Home Regulations. It is normal procedure to obtain written feedback from residents prior to the site visit using a document called “have your say”. This document sets out a number of questions for residents to answer. In the case of this key inspection it was not possible to send out these documents within set timescales. The opinions of the residents were sought however during discussions held at the site visit. Their views are reflected within this report. What the service does well: The home provides a comfortable, safe and homely environment for people to live in. The care home is very well managed. Residents have detailed care plans, which enables staff to know how residents needs are to be met. Staff, are well trained and supported by the registered manager and have a sound knowledge of resident’s needs. The staff team work well together and have established a good working relationship with the community health care teams and local GPs. Meadows Sands Care Home DS0000002552.V347981.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? 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. The summary of this inspection report can be made available in other formats on request. Meadows Sands Care Home DS0000002552.V347981.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 Meadows Sands Care Home DS0000002552.V347981.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 3 & 6 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. There are procedures in place which are used for the assessment of new residents to the service. This ensures that all of their personal care needs, health care and social needs are met. A dedicated intermediate care service is not provided by the home EVIDENCE: Three individual residents’ files were examined as part of the case tracking process. They all contained a full assessment including a risk assessment for each individual resident completed prior to the resident entering the care home. Any risk identified for an individual resident was transferred onto their care plan and a risk management assessment plan was put in place. The assessments sets out the care needs, social needs and health needs of each individual resident. The registered manager confirmed that residents are involved in the completion of care plans and in the review of their care plans. Meadows Sands Care Home DS0000002552.V347981.R01.S.doc Version 5.2 Page 9 Signatures on the care plan support this statement . Staff also confirmed that residents are involved in the review of their care plans. Residents were able to discuss the details of their care plans on the day of the site visit. The registered manager stated that all residents are given a copy of the homes service users guide which sets out the facilities and services offered by the home. Residents confirmed that they did have a copy of this document. Meadows Sands Care Home DS0000002552.V347981.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 7,8,9 7 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans identify all areas of need and provide detailed care instructions for staff; this enables staff to provide appropriate care. Residents’ health needs will be met. Residents privicy and dignity is respected by staff. EVIDENCE: The individual care plans of three residents being case tracked had been completed using information from their initial assessment. The plans had been reviewed. Care plans identified the health care and social care needs of each resident. They contained risk assessments and risk management strategies where appropriate. The choices and wishes of the residents were incorporated within care plans. This included the manner in which personal care should be provided, choice and wishes of social activities and goals for the future. The care records including care plans were written in plain English, were easy to follow and understand. All were completed to a good standard. Information Meadows Sands Care Home DS0000002552.V347981.R01.S.doc Version 5.2 Page 11 was filed in a consistent manner. Staff stated that care plans are used as working documents. Care plans contained details of health care assessments including nutrition and skincare. There were records of visits by community Healthcare visitors including general practitioners and district nurses. Quality assurance documents supplied by the care home substantiated that the residents were happy with the health care services provided to them. Staff are trained by outside agencies in the administration and storage of medication. Medication records had been completed in accordance with the national guidelines. Drugs are being stored correctly. Staff and the registered manager stated a resident can self medicate if they request to do so and a risk assessment confirmed that this would be safe practice. Residents confirmed that they felt staff treated them with courtesy and respect. One resident said staff are always kind and careful when they help me with my personal care. Staff were observed to speak politely to residents during the site visit. Staff checked with the residents being interviewed that they agreed to speak to the inspector and were appropriately dressed and comfortable. A Resident stated, “staff come very quickly here if you ask for help they can not do enough for you”. The two downstairs toilets are small and it is impossible for a staff member and a wheelchair and a resident to stand in the toilets with the door closed. On the day of the site visit curtains were fitted in the doorway to allow staff to stand out side the toilet with the curtain round them to maintain the resident’s dignity. This causes an obstruction in the corridor outside the dining room. This problem existed prior to the present ownership. The new owners are to find a solution to this problem. An agreement has been reached that an action plan with timescales will be submitted to the Commission for Social Care Inspection as soon as a practical solution is identified. Meadows Sands Care Home DS0000002552.V347981.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12,13,14 & 15 Quality in this outcome area is Good This judgement has been made using available evidence including a visit to this service. A range of activities are provided for residents which enables them to have an active and interesting social life. The home’s menu offer choices and meets the dietary needs of residents. EVIDENCE: Activities take place within the care home and within the community. There was evidence in the residents’ newsletter and care records of the residents meeting socially with other people who live in other care homes in the area. The activity organiser has in place a varied planned programme, which takes into account the wishes and choices of each individual resident. The process of identifying an activity of choice is recorded on the care records of each individual resident. These reflected their individual choice of activity and lifestyle. Activities were also to be taking place during the site visit. These activities are set out in the AQAA supplied by the registered manager. Meadows Sands Care Home DS0000002552.V347981.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ benefit from updated comprehensive complaints and adult protection procedures. EVIDENCE: The evidence from the inspection of the complaint procedures and records at the home, and discussion with staff and residents is that the complaints procedure is accessible to all residents. No complaints have been received by the home or the commission for social care inspection since the last key inspection. Residents stated they were confident in being able to make complaints if they needed to. There have been no notifications since the last key inspection that have raised any concerns. There have been no Adult protection enquiries held at the home since the last key inspection. Meadows Sands Care Home DS0000002552.V347981.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 19 & 26 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Residents live in a clean well maintained care home, which provides them with safe comfortable accommodation. EVIDENCE: Observations and records seen on the day of the site visit provided evidence that a large amount of work has been carried out to improve the environment since it changed ownership in July 2006. Residents spoken to at the site visit stated that they were satisfied with the home’s environment. The home has carried out a quality assurance exercise in November 2006. This produced written evidence that people are happy with the environment. No health and safety or infection control problem was identified during the site visit. The home was clean and smelt fresh. Meadows Sands Care Home DS0000002552.V347981.R01.S.doc Version 5.2 Page 15 Meadows Sands Care Home DS0000002552.V347981.R01.S.doc Version 5.2 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 consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 27,28,29 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are supported by well-trained staff, who are recruited safely. EVIDENCE: Residents stated that there is always sufficient staff on duty to meet their needs. They stated that Staff are kind and helpful and they do not have to wait for help. The inspection of recruitment records for new members of staff since the last key inspection, produced evidence that the recruitment procedure of the home is still being followed. The individual files for new members of staff contained all the appropriate documents outlined in the care home regulations. These documents have been obtained prior to a member of staff being employed. There was one exception of a member of staff who started with a POVA (Protection of vulnerable Adults) check and no CRB (Criminal records bureau) check). The registered manager stated that she was consistently supervised until her CRB was received. The home has in place a training plan for the next 12 months, which included specialised training courses. Staff members interviewed felt they were able to meet the needs of the residents of the care home. They were able to describe the three residents Meadows Sands Care Home DS0000002552.V347981.R01.S.doc Version 5.2 Page 17 being case tracked to identify their individual needs and demonstrate how these were being met. Staff stated that they worked well as a team and were well supported by the management of the care home. Morale in their opinion is high. Meadows Sands Care Home DS0000002552.V347981.R01.S.doc Version 5.2 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 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 31,33,35 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Leadership, guidance and direction are provided to staff to ensure that residents receive a good standard of care. Residents are happy with the service they receive. EVIDENCE: The present registered manager successfully completed her application in February 2007. Feedback from staff at the site visit was that manager is supportive and helpful. The registered manager was said to provide good leadership and found to be very approachable by staff and residents. The inspection of care records and discussion with staff provided evidence of good, positive leadership and direction to all staff members. Residents stated they Meadows Sands Care Home DS0000002552.V347981.R01.S.doc Version 5.2 Page 19 had confidence in the present manager and that they could go to the office at any time if they were concerned. The evidence from the quality assurance documents and discussions with residents who were being case tracked provided evidence that in their opinion residents feel the home is being run in their best interest. Feedback from relatives in the home’s quality assurance documents expressed the same opinion. The registered manger demonstrated in a discussion that the home has appropriate policies and procedures in place to protect the financial interests of residents. The registered manager said that supervision appraisals were being carried out appropriately. Staff concerned confirmed informal interviews that supervision was being provided on a one-to-one basis in accordance with the care home regulations. No health and safety issues or infection control issues were identified during the site visit. The registered manager demonstrated a detailed knowledge and understanding of the needs of people within the category of the home’s registration. Meadows Sands Care Home DS0000002552.V347981.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 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 N/a 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 Meadows Sands Care Home DS0000002552.V347981.R01.S.doc Version 5.2 Page 21 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. Refer to Standard Good Practice Recommendations Meadows Sands Care Home DS0000002552.V347981.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Lincoln Area Office Unity House, The Point Weaver Road Off Whisby Road Lincoln. LN6 3QN 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 Meadows Sands Care Home DS0000002552.V347981.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!