Inspection on 24/08/05 for Meadows Sands Care Home

This inspection was carried out on 24th August 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

Meadows Sands Care Home 08/12/09

Meadows Sands Care Home 10/06/09

Meadows Sands Care Home 02/08/07

Meadows Sands Care Home 03/08/06

Meadows Sands Care Home 05/04/06

Meadows Sands Care Home 19/12/05

Meadows Sands Care Home 14/12/04

Meadows Sands Care Home 23/08/04

Meadows Sands Care Home 10/03/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE Meadows Sands Care Home 98 South Parade Skegness Lincs PE25 3HR Lead Inspector Dawn Podmore Unnanounced 24 August 2005 @ 09:45 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. Meadows Sands Care Home C53 C04 S2552 Meadows Sands V232747 240805 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Meadows Sands Address 98 South Parade Skegness Lincs PE25 3HR 01754 762712 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) Accredited Care Limited To be determined Care Home Only (PC) 26 Category(ies) of Old Age, not falling within any other category registration, with number (OP) 26 of places Dementia - Over 65 years of age (DE(E)) 26 Meadows Sands Care Home C53 C04 S2552 Meadows Sands V232747 240805 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 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. Date of last inspection 14/12/04 Brief Description of the Service: Meadows 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 home. The bedrooms are situated on three floors with communal lounges and dining facilities on the ground floor. Mr Kevin Baker and Mr Andrew Hubbard purchased the home in November 2004. The home has changed its registration since the last inspection and now provides care only for older people who need help with personal care and those suffering from a disgnosed dementia, it no longer provides nursing care. Currently there is no Registered Manager for the home but a new manager has been appointed and the owners have applied for her to be registered with the Commisssion. Meadows Sands Care Home C53 C04 S2552 Meadows Sands V232747 240805 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place over 4 hours. 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, the care staff and observation of care practices. The former acting manager had completed a pre-inspection questionnaire, and residents and relatives returned 8 comment cards to the Commission giving their opinion on how the home operates. A partial tour of the premises was conducted with the new acting manager and care and staff records were examined. Seven residents and four members of staff including the deputy, the handyman and the cook were informally interviewed. What the service does well: What has improved since the last inspection? What they could do better: The home needs to ensure that initial assessments and care plans telling staff what care the resident requires must contain more detailed information regarding individual needs and identify any potential risks to the resident or the staff. The environment needs to be made safer with the completion of the programme for fitting radiator guards and cupboards containing cleaning products securely locked. People must be asked if they wish to have locks fitted on their bedroom doors to provide privacy and any decisions recorded. Locks should be fitted to bedroom doors for those who wish to have them. Meadows Sands Care Home C53 C04 S2552 Meadows Sands V232747 240805 Stage 4.doc Version 1.30 Page 6 The agency had not been carrying out all the necessary checks on new staff; they must do this before that person starts caring for people. Documented inductions must be provided to new staff to show that the home has provided them with important information concerning the running of the home and the care they will be providing. Further staff training and support needs to be provided to make sure that they have sufficient knowledge to enable them to provide a good standard of care and protection to the residents living at the home. The owner of the home needs to record his visits and produce a report detailing his findings on how the home is operating at least monthly. 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. Meadows Sands Care Home C53 C04 S2552 Meadows Sands V232747 240805 Stage 4.doc Version 1.30 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 Meadows Sands Care Home C53 C04 S2552 Meadows Sands V232747 240805 Stage 4.doc Version 1.30 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) 3 & 6 Documentation did not show that new residents had been fully assessed prior to admission; this could lead to inappropriate people being admitted to the home. EVIDENCE: Residents’ files did not all contain documented assessments carried out by the home’s staff prior to admission. There was no evidence that the home had written to the residents to confirm an admission date and say that they could meet their needs. Assessments by social services had been obtained but these did not provide the staff with sufficient details regarding people’s individual needs. The home does not provide intermediate care. Meadows Sands Care Home C53 C04 S2552 Meadows Sands V232747 240805 Stage 4.doc Version 1.30 Page 9 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 Care plans do not identify all areas of need or provide detailed care instructions for staff; this may lead to residents needs not being met. Input from outside agencies was not fully documented in care plans. EVIDENCE: Not all residents had a care plan containing information relating to their care needs and there had been little development of existing plans since the last inspection. Plans did not always provide enough information to staff to enable them to provide comprehensive care. The initial assessment of a resident admitted 10 days before the visit identified that they had high care needs but a care plan had not been formulated, neither was there any evidence that a risk or manual handling assessment had taken place. Staff had only the initial social services assessment document to provide brief information on the care they required and this provided insufficient detail to meet their needs. Plans had not been evaluated monthly to show any progress or deterioration in the residents’ condition. Meadows Sands Care Home C53 C04 S2552 Meadows Sands V232747 240805 Stage 4.doc Version 1.30 Page 10 Residents’ and relatives’ who were spoken with or completed questionnaires said that their care needs were being met, comments included: ‘the care of my husband is exceptional, second to none’ and ‘the home is very good and really relaxing’. Although there was involvement from outside agencies such as district nurses, opticians and chiropodists this had not been consistently recorded. A district nurse who was visiting the home on the day of the visit praised the home saying that it was a nice place to visit and the staff were very good, helpful and pleasant. Since the last inspection the owners had purchased suitable sit on scale to enable staff to regularly monitor residents weight. Meadows Sands Care Home C53 C04 S2552 Meadows Sands V232747 240805 Stage 4.doc Version 1.30 Page 11 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) 14 & 15 The home offers residents’ choice regarding their daily lives. Meals provided offer variety and choice. EVIDENCE: The meal on the day of the visit was well presented and nutritionally balanced. It consisted of pork casserole with potatoes and vegetables followed by harvest crumble and custard. The cook said that she knew the residents’ likes and dislikes and would provide alternatives to the main menu if requested. Meals can be taken in the dining room or in the privacy of the residents’ bedroom. Residents comments included: ‘the meals are nice, better than at the hospital’, ‘we get a choice if we don’t like what’s on offer’ and ‘the food is very good’. Two residents who returned questionnaires to the Commission said that sometimes the food was better than others. Meadows Sands Care Home C53 C04 S2552 Meadows Sands V232747 240805 Stage 4.doc Version 1.30 Page 12 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) 16 & 18 The home has satisfactory procedures for handling complaints. Residents and relatives had no complaints about the home. Residents are protected by the home’s procedures for handling allegations of adult abuse. EVIDENCE: The home has a complaints procedure, which tells residents and relatives how to make a complaint and how it will be handled. A copy is given to each resident on admission and forms part of the Service Users Guide. Residents’ spoken to and a visiting district nurse made positive remarks about the home. Eight questionnaires were returned to the Commission, most containing positive comments. The provider satisfactorily investigated a complaint received by the Commission in January; his findings were reported back to the Commission and any shortfalls addressed. The home’s adult protection policy was in line with current local guidelines. The acting manager had a good understanding of procedures to follow regarding reporting any suspected abuse to the Commission and social services. Training records showed that adult protection training had taken place but the manager must ensure that new staff employed receive appropriate training as soon as possible. Meadows Sands Care Home C53 C04 S2552 Meadows Sands V232747 240805 Stage 4.doc Version 1.30 Page 13 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) 19, 24, 25 & 26 Residents living at the home live in a clean, comfortable and homely environment. The lack of radiator covers or low surface temperature radiators could put residents at risk. EVIDENCE: Communal areas have a homey atmosphere and were seen to be clean and tidy. The four bedrooms inspected during this visit were all well maintained and furnished, including personal mementoes and small items of furniture. Residents said that they were happy with their rooms and the facilities the home provided. Although the home was generally in good repair the corridor carpet leading to the managers office was worn and stained. It was recommended that the provider include this for renewal in the homes business plan. Locks are not provided on residents’ private accommodation however a lockable drawer is available in the bedrooms. At the last two inspections a risk assessment document regarding the appropriateness of locks on individual Meadows Sands Care Home C53 C04 S2552 Meadows Sands V232747 240805 Stage 4.doc Version 1.30 Page 14 peoples bedroom doors had not been fully implemented; this issue is still outstanding. Radiators are not all guarded to protect residents from potential burns but risk assessments had been completed to minimise the risk. Although this has been a requirement from previous inspections the priority list discussed with the provider at the last visit showed that all radiators would be guarded within 9 months, this timescale ends at the end of September 2005 and no further action has been taken. One aspect of the complaint made in January was concerning the use of curtains on the downstairs toilet doors; this has been highlighted in previous inspection reports. It was recommended that the manager monitor the use of these curtains especially with regards to residents’ privacy and dignity. Meadows Sands Care Home C53 C04 S2552 Meadows Sands V232747 240805 Stage 4.doc Version 1.30 Page 15 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) 29 & 30 Recruitment policies had not been consistently followed. This resulted in residents’ receiving care from staff that had not been properly vetted therefore they could be put at risk. The shortfalls in staff induction and training could lead to residents’ needs not being met. EVIDENCE: Examination of personnel records identified that one carer had received only one reference prior to commencing employment. The home must obtain 2 satisfactory written references to make sure candidates are suitable to care for people before they allow them to start working at the home. C.R.B. (Criminal Records Bureau) checks had been obtained. Staff files did not contain evidence that new staff had consistently received a formal induction into the home. The content of the induction documentation was not comprehensive and therefore did not show that staff had been provided with adequate information and instruction to enable them to provide care. Records demonstrated that although training in subjects such as manual handling, dementia, first aid and fire safety had taken place not all staff had attended these sessions. Training needed included: basic food hygiene and manual handling for new staff (a session booked for 12/9/05). The new manager discussed her plans for the home, which included the appointment of more senior care staff to manage the delivery of care on each Meadows Sands Care Home C53 C04 S2552 Meadows Sands V232747 240805 Stage 4.doc Version 1.30 Page 16 shift. Residents and relatives commented positively about staff saying ‘the staff are kind and caring here’, ‘everyone is kind to me’ and some are better than others but on the whole they are very good’. Meadows Sands Care Home C53 C04 S2552 Meadows Sands V232747 240805 Stage 4.doc Version 1.30 Page 17 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) 36, 37 & 38 With the appointment of the new manager and regular visits by the providers, there is sufficient leadership available at the home. Shortfalls in staff supervision could lead to residents’ needs not being met. EVIDENCE: A new manager had been appointed the week before the inspection and the provider has requested an application form to enable her to apply to the Commission for registration. Mrs Sandra Burkitt has 23 years experience in the care sector. She has attained the N.V.Q. (National Vocational Qualification) level 4 in care and management and experience in providing dementia care. Documented staff supervision and appraisal had not consistently taken place although minutes from staff meetings were seen. The Registered provider is required to complete a monthly report detailing his findings at the home, there was no evidence that these visits had taken place. Meadows Sands Care Home C53 C04 S2552 Meadows Sands V232747 240805 Stage 4.doc Version 1.30 Page 18 Staff handling food had not all received basic food hygiene training, this was identified at the last inspection. All staff that handles food must receive this training to ensure that they are aware of the correct practices. The resiting of the gas turn off tap identified by the fire officer in his last report had taken place. Meadows Sands Care Home C53 C04 S2552 Meadows Sands V232747 240805 Stage 4.doc Version 1.30 Page 19 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 x x 2 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 x 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 3 15 3 COMPLAINTS AND PROTECTION 3 x x x x 2 2 3 STAFFING Standard No Score 27 x 28 x 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x x x x x 1 2 2 Meadows Sands Care Home C53 C04 S2552 Meadows Sands V232747 240805 Stage 4.doc Version 1.30 Page 20 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 3 Regulation 14 (1) Requirement Documented, comprehensive assessments must be undertaken prior to the admission of a service user to ensure that the home can meet their needs. The previous timescale February 1st 2005. All service users must have a documented plan of care. The plans must provide up to date, in depth information addressing the management of identified needs, appropriate goals and be regularly reviewed and revised as required. The previous timescale June 1st 2005. All service users must have a comprehensive risk assessment that identifies potentail risks. They must provide staff with documented information regarding the management of these risks and what actions should be taken to minimise them. The previous timescale February 1st 2005. To maintain service users privacy the home must provide Timescale for action September 11th 2005 2. 7 15(1)(2) (c)(d) October 1st 2005 3. 7 15(1)(2) (c)(d) 13 (4)(b)(c) September 11th 2005 4. 24 16 (1)12(4) October 1st 2005 Page 21 Meadows Sands Care Home C53 C04 S2552 Meadows Sands V232747 240805 Stage 4.doc Version 1.30 (a) 5. 6. 25 29 13(4)(a) (b)(c) 19 7. 30 18 (1) 8. 36 18(1)(a) (2) 26[1][4] [5] 18 (1)16(2) 9. 10. 37 38 11. 38 13 (4) (a)(b)(c) appropriate locks to service users accommodation or evidence that these have been either offered and refused or risk assessed as not advisable. Radiators must be guarded or be of the low surface temperature type. New staff must have 2 satisfactory written references prior to commencing employment, as stated in Schedule 2. All staff must attend mandatory training and new staff must undergo a comprehensive, documented induction programme. The previous timescale May 1st 2005. Staff must receive appraisal and supervision as required. The previous timescale March 1st 2005. Visits must be made by the provider and documented in accordance with regulation 26. It is a requirement to provide training in food handling, hygiene and safety for all staff involved in food preparation and handling. The previous timescale was April 1st 2005. Hazardous substances must be stored securely at all times. October 1st 2005 September 11th 2005 October 1st 2005 November 1st 2005 September 30th 2005 November 1st 2005 September 11th 2005 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 12 Good Practice Recommendations At the last inspection it was recommended that the activities programme be expanded to ensure that all C53 C04 S2552 Meadows Sands V232747 240805 Stage 4.doc Version 1.30 Page 22 Meadows Sands Care Home 2. 3. 4. 10 19 & 26 21 service users needs are met. This includes those people with dementia and other cognitive impairments. This had not been addressed. At the last inspection it was recommended that terms and conditions/contracts of employment should be issued to all staff, there was no evidence that this had been addressed. It is recommended that the provider include the renewal of the corridor carpet leading to the managers office in the homes business plan. It is recommended that the provider and manager monitor the use of curtains in the toilets on the downstairs corridors and address any issues relating to residents privacy and dignity. Meadows Sands Care Home C53 C04 S2552 Meadows Sands V232747 240805 Stage 4.doc Version 1.30 Page 23 Commission for Social Care Inspection Unity House The Point Weaver Road off Whisby Road Lincoln LN6 3QN 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 Meadows Sands Care Home C53 C04 S2552 Meadows Sands V232747 240805 Stage 4.doc Version 1.30 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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