Inspection on 16/08/05 for Meadowside

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 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 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

Meadowside 25/02/09

Meadowside 12/12/06

Meadowside 23/11/05

Meadowside 11/01/05

Meadowside 13/07/04

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

CARE HOME ADULTS 18-65 Meadowside 35 Plymouth Road Tavistock Devon PL19 8BS Lead Inspector Graham Thomas Announced 16 August 2005 th 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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary 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. Meadowside D54-D07 S3752 Meadowside V231814 160805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Meadowside Address 35 Plymouth Road, Tavistock, Devon, PL19 8BS 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) 01822 614336 01822 614336 Mr Roger Hine Mrs Anne Hine Mrs Anne Hine Care Home 10 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (10) of places Meadowside D54-D07 S3752 Meadowside V231814 160805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: One named Service User over the age of 65 years Date of last inspection 11th January 2005 Brief Description of the Service: Meadowside is a large extended Victorian House close to the centre of Tavistock. The home offers care to 10 people (under the age of 65) who have mental health needs. The majority of people who live at Meadowside have done so for many years, and whilst the home promotes independence the home does not offer intensive rehabilitation. The house has a lower ground floor where there is the kitchen and two bedrooms. There is a lounge, dining room and two single bedrooms on the ground floor. On the first floor there are four bedrooms and on the second floor there are two bedrooms. The home is staffed 24 hours per day, at night there are sleep in staff. At the time of this inspection, substantial building work was being undertaken which will extend the building and reconfigure the existing arrangement of rooms. This will provide two ground floor bedrooms with en-suite facilities and level access to the outside of the building. Staff accommodation is being improved and the homes office will be moved from the basement to the ground floor. Additional communal space is to be provided. An application to register the home for one additional place has been received. Meadowside D54-D07 S3752 Meadowside V231814 160805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection included a review of the pre-inspection questionnaire completed by Mrs. Hine. Comment cards were received from three relatives, one professional visitor and five service users. The Inspector spoke with seven service users and four staff members as well a Mrs. Hine, the Registered Provider. A tour of the building was conducted. A sample of care plans and other documents were examined. What the service does well: 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 Meadowside D54-D07 S3752 Meadowside V231814 160805 Stage 4.doc Version 1.40 Page 6 contacting your local CSCI office. Meadowside D54-D07 S3752 Meadowside V231814 160805 Stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Meadowside D54-D07 S3752 Meadowside V231814 160805 Stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2 Service users’ choice of home is supported by adequate pre-admission assessments. EVIDENCE: Admission policies and procedures were available for references. No service users had been recently admitted to the home. However, care plans showed that previously admitted service users had been properly assessed prior to admission. This included the gathering of information from relevant professionals. A care plan had been developed for each service user. Meadowside D54-D07 S3752 Meadowside V231814 160805 Stage 4.doc Version 1.40 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 7 and 9 Service users are adequately supported by the home’s staff to make individual choices and decisions. EVIDENCE: A sample of six service users’ care plans were examined. They included a personal profile and detailed plans for each individual. Other records held in the plans included daily activities, medical records, financial arrangements, visits and records concerning the Care Programme Approach. Service users have the opportunity to sign the plan. A key working system is in place to support individual service users. Where restrictions are in place such as limitations on cigarettes, these are clearly identified in the care plans. Service users felt that staff supported them in their day to day choices and decisions. Each service user has a timetable of activities which reflects their own choices. Staff were seen offering choices to service users during the inspection. Information about forthcoming activities and important events is posted in the home’s hallway. Risk assessments are included in the care plans. These provide a framework in which service users are supported to take responsible risks. The home has a policy and procedure for dealing with unexplained absences. Meadowside D54-D07 S3752 Meadowside V231814 160805 Stage 4.doc Version 1.40 Page 10 Meadowside D54-D07 S3752 Meadowside V231814 160805 Stage 4.doc Version 1.40 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14, 15, 16 and 17 Service users are sufficiently enabled to pursue the lifestyle of their choice. EVIDENCE: Service users confirmed that they engage in activities at an intensity and of a type of their choice. Some service users spoke of largely home based activities such as listening to music, puzzles and table top activities whilst others had a more intensely active lifestyle. One service user spoke of visiting friends, shopping, swimming, church attendance, attending ‘Rethink’, faith healing groups and other activities. The home has a good relationship with its immediate neighbours. The disruption of the recent building work has been carefully negotiated with an immediate neighbour. Service users use local community facilities such as cafes, shops the church and public transport. In many cases these are accessed independently. However, support is provided by staff where this is required. Individual rooms contained many items which related to individual’s hobbies and interests. For example, these included CDs and videos, a telescope and various magazines and books. Photographs were on display of a recent visit to Meadowside D54-D07 S3752 Meadowside V231814 160805 Stage 4.doc Version 1.40 Page 12 Cornwall by a group of service users. At the time of the inspection, service users were looking forward to the impending visit of an entertainer. Family links are supported and visits to and from family members are recorded. One service user spoke of support he had received to enable him to travel independently by public transport to see his father. Comment cards received from relatives indicated that they were generally happy with the level of contact and communication with the home. Each service user’s room is fitted with a lock to which they are offered a key. There are no fixed routines for service users. The Service User Guide specifies that service users are able to get up and go to bed when they wish, and to come and go from the home as they choose. The home has a well-furnished dining room and there is a small kitchenette that is used by service users for making tea and coffee. Part of the current building work will include a new dining room / lounge. Menus were seen which were varied and provided a balanced diet. Service users confirmed that they are able to choose an alternative to the meal on offer and could eat alone if they wished. Inspection of the kitchen showed the use of fresh ingredients. Some service users’ files contained weight monitoring charts. Meadowside D54-D07 S3752 Meadowside V231814 160805 Stage 4.doc Version 1.40 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18, 19 and 20 Service users’ healthcare needs are generally well met. However, shortfalls identified in practice concerning the administration of medicines could place service users at risk. EVIDENCE: Service users and feedback from a visiting professional confirmed that any consultations taking place in the home are in private. Each service user was dressed in the individual style of their choice. Routines in the home are individually flexible enabling service users to maintain their own preferred timetable. Care plans indicated where individuals required support in the form of prompts regarding personal hygiene. One service user has aids to support his mobility. Guidance has been sought regarding an Occupational Therapist regarding these matters. The current building programme will include improvements to the accommodation including level access to the garden and increased space in a new en-suite room for this service user. Care plans contained evidence of both routine and specialist medical appointments such as visits by the Chiropodist and District Nurse and mental health professionals. Some service users attend the Doctor’s surgery independently whilst others receive support. Some health monitoring such as recording weight was seen in the care plans. Individual files contained lists of current medication and medication risk assessments. Medication is stored securely in the home. Each service user’s Meadowside D54-D07 S3752 Meadowside V231814 160805 Stage 4.doc Version 1.40 Page 14 medication is stored in an individual box. During the inspection, medication was found in the wrong boxes. No homely remedies or controlled drugs were in use at the time of the inspection. Medication is supplied in individual blister packs and a record is kept of the medication administered. These records were generally in order. However, on the day of the inspection, none of the previous evenings medicines had been signed for. The Registered Provider spoke with an individual staff member concerning this and a memo was circulated to all staff concerning signing for medication. Certificates were seen on display and in staff files regarding external training in the administration of medicines. Meadowside D54-D07 S3752 Meadowside V231814 160805 Stage 4.doc Version 1.40 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 an 23 Service users can feel confident that their concerns are listened to and acted upon. Adequate protection from abuse is provided by the home. EVIDENCE: Service users felt that their they were listened to by staff and their concerns acted upon. The home has a complaints procedure which is accessible to service users. Two of the three relatives who provided feedback were not aware of this procedure. A complaints records is maintained by the home. No recent complaints had been received by the Commission at the time of the inspection. A Policy is in place concerning protecting vulnerable adults from abuse. The home has a copy of the locally produced “No Secrets” video which staff have seen. External training is also being made available. CRB / POVA checks are routinely conducted for new staff as evidenced in staff files. Meadowside D54-D07 S3752 Meadowside V231814 160805 Stage 4.doc Version 1.40 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24 and 30 Service users are provided with a clean and comfortable, homely environment which is undergoing substantial positive improvement. EVIDENCE: The home is situated within a short level walk to the centre of the town. Accommodation at Meadowside is arranged over four floors. At the time of this inspection, substantial building work was being undertaken which will extend the building and reconfigure the existing arrangement of rooms. This will provide two ground floor bedrooms with en-suite facilities and level access to the outside of the building. Staff accommodation is being improved and the homes office will be moved from the basement to the ground floor. Additional communal space is to be provided. An application to register the home for one additional place has been received. On inspection the home was generally clean and free from offensive odours and all areas were comfortably furnished. A maintenance plan is in place. Some minor attention required to parts of the home is currently in abeyance whilst the building work is in progress. The home has a small laundry with a washing machine and tumble dryer. This has cleanable walls and an impermeable floor. Service Users do their own laundry with support from staff. A hand basin is to be fitted in the laundry as Meadowside D54-D07 S3752 Meadowside V231814 160805 Stage 4.doc Version 1.40 Page 17 part of the current building programme. The home has developed a control of infection policy and staff attend control of infection training. Meadowside D54-D07 S3752 Meadowside V231814 160805 Stage 4.doc Version 1.40 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 35 and 36 Service users are supported by adequate numbers of staff who receive training appropriate to their needs. EVIDENCE: Feedback from service users, staff, relatives and a visiting professional all indicated satisfaction with present staffing levels. Staff responsibilities are clearly defined in the contract of terms and conditions with which they are provided. All staff receive copies of the Code of Conduct of the General Social Care Council. The staff interviewed were clear about the main aims and objectives of the home and appeared to enjoy positive and supportive relationships with service users. Potential improvements in clarifying staff roles were discussed with the Registered Provider during the inspection. The home achieved the Investors in People Award in 2003. Staff training plans have been set up by the Registered Provider. An induction training portfolio for the newest member of staff was available for inspection. A variety of training providers and media and are used to achieve the required training. These include training videos in the home, distance learning and attendance at local training courses. Topics include the specific needs of service users (e.g. Mental Health, Epilepsy) as well as health and safety training. Staff also have access to NVQ training. Certificates of staff training are on display in the home and staff spoke of a very positive attitude towards their training. Meadowside D54-D07 S3752 Meadowside V231814 160805 Stage 4.doc Version 1.40 Page 19 A system of staff supervision is in place though this still does not occur at the required frequency of six times per year. Meadowside D54-D07 S3752 Meadowside V231814 160805 Stage 4.doc Version 1.40 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 39, 41 and 42 Service users views do not adequately underpin the home’s plans for development. The health, safety and welfare of service users is adequately protected by the systems in place. EVIDENCE: Since the last inspection, work has been undertaken to improve the home’s quality assurance system. A service user survey has been conducted. Findings from this work have been acted upon. Timings for medication have been modified and holiday arrangements have been changed in line with service users’ preferences. The Registered Provider stated that a more detailed questionnaire is planned. A summary of this work has yet to be produced and integrated into the home’s annual development plan. The home’s records which were inspected were found to be in generally good order. However not all incidents had been reported to the Commission as required by regulation Certificates available for inspection showed that there is a programme of health and safety training for staff including topics such as food hygiene, fire Meadowside D54-D07 S3752 Meadowside V231814 160805 Stage 4.doc Version 1.40 Page 21 safety and moving and handling. Risk assessments were seen which included environmental risks such as burns and scalds from hot water and hot surfaces. Individual risk assessments were also in place. A fire safety record was seen which showed regular maintenance of fire systems and equipment. A water hygiene log book was also seen. The recommendations of a recent Environmental Health inspection had been followed (e.g. colour coded chopping boards). Maintenance checks for electrical and gas safety were seen including wiring and personal appliance testing. Hazardous substances were seen to be securely stored and COSHH data sheets available for reference. Other health and safety measures such as the use of colour coded mops and buckets were seen around the home. Meadowside D54-D07 S3752 Meadowside V231814 160805 Stage 4.doc Version 1.40 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 x x x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x x x 3 Standard No 11 12 13 14 15 16 17 x 3 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score 3 x x x 3 2 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Meadowside Score 3 3 2 x Standard No 37 38 39 40 41 42 43 Score x x 2 x 2 3 x D54-D07 S3752 Meadowside V231814 160805 Stage 4.doc Version 1.40 Page 23 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 20 Regulation 13 Requirement All medicines must be stored in accordance with the homes storage system to reduce potential risk to service users The administration of all medicines must be accurately recorded Staff supervision must occur at leat six times per year All significant events affecting the welfare of service users should be reported to the Commission in accordance with regulation and available guidance. Timescale for action immediate and ongoing immediate and ongoing 30.11.05 25.8.05 2. 3. 4. 20 36 41 13 18 37 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 39 Good Practice Recommendations The Registered Provider should complete the development of a quality assurance system and integrate this into the homes annual development plan. Meadowside D54-D07 S3752 Meadowside V231814 160805 Stage 4.doc Version 1.40 Page 24 Commission for Social Care Inspection Unit D1 Linhay Business Park Ashburton TQ13 7UP 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 Meadowside D54-D07 S3752 Meadowside V231814 160805 Stage 4.doc Version 1.40 Page 25 - 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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