Inspection on 21/10/08 for Meadowside

This inspection was carried out on 21st October 2008.

CSCI found this care home to be providing an Good service.

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 28/11/06

Meadowside 07/02/06

Meadowside 06/09/05

Meadowside 20/01/05

Meadowside 09/06/04

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Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Meadowside Liverpool Road Walmer Deal Kent CT14 7NW     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Christine Lawrence     Date: 2 1 1 0 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 24 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 24 Information about the care home Name of care home: Address: Meadowside Liverpool Road Walmer Deal Kent CT14 7NW 01304363445 01304381537 john.wilson@kent.gov.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Kent County Council Name of registered manager (if applicable) Mr John Wilson Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability physical disability Additional conditions: The maximum number of service users to be accommodated is 20. The registered person may provide the following category/ies of service only: Care home only ? (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Learning disability (LD) Physical disability (PD) Date of last inspection Brief description of the care home Meadowside provides respite and transitional care and support to a maximum of 20 people who either have learning disabilities or physical disabilities. The home is set in a quiet location in Walmer within 10 minutes drive of Deal. There is a car available for staff to take residents out and about but no vehicles with wheelchair access are available. There are public transport services in the area. The building is set in attractive gardens with an adjacent day service on the grounds. Care Homes for Adults (18-65 years) Page 4 of 24 care home 20 Over 65 0 0 20 20 Brief description of the care home Meadowside is set over two floors. There is push button access in and out of the home for people with disabilities. The office/reception is by the entrance. There is a range of communal facilities. There is a large lounge with a drinks/kitchenette adjoined by a serving hatch. There is a quiet lounge with a table that is usually used for board games and puzzles. There is an additional kitchen and lounge near the bedrooms that are used for transitional service users. All bedrooms are single. Bedrooms registered for people with learning disabilities are quite small with basic furnishings. Four bedrooms are registered for people with physical disabilities. There are two bedrooms with adjustable beds and overhead hoists and two other ground floor rooms with space for mobile hoists. There are 5 bathrooms one with a Parker bath, flush floor shower and overhead hoist. Meals are taken at the canteen/dining room, which is shared with the day centre. Service users can choose from the menu. The main kitchen adjoins the dining room and the kitchen staff serve service users. The current fees for the service at the time of the visit range from £400.00 to £500.00 per week. Information on the homes services and the CSCI reports for prospective service users will be made available on request. Care Homes for Adults (18-65 years) Page 5 of 24 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The inspection visit was announced a short while prior to the date and started at 10.10 and finished at 15.00. We, that is the commission for social care inspection (CSCI) looked at various records in the home and also used information sent to us by the manager through his completion of the Annual Quality Assurance Assessment (AQAA). Information from the previous inspection in November 2006 was also referred to as was the annual service review undertaken in February 2008. A tour of parts of the building was undertaken in the company of a senior member of staff. We observed staff interacting with residents and we spoke to staff on duty as well as some of the people using the service. We asked an expert by experience to accompany us during this inspection. An expert by experience is a person who, because of their shared experience of using services, and/or ways of communicating, visits a service with an Care Homes for Adults (18-65 years) Page 6 of 24 inspector to help them get a picture of what it is like to live in or use the service. He chatted with residents and staff and his comments and observations are also used for this report. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 24 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 24 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Prospective residents individual aspirations and needs will be assessed. Evidence: We looked at the records for four people who were at Meadowside at the time of the inspection. Meadowside has a mixture of people who use the service; some who come for regular short stays, others who are there for longer periods. The records show that there is a detailed assessment completed before someone comes into Meadowside. A care manager will complete a referral and this will include information from relatives and others. When people begin to come on a regular basis a format called returning clients is used which allows for information to be updated. The information gathered before someone uses Meadowside relates to various things including manual handling and other risk assessments; information about health needs and preferences for activities; mobility issues and medication. Care Homes for Adults (18-65 years) Page 10 of 24 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents can be confident that their changing needs will be noted in their individual plans and that they will be supported to make decisions and take risks to enable as independent lifestyle as possible. Evidence: The care plans are based on initial and ongoing assessments. We noted some examples of people signing their care plans and staff indicated that they try to involve people as much as possible. The expert by experience included the following in his report they (people who use the service) mentioned that these were effective and they were fully involved when talking to residents about care plans. The care plans were either updated through the returning client format or regular reviews. There were examples noted of residents making choices and decisions and a pen picture is now included which reflects preferences. Work is also being undertaken regarding aspects of the Mental Capacity Act. Risk assessments are included within the care plans. They were seen to be individual and looked at reducing risk rather than Care Homes for Adults (18-65 years) Page 11 of 24 Evidence: stopping people doing things. Care Homes for Adults (18-65 years) Page 12 of 24 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Activities and involvement in the local community, as well as support for personal relationships will be provided for residents. They will benefit from having a healthy diet. Evidence: The expert by experience spoke to residents about activities. He confirmed that people thought there were lots of things to do and staff will help them to organize what they want to do. Things which were taking place during the inspection included a craft session, meal preparation and watching a DVD. The expert by experience said I saw folk enjoying these activities. The expert by experience commented on the fact that residents had told him that although Meadowside has a car they can use to support some residents to out and about, they can no longer use the accessible vehicles of the day centre on the same grounds. Staff also confirmed that these Care Homes for Adults (18-65 years) Page 13 of 24 Evidence: vehicles used to be used at weekends but this no longer is available. This means that wheelchair users have to depend on public transport or taxis suitable for wheelchair users. We noted examples of people being supported to attend church. Staff told us that relatives are made welcome at Meadowside and this was confirmed in conversations with residents and with some relatives spoken to during this inspection. The care plans reflected that independence is an important part of the ethos at Meadowside. Each person has a personal responsibility agreement. There is an expectation of some household activities. Residents rights are recognised in the choices they make about their daily lives such as times for getting up and going to bed (one person had chosen to have a lie in on the day of the inspection), smoking, whether to be alone or with others, whether or not to join in an activity and to eat in ones own room or join others. The expert by experience included in his report feedback from residents, as well as his own observations about the meals/food provided. He said Yes people said they enjoyed the food. I was offered lunch, which I enjoyed very much. My P.A. had a veggie option. There was a friendly, warm atmosphere; the place was clean and people said they had great food and as much as they needed. It was good to see full use being made of the facilities and having the shared hall, they said, was a great bonus because folk in wheelchairs had plenty of room. Its used for social activities too and meetings. They said they like the room. We also spoke to the cook who confirmed that catering staff were aware of any special requirements. She confirmed that they also had the relevant training such as food safety and infection control. Care Homes for Adults (18-65 years) Page 14 of 24 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents are protected by the homes policies and procedures regarding medication and their physical and emotional needs will be responded to. Their preferences and requirements for support are respected. Evidence: The care plans contained information about individual preferences for how people wish to be supported and as noted previously this information is kept up to date at each visit. Routines are flexible and we saw that people were supported to be individual in their choices about their routines and their appearance. Meadowside has a key worker system in place, which residents indicated they thought was helpful. People who use the services provided by Meadowside maintain contact with their own GP and healthcare professionals during their stay. We noted staff supporting people to attend appointments etc and information about peoples healthcare needs is included within the care plans. We observed medications being given out and this, as well as storage and recording was satisfactory. The manager informed us through the AQAA that staff were appropriately trained if they were responsible for giving out medication Care Homes for Adults (18-65 years) Page 15 of 24 Evidence: and staff spoken to confirmed this. Care Homes for Adults (18-65 years) Page 16 of 24 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents views are listened to or ascertained, and acted on. Evidence: The AQAA indicated that there is a clear complaints procedure in place. It further stated that there had been no complaints in the last twelve months. This was confirmed by staff and by the complaints records. We spoke to some visitors who informed us that any small things got sorted out quickly so there was never a need to complain. The expert by experience reported that the people he spoke to were confident that they were listened to by staff. They also said that meetings were effective. Staff confirmed that they have received training in adult protection and this is updated every two years. Staff spoken to were also very clear about their responsibilities regarding protecting people from abuse. There are policies and procedures in place relating to this including safeguarding adults and the prevention of abuse, management of residents money and valuables and disclosure of bad practice. Care Homes for Adults (18-65 years) Page 17 of 24 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents benefit from living in a home which is homely and comfortable as well as clean and hygienic. Evidence: Meadowside is a suitable building for its stated purpose. All rooms are single and there is specialist equipment available such as hoists and accessible baths. Some redecoration and refurbishment has taken place over the last twelve months and more is planned. The expert by experience stated people looked at ease in their own rooms and lounges. There is a smoking area for those who choose to smoke which the expert by experience described as comfortable. He also noted that there was a disabled access ashtray as well as a wall mounted one. He also noted that some people spoke about bathrooms that would benefit from improvement. The building was clean and fresh and the laundry was seen to be appropriate. Suitable handwashing facilities are in place throughout the building and staff have received training with regard to food saftey and infection control. There are also policies and written procedures in place. Care Homes for Adults (18-65 years) Page 18 of 24 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Sound recruitment procedures and training already provided and training planned, will have a beneficial impact on residents. Evidence: We observed staff to be responsive to the people at Meadowside. They were polite and respectful and did not treat them as anything but adult and individual. Twenty of the staff have achieved level 2 or above in a national vocational qualification (NVQ) in care within the Learning Disability Award Framework. The expert by experience particularly noted examples of staff listening to residents; he said I could see staff making sure that they listened well to residents who had communication difficulties. Kent County Councils recruitment procedure is thorough and includes application forms, references, interviews and criminal record bureau checks. There is a training programme in place for staff called Best Core Programme as well as the NVQ opportunities. Staff confirmed that they are given opportunities to do a range of training courses. Care Homes for Adults (18-65 years) Page 19 of 24 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents benefit from a well run home and their health and safety is promoted and protected. Evidence: The manager has been in post for 5 years; he has gained his registered managers award and a certificate in management. As previously noted the expert by experience said that the people he spoke to felt their opinions were respected and they were listened to. They felt that residents meetings were effective. The AQAA indicated that visits to Meadowside are undertaken under Regulation 26 and we noted copies of reports of those visits in the home. There was evidence at the home that health and safety audits form part of the routine checks and this was also reflected in the AQAA. A spot check on maintenance and service contracts showed these to be appropriate and up to date. Staff said that they received training relating to health and safety including infection control, manual handling, food safety and fire safety. We noticed lots of posters about aspects of Care Homes for Adults (18-65 years) Page 20 of 24 Evidence: health and safety were on display on noticeboards and we saw policies and written procedures to underpin the training provided. Care Homes for Adults (18-65 years) Page 21 of 24 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 22 of 24 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 23 of 24 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. 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