Inspection on 28/11/06 for Meadowside

This inspection was carried out on 28th November 2006.

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.

Other inspections for this house

Meadowside 21/10/08

Meadowside 07/02/06

Meadowside 06/09/05

Meadowside 20/01/05

Meadowside 09/06/04

Similar services:

Thorndene

Insight - Eastchurch

Southfields

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Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

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

CARE HOME ADULTS 18-65 Meadowside Liverpool Road Walmer Deal Kent CT14 7NW Lead Inspector Joe Harris Key Unannounced Inspection 28th November 2006 10:00 Meadowside DS0000037510.V300077.R01.S.doc Version 5.2 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 Meadowside DS0000037510.V300077.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 Adults 18-65. 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. Meadowside DS0000037510.V300077.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Meadowside Address Liverpool Road Walmer Deal Kent CT14 7NW 01304 363445 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) Kent County Council Mr John Wilson Care Home 20 Category(ies) of Learning disability (16), Physical disability (4) registration, with number of places Meadowside DS0000037510.V300077.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users over the age of 65 to be restricted to 2 whose DOB are 05/11/1934 and 18/10/1936. 7th February 2006 Date of last inspection Brief Description of the Service: Meadowside provides respite and transitional care and support to a maximum of 16 people with learning disabilities and up to 4 people with physical disabilities. The home is set in a quiet location in Walmer within 10 minutes drive of Deal. Service users have access to minibuses and there are public transport services in the area. The building is set in attractive gardens with an adjacent day service on the grounds. Attending the day service is part of the respite service. 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. Information on the Home services and the CSCI reports for prospective service users will be detailed in the Statement of Purpose and Service User Guide. Meadowside DS0000037510.V300077.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key unannounced inspection process culminated in a site visit to the service on the 28th November 2006. This visit lasted for 6 hours, commencing at 10am and finishing at 4pm. During the course of the visit a tour of the premises was undertaken, discussions were held with the registered manager, staff and service users. A range of documentation was also examined including service user plans, health and safety records, staff personnel files and other documents relating to the day-to-day running of the service. What the service does well: What has improved since the last inspection? All requirements and recommendations made at the previous inspection have been addressed, which focussed mainly on environmental issues such as the replacement of carpets. A new system of needs assessment has been introduced ensuring that the home can meet the needs of service users at all times. Service user plans have continued to be developed providing clear guidance for staff. The registered manager has completed some work in developing service user guides to promote ease of reading including the use of pictures and symbols. Meadowside DS0000037510.V300077.R01.S.doc Version 5.2 Page 6 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. Meadowside DS0000037510.V300077.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection Meadowside DS0000037510.V300077.R01.S.doc Version 5.2 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 the following standard(s): 2 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Prospective service user’s needs and aspirations are assessed prior to admission to the home. EVIDENCE: There are strong and robust assessment processes being implemented in the home. As a dedicated respite service for people with physical and learning disabilities a number of the service users have had repeated stays in the home and are well known to the staff team. Nevertheless a system is in place to ensure that all admissions have been reassessed detailing changing needs, alterations to care plans and other significant information prior to each admission. All service user plans examined showed evidence of up to date care management assessments and care plans. The registered manager has also introduced an excellent system of needs assessment to ensure that, at any given time, the home is able to meet the needs of the service users. A dependency rating is assigned to each individual based on a variety of key factors, which informs the planning of admissions. Therefore, regardless of occupancy numbers, if the level of dependency in the home exceeds the number of staff on duty additional staff are provided or a block on further admissions occurs. Meadowside DS0000037510.V300077.R01.S.doc Version 5.2 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 the following standard(s): 6, 7 and 9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Each service user has an individual plan of care. Service users are enabled to make decisions about their lives. Service users are supported to take responsible risks. EVIDENCE: A number of service user plans were examined, all of which provided clear needs assessments, plans of care and guidance for staff to meet individual needs and promote independence enabling service users to return home. The plans of care are written in an accessible format using a narrative style clearly detailing actions and interventions to ensure that the assessed needs are met. The plans are based on assessment information gained from care managers and the home’s own dependency and needs assessments. There was evidence of regular review for the longer term transitional clients and updating and review for respite clients who have had multiple admissions to the home. Meadowside DS0000037510.V300077.R01.S.doc Version 5.2 Page 10 There is a clear ethos in the home promoting individuality and decision making as part of the process of maintaining independence. A number of service users were spoken to who confirmed that they are enabled to make choices about their day-to-day lives including routines and activities for the day. One service user said “I’m able to choose what I do and when I do it, the staff are really good when I need help”. The home does not take a role in the management of individual finances, but does provide safe keeping if required, with accurate records maintained. There is a clear process of risk assessment in place, with individual risks identified as part of the care planning process informed by care management information, the home’s assessments and other sources. Risk management plans are regularly reviewed and updated in an according fashion similar to that of the service user plans. Meadowside DS0000037510.V300077.R01.S.doc Version 5.2 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 the following standard(s): 12, 13, 14, 15, 16 and 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users have opportunities to take part in meaningful activities. Service users are able to remain part of the local community. There is a range of leisure activities available. Visitors are welcomed into the home. Individual rights are respected and responsibilities recognised. There is a healthy, balanced diet offered. EVIDENCE: Service users have access to a range of occupational and recreational activities. The home is adjacent to a linked day service for people with learning disabilities that provides a number of activities from daily living skill groups to arts and crafts and games sessions. Many of the service users attend the day Meadowside DS0000037510.V300077.R01.S.doc Version 5.2 Page 12 centre prior to staying in the home and are encouraged to continue to do so. However, if residents normally attend alternative day centres, activities or colleges they are enabled to continue with these pastimes and transport is provided as required. Within the home, due to a changing focus in the home and more availability of staff time a range of leisure activities are provided with individuals and groups. One service user stated, “ There’s loads to do. I’m going to help do some things for Christmas.” As well as standard activities such as television, music and reading, staff try to assist service users in engaging in other activities around the home such as games, creative work and other events. It was reported that visitors are welcomed into the home and are free to visit at all reasonable times. There is adequate space throughout the home to ensure that people can meet in private should they wish to do so. Service users are encouraged to maintain their independence by taking part in the running of the home should they wish to do so. One of the transitional clients was helping with Christmas decorations. Residents can choose their own times for getting up and going to bed and all other aspects of the daily routine. A healthy and balanced diet is offered with individual nutritional needs catered for. Service users have their meals in the dining room of the adjoined day centre, but can choose to eat in their rooms or one of the smaller lounges if they choose. Menus demonstrated that a wide range of food is offered with available choices. One individual said, “The food is lovely and there are always choices. You can have a salad if you want, but I don’t like them in the winter.” Meadowside DS0000037510.V300077.R01.S.doc Version 5.2 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 the following standard(s): 18, 19 and 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users receive support in the way that they prefer. Individual physical and emotional healthcare needs are met. There are robust medication procedures in place and service users are enabled to retain control of medication where possible. EVIDENCE: Service user’s individual plans of care clearly detail individual preferences and requirements regarding all issues of personal care. Staff enable service users to choose how they wish to be supported and were observed to provide support in a sensitive and discreet fashion. Residents are enabled to choose how they spend their days and there is flexibility within the routines of the service. Where restrictions are required these are discussed with the service user, care manager and any relevant significant others. Healthcare records were maintained and up to date. All service users retain contact with their own GP and healthcare professionals during their periods of respite care. The home enables access to all required health and social services, liaising well with relevant professionals. Additional healthcare support Meadowside DS0000037510.V300077.R01.S.doc Version 5.2 Page 14 is provided as required in respect of Chiropody, dentist and opticians, etc. The home operates a key worker system. The registered manager has continued to update and improve the medication processes in the home ensuring safe recording, storage and administration. Service users and their relatives are given clear guidance regarding the medication brought in to the home ensuring that all medication remains in original packaging and is clearly labelled. There is a handover system with staff checking stocks and administration records at the changeover from each shift. Storage facilities are suitable for purpose and all record keeping in relation to medication was up to date. Staff are provided with adequate training before being able to administer medications. Service users are supported to retain control of their medication and are assessed in terms of capability in this area. It was advised that the self-administration questionnaire could be revised to include more open-ended questions to further demonstrate competency issues. Meadowside DS0000037510.V300077.R01.S.doc Version 5.2 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 the following standard(s): 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users views and concerns are listened to and acted upon. Service users are protected from forms of abuse. EVIDENCE: The home has a clear, comprehensive and accessible complaints procedure addressing all necessary issues. The home aims to address any concerns or complaints in an informal manner in the first instance, but should this be unsatisfactory then there are formal processes clearly set out. A copy of the complaints procedure is displayed in the home and accessible. A record of complaints is maintained. The home has clear policies and procedures in place aimed at protecting service users from potential abuse and mistreatment. Systems are in place to record and document any incidence of abuse should it occur and procedures for reporting such incidents are also in place. There is an awareness and understanding of legislation and responsibilities regarding the Protection Of Vulnerable Adults. Staff are provided with guidance and training relating to adult protection and demonstrated good levels of awareness. Policies and procedures regarding service users finances are clear and adhered to. Meadowside DS0000037510.V300077.R01.S.doc Version 5.2 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 the following standard(s): 24 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Meadowside is a comfortable and safe environment. The home is clean and hygienic. EVIDENCE: Meadowside is a comfortable and safe environment for service users requiring respite and transitional care. There are relatively self-contained transitional client flats at each end of the home, which have a more personalised and homely atmosphere. The service has adequate space throughout with a number of lounges and quiet areas. All bedrooms are single occupancy and suitable for purpose, although some rooms could still benefit from redecoration to give a more homely feel. Meadowside is a reasonably modern and purpose built service and is bright, airy with adequate ventilation. There is access to a main kitchen in the adjoining day centre at all times, but the home has a number of smaller, domestic-sized kitchens on site. The home is situated on the outskirts of Deal within driving distance of the main town and local shops, which are approximately 1.5 miles away. Meadowside DS0000037510.V300077.R01.S.doc Version 5.2 Page 17 The home has good facilities to cater for a limited number of people with physical disabilities and dedicated bedrooms and bathrooms with all necessary equipment as defined within the LOLER regulations. Furnishings and fitting throughout the home are of a satisfactory standard and is well-maintained and renewed as required. The home meets the requirements of the environmental health and fire safety departments. Meadowside DS0000037510.V300077.R01.S.doc Version 5.2 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 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are supported by a competent and qualified staff team. There are robust recruitment procedures in place. Staff receive all required and supplementary training. EVIDENCE: The home benefits from an experienced and stable staff team. Service users commented about the quality of the staff stating, “It’s really friendly here; the staff are lovely.” Staff members on duty were observed to be attentive to service users having developed positive relationships and treating people with respect. The registered manager and organisation have been proactive in enabling staff to work towards National Vocational Qualifications. At the current time 21 staff have achieved NVQ level 2 or above equating to 84 of the team. A number of staff have also completed level 3 awards. In discussion with staff it was evident that there was a good understanding of the individual and collective needs of the service users. A number of staff personnel files were viewed all of which contained all required information including evidence of CRB and POVA checks, two written references and proof of identity. Staff receive written terms and conditions of employment and a staff handbook including key terms from the GSCC code of Meadowside DS0000037510.V300077.R01.S.doc Version 5.2 Page 19 conduct. All staff appointments are subject to a probationary period. There has been a very low turnover of staff with no team members leaving since the last inspection and two new members joining. The service provides a good staff development and training programme. All new staff have an induction process which includes an organisational induction day covering general expectations and terms of employment and a service specific induction. The latter part of the programme is currently being reviewed with a view to updating it in line with the common induction standards. All new staff complete the Learning Disability Award Framework as part of the induction process. All mandatory training is provided and updates and refreshers are organised as required. The home’s training matrix demonstrated that staff are up to date with regard to training requirements and this was further underpinned through the evidence of training certificates on staff files. The organisation has a large training department with a wide range of courses available and staff have completed a number of additional courses including adult protection, dementia, epilepsy and COSHH amongst others. Meadowside DS0000037510.V300077.R01.S.doc Version 5.2 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 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users benefit from a well run home. There are good quality monitoring processes in place. The health, safety and welfare of service users and staff is protected and promoted. EVIDENCE: The registered manager has been in post for a number of years and has achieved his NVQ 4/RMA. He has demonstrated, since being in post, a positive attitude towards management developing and introducing new ideas, delegating responsibilities and consistently aiming to improve the service. He has continued to update his own knowledge and attend further training courses. Meadowside DS0000037510.V300077.R01.S.doc Version 5.2 Page 21 There are adequate quality assurance and monitoring processes in place both through the organisation and within the service. There is evidence that the organisation (KCC) has implemented consistent methods of ensuring on going development. An annual budget is provided to the home and environmental works are prioritised accordingly. A senior manager visits the home on a monthly basis to complete a quality audit and it was reported that the registered manager receives good line management support. Service users and/or their representatives are asked to complete feedback questionnaires following their stay in the home and annual satisfaction surveys are also completed. The registered manager and staff team have also introduced a number of systems to ensure records and documents are audited and health and safety checks are completed. A range of records were viewed in relation to health and safety issues including service and maintenance checks, all of which were up to date. There are all necessary policies and procedures in place relating to safe working practices. Staff have received all required mandatory training. fire safety logs and accident records were up to date and in place. Environmental risk assessments have been completed and are reviewed on a regular basis. It was reported that the home complies with all relevant regulations and legislation. Meadowside DS0000037510.V300077.R01.S.doc Version 5.2 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 Standard No Score 1 X 2 4 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 4 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Meadowside DS0000037510.V300077.R01.S.doc Version 5.2 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. 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 Meadowside DS0000037510.V300077.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Kent and Medway Area Office 11th Floor International House Dover Place Ashford Kent TN23 1HU 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 DS0000037510.V300077.R01.S.doc Version 5.2 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. 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!