Inspection on 26/04/06 for Meadowside Residential Home

This inspection was carried out on 26th April 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Meadowside Residential Home 08/05/08

Meadowside Residential Home 12/01/06

Meadowside Residential Home 26/07/05

Meadowside Residential Home 22/01/05

Meadowside Residential Home 15/06/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 Meadowside Residential Home 41 Highweek Road Newton Abbot Devon TQ12 1TR Lead Inspector Sam Sly Unannounced Inspection 26th April 2006 2 pm Meadowside Residential Home DS0000003753.V289109.R01.S.doc Version 5.1 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 Residential Home DS0000003753.V289109.R01.S.doc Version 5.1 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 Residential Home DS0000003753.V289109.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Meadowside Residential Home Address 41 Highweek Road Newton Abbot Devon TQ12 1TR 01626 363243 01626 363243 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) Newton Abbot & District Society for Mentally Handicapped Children & Adults Julie Anne Bishop Care Home 10 Category(ies) of Learning disability (10) registration, with number of places Meadowside Residential Home DS0000003753.V289109.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 12th January 2006 Brief Description of the Service: Meadowside cares for up to 10 adults with learning disabilities. It is owned by a registered charity. The Home is a large detached house with gardens and a day resource in the grounds, close to the centre of Newton Abbott with all its amenities and transport links. Meadowside is currently set out on a ground and first floor, with all the bedrooms on the first floor with bathroom and toilet facilities and a staff sleep-in room. On the ground floor are the kitchen, offices, laundry, a hobbies room, dining room, lounge and a staff sleep-in room. There is an unfinished extension to the rear of the property, which will add additional bedrooms, a sitting area and bathroom facilities when completed. The Owners intentions are not to increase the number of residents cared for at Meadowside but given all residents a single bedroom and more space. Meadowside Residential Home DS0000003753.V289109.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The site visit was unannounced and took place during an afternoon and early evening in April. It included discussion with all the residents, all staff on duty and the taxi driver used by the Home. Tracking the care of three residents including discussion and confirmation of their care plans. One resident, who did not communicate verbally, was communicated with using symbols and photos to find out what activities they liked doing. Care records and health and safety records were also examined. The registered manager was not present so a second visit was made the following day to look at staff records, the quality assurance system, discuss quality and diversity and give feedback. The Inspection process also included a review of contact the Commission has had with Meadowside since the last key inspection, comment cards from all ten residents, seven relatives, one staff member and one professional, and a preinspection questionnaire, returned by the registered manager, which included information about a range of systems in the Home. All the required core standards were assessed during key inspection process. What the service does well: All comment cards from relatives and professionals said they were satisfied with the overall care provided, and residents spoken to confirmed that they were happy with their care at Meadowside, saying: ‘I am happy living here’, ‘I do what I want’, ‘I know who to talk to if I am unhappy’. These comments were reflected in the outcomes of the site visit. Relatives were very positive about the care provided saying: ‘I am very impressed by the care taken by the staff’, ‘I am very happy with the care received in a very caring environment’, ‘I am totally satisfied with the care my [relative] receives at Meadowside’. Residents led active, interesting lives and are a very real part of the local community. This was confirmed by comments from two community members. Decision-making is part of everyday life for residents, and the registered manager and owners should be commended for engendering such an inclusive, positive environment where residents are evidently encouraged to make the decisions about how the home is run and comment of things that concern them. Meadowside Residential Home DS0000003753.V289109.R01.S.doc Version 5.1 Page 6 Meadowside is homely, clean and well decorated and furnished with an ongoing maintenance plan. Resident’s are proud of their beautiful bedrooms, which are full of their treasured personal possessions. Residents said they liked the Manager Julie Bishop and the staff. Comments received described Julie and her deputy’s devotion to the residents as admirable, and generally comments reflected that the staff made it a very caring environment. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Meadowside Residential Home DS0000003753.V289109.R01.S.doc Version 5.1 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 Residential Home DS0000003753.V289109.R01.S.doc Version 5.1 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 The overall quality outcome for choice of home is good. Resident’s needs are well assessed, recorded, understood and met by staff. EVIDENCE: Since the last inspection one resident had been admitted to Meadowside. This resident’s care was tracked during the site visit, and the admission process discuss with them. The resident said they had come for tea, met the other residents and chosen to move to Meadowside. The resident said they ‘had settled well’. There was a clear care plan recorded, which included information from the resident’s care manager and parents. The resident’s family sent in a comment card that stated the ‘care and concern shown by staff had made the transition much easier for everyone’. Their care manager sent a comment card to the Commission stating that the ‘manager and staff have worked hard to help a new service user with transition in leaving home to live with them’. Meadowside Residential Home DS0000003753.V289109.R01.S.doc Version 5.1 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 & 9 The overall quality outcome for individual needs and choices is good. Care plans reflect the needs and goals of residents, and clear risk assessment ensures they can lead as interesting and independent a life as is possible. Resident’s are given every opportunity to make decisions about their lives, and are fully involved in the day to day running of Meadowside. EVIDENCE: The risk assessments and plans for three residents were case tracked, and the plans and daily records discussed with them, and separately with staff on duty. Discussion found that the residents were involved in developing their plans, the information recorded was accurate and up to date and each resident was happy with what was recorded. Resident’s daily tasks, for example the kitchen rota, included photos for those residents with communication needs. Staff are aware of resident’s needs and acted as key worker helping an individual resident on a personal basis, and getting to know them well. Plans show that health care needs are understood and addressed appropriately. Residents have regular sight, hearing and chiropody appointments. Meadowside Residential Home DS0000003753.V289109.R01.S.doc Version 5.1 Page 10 There were many examples of resident’s being involved in decision-making about their lives, and the day-to-day running of Meadowside. Resident’s said they speak to ‘Norman’ (the responsible individual) regularly and are able to tell him, or ‘Julie’ (the manager) if they are unhappy or have suggestions about improving the Home. Norman had visited the Home to talk to the residents the night before the site visit. Resident’s recently discussed and planned their annual holidays, and many have their own bank accounts. Where the registered manager is acting as Department of Work and Pensions appointee for residents, clear accounts are kept, and examination of the money held in the safe found records to be accurate. Meadowside Residential Home DS0000003753.V289109.R01.S.doc Version 5.1 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 & 17 The overall quality outcome for lifestyle is good. Resident’s lead full active, interesting lives and are active and valued in the local community. The meals are varied, and thoroughly enjoyed by residents. EVIDENCE: As at the previous two site visits resident were very happy with what they did at Meadowside and talked at great length about the activities they are involved with in the local community, and holidays they had been on or are planning for example going to Butlins. One family member said their relative at Meadowside enjoyed hobbies, holidays and outings. Another said residents are encouraged to follow activities outside of the home. All the resident comment cards stated they could do what ever they wanted to do, including visiting and staying with relatives, and going into town unsupported if able. Residents are involved in cooking, craft, coffee mornings, education, work skills placements and voluntary work, swimming, bowling, reading, football and like going to the pub occasionally. Residents also talked about friends they visited in the locality. Meadowside Residential Home DS0000003753.V289109.R01.S.doc Version 5.1 Page 12 The taxi driver who regularly takes the residents to their various activities was spoken to at the site visit, he confirmed that most of his time was spent taxiing residents around the community, and he said in his opinion they are cared for very well. A good rapport was observed between the residents and the taxi driver. Residents, who wish, have a strong relationship with the local Church. A main meal was shared with residents at the site visit, which was tasty and healthy. Residents said the meal was as good as the food always was. Residents said they were involved in shopping for food, preparing, cooking and clearing up after meals. There was a rota system so everyone knew what their job was each day. Residents were happy to be involved. A balanced menu sheet was also included with the pre-site visit information. Residents are also encouraged to help with housework and laundry. Meadowside Residential Home DS0000003753.V289109.R01.S.doc Version 5.1 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 & 20 The overall quality outcome for personal and healthcare support is good. Personal and health care needs are well supported and staff administers resident’s medication safely. EVIDENCE: Residents personal and health care support needs is clearly documented in the care plans case tracked. Residents said they have regular doctor, sight, dental, hearing and specialist check ups with two residents visiting the doctor and dentist, with staff support, during the site visit. Residents are encouraged to do as much for themselves as possible, so for staff a main task is encouraging and prompting them. Residents said they could go to bed and get up when they liked and choose their own clothes and hairstyles. On the day of Inspection all the residents were dressed to reflect their age, personality and the time of year. None of the residents administered their own medication, and when asked said this was their choice. Medication was being received, recorded, stored, and disposed of appropriately by trained staff. One resident required insulin by Meadowside Residential Home DS0000003753.V289109.R01.S.doc Version 5.1 Page 14 injection, and staff had been trained to administer this via an epipen, with a separate fridge available to store the insulin. Meadowside Residential Home DS0000003753.V289109.R01.S.doc Version 5.1 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 & 23 The overall quality outcome for concerns, complaints and protection is good. The system in place ensures residents have confidence that their concerns will be listened to, and dealt with quickly and that every effort is made to protect them from abusive situations. EVIDENCE: The registered manager and owners should, once again, be commended on the open atmosphere that has been encouraged at Meadowside. Residents are absolutely clear about whom they can complain to, and know concerns will be acted on. Every resident stating in their comment card that they knew who to speak to if they were unhappy. One resident has a complaints procedure in Braille. Residents said that Norman Evans and other members of the Home’s Committee visited them regularly to ask if they have any concerns. Residents were also clear that they could speak to the Commission if necessary. The staff spoken to at the site visit were clear about the procedure should they be concerned about an abusive situation, and all staff had received Adult Protection training, with a range of policies and procedures available at Meadowside. A Professional commented that they felt confident about the Home’s attitude towards Adult Protection. Meadowside Residential Home DS0000003753.V289109.R01.S.doc Version 5.1 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 & 30 The overall quality outcome for the environment is good. Meadowside has a homely, bright, clean, hygienic and well-maintained environment, and the maintenance programme in place will ensure this continues. EVIDENCE: Nine of the residents said Meadowside is always clean and fresh, one said sometimes. At the site visit the environment was very clean, well decorated, well maintained with a homely feel due to the personal belongings and effects that were throughout the Home. A cleaner is employed on a regular basis, and has great pride in her work. Residents are encouraged to help clean their own bedrooms. Several residents’ bedrooms were observed, and each was decorated to the taste of the residents and was full of personal belongings. Residents said they liked their bedrooms. Each resident has a single bedroom with their own key, and an extension is underway to provide two current residents with even better accommodation. Meadowside Residential Home DS0000003753.V289109.R01.S.doc Version 5.1 Page 17 The laundry is tidy, clean and hygienic, with staff attending food hygiene and infection control training. Meadowside Residential Home DS0000003753.V289109.R01.S.doc Version 5.1 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, 33, 34, 35 & 36 The overall quality outcome for staffing is good. Residents benefit from fit, competent, qualified and well-supported staff and are protected by the recruitment procedures. EVIDENCE: Relatives commented that they were ‘totally satisfied’, ‘very satisfied’, and ‘impressed’ with the care provided which two relatives said was ‘excellent’ and another a ‘high quality’. Lots of interaction between staff and residents was observed at the site visit, with everyone comfortable in each other’s company, and residents able to be alone, or eat alone if they wished. Three staff files were examined, and those staff spoken at the site visit. Correct recruitment checks had been carried out including CRB’s. However, it was recommended that POVA First checks are received before a member of staff starts work. Nearly half the staff had achieved at least NVQ 2, and staff spoken to were pleased with the training provided, which was linked to their needs and the needs of residents. Staff had induction training, but it did not meet the recommended quality. Staff disciplinary matters are dealt with appropriately. Equality and diversity was discussed, and there were examples of how residents are enabled to be valued members of society, follow a faith, efforts Meadowside Residential Home DS0000003753.V289109.R01.S.doc Version 5.1 Page 19 are made to assist with aides and adaptations and barriers to access in the community have been contested by the manager and staff, however, staff were not fully aware of equality and diversity issues, and the Home did not have robust policies and procedures, it was recommended that staff receive some training, and policies are developed. There were sufficient numbers of staff on duty to ensure residents had active, fulfilling lives. Staff spoken to felt supported by the registered manager and able to go to her with any concerns. Regular staff meetings and supervision took place. Meadowside Residential Home DS0000003753.V289109.R01.S.doc Version 5.1 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, 38, 39 & 42 The quality of outcome for conduct and management of the Home is good. Resident’s benefit from an open, positive and inclusive ethos at Meadowside engendered by a competent registered manager. Resident’s health, safety and welfare are, on the whole, protected at Meadowside. EVIDENCE: The registered manager demonstrates through the information received by the Commission since the last Inspection, the smooth running of Meadowside at the site visit, and the comments received by residents, relatives and professionals that she is competent and held in high esteem. The registered manager and owners should be commended on the open and inclusive atmosphere that is engendered at Meadowside where resident’s needs are central to the running of the Home. The Quality Assurance system is progressing since the last Inspection, with an annual development report expected by June 2006. The Owners already have Meadowside Residential Home DS0000003753.V289109.R01.S.doc Version 5.1 Page 21 in place a regular monitoring process, including meetings with the registered manager and with residents. When the Inspector arrived for the site visit, one resident, although not in immediate danger, was standing alone outside the premises. When the resident was returned to Meadowside, it was found that the staff member on duty was unaware of the resident’s whereabouts. Staff have received all the necessary health and safety training. The Pre-site visit information showed that all the required maintenance and servicing checks are carried out. Several windows were unrestricted on the first floor, and although the registered manager said the windows did not pose a risk to residents, it was recommended that this was included in the environmental risk assessment. Fire checks and procedures were being adhered to with an evacuation taking place on the evening of the site visit. This evacuation went smoothly with all residents moving quickly to the fire exit. An accident book was kept appropriately. Meadowside Residential Home DS0000003753.V289109.R01.S.doc Version 5.1 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 3 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 4 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 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 4 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 4 14 3 15 3 16 3 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 4 3 X X 2 X Meadowside Residential Home DS0000003753.V289109.R01.S.doc Version 5.1 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 YA42 Regulation 14 (4) (c) Requirement Strategies must be in place to ensure the resident identified is safe at all times. Timescale for action 05/06/06 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. 2. 3. Refer to Standard YA32 YA34 YA35 Good Practice Recommendations At least 50 of care staff should have NVQ 2. The registered provider must receive a POVA First check back before a staff member begins work. The registered manager should ensure she, and the staff team have a good understanding of equality and diversity, including training, and ensure it is promoted at Meadowside. The Homes Induction and Foundation training should be accredited to the Learning Disability Award Framework and all new staff must do the training. A copy of the Home’s annual development plan should be available to CSCI and other interested people when produced. Windows that are not restricted must be risk assessed. 4. 5. 6. YA35 YA39 YA42 Meadowside Residential Home DS0000003753.V289109.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Ashburton Office 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 Residential Home DS0000003753.V289109.R01.S.doc Version 5.1 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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