Inspection on 20/10/05 for Meadowsweet

This inspection was carried out on 20th October 2005.

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 found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 10 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Meadowsweet 30/04/08

Meadowsweet 30/10/07

Meadowsweet 22/06/07

Meadowsweet 22/05/06

Meadowsweet 14/06/05

Meadowsweet 02/12/04

Meadowsweet 07/06/04

Meadowsweet 19/01/04

Similar services:

Ashlong House

Norbury Crescent (30)

Edenvale

Wadham Avenue

Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

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

CARE HOME ADULTS 18-65 Meadowsweet, 14 14 Meadowsweet Close Raynes Park London SW20 9PB Lead Inspector Emma Dove Unannounced Inspection 10:20 20th October 2005 and 2 November 2005 nd Meadowsweet, 14 DS0000034132.V261974.R01.S.doc Version 5.0 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 Meadowsweet, 14 DS0000034132.V261974.R01.S.doc Version 5.0 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. Meadowsweet, 14 DS0000034132.V261974.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Meadowsweet, 14 Address 14 Meadowsweet Close Raynes Park London SW20 9PB 020 8544 9830 020 8544 9830 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) London Borough of Merton Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Meadowsweet, 14 DS0000034132.V261974.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. For the manager and staff to receive training on Care Standard Act Legislation, Regulations and Standards and the Protection of Vulnerable Adults. 14/06/05 Date of last inspection Brief Description of the Service: 14, Meadowsweet Close is a registered care home for up to six adults with learning disabilities. Six adults are currently residing at the home. Meadowsweet is owned by a Housing Association and staffed by the London Borough of Merton. The home is situated in a residential area of Raynes Park close to local shops, bus services and leisure facilities. Accommodation is provided over two floors. One bedroom, bathroom, lounge/dining room, kitchen, laundry room and office are available on the ground floor. Five bedrooms, one bathroom with toilet and a staff room are available on the first floor. A lift services both floors. The home is staffed twenty-four hours a day. Three meals a day are provided and service users are able to prepare drinks and snacks in between meals. Meadowsweet, 14 DS0000034132.V261974.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out over the course of three hours one morning and one hour one afternoon by one regulatory inspector. The inspection consisted of examination of records, inspection of communal areas of the home and two residents bedrooms, talking to residents and staff. The inspector had the opportunity to speak with five residents and two members of staff. What the service does well: What has improved since the last inspection? What they could do better: The Statement of Purpose and Service Users Guide must be in place and available for prospective service users, relatives and placing social workers and be available for inspection. Clear written instructions regarding ‘as required’ medication must be in place for one resident. Meadowsweet, 14 DS0000034132.V261974.R01.S.doc Version 5.0 Page 6 The fire alarm must be tested weekly for safety reasons. Evidence must be available confirming that the electrical supply has been tested, to ensure residents and staff safety. 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. Meadowsweet, 14 DS0000034132.V261974.R01.S.doc Version 5.0 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 Meadowsweet, 14 DS0000034132.V261974.R01.S.doc Version 5.0 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): 1&5 Prospective residents do not have access to information to make an informed choice regarding moving into the home. Residents have a contract of residence with the home. EVIDENCE: A Statement of Purpose and Service Users Guide to the home were not available during the course of the inspection. Failure to comply with outstanding Requirements may result in enforcement action being taken. The contract of residence has been updated to include the room to be occupied ensuring this is clearly recorded for residents. Meadowsweet, 14 DS0000034132.V261974.R01.S.doc Version 5.0 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&9 Residents needs are appropriately assessed and developed into care plans which are regularly reviewed. Risk assessments are in place with one exception. EVIDENCE: Case files examined contained care plans which incorporate needs assessments and copies of reviews of care provided. Residents had signed their care plans and three residents confirmed that they are involved in the care planning process and attend reviews. The care plans should include more details of the assistance individuals require and how staff should provide care to ensure consistency of care for residents. Person Centred Plans are being developed for residents. Review records identified actions to be taken by staff at the home and daily records clearly evidenced these actions had been taken. Appropriate risk assessments are in place for residents, however one issue noted for one resident did not include a risk assessment, which must be completed to protect both residents and staff. Meadowsweet, 14 DS0000034132.V261974.R01.S.doc Version 5.0 Page 10 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, 15, 16 & 17 Residents attend various day centres, clubs and groups depending on their wishes and needs. Residents are supported and assisted in maintaining links with family and friends. Residents are involved in choosing the meals provided. EVIDENCE: Residents attend day centres, clubs, groups and participate in all aspects of the day-to-day running of the home. One resident said ‘I don’t do much, I’m going out to college later’ another resident said ‘I go to the day centre and see my friends, I like the day centre’ and another resident said ‘I go out shopping, do the hovering and spend time listening to music’. An activities programme has been developed for one resident who reported they were involved in the process. Staff reported that residents are assisted to maintain links with family and friends. Two residents confirmed that they see friends and family members at the home and in the community. Two residents reported that they get up at the time of their choice and go to bed when they wish. Residents have a key for their bedroom doors and staff Meadowsweet, 14 DS0000034132.V261974.R01.S.doc Version 5.0 Page 11 were observed knocking and waiting for response prior to entering residents bedrooms. Residents receive three meals a day with a cooked meal served in the evening. Three residents made positive comments regarding the food they receive. Meadowsweet, 14 DS0000034132.V261974.R01.S.doc Version 5.0 Page 12 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 & 21 Residents privacy and dignity is respected. Residents receive appropriate support to meet their needs. Residents health needs are met by policies, procedures and practices in place at the home. EVIDENCE: Two residents reported that staff provide appropriate assistance with personal care tasks. Residents are registered with a GP and see other health professionals as required. Staff support residents with attending health appointments. Medication policies, procedures and practices at the home ensure residents health and welfare are maintained. Medication is securely stored and correctly labelled. Medication Administration Record Sheets were signed and up to date. Staff reported that clear written guidelines for one residents ‘as required’ medication has been requested from the GP, however it has not been received at the home. Records are maintained of medications received at the home and returned to the pharmacist. Progress has been made with ascertaining residents wishes regarding terminal care and death. This procedure must be completed to ensure residents needs are known and available to staff. Meadowsweet, 14 DS0000034132.V261974.R01.S.doc Version 5.0 Page 13 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): 23 Residents are protected by policies in place at the home and within the organisation. EVIDENCE: Policies are in place and available to staff regarding the protection of vulnerable adults. No issues were raised by residents or staff regarding the protection of vulnerable adults. Meadowsweet, 14 DS0000034132.V261974.R01.S.doc Version 5.0 Page 14 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 home provides a comfortable, homely environment for residents with suitable furnishings and fittings. The home was clean and hygienic however, some areas of paintwork require cleaning. EVIDENCE: The home was purpose built and meets the needs of current residents. The home provides a comfortable and safe environment for residents. Residents have access to a large lounge/dining area and all bedrooms are single. Residents reported that they complete domestic tasks including cleaning in their bedrooms and that they take it in turns to clean communal areas of the home with staff support. The banisters and woodwork are not included in the residents cleaning schedule and these areas were dusty and in need of cleaning to maintain hygiene standards. The laundry is away from the kitchen and dining area and is fitted with a wash hand basin and has a linoleum floor. Residents do their own laundry with staff support if required. Meadowsweet, 14 DS0000034132.V261974.R01.S.doc Version 5.0 Page 15 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 Residents receive care from competent staff who have access to training courses. EVIDENCE: Two members of staff are on duty during the day with one member of staff asleep but on call at the home at night. These staffing levels were observed to be sufficient during the course of the inspection. The staff team has remained stable since the last inspection with the exception of one member of staff who has commenced employment at the home and one new member of staff is due to commence employment. Staff have access to training courses, two members of staff have completed NVQ to Level 3, two staff have completed training in manual handling and one member of staff has completed training in completing health action plans. Staff reported that they have staff meetings every two to four weeks with minutes available. Meadowsweet, 14 DS0000034132.V261974.R01.S.doc Version 5.0 Page 16 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): 40 & 42 Residents are protected by policies and procedures at the home. Appropriate health and safety policies are in place, however some of the recording practices do not protect residents and staff. EVIDENCE: The in-house policies and procedures have been updated to include details of the CSCI as required at the last inspection. Health and safety policies are in place with records maintained, however records were not available confirming that the electrical supply has been checked and the fire alarm has not been tested every week. Meadowsweet, 14 DS0000034132.V261974.R01.S.doc Version 5.0 Page 17 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 2 X X X 3 Standard No 22 23 Score X 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 X X 2 X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 X X X X X 2 LIFESTYLES Standard No Score 11 X 12 3 13 X 14 X 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score X 3 3 X X X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Meadowsweet, 14 Score 3 3 3 2 Standard No 37 38 39 40 41 42 43 Score X X X 3 X 2 X DS0000034132.V261974.R01.S.doc Version 5.0 Page 18 YES Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA1 Regulation 4 Requirement The registered person must ensure that the Statement of Purpose is up to date and available at the home. The registered person must ensure that a Service Users Guide to the home is developed. (timescale of 13/08/04 not met) The registered person must ensure that a person centred plan is developed for all residents. (timescale of 28/02/05 not met) The registered person must ensure that care plans include full details of how staff should provide care to individual residents. The registered person must ensure that risk assessments are reviewed and updated when new risks become apparent. The registered person must ensure that clear written guidance is in place for the use of ‘as required’ medication. (timescale of 28/02/05 not met) The registered person must ensure that all residents wishes regarding illness, terminal care DS0000034132.V261974.R01.S.doc Timescale for action 22/12/05 2 YA1 5 22/12/05 3 YA6 15 (1) 22/12/05 4 YA6 15 (1) 22/12/05 5 YA9 12 (1) a 22/12/05 6 YA20 13 (2) 22/12/05 7 YA21 15 (2) c 22/12/05 Meadowsweet, 14 Version 5.0 Page 19 8 9 YA30 YA42 23 (2) d 13 (4) 10 YA42 23 (4) c (iv) and death are recorded. (timescale of 13/08/04 not met) The registered person must 22/12/05 ensure that all areas of the home are clean. The registered person must 22/12/05 ensure that the electrical supply is checked with the certificate confirming this available at the home. (timescale of 13/08/04 not met) The registered person must 22/12/05 ensure that the fire alarm is tested weekly. (timescale of 05/08/05 not met) 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 Meadowsweet, 14 DS0000034132.V261974.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection SW London Area Office Ground Floor 41-47 Hartfield Road Wimbledon London SW19 3RG 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 Meadowsweet, 14 DS0000034132.V261974.R01.S.doc Version 5.0 Page 21 - 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!