Inspection on 22/06/07 for Meadowsweet

This inspection was carried out on 22nd June 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector 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 6 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 22/05/06

Meadowsweet 20/10/05

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 Meadowsweet Close Raynes Park London SW20 9PB Lead Inspector Emma Dove Unannounced Inspection 22nd & 28th June 2007 11:45 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 DS0000034132.V344784.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. Meadowsweet DS0000034132.V344784.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Meadowsweet Address 14 Meadowsweet Close Raynes Park London SW20 9PB 020 8544 9830 F/P 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) www.merton.gov.uk/housingsupport London Borough of Merton Post Vacant Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Meadowsweet DS0000034132.V344784.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 5th October 2006 Brief Description of the Service: 14, Meadowsweet Close is a registered care home for up to six adults with learning disabilities. Six people are currently living 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 an 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. The address of the CSCI is included in the Statement of Purpose. The fees are varied, depending on people’s income. Meadowsweet DS0000034132.V344784.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out over four hours on the 22nd June and three hours on the 28th June 2007 by one regulation inspector. The inspection included examination of records, inspection of communal areas, two bedrooms, talking with residents, staff and the manager. Questionnaires were left with residents, sent to relatives, health and social services. No completed questionnaires have been received by the CSCI. An Annual Quality Assurance Assessment was sent to the home in April 2007. This document has not been returned to the CSCI. No other information has been received from the home since the last inspection in October 2006. What the service does well: What has improved since the last inspection? What they could do better: The Statement of Purpose must be updated to include details of new staff. The kitchen floor needs repairing or replacing. Dining room chairs also need replacing. The manager must register with the CSCI, failure to do this may result in enforcement action being taken. An annual development plan must be in place that includes seeking residents and their representatives views on the services provided. Meadowsweet DS0000034132.V344784.R01.S.doc Version 5.2 Page 6 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. The summary of this inspection report can be made available in other formats on request. Meadowsweet DS0000034132.V344784.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 Meadowsweet DS0000034132.V344784.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. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 2 People who use this service receive adequate quality in this outcome area. This judgement has been made using available evidence including a visit to this service. The Statement of Purpose and Service Users Guide set out the aims and objectives of the home, these documents require updating. Pre-admission assessments are carried out. EVIDENCE: The Statement of Purpose and Service Users Guide contain information about the service provided, the facilities available, how referrals are made, some of the activities provided, staff and how to make a complaint. The Service Users Guide is in written format and has photographs, appropriate for current and prospective residents. The Statement of Purpose and Service Users Guide need updating to include staff working at the home. Residents confirmed that they are happy at the home and chose to move in. Assessments are completed before admission, kept under review and updated as required. Meadowsweet DS0000034132.V344784.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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9 People who use this service receive good quality in this outcome area. This judgement has been made using available evidence including a visit to this service. Care plans are in place and residents are involved in developing person centred plans and have personal goals. Residents are encouraged and supported to make their own decisions. EVIDENCE: Case files contain information about the individuals likes and dislikes, their weekly timetable, a copy of the contract of residence, a care plan, review minutes and medical information. A separate Person Centred Plan (PCP) has been developed with residents. These documents are ongoing and updated as goals are achieved and changes are needed. A key work system is in place, which means that each resident has an allocated member of staff who supports them with their PCP, preparing for meetings and reviews, assists with shopping and liaises with family members, health professionals and keeps the staff team informed of any changes. Meadowsweet DS0000034132.V344784.R01.S.doc Version 5.2 Page 10 Residents confirmed that they are involved in decisions about their lives, that they meet with staff and have been working on PCP. Risk assessments are in place, these are reviewed and updated as required. Meadowsweet DS0000034132.V344784.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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17 People who use this service receive good quality in this outcome area. This judgement has been made using available evidence including a visit to this service. The service has a commitment to enabling people who use services to develop their skills, including social, emotional, communication and independent living skills. EVIDENCE: All residents have a weekly timetable of social, leisure and educational activities. People attend different clubs, groups and day centres depending on their needs and choice. The manager reported that some residents have tried a few new clubs and leisure activities this year, which they were reported to have enjoyed. The level of activities outside the home has increased since the last inspection. Residents made positive comments about the level of activities and the new clubs they have been attending. Meadowsweet DS0000034132.V344784.R01.S.doc Version 5.2 Page 12 Two residents were excited about going on holiday and were busy preparing to get some new clothes, spending money and checking they had tickets and everything else they needed. One resident is planning to stay with relatives for a holiday this year. Residents are involved in planning meals and shopping and take it in turns to help staff cook and clear away. Resident’s comments about the food included ‘the food is alright’, ‘the food is good’, ‘I like the food’ and ‘the food is usually good’. Meadowsweet DS0000034132.V344784.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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 and 21 People who use this service receive good quality in this outcome area. This judgement has been made using available evidence including a visit to this service. Case files contain details of people’s health care needs. Staff respect privacy and dignity and are sensitive to peoples changing needs. Medication is well managed. Medication records are fully completed, up to date and signed. EVIDENCE: People’s health care needs are noted in their case files and in Person Centred Plans. One resident said that they see the GP regularly and have been to hospital and staff give appropriate support. One resident said ‘staff help with health care’. Appropriate medication policies and procedures are in place. Staff complete training in the administration of medication. Medication Administration Record Sheets were up to date and signed by staff. At the last inspection a recommendation was made to monitor the temperature of the medication cabinet. The manager reported that this has been completed with no issues raised, however they will be moving the medication to a different area in the future. One resident said ‘staff manage my medication well’. Meadowsweet DS0000034132.V344784.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 People who use this service receive good quality in this outcome area. This judgement has been made using available evidence including a visit to this service. The complaints procedure is clearly written and accessible to residents, their relatives and placing social workers. A policy is in place for the protection of adults and staff complete training in issues relating to protection. EVIDENCE: The complaints procedure is included in the Statement of Purpose and Service Users Guide. Residents said that they would speak with the manager or their key worker if they have concerns or worries. No concerns were raised at this visit. One complaint was recorded since the last inspection. The complaint was not related to the care or services provided. The record did not indicate the actions taken and whether the complainant was satisfied with the outcome. The manager reported that staff on duty dealt with the complaint with no further action required. One member of staff has completed training in the protection of vulnerable adults in 2007. Other staff have completed this training prior to 2006. The home holds some money for residents, this is appropriately stored with up to date records and balances checked on a daily and weekly basis. A recommendation was made at the last inspection to develop a protocol for when residents spend money on large items such as furniture. The manager reported that this has not been completed and should be to ensure residents are protected from harm. Meadowsweet DS0000034132.V344784.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 27, 28 and 30 People who use this service receive good quality in this outcome area. This judgement has been made using available evidence including a visit to this service. The home provides appropriate accommodation for residents, the environment is generally well maintained. Bedrooms are all single and residents can personalise their rooms to their taste. EVIDENCE: The home was purpose built and is in a residential road close to local shops, leisure facilities and public transport. Residents have a single bedrooms and access to a lounge/dining room and a garden. Bedrooms have been personalised and decorated to the individual’s choice. Residents made comments including ‘I like my room’, ‘I’m comfy here’, ‘I bought my furniture’ and ‘I have my things around me’. A bathroom with toilet is available on the first floor with a shower room with toilet and separate toilet on the first floor. The flooring in the shower room needed to fit around the toilet at the last inspection. This has been completed Meadowsweet DS0000034132.V344784.R01.S.doc Version 5.2 Page 16 and the manager reported that new flooring is being ordered for the shower room in the near future. The home was seen to be clean and fresh and is generally in a good state of repair and redecoration with a few issues noted, for example the flooring in the kitchen, dining room chairs and the hall carpet. Meadowsweet DS0000034132.V344784.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 and 36 People who use this service receive good quality in this outcome area. This judgement has been made using available evidence including a visit to this service. People who use the service are happy with the care that they receive. Staff receive appropriate training. The recruitment procedure meets regulations and National Minimum Standards, however some records are not in place. EVIDENCE: The published staffing rota showed two members of staff are usually on duty during the day with one member of staff asleep but on call at the home at night. Some days extra staff are at the home to enable residents to participate in community activities or outings. Some staff recruitment information is at the home and some information is at the organisations head office. Clear records of the information kept at the organisations head office must be at the home. Staff have access to training in first aid, food hygiene, infection control, equal opportunities, anti discriminatory practice, medication, manual handling, risk assessments, health and safety, Person Centred Planning, diversity and NVQ. Meadowsweet DS0000034132.V344784.R01.S.doc Version 5.2 Page 18 One member of staff has completed NVQ to Level 2, two members of staff are in the process of NVQ 3 and the manager is doing NVQ Level 4. Staff confirmed that they have access to training to help them do their job. Staff also said that they receive sufficient support and supervision. Meadowsweet DS0000034132.V344784.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 People who use this service receive poor quality in this outcome area. This judgement has been made using available evidence including a visit to this service. The manager has consistently failed to register with the CSCI. More work is needed around planning for the future and developing the service with residents and their representatives. Good systems are in place for managing health and safety with checks completed and records up to date. EVIDENCE: The manager has been at the home for two years and has not yet registered with the CSCI even thought this has been a Requirement at the last two inspections. If the manager fails to register with the CSCI, enforcement action may be considered. Meadowsweet DS0000034132.V344784.R01.S.doc Version 5.2 Page 20 A representative from the organisation visits the home and completes a report on findings, which is available at the home with a copy sent to the CSCI. Progress has not been made with producing a development plan for the home. Residents, their relatives, representatives and placing social workers opinions have not been sought on the services provided. Policies, procedures and practice regarding health and safety are good. Checks have been made on the portable electrical appliances and the fire alarm system as required. Residents said that they feel safe at the home. Meadowsweet DS0000034132.V344784.R01.S.doc Version 5.2 Page 21 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 2 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 3 23 3 ENVIRONMENT Standard No Score 24 2 25 3 26 X 27 3 28 3 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 2 35 3 36 3 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 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 3 1 X 2 X X 3 X Meadowsweet DS0000034132.V344784.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? YES 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. 2. 3. 4. 5. Standard YA1 YA24 YA24 YA34 YA31 Regulation 4&5 23 (2) b 23 (2) b 17 (2) Sch 4 (6) 8 (1) a Requirement The Statement of Purpose and Service Users Guide must be updated. The entrance hall and lounge carpet needs cleaning or replacing. The flooring in the kitchen requires repairing or replacing. Information regarding staff recruitment must be kept at the home. The manager must apply to register with the CSCI. (timescales of 28/07/06 & 30/11/06 not met) An annual development plan must be produced and residents and their relatives views of services provided must be sought. (timescales of 28/07/06 & 30/11/06 not met) Timescale for action 29/08/07 29/10/07 29/10/07 29/08/07 29/08/07 6. YA39 24 29/08/07 Meadowsweet DS0000034132.V344784.R01.S.doc Version 5.2 Page 23 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. Refer to Standard YA7 YA23 Good Practice Recommendations Referrals to advocacy agencies should be followed up. A protocol to cover should be in place for when residents spend money on large items of furniture. Meadowsweet DS0000034132.V344784.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection SW London Area Office Ground Floor 41-47 Hartfield Road Wimbledon London SW19 3RG National Enquiry Line: 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 © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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