Inspection on 22/05/06 for Meadowsweet

This inspection was carried out on 22nd May 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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 7 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 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 14 Meadowsweet Close Raynes Park London SW20 9PB Lead Inspector Emma Dove Unannounced Inspection 22nd May 2006 10:30 Meadowsweet, 14 DS0000034132.V295051.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 Meadowsweet, 14 DS0000034132.V295051.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, 14 DS0000034132.V295051.R01.S.doc Version 5.2 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) www.merton.gov.uk/housingsupport London Borough of Merton Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Meadowsweet, 14 DS0000034132.V295051.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 20th October and 2nd November 2005 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. Information regarding fees was not available at this inspection. The address of the CSCI is included in the Statement of Purpose which is available at the home. Meadowsweet, 14 DS0000034132.V295051.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 the course of seven and a half hours on the 22 May 2006 by one regulation inspector. The inspection consisted of examination of records, inspection of communal areas of the home, two residents bedrooms, talking to residents, staff and the manager. The inspector had the opportunity to speak with three residents and four members of staff. A Pre-Inspection Questionnaire was left with the manager on the 22 May 2006 which has not been received by CSCI. Further questionnaires to relatives and health and social care professionals could not be sent at this inspection due to the lack of information received from the home. What the service does well: What has improved since the last inspection? What they could do better: The Statement of Purpose should be updated to include the London Borough of Merton’s complaints procedure. Further work is required to develop Person Centred Plans (PCP) for all residents to ensure their needs and wishes are fully recorded and can be met by staff. The provision of advocates would provide support for individuals with decision making and developing their PCP. The temperature of the medication cabinet should be monitored and checked with the pharmacist. Meadowsweet, 14 DS0000034132.V295051.R01.S.doc Version 5.2 Page 6 Residents wishes regarding terminal care and death should be included in their PCP. A protocol regarding spending residents spending money on large items of furniture to ensure their financial interests are protected. Staff files must contain proof of the individuals identity, a recent photograph, confirmation that a Criminal Records Bureau check has been completed and copies of two written references. A quality assurance system should be developed to ensure residents and their representatives views are sought on a regular basis and an annual development plan should be in place. 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.V295051.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, 14 DS0000034132.V295051.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): 1&2 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. A Statement of Purpose has been developed which includes information prospective residents would need to make a choice regarding moving into the home. This document requires updating to reflect equipment provided by the home and complaints. Assessments were completed prior to or on admission to the home but must be updated to reflect changes in residents needs. EVIDENCE: A Statement of Purpose has been developed which includes information regarding the home, facilities, referrals, activities, staffing and complaints. Details regarding facilities must clearly indicate the furniture provided by the local authority and that residents may purchase their own furniture. Also the information regarding complaints must include the local authorities complaints procedure. Residents needs are assessed prior to or on admission to the home, these assessments must be kept up to date to reflect changes in residents needs. Meadowsweet, 14 DS0000034132.V295051.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 & 9 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Assessments have been completed and developed into care plans, but require updating and further work to ensure that they are person centred. EVIDENCE: Care plans have been developed from assessments and residents confirmed that they meet with their key workers to plan for the future. The manager and staff reported that progress has been made with Person Centred Planning (PCP) with further work required to complete this process for all residents. A detailed communication profile was in place, which is an excellent assessment of the resident, containing information for staff to enable them to meet the individuals needs. This document should be completed and kept up to date with the PCP. Residents confirmed that they attend reviews and are involved in making decisions regarding their lives. Risk assessments are in place but must be kept under review. Meadowsweet, 14 DS0000034132.V295051.R01.S.doc Version 5.2 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, 13, 15, 16 & 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents social needs are appropriately met by attending day centres, groups, classes and clubs during the week depending on their wishes and needs. EVIDENCE: Five residents attend day centres four days a week with one day spend at home doing household tasks and shopping. One resident remains at the home every day and reported that they go shopping, do the hoovering, watch television and listen to music. One resident said that they enjoy the clubs and groups they attend. Residents also go to local clubs and groups in the evening. A notice board in the entrance of the home included details of events residents could attend. One resident reported that attending church is important to them and staff reported that other residents attend a religious group and a local church each week. Meadowsweet, 14 DS0000034132.V295051.R01.S.doc Version 5.2 Page 11 Residents confirmed that they can have visitors and maintain contact with relatives and friends. One case file contained details of relatives Birthdays, so the resident can send greeting cards. Residents and staff are currently discussing holiday options for the summer. A copy of the menu was provided which was dated January 2003. The menu indicated a choice of main meal in the evening with lunch taken at the day centre on weekdays or residents are assisted in preparing a light lunch on their training day and at weekends. Residents reported that they are involved in meal preparation and shopping. Comments regarding the food included: ‘the food is ok’; ‘I like the food’; ‘I get my own breakfast’ and ‘I can choose what I eat and staff get me something different if I don’t like what’s on the menu’. Meadowsweet, 14 DS0000034132.V295051.R01.S.doc Version 5.2 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, 20 & 21 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the home. Residents receive appropriate personal and health care support. EVIDENCE: Residents reported that staff provide appropriate support when required with personal care tasks, maintaining their privacy and dignity. Residents are registered with a GP and staff support individuals with attending health related appointments. Medication policies, procedures and practices ensure residents health and welfare are protected. Medication is correctly labelled with Medication Administration Record Sheets signed and up to date. The medication cupboard was warm and it is recommended that the temperature is monitored and checked with the pharmacist. One case file contained information regarding residents wishes around ill health and death and staff reported that they are still working with some residents and their families to ensure this information is available. Meadowsweet, 14 DS0000034132.V295051.R01.S.doc Version 5.2 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): 22 & 23 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the home. Complaints and protection of vulnerable adults policies and procedures are in place. EVIDENCE: The complaints procedure is included in the Statement of Purpose and is displayed in the entrance of the home accessible by all residents. The complaints procedure does not direct residents to the London Borough of Merton’s complaints procedure and this should be added. Residents were aware of who to speak with regarding concerns and complaints and all residents have family members, social worker or day centre staff who are outside of the home to offer support. The provision of advocates would be beneficial for some residents, the manager reported that an advocacy agency has been approached. This issue should be followed up to provide residents with additional support in decision making and raising concerns. No issues were raised during the course of the inspection, the CSCI has not received any complaints since the last inspection of the home. Records are maintained of complaints, no complaints have been received at the home since the last inspection. Staff have not completed training in the protection of vulnerable adults, courses are available in July 2006. The inspector noted that a resident had purchased their own furniture and protocols should be in place to ensure residents financial interests are protected. Meadowsweet, 14 DS0000034132.V295051.R01.S.doc Version 5.2 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, 25, 26, 27 & 30 Outcomes in this area are good. This judgement has been made using available evidence including a visit to the home. Residents live in a homely, well maintained environment with the exception of the laundry room which requires attention to bring it in line with the rest of the home. EVIDENCE: The home was purpose built and meets the needs of current residents. Residents have single bedrooms and access to a large communal lounge/dining room with doors to the garden. Residents have personalised their bedrooms with pictures, photographs and belongings with some residents purchasing some items of furniture. Residents comments regarding their bedrooms included ‘I like my room’, ‘I have all I want in my room’ and ‘I’ve bought a new television and DVD player which I enjoy watching’. Residents were observed to be comfortable and relaxed in communal areas of the home and in their individual bedrooms. A small domestic kitchen is available which residents access to prepare drinks snacks and meals. A large shower room with toilet and a separate toilet are available on the ground floor with a bathroom with toilet on the first floor. Meadowsweet, 14 DS0000034132.V295051.R01.S.doc Version 5.2 Page 15 The laundry room provides a washing machine, tumble drier, clothes airer and iron and ironing board for residents to use. The laundry room had a damp smell which should be investigated to ensure no leaks have occurred and to continue providing a good environment for residents. All areas of the home were clean and hygienic. Residents reported that they complete domestic tasks in their bedrooms and communal areas every week with staff providing support and assistance and ensuring the kitchen, bathrooms and laundry area are clean on a daily basis. Further development of the cleaning programme has improved the environment for residents. Meadowsweet, 14 DS0000034132.V295051.R01.S.doc Version 5.2 Page 16 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 & 35 Outcomes in this area are good. This judgement has been made using available evidence including a visit to the home. Staffing levels are appropriate to meet residents needs and staff receive appropriate training opportunities. EVIDENCE: The published staffing rota identified two members of staff on duty during the day with one asleep but on call at the home with another member of staff away from the home and on call at night. The organisation has a training and development programme which is available to all staff. Staff have completed training in fire safety, moving and handling, food hygiene, health and safety, first aid, Person Centred Planning, completing health care plans, diversity, fire risk assessments and risk assessments. One member of staff has completed NVQ training to Level 3, the manager is due to commence NVQ to Level 4 and two members of staff are due to commence NVQ to Level 3. Two new members of staff are completing their induction. Staff files are held at the organisations head office, with some information retained at the home. A copy of two written references, confirmation that the Criminal Records Bureau check has been completed, a recent photograph and proof of identity must be held at the home. Meadowsweet, 14 DS0000034132.V295051.R01.S.doc Version 5.2 Page 17 Staff reported that they have regular staff meetings, supervision sessions and training. Meadowsweet, 14 DS0000034132.V295051.R01.S.doc Version 5.2 Page 18 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 & 42 Outcomes in this area are adequate. This judgement has been made using available evidence including a visit to the home. The home is run to meet residents needs. Further work is required to develop quality assurance systems to ensure all residents and their representatives views are sought on a regular basis. EVIDENCE: The manager has been at the home for over a year and has not yet applied to register with the CSCI, this must be done to comply with the Care Homes Regulations 2001. Residents benefit from the inclusive way the home is run. Staff reported that they are focussing more on residents needs and how best to meet them and that this has improved the services provided. A representative from the organisation visits the home every month and speaks with residents, staff and checks required paperwork. Further work is required to develop quality assurance systems and to seek the views of Meadowsweet, 14 DS0000034132.V295051.R01.S.doc Version 5.2 Page 19 residents, relatives and their representatives regarding the services provided at the home. An annual development plan should also be available for the service. Appropriate health and safety policies, procedures and records are in place and up to date. Residents are aware of the importance of health and safety and staff complete safety checks and take action as required. Gas and electrical equipment have been checked at the required intervals. The fire alarm has been tested weekly. The lift has been serviced as necessary. Meadowsweet, 14 DS0000034132.V295051.R01.S.doc Version 5.2 Page 20 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 2 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 2 23 2 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 3 28 X 29 X 30 2 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 2 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 X 2 2 2 X 2 X X 3 X Meadowsweet, 14 DS0000034132.V295051.R01.S.doc Version 5.2 Page 21 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 updated to include details of the London Borough of Merton’s complaints procedure. The registered person must ensure that a person centred plan is developed for all residents. (timescale of 28/02/05 & 22/12/05 not met) The registered person must ensure that risk assessments are kept under review. The registered person must ensure that all residents wishes regarding illness, terminal care and death are recorded. (timescale of 13/08/04 & 22/12/05 not met) The registered person must ensure that staff files contain copies of two written references, confirmation that a CRB check has been completed, a recent photograph and proof of the DS0000034132.V295051.R01.S.doc Timescale for action 28/07/06 2. YA6 15 (1) 28/07/06 3. YA9 12 (1) a 28/07/06 4. YA21 15 (2) c 28/07/06 5. YA34 17 (2) Sch (4) 6 28/07/06 Meadowsweet, 14 Version 5.2 Page 22 individuals identity. 6. YA31 8 (1) a The registered person must ensure that the manager applies to register with the CSCI. The registered person must ensure that an annual development plan is produced and that residents and their relatives views are ascertained. 28/07/06 7. YA39 24 28/07/06 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 YA7 YA20 YA23 Good Practice Recommendations The registered person should follow up referrals to advocacy agencies. The registered person should monitor the temperature of the medication cabinet and check with the pharmacist. The registered person should produce a protocol to cover when residents spend money on large items of furniture. Meadowsweet, 14 DS0000034132.V295051.R01.S.doc Version 5.2 Page 23 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. 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