Inspection on 30/04/08 for Meadowsweet

This inspection was carried out on 30th April 2008.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Meadowsweet 30/10/07

Meadowsweet 22/06/07

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 28/09/2008.

CARE HOME ADULTS 18-65 Meadowsweet 14 Meadowsweet Close Raynes Park London SW20 9PB Lead Inspector Emma Dove Key Unannounced Inspection 30th April and 2nd May 2008 2:00 Meadowsweet DS0000034132.V362384.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 DS0000034132.V362384.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.V362384.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 Anthea Chambers Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Meadowsweet DS0000034132.V362384.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care Home Only (CRH - PC) to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: 2. Learning disability - Code LD The maximum number of service users who can be accommodated is: 6 30th October 2007 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 people are currently living there. 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 are provided each day and people who use the service are able to prepare drinks and snacks in between meals. The address of the CSCI is included in the Statement of Purpose and inspection reports are available at Meadowsweet. The fees are varied, depending on people’s income. Meadowsweet DS0000034132.V362384.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means people who use this service experience good quality outcomes. This unannounced inspection took place over three and a half hours on the 30th April and one and a half hours on the 2nd May 2008. One regulation inspector visited, looked at records, spoke with people who use the service, the manager and four members of staff. Questionnaires were sent to people who use the service, their relatives, placing social workers, health professionals and staff. We received four completed questionnaires, comments from these are included throughout this report. The manager completed an Annual Quality Assurance Assessment (AQAA) that was late, but which contained limited information that is included in this report. The service has notified the CSCI of relevant issues since the last inspection. What the service does well: What has improved since the last inspection? What they could do better: Keep the environment to a good standard with new flooring required in the kitchen and hallway and redecoration of the home. Meadowsweet DS0000034132.V362384.R01.S.doc Version 5.2 Page 6 A protocol should be developed for people who use the service when they spend money on for example large items of furniture, to protect people from financial abuse. People who use the service and their representatives should be offered the opportunity to be involved in the annual development plan for the service. 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.V362384.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.V362384.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 good quality in this outcome area. This judgement has been made using available evidence including a visit to this service. The home has developed clear information about the service to help people choose a home that will meet their needs. Admissions are not made until a full needs assessment has been completed. EVIDENCE: An information pack including a Statement of Purpose and a Service Users Guide has been developed. These documents include information about the services provided, the facilities, staff and how to make a complaint. The Service Users Guide includes photographs to help people understand what they can expect from the home. Two people said that they had been asked if they wanted to move into the home. Two people said they ‘had enough information to help them make a decision about moving in. Assessments are completed before people admission and are kept up to date to reflect any changes in individuals needs. Meadowsweet DS0000034132.V362384.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, 8 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. The service involves individuals in planning the care they need. Care plans are person centred, developed from assessments and kept under review. A key work system is in place, which enables staff to work with individuals to develop goals and review care plans. People who use the service are encouraged and supported to make decisions about their lives. Risk assessments are completed with an appropriate balance between risk and allowing people to live full meaningful lives. EVIDENCE: Care plans contain details of peoples needs, information about how care and support should be provided and what the individual is able to do with verbal prompting rather than staff ‘doing it for them’. People said they have developed Person Centred Plans with their key worker, including goals to achieve in the next six to twelve months. It is clear from Meadowsweet DS0000034132.V362384.R01.S.doc Version 5.2 Page 10 records that people have achieved some of their goals and are ‘happy’ and ‘excited’ about this. We saw assessments of individuals personal care needs and support, confirming that staff have the information to provide the appropriate level and type of support. People are ‘happy’ with the level of care and support they receive. Two staff said that they ‘always’ have up to date information about people needs. Two people said they ‘always’ make decisions about what they do each day and confirmed that they do what they want during the day, evening and at weekends. Staff said that they support people to make decisions about their day to day lives. Minutes of ‘house’ meetings noted the decisions regarding meals, activities, outings and how to improve the home environment are made by the people who use the service, not staff or the manager. We saw appropriate risk assessments in individuals case files. Staff meeting minutes confirmed that staff have discussions about the balance between risk and quality of life, ensuring people lead meaningful lives. Meadowsweet DS0000034132.V362384.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): 11, 12, 13, 14, 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 strong commitment to enabling people who use the service to develop and maintain social, emotional and independent living skills. People have the opportunity to develop and maintain important personal and family relationships. Staff practice promotes individuals rights and choice. Staff help with communication skills to enable people to fully participate in activities of daily living. People are involved in daytime activities of their choice and are involved in the domestic routines of the home. EVIDENCE: People who use the service have a weekly timetable of educational, social and leisure activities, which they are involved in planning. People attend various day centres, classes, groups and clubs, depending in their needs and choice. Staff are looking with individuals at further education, work and new activities Meadowsweet DS0000034132.V362384.R01.S.doc Version 5.2 Page 12 to participate in. People confirmed that that they do ‘what I want’ during the day and weekends. The manager said that visitors are welcome and a number of events and parties have been held over the past year to celebrate individuals Birthdays and other important events. Two people were very ‘excited’ and ‘happy’ about recent and forthcoming parties, when friends and family members attended and have been invited. We saw staff demonstrate a good understanding of individuals rights and responsibilities and noted that they were aware how best to support people. The manager said ‘all people participate in the daily cleaning and running of the home’. We saw this happen during our visit. People who use the service said they ‘have to hoover and tidy their room’ and agreed that this is ‘fair’. The manager reported that people choose the menu and are involved in all aspects of meal preparation including shopping, cooking and clearing away. We saw people laying the table and clearing away after meals. People were happy with the meals and the level of involvement in choice of menu and meal preparation. Meadowsweet DS0000034132.V362384.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 and 20 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. Personal support is responsive to the varied needs and preferences of individuals. Staff respect privacy and dignity and respond to individuals choices and decisions. People have access to appropriate healthcare services in the community. Medication is well managed. EVIDENCE: We saw records of peoples health care needs and clear details for staff to follow when required. Two people said they felt their ‘health needs were being met’ and valued the support from staff to attend appointments. The service uses community health professionals to offer support in meeting individuals needs. Everyone is registered with a GP and has regular dental and opticians appointments as necessary. We saw staff responding to people who use the service in an appropriate manner, respecting individuals privacy and maintaining their dignity. Meadowsweet DS0000034132.V362384.R01.S.doc Version 5.2 Page 14 Medication policies, procedures and practice are good. Staff complete training in the administration of medication. We found medication to be appropriately stored and labelled. Medication Administration Record Sheets were up to date and signed by staff. Meadowsweet DS0000034132.V362384.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. 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 service has a complaints procedure, which is clearly written and easy to understand. People who use the service are happy with the service provided, feel safe and supported by staff. EVIDENCE: Information on how to make a complaint is included in the Statement of Purpose and Service Users Guide. Two people who use the service were aware of who to speak to if they have any concerns or complaints. Two members of staff were aware of their responsibilities to respond to and report complaints raised, by people who use the service, their relatives or representatives or other stakeholders. We have not received any complaints or concerns about Meadowsweet since the last inspection in October 2007. Records indicated that two environmental complaints were received in February 2008, it was not clear if any actions had been taken, however, other records indicated that the issues were being addressed and staff were aware of the concerns and how to minimise further issues. Staff have completed training in the protection of vulnerable adults and are aware of safeguarding issues and their responsibility to report issues. Some money is held for people who use the service. Records are up to date and correct. People who use the service feel staff help them manage their money well. Meadowsweet DS0000034132.V362384.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 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 a physical environment that is appropriate to the specific needs of the people who live there. Bedrooms are single and people have personalised them. The environment promotes peoples privacy and dignity. All areas were clean, tidy and fresh. EVIDENCE: Meadowsweet was purpose built and designed to meet the needs of people who use the service. A lounge/dining room, kitchen, laundry area and office are available on the ground floor. One single bedroom is on the ground floor, other bedrooms are on the first floor. One person was very ‘proud’ of their room and new items they had bought. Two people were happy with their rooms and have made them ‘comfy’ with their own belongings and have had them painted the colour of their choice. Meadowsweet DS0000034132.V362384.R01.S.doc Version 5.2 Page 17 Two people said the home is ‘always’ clean and fresh. All areas of the home were seen to be kept to a good standard of cleanliness. The manager and staff are aware of areas which need improving (redecorating some areas, new flooring in the kitchen and carpet in the hallway) and have reported these to the housing association to be repaired or replaced. Meadowsweet DS0000034132.V362384.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. 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. There are enough staff to meet the needs of people who use the service. The staff structure is based around delivering outcomes for people who use the service. All staff receive relevant training that is focussed on delivering improved outcomes for people living there. There is a good recruitment procedure, which ensures people are protected. Regular staff meetings take place. Staff receive regular supervision. EVIDENCE: The staff rota recorded two members of staff on duty during the day with the manager available in addition on some days. One member of staff is asleep but on call at the home at night. These staff levels were seen to meet the needs of people who use the service. One member of staff said there is ‘always’ enough and one member of staff said ‘usually’ enough staff to meet peoples needs. Two people said that staff ‘always’ treat them well, ‘always’ listen and act on what they say. Meadowsweet DS0000034132.V362384.R01.S.doc Version 5.2 Page 19 Staff have access to relevant training, ensuring they have up to date information on current trends and are better equipped to meet the needs of people who use the service. One member of staff said that they hadn’t done much training recently but some updates were being booked. Two members of staff said they get enough appropriate training to carry out their role. The manager reported that three staff are due to complete training in the Mental Capacity Act in the near future. Two members of staff said they had the appropriate checks before they started work. Staff files contain information required to confirm appropriate checks were carried out before staff started work, with some records held at the organisations head office. Two members of staff reported that they received an appropriate induction when they started work. The manager reported that she supervises five members of staff with a senior member of staff providing supervision to two staff every four to six weeks. Two staff confirmed that they receive ‘regular’ support from their manager. We saw records of monthly staff meetings. The staff team have written ‘objectives’ for the year, which are very person centred and include helping people who use the service to develop. Meadowsweet DS0000034132.V362384.R01.S.doc Version 5.2 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 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 manager has the required qualifications and experience to run the home. The manager promotes equal opportunities, understands the importance of person centred care and effective outcomes for people who use the service. Good health and safety policies, procedures and practices are in place to protect people who use the service. EVIDENCE: The manager has previous experience managing a similar service and has registered with the CSCI. The manager reported that the service is working with an advocacy organisation to complete a survey for people who use the service, to seek their Meadowsweet DS0000034132.V362384.R01.S.doc Version 5.2 Page 21 opinions of the service and any suggestions for improvements or changes. A representative from the organisation has visited twice since the last inspection in October 2007 to complete monthly visits, this is not monthly as the Care Homes Regulations require. We saw records confirming that meetings for people who use the service are held every month. These meetings offer people who use the service the opportunity to discuss any issues, plan outings and activities and go through routines such as cleaning schedules for communal areas. Health and safety policies and procedures are good and protect people who use the service, staff and visitors from harm. We saw records of required checks to be up to date for the gas safety, electrical supply, fire alarm service and test. The lift service was due in February 2008 and the portable electrical appliance test was due in April 2008. Meadowsweet DS0000034132.V362384.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 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 3 25 3 26 X 27 X 28 3 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 X LIFESTYLES Standard No Score 11 3 12 4 13 3 14 4 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Meadowsweet DS0000034132.V362384.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. Refer to Standard YA23 YA24 YA39 Good Practice Recommendations A protocol should be in place for when people who use the service spend money on large items of furniture, to ensure that they are protected from harm. The flooring in the kitchen requires repairing or replacing, to ensure the health and safety of people who use the service and staff is maintained. People who use the service and their representatives should offered the opportunity to be involved in the annual development plan for the service. Meadowsweet DS0000034132.V362384.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection London Regional Office 4th Floor Caledonia House 223 Pentonville Road London N1 9NG 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. Extracts may not be used or reproduced without the express permission of CSCI Meadowsweet DS0000034132.V362384.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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