Inspection on 30/10/07 for Meadowsweet

This inspection was carried out on 30th October 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 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Meadowsweet 30/04/08

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 09/07/2008.

CARE HOME ADULTS 18-65 Meadowsweet 14 Meadowsweet Close Raynes Park London SW20 9PB Lead Inspector Emma Dove Key Unannounced Inspection 30th October 2007 1:30 Meadowsweet DS0000034132.V352417.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.V352417.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.V352417.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.V352417.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 22nd June 2007 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 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. The fees are varied, depending on people’s income. Meadowsweet DS0000034132.V352417.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 three and a half hours on the 30th October 2007 by one regulation inspector. The inspection included looking at records, looking around communal areas, talking with people who use the service, staff and the manager. An Annual Quality Assurance Assessment form (AQAA) has not been received from the service for this inspection or for the last inspection in June 2007, even though written and verbal reminders have been given in July, September and October 2007. Questionnaires were sent to people who use the service and health professionals. We have received four completed questionnaires, comments from these are included in the relevant section of this report. What the service does well: What has improved since the last inspection? What they could do better: The flooring in the kitchen still needs to be repaired or replaced to ensure the health and safety of people who use the service and staff is maintained. Carpets in entrance hall need to be cleaned or replaced to keep the environment in a good state for people who use the service. A protocol should be developed for when people who use the service plan to spend money on large items of furniture, to ensure that they are protected from harm. Meadowsweet DS0000034132.V352417.R01.S.doc Version 5.2 Page 6 Staff files must contain details to confirm that appropriate recruitment practices are in place so that people who use the service are protected from harm. An annual development plan must be produced and people who use the service and their representatives views of the services provided must be sought. This will ensure that peoples views on the services are included in the development of the service and to comply with the Care Home Regulations 2001. 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.V352417.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.V352417.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 the service receive good in this outcome area. This judgement has been made using available evidence including a visit to this service. The service has developed a Statement of Purpose and Service Users Guide to provide information to people about the services provided. Admissions are not made until a full needs assessment has been completed. EVIDENCE: A Statement of Purpose and Service Users Guide have been developed which include information about the services provided, facilities available, staff and how to make a complaint. The Service Users Guide includes photographs to help people understand the services provided. One person said that they ‘had been asked if they wanted to move into the home’ and one person couldn’t remember if they had been asked and involved in the decision to move in. One person said that they had ‘enough information about the service’ and one person couldn’t remember due to the length of time they had lived there. Assessments were completed before people moved in and kept updated with any changes in peoples needs. Meadowsweet DS0000034132.V352417.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 the service receive good in this outcome area. This judgement has been made using available evidence including a visit to this service. Care plans are person centred, developed from assessments and completed with the individual. A key work system is in place, which enables staff to work on an individual basis and be involved in goal setting. EVIDENCE: Care plans are in place and separate Person Centred Plans have been developed with five people, with the sixth one in progress. People using the service have developed goals and are working to achieve them. Case files contain information about people’s communication, their weekly timetable, the contract of residence, annual reviews of care and health and their social history. Daily records must be factual and not be the opinion of the member of staff. Care must be taken to ensure descriptions of the behaviour of people who use the service is accurate. Meadowsweet DS0000034132.V352417.R01.S.doc Version 5.2 Page 10 A key work system is in place and people who use the service are aware of who their key worker is and said that they meet regularly to go through their care needs and plans for the future. One person said that they ‘always’ and one person said they ‘usually’ make decisions about what they do each day. Two people said that they feel ‘well cared for’. Regular meetings are held, which allows people who use the service to be involved in the day to day running of the home and in planning for the future of the service. Appropriate risk assessments are in place. These documents are kept under review and updated as necessary. Meadowsweet DS0000034132.V352417.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 the service receive good in this outcome area. This judgement has been made using available evidence including a visit to this service. The service is committed to enabling people who use the service to develop and maintain social, emotional and independent living skills. People have been supported to develop goals and are working towards achieving them. People have the opportunity to develop and maintain important personal and family relationships. People who use the service are involved in the domestic routines of the home, take responsibility for their own room, menu planning and cooking meals. EVIDENCE: People who use the service have a weekly programme of education, leisure and social activities that they have been involved in planning. This involves people attending different day centres, groups, classes and clubs, depending on their needs and choice. Meadowsweet DS0000034132.V352417.R01.S.doc Version 5.2 Page 12 Two people said that the activities are ‘good’. People were seen to go be involved in community activities and clubs One person said ‘I like shopping and going to the nightclub’. People are supported to maintain relationships with family members and have been supported to develop personal relationships. Peoples religious needs are noted and are met by attending church services and groups of their choice. All people using the service have had a holiday this year, to a place of their choice and were thinking about where to go on holiday next year. Two people said that they like the food provided. People were seen to be involved in menu planning and meal preparation and are happy with the level of involvement. Meadowsweet DS0000034132.V352417.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 the service receive good in this outcome area. This judgement has been made using available evidence including a visit to this service. The health care needs of people who use the service are clearly recorded. People have access to appropriate healthcare professionals. Health needs are monitored and appropriate actions taken when required. Medication is well managed, records are completed in full and signed. EVIDENCE: Two people who use the service said that their privacy is respected and that they get the help and support they need. People who use the service are registered with a GP and have access to community and specialist health care professionals as required. One person said that staff support them to attend appointments and that this is their choice. One person’s daily records noted that they had complained of toothache one day, however there was no follow up action noted. The manager reported that this would have been where the person complained of pain on one occasion Meadowsweet DS0000034132.V352417.R01.S.doc Version 5.2 Page 14 only, that any further notes about pain would have been referred to the GP or dentist. The records of one person’s weight indicated a large loss over a two month period but no records of any follow up with the GP or dietician or more regular weight recording or any check in case the scales were misread. Good medication policies, procedures and practices are in place. Staff complete training in the administration of medication. Medication storage and recording is appropriate, with Medication Administration Record Sheets up to date and signed by staff. Meadowsweet DS0000034132.V352417.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 the service receive good in this outcome area. This judgement has been made using available evidence including a visit to this service. The service has a clear complaints procedure which is accessible to people who use the service and their representatives. Policies are in place for the protection of vulnerable adults. Staff complete training in adult protection. EVIDENCE: The complaints procedure is included in the Statement of Purpose and Service Users Guide. Four people who use the service were aware of who to speak to with any concerns. We have not received any complaints and no complaints have been received at the home since the last inspection. The manager reported that two members of staff have completed training in dealing with complaints and that two staff are due to complete this training in the near future. Appropriate policies are in place for the protection of vulnerable adults. Staff complete training in adult protection and are aware of their responsibilities. At the last inspection, a recommendation was made for a protocol to be developed to ensure people who use the service are protected when they spend their money on large items of furniture. No progress has been made with this. Some money is held for people who use the service and the records are clear and up to date. Meadowsweet DS0000034132.V352417.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 and 30 People who use the service receive good 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 meet the needs of the people who live there. Bedrooms are single and people are encouraged to personalise their rooms. All areas of the home were clean and fresh. EVIDENCE: Meadowsweet was purpose built and designed to meet the needs of people who use the service. People have access to a lounge/dining room, kitchen and laundry room on the ground floor with a garden to the side and rear of the home. The curtains in the lounge are starting to look worn and staff reported that they have plans to replace these. New chairs have been bought for the dining area, which provides more comfortable and appropriate seating for people who use the service. Bedrooms are single and have been decorated and personalised to individuals taste. Meadowsweet DS0000034132.V352417.R01.S.doc Version 5.2 Page 17 A shower room with toilet and a separate toilet are on the ground floor. A bathroom with toilet is on the first floor. The environment is generally maintained to a good standard of decoration and repair with the flooring in the entrance hall, lounge and kitchen being in need of cleaning and or replacing. The manager reported that there are plans to clean the hall and lounge carpets and to replace the lino in the kitchen next year. All areas were clean and fresh. One person said the home is ‘always’ and one person said that the home is ‘usually’ clean and fresh. Meadowsweet DS0000034132.V352417.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 and 35 People who use the service receive good 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 they receive. Staff have good training opportunities. The recruitment process is in line with regulations, although some gaps were found in the recording. EVIDENCE: The published staff rota identified two members of staff on duty during the day with the manager in addition on some days. One member of staff is asleep but on call at the home at night. These staffing levels are in line with the needs of people who use the service. The staff team have remained stable since the last inspection, which provides consistency of care to people who use the service. Four people said that staff ‘always’ treat them well. Two people said that staff ‘always’ listen and act on what they say. Staff recruitment policies are in line with regulations, however not all records are held at the home and it is not possible to check that appropriate checks Meadowsweet DS0000034132.V352417.R01.S.doc Version 5.2 Page 19 have been made before staff start work. No progress has been made with ensuring staff files contain the information required since the last inspection. Staff have access to appropriate training to help them carry out their role and to ensure they are up to date with current good practice initiatives. Three members of staff have completed training on the Mental Capacity Act and five staff are due to undertake this training. The manager provides regular supervision to all staff. Staff said that they are supported to carry out their job. Meadowsweet DS0000034132.V352417.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 the service receive adequate in this outcome area. This judgement has been made using available evidence including a visit to this service. The manager is qualified and has the necessary experience to run the home however, she does not demonstrate an understanding of her responsibilities under the Care Standards Act 2000. The service is planning to be focused on the people who use the service, to work in partnership with families and professionals and to take into account equality and diversity issues. EVIDENCE: The manager applied to register with us at the end of October 2007, this had been a repeated Requirement for the last three inspections. The manager has been at the home for two and a half years and has previous experience working with people with disabilities and supporting staff. Meadowsweet DS0000034132.V352417.R01.S.doc Version 5.2 Page 21 The manager reported that she has approached a local advocacy agency to enlist their support with quality assurance questionnaires for people who use the service. The information from these questionnaires will be used to inform the development plan for the service. A representative from the organisation visits every month to check on the quality of the services provided. We receive a copy of the report from this visit. Good health and safety policies, practices and records are in place. The required checks have been made on the fire alarm system and electrical appliances. Meadowsweet DS0000034132.V352417.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 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 2 33 X 34 2 35 3 36 X 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 X 2 X 2 X X 3 X Meadowsweet DS0000034132.V352417.R01.S.doc Version 5.2 Page 23 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. Standard YA24 Regulation 23 (2) b Requirement Timescale for action 31/03/08 2. YA24 23 (2) b 3. YA34 17 (2)Sch 4 (6) 4. YA39 24 The entrance hall and lounge carpet needs cleaning or replacing, to keep the environment in a good condition for people who use the service. (previous timescale of 29/10/07 not met) The flooring in the kitchen 31/01/08 requires repairing or replacing, to ensure the health and safety of people who use the service and staff is maintained. (previous timescale of 29/10/07 not met) Information regarding staff 31/12/07 recruitment must be kept at the home, to confirm that appropriate recruitment practices are in place and that people who use the service are protected from harm. (previous timescale of 29/08/07 not met) An annual development plan 31/01/08 must be produced, which includes seeking the views of people who use the service and their representatives. To ensure that people who use the service are involved in the development DS0000034132.V352417.R01.S.doc Version 5.2 Meadowsweet Page 24 of the service. (previous timescales of 28/07/06, 30/11/06 and 29/08/07 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. 1. Refer to Standard YA23 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. Meadowsweet DS0000034132.V352417.R01.S.doc Version 5.2 Page 25 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. Extracts may not be used or reproduced without the express permission of CSCI Meadowsweet DS0000034132.V352417.R01.S.doc Version 5.2 Page 26 - 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!