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Inspection on 24/05/05 for Meadowview Nursing Home

Also see our care home review for Meadowview Nursing Home for more information

This inspection was carried out on 24th May 2005.

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

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

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The home provides a homely environment, with easy access for residents and relatives to the manager and proprietor. Staff provide a caring and increasingly skilled service for the residents. The catering and housekeeping arrangements suit the residents` needs.

What has improved since the last inspection?

A new conservatory has been built, and is fitted with carpet and sun blinds. Several areas of the home have been newly painted and decorated, including the entrance hall and two upstairs bedrooms. The refitting of the upstairs shower room has been completed. The key worker system of managing daily care for the residents is in place. The care plan documents have been improved. Training for staff has improved, so that the needs of those with dementia are better understood. The Service Users Guide has been improved and a copy of the Guide and the home`s Statement of Purpose are available in each resident`s room.

What the care home could do better:

The proprietor needs to satisfy himself that the references for new staff recruited through an agency are genuine. There are no hand washing facilities in the sluicing area, and staff should be able to disinfect their hands (with gel or other products) to minimise the possibility of the spread of any infections.

CARE HOMES FOR OLDER PEOPLE Meadowview Nursing Home 48 Rack End Standlake, Witney, Oxfordshire OX29 7SB Lead Inspector Kate Harrison Announced 24 May 2005 09:30 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 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 Older People. 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. Meadowview Nursing Home H57-H08 S27163 Meadowview V217542 240505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Meadowview Nursing Home Address 48 Rack End, Standlake, Witney, Oxfordshire, OX29 7SB Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01865 300205 01865 300205 Mr Farhad Pardhan Ms Caroline Schofield Care Home with Nursing 30 Category(ies) of Old age, not falling within any other category registration, with number (30) of places Meadowview Nursing Home H57-H08 S27163 Meadowview V217542 240505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: On admission persons should be aged 60 years and over. Date of last inspection 02 December 2004 Brief Description of the Service: Meadowview is a privately owned nursing home located in Standlake, Oxfordshire, and is situated in a residential area of the village. The two storey building has been extended to provide private rooms and communal areas for residents, and has recently been extended to provide a conservatory. The majority of the private accommodation is provided downstairs with two double rooms provided upstairs. There is a passenger lift and toileting, bathing and showering facilities for all the residents. The village of Standlake has shops and pubs and has a local bus service. The proprietor is planning to further extend the home to improve the homes environment and to provide some extra rooms. Meadowview Nursing Home H57-H08 S27163 Meadowview V217542 240505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection took place over one day in May 05. The manager had previously completed the pre-inspection questionnaire provided by the Commission containing specific information about the home and returned it to the inspector. The inspector spoke to a number of residents, staff, visitors and relatives during the inspection to hear their views of the home. Comment cards provided by the Commission to relatives, visitors, and health and social care professionals including GPs had been completed and returned to the inspector. A new manager has recently taken over at the home, and is in the process of becoming registered with the Commission. The inspector looked at some records and saw all areas of the home, and had discussions about the management of the home and the planned developments with the proprietor and new manager. What the service does well: What has improved since the last inspection? A new conservatory has been built, and is fitted with carpet and sun blinds. Several areas of the home have been newly painted and decorated, including the entrance hall and two upstairs bedrooms. The refitting of the upstairs shower room has been completed. The key worker system of managing daily care for the residents is in place. The care plan documents have been improved. Training for staff has improved, so that the needs of those with dementia are better understood. The Service Users Guide has been improved and a copy of the Guide and the home’s Statement of Purpose are available in each resident’s room. Meadowview Nursing Home H57-H08 S27163 Meadowview V217542 240505 Stage 4.doc Version 1.30 Page 6 What they could do better: 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. Meadowview Nursing Home H57-H08 S27163 Meadowview V217542 240505 Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Meadowview Nursing Home H57-H08 S27163 Meadowview V217542 240505 Stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3 A full assessment of needs is carried out for prospective residents to make sure that the home can meet their needs. EVIDENCE: The manager told the inspector that she carries out the needs assessment, and that afterwards she writes a letter to the prospective resident to say that the home is suitable to meet his or her needs. An NHS nurse assesses the level of NHS funding of residents’ care, and the Service Users Guide details how the NHS funding is managed by the home. A care plan is developed for every resident, and several appropriate care plans were seen by the inspector. Meadowview Nursing Home H57-H08 S27163 Meadowview V217542 240505 Stage 4.doc Version 1.30 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7 and 8. Residents’ care needs are set out in a personalised care plan, and health care needs are fully met. EVIDENCE: The inspector assessed three care plans and in each the health, personal and social care needs of the residents were recorded. It was clear that residents and/or relatives or representatives are involved in planning the care of residents. In the care plan reviews, the inspector saw that residents and relatives sign the care plans to show their involvement and agreement. Appropriate risk assessments were in place in the three care plans seen by the inspector, so that the staff had all the information at hand on how to look after the resident’s health needs. Systems are in place so that the staff have access to other health care professionals for help and advice when necessary. Meadowview Nursing Home H57-H08 S27163 Meadowview V217542 240505 Stage 4.doc Version 1.30 Page 10 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 15 Residents can choose nutritious food from the menu, and can eat in pleasant surroundings at times suitable for them. EVIDENCE: The summer two-week menu is included in the Service Users Guide available in residents’ rooms, and residents told the inspector that the food was enjoyable. One resident said that she could have breakfast when she wanted it, and the inspector noticed that one resident was having tea and toast at 10.30am. Food is appropriately prepared according to need, and staff receive training on how to help residents to eat. Drinks are available at all times for residents. The dining room is pleasant, though small, and two meal sittings are arranged to accommodate all the residents who wish to use the dining room. Meadowview Nursing Home H57-H08 S27163 Meadowview V217542 240505 Stage 4.doc Version 1.30 Page 11 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 The home’s complaints procedure is easy to use, and all complaints are taken seriously and responded to. EVIDENCE: The home’s complaints procedure is available in every room and complaints can be made directly to the person in charge of the home at any time. The manager is responsible for responding to all complaints and complaints can be made to the Commission at any time. Records are kept of all complaints and one complaint has been received and appropriately responded to since the last inspection. Meadowview Nursing Home H57-H08 S27163 Meadowview V217542 240505 Stage 4.doc Version 1.30 Page 12 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 24 and 26. Residents’ rooms suit their needs and they benefit from the well-maintained and improved environment. The home is pleasant and clean and two easy measures recommended by the inspector will improve infection control in the laundry and sluicing areas. EVIDENCE: Several improvements have been made to the home’s environment since the last inspection, and plans are in hand to further improve and extend the home. The inspector saw residents’ rooms which were personalised and contained furniture and fittings to meet their needs. The majority of the beds in the home are suitable for the needs of residents receiving nursing care, and all beds suit the needs of the residents. The home’s laundry and sluicing facility are fitted in confined spaces and do not have hand washing facilities. Staff use gloves and aprons when dealing with soiled items. In the laundry staff use a gel preparation as a substitute for hand washing, and staff should have the same facility in the sluicing area. A Meadowview Nursing Home H57-H08 S27163 Meadowview V217542 240505 Stage 4.doc Version 1.30 Page 13 waste bin should be available in the sluicing area, and a fixture should be in place to hold the gel preparation so that staff can readily access the gel, as it is a key infection control measure. Meadowview Nursing Home H57-H08 S27163 Meadowview V217542 240505 Stage 4.doc Version 1.30 Page 14 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 28,29,30 The home’s staff training and development programme is in place. The home’s policy of accepting photocopies of ‘To Whom It May Concern’ references from recruitment agencies could put residents at risk, though the home’s own recruitment process is thorough. EVIDENCE: The proprietor should satisfy himself as to the authenticity of photocopied ‘To Whom It May Concern’ references when recruiting staff through an agency. The inspector saw staff files recruited through an agency containing such references and discussed with the proprietor how the authenticity of the references could be verified by the agency. At present three members of care staff have either NVQ Level 2 or 3, and by the end of this year to meet the standard at least 7 of the 14-member team should have NVQ certificates in care. The home has a training and development programme for staff and has arrangements in place for two members of staff to be trained to be NVQ assessors. When the staff are trained it is expected that it will be easier for the home to increase its percentage of staff with NVQ certificates. Staff have received training in dementia care, in moving and handling residents and in first aid since the last inspection. The manager has completed Meadowview Nursing Home H57-H08 S27163 Meadowview V217542 240505 Stage 4.doc Version 1.30 Page 15 a ‘Dementia Care and Mentoring’ course, and one registered nurse is now a trainer in moving and handling residents. Meadowview Nursing Home H57-H08 S27163 Meadowview V217542 240505 Stage 4.doc Version 1.30 Page 16 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33 Residents and their representatives are able to make their views known to the home’s management, to make sure that the home is run in their interests. EVIDENCE: The home has a quality assurance system based on seeking the views of residents and their representatives, and is a mixture of formal and informal methods. A recent questionnaire to residents and representatives had a low response rate. The proprietor or manager is personally available to residents and their representatives most days, and are easily contactable by phone. Residents told the inspector that they can discuss any issues with the home’s management, and relatives said that the manager was accessible and had an open attitude to residents and relatives. The ‘Friends of Meadowview’ meet regularly to discuss issues and raise funds for the home. It is also used as a forum to discuss any matters arising with the manager. Meadowview Nursing Home H57-H08 S27163 Meadowview V217542 240505 Stage 4.doc Version 1.30 Page 17 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 3 COMPLAINTS AND PROTECTION 3 x x x x 3 x 2 STAFFING Standard No Score 27 x 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x x x 3 x x x x x Meadowview Nursing Home H57-H08 S27163 Meadowview V217542 240505 Stage 4.doc Version 1.30 Page 18 No 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 Regulation None. 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. Refer to Standard 26 29 Good Practice Recommendations A waste bin should be available in the sluicing area and a fixture should be in place to hold the gel preparation so that staff can readily access the gel. The proprietor should satisfy himself as to the authenticity of references for prospective employees, especially those recruited through an agency. Meadowview Nursing Home H57-H08 S27163 Meadowview V217542 240505 Stage 4.doc Version 1.30 Page 19 Commission for Social Care Inspection Burgner House, 4630 Kingsgate, Cascade Way, Oxford Business Park South, Cowley, Oxford. OX4 2SU National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Meadowview Nursing Home H57-H08 S27163 Meadowview V217542 240505 Stage 4.doc Version 1.30 Page 20 - 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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