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Inspection on 31/10/05 for Meadowview Nursing Home

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

This inspection was carried out on 31st October 2005.

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 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

Meadowview Nursing Home provides a homely environment for residents. Residents told the inspector that staff are kind and caring and that the manager is `good`. Residents told the inspector that staff respect their preferences.

What has improved since the last inspection?

References for staff recruited through agencies are verified so that the proprietor knows that all staff in the home are properly recruited. Infection control procedures have improved. The training of staff to care for individuals with dementia has improved, and is continuing. The new conservatory provides more space and is regularly used by residents.

What the care home could do better:

The nurse recording the delivery of medication needs to sign and date the entry. The topics of privacy and dignity need to be included in the induction programme. The activities programme should be written so that residents can refer to it as necessary. The home`s adult protection procedures should include information for staff on the Oxfordshire codes of practice. Some Health and Safety procedures need to be reviewed to ensure that all staff are appropriately trained in the fire procedures, and that staff are familiar with the evacuation procedures for residents using wheelchairs. The broken window in a shared room needs to be replaced.

CARE HOMES FOR OLDER PEOPLE Meadowview Nursing Home 48 Rack End Standlake Witney Oxfordshire OX29 7SB Lead Inspector Kate Harrison Unannounced Inspection 31st October 2005 09:30 X10015.doc Version 1.40 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 Meadowview Nursing Home DS0000027163.V261923.R01.S.doc Version 5.0 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 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 DS0000027163.V261923.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Meadowview Nursing Home Address 48 Rack End Standlake Witney Oxfordshire OX29 7SB 01865 300205 01865 300205 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) farhadpardhan@aol.com Mr Farhad Rajabali Pardhan Care Home 30 Category(ies) of Old age, not falling within any other category registration, with number (30) of places Meadowview Nursing Home DS0000027163.V261923.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Admission of one named resident under the age of 60. On admission persons should be aged 60 years and over. Date of last inspection 24th May 2005 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 extra rooms. Meadowview Nursing Home DS0000027163.V261923.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This CSCI unannounced inspection was conducted over one morning when the nurse manager was not on duty. A registered nurse was on duty and the proprietor was in the home during the inspection. The nurse manager is in the process of becoming the registered manager and the process is expected to be completed soon. The inspector spoke to several residents, visited most areas of the home, saw records, policies and procedures, and discussed the management of the home with the proprietor and staff. The proprietor is planning to extend the home and is continuing to work with the appropriate authorities to meet all the planning and building requirements. What the service does well: What has improved since the last inspection? References for staff recruited through agencies are verified so that the proprietor knows that all staff in the home are properly recruited. Infection control procedures have improved. The training of staff to care for individuals with dementia has improved, and is continuing. The new conservatory provides more space and is regularly used by residents. Meadowview Nursing Home DS0000027163.V261923.R01.S.doc Version 5.0 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 DS0000027163.V261923.R01.S.doc Version 5.0 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 Outcomes Statutory Requirements Identified During the Inspection Meadowview Nursing Home DS0000027163.V261923.R01.S.doc Version 5.0 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 the following standard(s): None None of these standards were assessed at this inspection. Standard 3 was assessed at the last inspection and Standard 6 does not apply to the home. EVIDENCE: Meadowview Nursing Home DS0000027163.V261923.R01.S.doc Version 5.0 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 the following standard(s): 9 and 10. Medication is well managed at the home, though there is some difficulty with supply. Residents are treated with respect and privacy is respected. EVIDENCE: The home’s medication is supplied from the pharmacy attached to a GP practice, and staff report problems in getting the pharmacy to act quickly in replying to their requests. Medication is delivered weekly and recorded for individual residents in the appropriate book. To comply with the Royal Pharmaceutical Society’s guidelines the nurse recording the delivery must sign and date the entry. The inspector spoke to two residents who said that staff treat them with respect, and the inspector witnessed good practice regarding privacy. The inspector saw the home’s induction policy and recommends that the topics of privacy and dignity be included in the induction programme. Meadowview Nursing Home DS0000027163.V261923.R01.S.doc Version 5.0 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 the following standard(s): 12, 13 and 14. Improvements are planned to the lifestyle at the home so that residents can have more opportunities for stimulation. Residents can maintain contact with relatives, friends and the local community as they wish. Residents are helped to be as independent as possible. EVIDENCE: The inspector spoke to several residents about their experiences of life at the home. Some go to the nearby ‘Over 60’s Club’ regularly, and it was clear that individual preferences are respected from the detail given to the inspector. The proprietor has plans in hand to improve opportunities for stimulation for the residents by appointing an activities organiser, as at present there is little provision for individual preferences. There is no printed activities list, although staff are aware of when entertainers regularly visit the home, and remind residents of the day’s activity. Residents said that visitors could come at any reasonable time, and that there were no restrictions on contacting relatives when they wished to. Residents are encouraged to be as independent as possible, and can bring personal possessions with them into the home. Meadowview Nursing Home DS0000027163.V261923.R01.S.doc Version 5.0 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 the following standard(s): 17 and 18. Residents’ legal rights are protected. Residents are protected from abuse, but the procedures need to be amended. EVIDENCE: Relatives help residents with legal matters, and residents can access an advocacy service if necessary. Staff and relatives help residents who want to vote. The home has policies and procedures to protect residents from abuse, and reference to the Oxfordshire codes of practice should be included in the home’s adult protection procedures. Training updates for staff on protecting vulnerable adults are organised. Meadowview Nursing Home DS0000027163.V261923.R01.S.doc Version 5.0 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 the following standard(s): None None of these standards were assessed at this inspection. Standards 19 and 26 were assessed at the last inspection. EVIDENCE: Meadowview Nursing Home DS0000027163.V261923.R01.S.doc Version 5.0 Page 13 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 consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27. The numbers and skill mix of staff meet the residents’ needs. EVIDENCE: The inspector saw the staff rota, showing which staff were on duty during the days and nights of the week of inspection. It was clear that appropriate numbers of skilled staff are available to meet the needs of the residents. Household staff are employed to cover kitchen, laundry and cleaning duties. Meadowview Nursing Home DS0000027163.V261923.R01.S.doc Version 5.0 Page 14 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 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 35, 36 and 38. Residents’ financial interests are protected. Staff are appropriately supervised. Due to uncertainty around fire procedures and a broken window, it was not clear that the safety of residents was safeguarded at the time of inspection. EVIDENCE: Few residents are able to manage their own financial affairs and when residents are not able to manage, then relatives or Money Management takes responsibility. Written records of all transactions are kept. Formal supervision is in place for staff and appropriate records kept. The inspector saw the fire safety records and discussed with staff the home’s arrangements regarding safety of residents in the event of a fire. One member of staff was not sure how a particular fire door was opened, and it was clear that wheelchair users would not be able to use the same door in the event of a Meadowview Nursing Home DS0000027163.V261923.R01.S.doc Version 5.0 Page 15 fire, though staff did not know this. From the recording it was not clear to the inspector that all staff had attended fire lectures, as a matrix is not used. The inspector recommends that the individual responsible for Health and Safety at the home should review procedures to ensure that all staff are appropriately trained in the fire procedures, and that staff are familiar with evacuation procedures for residents using wheelchairs. The inspector noted that a secondary glazed window in a shared room upstairs had 2 broken panes of glass. The proprietor complied with the requirement to arrange for replacement glass to be fitted as soon as he was informed. Meadowview Nursing Home DS0000027163.V261923.R01.S.doc Version 5.0 Page 16 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 2 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 3 18 2 X X X X X X X X STAFFING Standard No Score 27 3 28 X 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X 3 X X 2 Meadowview Nursing Home DS0000027163.V261923.R01.S.doc Version 5.0 Page 17 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. 1 Standard OP38 Regulation 23 Requirement The proprietor must ensure that staff are familiar with evacuation procedures for residents using wheelchairs in all areas of the home. The proprietor must make arrangements for the broken glass to be replaced in the identified window. Timescale for action 30/11/05 2 OP38 13 01/11/05 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 4 5 Refer to Standard OP9 OP10 OP12 OP18 OP38 Good Practice Recommendations The nurse recording receipt of medications into the home should sign and date the entry. The staff induction policy should include advice for staff on the topics of privacy and dignity. The activities programme should be in writing so that residents who are able can refer to it as necessary. The home’s adult protection procedures should include information for staff on the Oxfordshire codes of practice. The proprietor should ensure that the individual DS0000027163.V261923.R01.S.doc Version 5.0 Page 18 Meadowview Nursing Home responsible for Health and Safety at the home should review procedures to ensure that all staff are appropriately trained in the fire procedures. Meadowview Nursing Home DS0000027163.V261923.R01.S.doc Version 5.0 Page 19 Commission for Social Care Inspection Oxford Area Office 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 DS0000027163.V261923.R01.S.doc Version 5.0 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. 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. 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