Inspection on 06/07/06 for Meadowview Nursing Home

This inspection was carried out on 6th July 2006.

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

Meadowview Nursing Home 31/10/05

Meadowview Nursing Home 24/05/05

Meadowview Nursing Home 02/12/04

Meadowview Nursing Home 06/05/04

Meadowview Nursing Home 05/01/04

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Meadowview Nursing Home 48 Rack End Standlake Witney Oxfordshire OX29 7SB Lead Inspector Kate Harrison Unannounced Inspection 6th July 2006 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.V302753.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 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.V302753.R01.S.doc Version 5.2 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 Mrs Caroline Campbell Schofield Care Home 30 Category(ies) of Old age, not falling within any other category registration, with number (30) of places Meadowview Nursing Home DS0000027163.V302753.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. On admission persons should be aged 60 years and over. Admission of one named resident under the age of 60. Date of last inspection 31st October 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 proprietor and the registered manager run the home with a team of nurses, care staff and housekeeping staff. The weekly fees range from £567 to £620. The village of Standlake has shops and pubs and has a local bus service. The home is currently being further extended to provide more single rooms and will also provide an enclosed garden when completed. Meadowview Nursing Home DS0000027163.V302753.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Commission has, since the 1st April 2006, developed the way it undertakes its inspection of care services. This inspection of the service was an unannounced ‘Key Inspection’. The inspector arrived at the service at 09.30 hours and was in the service for 8 hours. This inspection was a thorough look at how well the service is doing. It took into account detailed information provided by the service’s manager, and any information that CSCI has received about the home since the last inspection. The inspector saw all areas of the home and looked at records and documents relating to the care of the residents. The inspector asked the views of the people who use the services and other people seen during the inspection or who responded to questionnaires that the Commission had sent out. 10 residents as well as several relatives and health and social care professionals responded to the survey. From the evidence seen and comments received, the inspector considers that this service would be able to provide a service to meet the needs of individuals of various religious, racial or cultural needs, and the inspector saw good practice in action. What the service does well: What has improved since the last inspection? The named nurse and key-worker system is used at the home, so that residents and relatives know the name of the nurse and carer responsible for their care. The care planning system has been improved and now the home uses a core set of care plans for every individual, and it is easier for staff to record necessary information. Meadowview Nursing Home DS0000027163.V302753.R01.S.doc Version 5.2 Page 6 The water supply to the home has been thoroughly overhauled and improved, so that all the residents have a good supply of hot and cold water when they want it. The TV reception is much improved in the lounges and in residents’ private rooms. A new carpet shampooer is in use and the corridor lighting has been improved, so that the residents’ areas are cleaner and brighter. Rooms have been redecorated and some carpets have been replaced. The manager has improved the ordering system for the medications, and with the appointment of a pharmacist at the GP practice, it is now easier for any issues about medication to be discussed and resolved. Training for staff has improved, especially training in how to care for individuals with dementia. Staff members who need to improve their English are able to attend free language classes, so that they will be better able to communicate with residents and relatives. Computer lessons are also offered to staff. The manager now has her own office and computer to help her to run the home more effectively. 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.V302753.R01.S.doc Version 5.2 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.V302753.R01.S.doc Version 5.2 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): 3. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home does not provide intermediate care. EVIDENCE: The home has a good system of assessing prospective residents. Following the first referral to the home, information from other professionals such as social workers and hospital staff involved with the individual is gathered. A senior member of the nursing staff, usually the registered manager, visits the individual and carries out the pre-admission assessment. The home’s sevenpage assessment document covers all the medical, psychological and social needs of the individual, and documents how the home can meet the needs of the individual. Pre-admission visits by the prospective resident and family to the home are encouraged and expected, though at times only family members are in a position to do so. Feedback from the CSCI survey indicated that families were happy with the pre-admission process at Meadowview. Meadowview Nursing Home DS0000027163.V302753.R01.S.doc Version 5.2 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): 7, 8, 9 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The care planning system has been improved and now the home uses a core set of care plans for every individual, and other care plans as needed on an individual basis are then developed. The inspector was satisfied that the care plans seen for three randomly selected individuals were comprehensive, regularly reviewed and appropriate. The named nurse and key-worker system is used at the home, so that residents and relatives know the name of the nurse and carer responsible for the care of the resident. Health risk assessments are in place, and appropriate action is taken according to the assessments. Records show that health care needs are noted and appropriate action is taken in a timely way to address any issues. A local GP manages the health needs of several of the residents and visits the home as necessary, and other professionals, such as the Macmillan nurses are consulted for advice when needed. Meadowview Nursing Home DS0000027163.V302753.R01.S.doc Version 5.2 Page 10 Survey results from the residents show that in answer to the question ‘Do you receive the medical support you need?’ all those who responded said that they ‘usually’ or ‘always’ received it. The registered manager has improved the ordering system for the medications, and with the appointment of a pharmacist at the GP practice it is now easier for any issues about medication to be discussed and resolved. Staff have easy access to the medication policy and procedure, and the recording of the reception, administration and disposal of drugs is appropriate. Controlled drugs are also well managed. New members of staff receive training and advice on how to show respect to residents, especially in matters of personal care, and the residents said that staff listen and act on what they say. Measures are in place to address language difficulties for one resident from abroad, such as the use of an interpreter and a communication board, and details are included in the care plans, so that staff know which tools to use appropriately. Meadowview Nursing Home DS0000027163.V302753.R01.S.doc Version 5.2 Page 11 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, 14 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The majority of the residents’ replies to the CSCI question about activities in the home show that there are ‘usually’ activities available that they can take part in. The weekly activities plan shows that some activity is planned for most days of the week, but that the weekends are not included. The hours of the activities organiser have recently been increased to full time. The activities organiser also plans to take a course on the subject, so that the provision can be improved for individual and for group activities. Regular outings for resident are being organised. Some residents attend the ‘Over 60’s’ club provided nearby. Visiting by friends and relatives is encouraged, and residents can use the telephone to contact whomever they want to. Relatives and friends can join the home’s support group if they want to. The home’s ethos encourages the residents to maintain their independence, and the registered manager is able to help those who would benefit from the support of an advocate. Meadowview Nursing Home DS0000027163.V302753.R01.S.doc Version 5.2 Page 12 The home’s four-week menu is displayed by the entrance to the dining room, and staff discuss the next day’s menu with residents to enable them to make a choice. Residents who replied to the CSCI’s survey said that they ‘always’ or ‘usually’ liked the food, and several told the inspector that the food was good. Several residents do not use the dining room, and eat in the lounge from trays or in their own rooms, and staff help those who need help with eating. The more mobile residents usually use the small dining room, and the tables are attractively set with tablecloths and flowers. Meadowview Nursing Home DS0000027163.V302753.R01.S.doc Version 5.2 Page 13 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): 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a complaints policy and procedure, and the procedure is displayed in the home. All the respondents to the CSCI survey said that they knew whom to address complaints to, and the registered manager is usually available in the home, so that residents or relatives can discuss any issues arising with her. The proprietor is available at the home regularly, and is also able to meet with residents and relatives. The Commission has received information concerning one complaint made against the service since the last inspection, and the proprietor has taken appropriate action to resolve the issues brought to his attention. Staff members receive training on the protection of vulnerable adults, and new staff members also receive information on how to respond to concerns. The home has policies and procedures for staff, and staff know how to contact the local adult protection support worker. Meadowview Nursing Home DS0000027163.V302753.R01.S.doc Version 5.2 Page 14 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): 19 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home is located in a residential area of the village, and the proprietor expects the building work to extend the home to be completed by October 2006. The extended home will be able to provide 12 more single rooms, with improved communal facilities, and an enclosed central garden. The home employs two individuals to be responsible for the maintenance of the home, and the day-to-day maintenance is recorded and addressed quickly. The lighting has been improved in corridors, and the general upkeep of the home continues. The plumbing system has recently been overhauled and improved, and the water supply for the residents is now more dependable. The registered manager recently acquired her own office and computer, and uses them to dedicate time to improving the supervision arrangements and planning for the future. Meadowview Nursing Home DS0000027163.V302753.R01.S.doc Version 5.2 Page 15 The home has two shared upstairs rooms and because of the shape of the rooms it is not always possible for the appropriate furniture, such as a bedside table or a wheelchair, for two residents to be appropriately available for them. The registered manager should carefully consider how the upstairs rooms could meet the needs of prospective residents. A health and safety audit of the home was carried out in January 2006, and the proprietor is addressing the one remaining recommendation made. The home has two laundry rooms, and the plans for the extension are that one improved laundry room will replace the present arrangements. The staff members have access to the home’s infection control policies, and items such as protective clothing and gel disinfectant are available for staff. Meadowview Nursing Home DS0000027163.V302753.R01.S.doc Version 5.2 Page 16 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, 28, 29 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The staff rota shows what staff members are on duty over a two-week period, and the staffing for each shift is organised for the different areas of the home. A registered nurse is available over the 24 hours, and care staff and housekeeping staff are available in sufficient numbers to meet the needs of the residents. The registered manager has organised free English language classes for the overseas staff so that they will be better able to communicate with the residents. The majority of the home’s care staff are nurses qualified in India and are employed as carer whilst undertaking, or waiting to undertake, the conversion course to attain their UK nursing qualification. The home is in discussion with the appropriate authority to agree what the NVQ equivalent for the nurses qualified in India should be, whilst working as care assistants at the home. Care staff members are encouraged to take NVQ qualifications and 80 of the local staff have NVQ Level 2 or above. One nurse who qualified abroad is undertaking the adaptation course, and two more carers are undertaking the NVQ training. One extra staff member is training to become an NVQ assessor so that the numbers of carers taking the NVQ training can be improved. Meadowview Nursing Home DS0000027163.V302753.R01.S.doc Version 5.2 Page 17 The staff recruitment procedure includes completing the application form, applying for references and getting an enhanced CRB clearance with checks also being made to see if the individual’s name is on the Protection of Vulnerable Adults list. From the records checked by the inspector, it was not clear that all the appropriate checks had been made, but after telephone checks to the CRB office it became clear that the proprietor had followed the appropriate procedure, and that the CRB office had not completed the CRB certificates appropriately. To assist the home in keeping track of the procedures undertaken by the home for all new applicants, the inspector recommends that a checklist be used to record dates when action to progress the application was completed. The registered manager has improved the staff training programme, and the programme includes weekly in-house training for care staff on health and welfare issues. Staff members attend all regular update training on safety topics, and the registered manager arranges for expert training on issues such as falls prevention, nutrition and wound management as necessary. Ten of the care staff are enrolled on the dementia awareness distance-learning programme, and complete the assessment of each unit before progressing. Meadowview Nursing Home DS0000027163.V302753.R01.S.doc Version 5.2 Page 18 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): 31, 33, 35 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The registered manager is qualified, skilled and knowledgeable about care issues, and continues to gain new knowledge and skills. She recently gained her mentorship for dementia care and has a specialist qualification in palliative care. She manages the programme for overseas nurses course at the home, and provides effective leadership for all the staff. The home has started annual quality assurance surveys, and this year’s results are due to be published in the revised Service Users Guide. Monthly audits of important areas such as the safety of wheelchairs and bedrails and the effectiveness of cleaning schedules are regularly monitored and help to keep residents safe. Meadowview Nursing Home DS0000027163.V302753.R01.S.doc Version 5.2 Page 19 Relatives and friends can join the home’s support group if they want to, and regular meetings are held to discuss relevant issues and the meetings also provide social occasions for residents, friends and relatives. None of the residents manage their own financial affairs, and relatives or other representatives take the responsibility. Secure arrangements are in place to store valuables, and records are kept of transactions. A fire risk assessment was carried out in January 2006, and fire training and the appropriate monthly fire safety testing are carried out. Meadowview Nursing Home DS0000027163.V302753.R01.S.doc Version 5.2 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for 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 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Meadowview Nursing Home DS0000027163.V302753.R01.S.doc Version 5.2 Page 21 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 OP12 OP19 OP29 Good Practice Recommendations The weekly activities plan should include the activities for the weekend. The registered manager should consider how the shared upstairs rooms could meet prospective residents’ needs. To assist the home in keeping track of the procedures undertaken by the home for all new applicants, the inspector recommends that a checklist be used to record dates when action to progress the application was completed. Meadowview Nursing Home DS0000027163.V302753.R01.S.doc Version 5.2 Page 22 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.V302753.R01.S.doc Version 5.2 Page 23 - 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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