Inspection on 07/03/06 for Meads House Residential Care Home

This inspection was carried out on 7th March 2006.

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.

Other inspections for this house

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

CARE HOMES FOR OLDER PEOPLE Meads House Residential Care Home 26 Denton Road Eastbourne East Sussex BN20 7ST Lead Inspector Gwyneth Bryant Unannounced Inspection 7 March 2006 10:00 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 Meads House Residential Care Home DS0000065559.V267890.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. Meads House Residential Care Home DS0000065559.V267890.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Meads House Residential Care Home Address 26 Denton Road Eastbourne East Sussex BN20 7ST 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) 01323 732632 Nifinara Limited Prital Moskal Care Home 17 Category(ies) of Old age, not falling within any other category registration, with number (17) of places Meads House Residential Care Home DS0000065559.V267890.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The maximum number of service users to be accommodated is seventeen (17). Service users accommodated must be older people aged sixty-five (65) years or over on admission. One named service user to be accommodated who has a mental disorder. 24 August 2005 Date of last inspection Brief Description of the Service: Meads House is a large three-storey detached property in the Meads area of Eastbourne. It is registered to provide care and accommodation for up to seventeen older people. There are sixteen single rooms all of which have en-suite facilities, with the exception of one room which has a toilet and wash hand basin nearby. The homes only double room is used as a single room. The home has two communal bathrooms of which both have bathing hoists and there is also a shower. The ground floor has a large lounge/dining area. A stair lift facilitates access to all floors. All parts of the grounds and gardens are accessible by the provision of ramps. Call bells are available in all accessible areas and hand rails provided where required. Local shops and the seafront are easily accessible to service users and Eastbourne town centre is only a short drive away. The home has an attractive, well-maintained garden to the rear of the building and parking to the front. It is situated in a quiet residential road. Meads House Residential Care Home DS0000065559.V267890.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection and there were fourteen service users in residence on the day. The inspection was undertaken over six hours and its purpose was to check that the requirements of previous inspections had been met. Since the last inspection the home has new owners and a new registered manager therefore all key standards were inspected. As part of the inspection a number of records and documents were viewed; including the complaints book, medication records and care plans. A tour of the premises was carried out. The new Registered Providers have been granted a major variation to change the current registration from older people to older people with a dementia type illness to take effect from 1 April 2006. There are plans to implement a programme of staff training and for changes to the environment to facilitate this change. What the service does well: What has improved since the last inspection? The home has met the requirements of the last inspection, including regular reviews of care plans and a photograph of the service user in the plan. Risk assessments are now more detailed to ensure staff are aware of risks and how they are to be managed. Records relating to the service are now available, on site, for inspection at all times. Staff meetings have been formalised and minutes available for inspection. Service users meetings are informal until a suitable format for this activity can be devised and staffing has been increased at key times of the day. The use of door wedges has ceased in line with the latest fire safety guidance. Meads House Residential Care Home DS0000065559.V267890.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. Meads House Residential Care Home DS0000065559.V267890.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 Meads House Residential Care Home DS0000065559.V267890.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): 3. Standard 6 is not applicable Satisfactory pre-admission assessments are carried out prior to service users moving into the home that ensure that their assessed needs can be met. EVIDENCE: There has been only one admission since the last inspection and the preadmission documents for this person was found to be detailed and demonstrated that the home could meet their assessed needs. Meads House Residential Care Home DS0000065559.V267890.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): 7, 8, 9, 10 and 11 The care planning system is clear and consistent and provides staff with the information they need to satisfactorily meet service users’ needs. Service users’ are protected by satisfactory systems for the recording, handling and storing of medication. Service users’ privacy and dignity is protected. EVIDENCE: A sample of four care plans were viewed and found to be comprehensive and include details of how care needs are to be met. They include personal preferences in respect of getting up, going to bed, and food likes and dislikes. The care plans are reviewed on a regular basis, the manager and staff have a good understanding of service users needs and were able to discuss them and explain the support that is provided. Satisfactory risk assessments are carried out for all activities both within and outside the home. Where risks are identified they are discussed with the service user and/or their relatives to ensure all parties agree to any limitations. The home has introduced a care audit trail, which consists of daily notes that are used to develop the continuous evaluation sheet, and this sheet is the basis for service users’ daily living needs record; thus information is available to guide staff on how best to meet daily care needs and rapidly identify changes. Meads House Residential Care Home DS0000065559.V267890.R01.S.doc Version 5.0 Page 10 The service users who were able to give an opinion spoke positively about the care they receive and that they felt they could discuss any issues with staff or the manager. Staff were observed to treat service users with respect and it was evident that staff and service users are comfortable with each other. Service users are registered with GP’s and can access other health professionals as required, including chiropodist, district nurses and dentist. Medication records and storage arrangements were viewed and both aspects were satisfactory. Medication administration charts were up to date, accurate and clear. Meads House Residential Care Home DS0000065559.V267890.R01.S.doc Version 5.0 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 Service users’ benefit from a range of in-house activities. The routines of the home enable service users to exercise choice and control over their daily lives. The meals in Meads House are good offering both choice and variety and catering for special dietary needs. EVIDENCE: The home provides a range of in-house activities, including musical entertainment, exercise and hand/foot massage. Service users’ social interests and hobbies are recorded at pre-admission stage and the manager intends to introduce a system to review the activity programme to ensure it continues to meet service users preferences and is within their capabilities. Service users spoken with confirmed they are enabled to make choices about their daily lives. Service users confirmed that they are encouraged to go out into the community and that visitors are welcome at all times. One service user said he had a telephone installed to enable him to receive daily calls from his family. There is a notice in the kitchen detailing service users food likes and dislikes. In addition details of service users breakfast preferences are also posted in the Meads House Residential Care Home DS0000065559.V267890.R01.S.doc Version 5.0 Page 12 kitchen to ensure breakfasts are exactly to service users requirements and at their preferred time. Menus are varied and balanced and service users spoken with all highly praised the quality and choice of meals. Meals taken by service users are recorded in their daily notes to enable staff to monitor individual nutritional intake. Meads House Residential Care Home DS0000065559.V267890.R01.S.doc Version 5.0 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 The home has a satisfactory complaints system with some evidence that service users feel that their views are listened to and acted upon. Training in Adult Protection is provided for all staff to ensure that service users are protected from abuse. EVIDENCE: Appropriate procedures and policies concerning complaints are in place and a summary is posted in the homes hallway. There have been no complaints since the last inspection and service users spoken with said they would be happy to raise any concerns with the manager or owners. The homes’ in-house training officer has provided training in adult protection for all staff and detailed whistle-blowing policies and procedures are in place. Staff and the manager were clear about the procedures in the event of an allegation of abuse. Meads House Residential Care Home DS0000065559.V267890.R01.S.doc Version 5.0 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 The standard of décor is good, providing service users with a safe, homely and attractive place in which to live. Improvements need to be made in respect of minor repairs and refurbishment. Laundry facilities are satisfactory and service users protected by effective infection control systems. EVIDENCE: A tour of the premises was carried out and generally the home is well maintained, including the gardens, and décor is also good. A number of minor repairs and refurbishment was noted, including replacing toilet roll holders, some paintwork is chipped and the positioning of some grab rails. These were discussed with the manager and provider both of whom are aware that it is necessary to make a thorough inspection of all parts of the home to ensure it remains a pleasing and safe environment for service users. Heating and lighting is satisfactory and ensures that the environment remains at a comfortable temperature. Meads House Residential Care Home DS0000065559.V267890.R01.S.doc Version 5.0 Page 15 The laundry was clean, with washing machines that wash soiled laundry at high temperatures. Training in infection control for staff have been provided and staff were observed to follow infection control procedures. Meads House Residential Care Home DS0000065559.V267890.R01.S.doc Version 5.0 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, 29 and 30 There are sufficient numbers of staff deployed to ensure service users’ needs are met. There is a competent and effective staff team who work positively to ensure service users have a good quality of life. Staff recruitment and induction are robust and offer protection to service users living at the home. EVIDENCE: Staff rotas were viewed and showed there are two carers on duty for each daytime shift and three at key times of the day. One sleeping night staff member is employed. In addition cooks, kitchen assistants, domestic and laundry staff are also employed. Maintenance work is provided by local trades people as required. A training officer is also employed to ensure staff remain up to date for all training. Staffing levels are to be increased when the change of registration category is implemented. Personnel documents for the recently recruited carer was viewed and this documentation showed that appropriate checks were undertaken, including two written references and a Criminal Records Bureau check, prior to appointment. All new staff undergo comprehensive induction and foundation training and currently the home exceeds the requirement for 50 of staff trained to NVQ level 2. Meads House Residential Care Home DS0000065559.V267890.R01.S.doc Version 5.0 Page 17 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 The home is well managed by a suitably qualified and experienced manager. Satisfactory arrangements are in place to protect service users financial interests. The introduction of formal quality monitoring systems would enable the Provider to critically evaluate the service and take action where required. Most aspects of service users health, safety and welfare is promoted and protected. EVIDENCE: The Registered Manager is experienced in the care industry and has satisfactory management qualifications. She is in the process of gaining NVQ Level 4 in care in order to fully meet the standard and ensure she remains up to date in current good practice. Staff spoke positively of her management style and said they felt valued and supported. Meads House Residential Care Home DS0000065559.V267890.R01.S.doc Version 5.0 Page 18 Some work has begun on compiling information for the quality monitoring process, in the form of a quarterly achievement sheet detailing improvements made in all aspects of the service. This information is shared with staff enabling them to be consulted on how the service is run. The Registered Provider carries out monthly visits in line with the requirements of Regulation 26. These activities need to be expanded into formal quality monitoring and quality assurance systems to enable a detailed evaluation of the service. The manager does not act as an appointee for anyone; some service users handle their own finances while family or solicitors do so on behalf of others. Documents relating to safe working practices and Health and Safety were available and found to be satisfactory as were accident records. Smoke alarms and emergency lighting are also tested regularly ensuring the safety of both service users and staff. Fire safety training is provided for all staff and regular fire drills are carried out and documented. It was found that annual servicing of fire extinguishers and bath hoists had not been carried out. Discussion with the manager and provider found that these checks had become due at the time of buying the home, therefore this was an oversight and would be addressed immediately. The use of door wedges has ceased and the registered provider intends to fit self closing devices on all doors where service users prefer to be left open. Certificates to demonstrate that gas appliances, stairlifts, electrical systems and appliances are safe were provided. Call bells, water temperatures, fire alarms and emergency lighting are regularly tested and action taken should any be faulty. Mandatory training is provided for staff and includes fire training in addition to infection control and first aid. Meads House Residential Care Home DS0000065559.V267890.R01.S.doc Version 5.0 Page 19 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 3 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 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 X 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 X X 2 Meads House Residential Care Home DS0000065559.V267890.R01.S.doc Version 5.0 Page 20 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 2 3 Standard OP19 OP33 OP38 Regulation 23(1a) (2b 24 (1ab) (2)(3) 24 (a)(c)(i) Requirement That minor repairs and refurbishments are carried out. That formal quality monitoring and quality assurance systems be created and implemented That fire equipment and bath hoists are serviced annually. Timescale for action 07/06/06 07/06/06 07/04/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Meads House Residential Care Home DS0000065559.V267890.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection East Sussex Area Office Ivy House 3 Ivy Terrace Eastbourne East Sussex BN21 4QT 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 Meads House Residential Care Home DS0000065559.V267890.R01.S.doc Version 5.0 Page 22 - 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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