Inspection on 04/07/06 for Meadway Court

This inspection was carried out on 4th 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Meadway Court 27/01/09

Meadway Court 17/01/08

Meadway Court 08/03/06

Meadway Court 12/05/05

Meadway Court 08/12/04

Meadway Court 24/05/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Meadway Court Meadway Bramhall Stockport Cheshire SK7 1JZ. Lead Inspector Kathleen Mcall Unannounced Inspection 4th July 2006 10:55 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 Meadway Court DS0000008567.V297686.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. Meadway Court DS0000008567.V297686.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Meadway Court Address Meadway Bramhall Stockport Cheshire SK7 1JZ. 0161-440 8150 0161 439 5629 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) Borough Care Limited Jacqueline MacFall Care Home 42 Category(ies) of Dementia - over 65 years of age (5), Old age, registration, with number not falling within any other category (42) of places Meadway Court DS0000008567.V297686.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users to include up to 42 OP and up to 5 DE(E). Date of last inspection 8th March 2006 Brief Description of the Service: Meadway Court provides permanent residential care for up to 36 older people and offers intermediate care facilities for up to six residents. Intermediate care is for people who have been assessed, by health and social care professionals, as being suitable for a short-term placement of rehabilitative care. The length of stay is time limited between one to six weeks. During their stay residents are seen by Physiotherapists, Occupational therapists, Social Workers and district nurses. Meadway Court also offers day care facilities for up to four service users over seven days per week. The home is one of 12 care homes owned by Borough Care Limited, a ‘not-forprofit’ company. The home consists of 40 single bedrooms and one shared bedroom. Bedrooms are situated on the ground and first floor areas of the home, 24 of the rooms have en-suite facilities, which comprises of a washhand basin and toilet. There are several lounge areas situated throughout the home, four dining rooms and a large conservatory to the rear of the building. A full passenger lift is in place. There is a conservatory to the rear of the home, which opens onto a large patio area with garden furniture. The gardens are pleasantly landscaped with flowers and shrubs. The home is situated at the end of a cul-de-sac in the Bramhall area of Stockport. Bramhall village is approximately ten minutes walk away. The village has a wide variety of shops, restaurants, churches and banks. Access to motorway networks, public transport and train station are within a reasonable distance of the home. Meadway Court DS0000008567.V297686.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a key unannounced inspection, which took place over the course of a day. The acting manager assisted the inspector throughout the inspection process. Care plans, assessment documentation and other records were examined. The inspector spoke with a number of residents; all were happy with the care they were receiving. The Inspector spoke with one relative who was visiting the home at the time of the inspection. What the service does well: What has improved since the last inspection? Care plans had improved significantly since the last inspection and were now detailed, particularly those care plans for residents’ intermediate care services at the home. Meadway Court DS0000008567.V297686.R01.S.doc Version 5.2 Page 6 The administration and storage of medication in the home had improved. The manager contacted the local fire authority who confirmed that the home complied with fire safety standards. Risk assessments were routinely completed for those residents who were assessed as needing to use bed rails. Similarly, risk assessments were completed for all identified risks to residents, including falls and for those residents who wished to manage their own medication. 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. Meadway Court DS0000008567.V297686.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 Meadway Court DS0000008567.V297686.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, 4 and 6. Quality in this outcome area is good. Service users’ care needs were fully assessed before admission and their needs were met. This judgement has been made using available evidence, including a visit to this service. EVIDENCE: Several new service users had been admitted to the home since the last inspection. As part of the inspection, a selection of service user files were examined. These contained a sufficient amount of assessment information in respect of each service user. It was the practice of the home that service users were assessed prior to their admission. Assessments were obtained from social workers and health professionals if they had been involved in the admission and no service users were admitted to the home without their care needs having been assessed. Meadway Court DS0000008567.V297686.R01.S.doc Version 5.2 Page 9 Borough Care Ltd had its own assessment documentation called the ‘care planning assessment tool’; which was completed for each new admission to the home. Since the last inspection the registered manager had reviewed and updated the care planning assessment tool for all service users resident in the home. Meadway also provided six intermediate care beds. Service users who accessed these beds were assessed prior to their admission under the Department of Health ‘Single needs Assessment Process’ (SAP) and were admitted directly from hospital or from home. All service users had a contract and an overview assessment on their files. Assessments were detailed, comprehensive and provided care staff with sufficient information about a service user. Physiotherapy, occupational therapy and district nursing input were available for intermediate care service users Monday to Friday. Care staff had received training in Intermediate Care and promoting independence. The inspector met several service users at the home who said that they were happy with the way in which the home was meeting their needs and that they had no complaints. Those service users using the intermediate care facilities appreciated the opportunity to prepare for their return home. Evidence that care staff regularly updated their moving and handling training and health and safety training was made available at the time of the visit. Care staff demonstrated a good understanding of service users’ care needs. Meadway Court DS0000008567.V297686.R01.S.doc Version 5.2 Page 10 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. Care plans accurately reflected how service users’ care needs were met and service users were treated with respect and dignity at all times. This judgement has been made using available evidence, including a visit to this service. EVIDENCE: Since the last inspection the overall standard of care plans had improved. All service users had a care plan which was stored in their bedrooms or just outside of their bedrooms. Care plans were recorded and stored electronically and a printed version was put on service users’ files. Care plans included the health; personal and social care needs of service users. Care plans were printed off on an annual basis unless there were changes to a service users’ needs, in which case they would be updated and changed. Additionally, care supervisors reviewed care plans on a monthly basis. Evidence that files had been reviewed and changes incorporated into the care plan was seen at the inspection. Meadway Court DS0000008567.V297686.R01.S.doc Version 5.2 Page 11 Care plans held in respect of service users receiving intermediate care were hand written. These care plans were comprehensive, detailed and gave a clear account of actions undertaken and plans for future return home. As previously identified, daily recordings by care staff continued to contain a limited amount of information, with recordings including ‘as per care plan’. Daily recordings did not give a full picture of how a service user had spent the day or how care staff had assisted them. Since the last inspection risk assessments for those service users who used bedrails had been put in place to ensure safe care practices. Similarly, there was evidence that risk assessments were in place for falls and for those service users who wished to manage their own medication. Systems were in place, which allowed for service users’ weight to be monitored on a regular basis. The manager said that care staff aimed to weigh all service users on a monthly basis or weekly if there were concerns about a service user’s nutrition and weight. At a previous inspection evidence of poor practice in the storage, recording and administration of medication was found and a number of requirements were issued. At the time of the site visit it was observed that the medication practices at the home had improved considerably. Since the last inspection a new medication system had been put in place, which had resolved many of the identified areas of concern. One area of concern that was identified at the time of the inspection was the home’s use of cream charts for service users. Prescribed creams were recorded on MAR charts. This information was then recorded by care staff on a blank MAR charts without verification by another member of staff. The manager was advised that printed MAR sheets would be a preferred option and would ensure safer administration. Records of medication administered by district nurses were also kept in printed formats and stored in service users care files in their bedrooms. It was recommended that the manager considered similar actions for cream charts. Service users told the inspector that staff treated them well and they were very satisfied with the care they received. Care staff’s approach towards service users was observed to be respectful, sensitive and caring at all times. Meadway Court DS0000008567.V297686.R01.S.doc Version 5.2 Page 12 At a previous inspection the manager was required to discuss with the fire authority the practice of retaining fire doors open. Several service users choose to leave their bedroom door open in the daytime and it was felt this practice compromised service users’ dignity and privacy and thus put them at risk. Since the last inspection the registered manager had consulted with the fire authority who was satisfied with the home’s fire prevention and safety practices. Meadway Court DS0000008567.V297686.R01.S.doc Version 5.2 Page 13 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. The day-to-day routine of the home, including mealtimes, was relaxed and informal and met service users’ needs. This judgement has been made using available evidence, including a visit to this service. EVIDENCE: The day-to-day routine of the home was relaxed and flexible. were able to spend time in their bedrooms if they wished. Service users The home had an activities programme, which was displayed in several areas around the home. Bingo was planned for the afternoon, however service users choose to sit outside in the sun as it was a very hot afternoon. Monthly events taking place at the home were recorded on the back of daily menus so all service users could see the forthcoming events planned. Three barge trips and a visiting entertainer were planned for the month. Service users were satisfied with the range of activities provided. Meadway Court DS0000008567.V297686.R01.S.doc Version 5.2 Page 14 Service users were given the opportunity to express choice and preference throughout the day. Some preferred to spend time in their rooms or in one of several lounges. Visitors were welcome to the home and the home maintained contact with the local community ie church visits. Service users were able to see visitors in private. Service users expressed a high level of satisfaction about the meals and quality of food provided at the home and service users could eat in their rooms if they wished or in one of several dining areas. Meadway Court DS0000008567.V297686.R01.S.doc Version 5.2 Page 15 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 adequate. Service users felt confident that their complaints would be taken seriously and acted upon. Staff did not follow policy and procedures in relation to adult protection and thus placed vulnerable people at risk. This judgement has been made using available evidence, including a visit to this service. EVIDENCE: There had been four complaints since the last inspection. Service users told the inspector that they knew who to complain to and felt that their complaint would be dealt with in a suitable manner. The home had a procedure for responding to allegations of abuse. A number of care staff had undertaken appropriate training in adult protection as part of their National Vocational Qualification training and as part of their induction. At the time of the inspection it was identified that one of the complaints had not been dealt with a satisfactory manner. The manager had not followed Stockport’s Inter-Agency Vulnerable Adults Protection Policy in relation to one of the recorded complaints. The manager failed to inform Stockport’s Adult and Communities Directorate and the Commission for Social Care Inspection about what had happened and the actions taken. Meadway Court DS0000008567.V297686.R01.S.doc Version 5.2 Page 16 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, 24 and 26. Quality in this outcome area is good. The home was well maintained and provided comfortable living accommodation for service users. This judgement has been made using available evidence, including a visit to this service. EVIDENCE: The home provided comfortable accommodation throughout. It was clean, tidy, bright and airy and was free from any unpleasant odours. The premises were well maintained, both internally and externally. Garden areas were maintained and garden furniture was provided for service users and there were plans to build a barbeque area in the grounds of the home. Meadway Court DS0000008567.V297686.R01.S.doc Version 5.2 Page 17 A smoking lounge was available for those service users who smoked. Since the last inspection the main lounge area on the ground floor had been decorated, as had two bedrooms. In addition, skirting boards and doorframes throughout the home had been painted. A number of service users’ rooms were seen, these were also furnished and equipped to a comfortable standard, many had been personalised by the occupants. The home complied with the requirements of the local fire authority. Meadway Court DS0000008567.V297686.R01.S.doc Version 5.2 Page 18 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 adequate. The home was sufficiently staffed, with a staff group that was trained to meet needs of service users. However, procedures for the recruitment of staff to the home did not provide adequate protection for service users. This judgement has been made using available evidence, including a visit to this service. EVIDENCE: At a previous inspection the registered person was required to ensure that staff at the home were familiar with the needs and abilities of service users and provide care as defined within the care plan. This requirement was made following a number of concerns expressed by service users about agency staff being used in the home. At the time of the key unannounced inspection the home was sufficiently staffed; a staff rota showing which staff were on duty and in what capacity, was made available for inspection. A relative described the staff group at the homes as ‘friendly’ and said that staff were always very approachable, particularly management staff. Several service users told the inspector that they liked the staff group, described them as caring and said that there were always enough staff on duty to assist them. One service user said that staff understood her care needs and she felt well cared for. Meadway Court DS0000008567.V297686.R01.S.doc Version 5.2 Page 19 The manager advised that the home no longer used agency staff but had its own bank of casual staff who were familiar with service users’ care needs. Evidence that care staff had undertaken further training to assist them in their role as carers, including manual handling, food hygiene, fire training and induction was made available at the time of the inspection. One new employee had been employed at the home since the last inspection. It was found that not all of the required records were available at the time of the inspection, for example, references and a CRB certificate. The manager was advised that all records required by regulation in respect of persons working at the care home must be made available for inspection. At a previous inspection in May 2004 it was recommended that the registered provider should amend the job application form to include an applicant’s full employment history from leaving school or full time education and explain any gaps in order to protect service users. At the time of this key unannounced inspection it was found that there had been no alterations to the application form to include this information and a full employment history had not been obtained in respect of the most recent employee to the home. Meadway Court DS0000008567.V297686.R01.S.doc Version 5.2 Page 20 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, 36 and 38. Quality in this outcome area is good. The home was well managed and the health and safety of staff and service users was safeguarded. This judgement has been made using available evidence, including a visit to this service. EVIDENCE: The registered manager, Julie Veretiero, has been the acting manager at Meadway since August 2005. She holds a NVQ level 4 and the Registered Manager’s Award. Meadway Court DS0000008567.V297686.R01.S.doc Version 5.2 Page 21 Feedback from service users was sought through reviews, team meetings, residents’ meetings, key worker systems and staff supervision. Questionnaires were usually given out at reviews, to both permanent service users and to those service users in intermediate care beds. It was the practice that questionnaires were returned to head office and information was collated and feedback was given to the home on their performance. Service users’ monies were dealt with as per other Borough care homes. Families brought personal monies in for service users and receipts and records of all transactions were kept. Intermediate care service users’ monies were dealt with in the same way, though all service users, regardless of the terms and conditions of their stay, had the option of handling their own finances. Staff received regular supervision to support them in their work and records of such meetings were made available at the time of the inspection. Certificates confirming the maintenance of the passenger lift and hoisting equipment were seen on inspection. The home maintained records in respect of fire safety at the home, which ensured service user and staff safety. At a previous inspection it was recommended that a daily kitchen-cleaning schedule be completed. At the time of this inspection examination of daily kitchen cleaning schedules confirmed that appropriate actions were undertaken. Meadway Court DS0000008567.V297686.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for 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 3 X 3 HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 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 2 3 X X X X 3 X 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 3 X 3 Meadway Court DS0000008567.V297686.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? Yes. STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP7 Regulation 17 Requirement The registered person must ensure that the daily recordings give a complete picture of how a service user has spent their time and how staff have assisted them. (Timescale of 30/04/06 not met). The registered person must ensure that policies and procedures relating to adult protection are adhered to and relevant professional bodies are informed. The registered person must ensure that all records held in respect of persons working at the home as listed in Schedule 2 of the Care Standards Act 2000 (Miscellaneous Amendments) Regulations 2004 are in place before a member of staff is employed at the care home. The registered person must ensure that a full employment history, together with a satisfactory written explanation of any gaps in employment, is obtained before an employee starts work at the care home. DS0000008567.V297686.R01.S.doc Timescale for action 04/10/06 2 OP18 12, 13. 04/07/06 3 OP29 Schedule 2 04/07/06 4 OP29 Schedule 2 04/07/06 Meadway Court Version 5.2 Page 24 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. 5 Standard OP33 Regulation 24 Requirement The registered person must continue to review the quality of care provided at the home and supply to the commission and service users the findings of the review. Timescale for action 04/10/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP9 Good Practice Recommendations The registered person should consider the use of printed cream sheets stored in a service user’s room. Meadway Court DS0000008567.V297686.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Ashton-under-Lyne Area Office 2nd Floor, Heritage Wharf Portland Place Ashton-u-Lyne Lancs OL7 0QD 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 Meadway Court DS0000008567.V297686.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!