Inspection on 08/03/06 for Meadway Court

This inspection was carried out on 8th March 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Poor. 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

Meadway Court 27/01/09

Meadway Court 17/01/08

Meadway Court 04/07/06

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 Kath Oldham Unannounced Inspection 8th March 2006 08:30 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 Meadway Court DS0000008567.V283191.R01.S.doc Version 5.1 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.V283191.R01.S.doc Version 5.1 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.V283191.R01.S.doc Version 5.1 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 Brief Description of the Service: Meadway Court provides permanent care for 36 elderly people and intermediate care for six. Four day-care places are also provided seven days per week; these places are not included in the registration. 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. There are six lounge/dining rooms situated over two floors. Twentyfour of the rooms have en-suite facilities, which comprise of a wash-hand basin and toilet. The shared bedroom has an en-suite shower facility. 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.V283191.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place on 8th March 2006, commencing at 8:30am. Time was spent talking to residents and their families and visitors, in addition to examining a sample of records maintained for the purpose of regulation. One meal was eaten with residents. Residents were complimentary regarding the care they receive, making comments such as “the staff are lovely”, “nothing is too much trouble for staff” and “we have a good laugh”. Relatives and visitors were equally complimentary regarding the regular care staff and said they felt assured that their cared for relative was well looked after. Residents appeared confident in describing their views and opinions and used the opportunity of the inspection to tell the inspector what they liked about living at the home and what they wanted changing. Comment cards were left at the home for distribution to residents, their relatives and visitor and also for placing social workers. The comments from these and the comments received on the inspection are included in the report. The registered manager is currently on sick leave and a deputy manager from another of the company’s homes is covering the role of acting manager. The inspection undertaken in May 2005 reported on the key national minimum standards, which must be inspected each year. Readers should read that inspection report alongside this one to get a fuller picture of the service provided at Meadway Court. What the service does well: Residents said that they received good care and staff were helpful. A number of residents told the inspector that they liked living at the home and that they felt well cared for. The atmosphere of the home is relaxed and friendly and the accommodation is clean and comfortable. Residents’ choice and independence are promoted and the home is open to relatives and friends. Meadway Court DS0000008567.V283191.R01.S.doc Version 5.1 Page 6 Residents are encouraged to maintain their own identities while living in the home. Staff are provided with opportunities to gain and develop skills through training. What has improved since the last inspection? What they could do better: The home has had staff vacancies and illness which has meant that agency staff or staff from another of the company’s homes have been covering in the home. Residents said this has meant that workers did not know them or their routines or abilities, which had reduced the level of service to them. The medication administration and record keeping need to be improved upon, as the present systems do not safeguard residents or confirm if they have had their medication. The care plan needs to be further developed to ensure that the care needs of residents are recorded. In addition, the accuracy of the care plan needs to be reviewed, as the care needs detailed were not always the care provided. The reports completed by staff each day to detail the care and support provided to residents need to be improved upon to ensure that the content is factual, relates to the actual care provided and does not contain staff judgements about how residents are feeling. Residents appeared confident that if they made a complaint it would be listened to and acted upon. The complaints record needs to be developed to record the complaints made at the home. The routine of keeping residents’ bedroom doors open whilst they are in bed does not promote their dignity and privacy and could compromise their safety. Meadway Court DS0000008567.V283191.R01.S.doc Version 5.1 Page 7 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.V283191.R01.S.doc Version 5.1 Page 8 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.V283191.R01.S.doc Version 5.1 Page 9 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): These standards were not assessed as part of this inspection. Readers are referred to the May 2005 inspection report when the key standards were reported on. EVIDENCE: Meadway Court DS0000008567.V283191.R01.S.doc Version 5.1 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, 9 & 10 Poor care planning is evident, in that, care plans lack detail. Poor practice in the administration and recording of medication puts residents at risk. The privacy and dignity of service users is compromised by the routines in the home. EVIDENCE: A sample of residents’ care files was examined. The care plans contained minimal information in relation to residents’ care needs. The care plans would not provide staff with enough information to provide residents with the care that they need. The accuracy of some of the care plans was questionable. In one care file it said the resident had two baths each week and needed to be weighed fortnightly. It was not possible to verify that this had happened. Care plans were recorded as having been reviewed with no changes to the care provided. Meadway Court DS0000008567.V283191.R01.S.doc Version 5.1 Page 11 A record of what individual residents weighed was in the care file, they were not always completed monthly. One resident’s care file recorded that they had not been weighed for three months and the most recent record indicated a weight loss. There were no details of any action the home may have taken to look into this. The daily reports used by staff to detail the care and support provided to residents contained very little information and, in some instances, contained staff judgements about how the resident was feeling. From reading the reports you were unable to get a sense as to how residents spent their day or the care they received. Entries such as “care 1 and 2” were made in the records. Risk assessments were in place in the care files inspected; however, in some cases lacked detail. One resident’s file indicated that rails were fitted to their bed. The record did not indicate how the decision had been made to have these fitted and who was involved with the decision-making. There was no evidence of this being reviewed. Examination of the medication administration records found that there were omissions in recording. A symbol used in the medication records was not a recognised symbol and was not defined within the record. The acting manager said the home had a new design of medication records and the symbol used was one which was previously recognised. Photographs of residents accompanied most of the medication records as a means of identification. Residents living at the home on a more temporary basis did not have photographs on file. Medication was handwritten on the medication records; the record had not been signed or verified by a second staff member to safeguard residents and to make sure staff have written the entry correctly. The home retains a list of staff members authorised to administer medicines, including a record of their signature and approved initials. Residents who manage all or part of their medication should have a risk assessment to make sure they know how and when to take it. Examination of a sample of residents’ files identified a risk assessment specific to medication. Meadway Court DS0000008567.V283191.R01.S.doc Version 5.1 Page 12 The risk assessment for one resident was completed in September 2005, the detail was quite minimal and did not detail a review. A number of residents are prescribed creams and lotions; the administration of these is recorded on a separate creams form. Not all residents who are prescribed creams and lotions had a record of their creams administered. A number of residents’ bedroom doors were kept open whilst they were in bed, which compromises residents’ dignity or privacy. One resident said they spent time in their bedroom and liked to keep the door open during the day so they could see the comings and goings on the corridor. The bedroom doors are fire doors and, as such, should be closed. Any exceptions to this should be risk assessed and discussed with the fire authority to safeguard residents and staff. Meadway Court DS0000008567.V283191.R01.S.doc Version 5.1 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): 15 The daily routine within the home was flexible and enabled residents to make choices in various aspects of their daily life within the home. EVIDENCE: Residents were, in the main, complimentary about the meals. However, they felt that there could be improvements to the teatime meal. One resident said they didn’t want soup for their tea. Examination of the menus identified a number of choices to the meal times. One resident said all the meals and sweets are homemade and they were “really lovely”. Residents commented that they felt it was discourteous when visitors come into the dining room at mealtimes and sat with their cared for relative. A couple of residents said “the other week one visitor sat in the dining room and stared at them all the time they were having their meal”. The acting manager said it was unusual for relatives or visitors to go into the dining room at mealtimes. Meadway Court DS0000008567.V283191.R01.S.doc Version 5.1 Page 14 A meal was shared with residents. Time was taken by staff asking what residents wanted to eat and this was provided. Some residents had forgotten they had eaten breakfast and were assured by staff that they had. A further resident was given a second breakfast as she felt hungry, as she thought she hadn’t eaten. Staff support and interaction were courteous and sensitive to the needs of residents. Residents said they could have what they wanted to eat for breakfast. One of the residents said she would like new placemats on the tables as they were showing signs of wear and tear. A further resident commented that since the dishwasher has been taken out from upstairs, staff are doing more household duties and have to wash up some items or take dirty crockery down to the kitchen, which takes them away from looking after residents. Staff were not aware if the dishwasher was being replaced. Meadway Court DS0000008567.V283191.R01.S.doc Version 5.1 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 The complaints procedure ensured that all interested parties were aware of how to complain and the process that would be undertaken. EVIDENCE: Residents said they were able to voice their views and opinions as they arose, in addition to having residents’ meetings. One resident said they received a notice to let them know the meetings were on. Residents said that they felt that staff listened to them and acted on what they were told. One resident said her family would complain on her behalf if there were ever a reason to do so. Relatives and representatives said they were more than happy about the care their cared for relative received at the home. A complaints book is in place, which records complaints and compliments. There were two complaints recorded in November 2005 and the action taken to remedy the complaints. No comments or complaints were recorded after this time. Meadway Court DS0000008567.V283191.R01.S.doc Version 5.1 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): These standards were not assessed as part of this inspection. Readers are referred to the May 2005 inspection when these standards were reported on. EVIDENCE: Meadway Court DS0000008567.V283191.R01.S.doc Version 5.1 Page 17 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 use of agency and casual staff has compromised the level of care provided to residents. EVIDENCE: Residents were complimentary about the skills and personalities of the staff team. Residents making comments like, “they are lovely”, “nothing is too much trouble”. Residents said staff are “kind” and “would do anything for you”. Residents said they felt safe at the home. Residents made comments about when agency or casual staff were on duty and that the service they receive is not as good. Residents made comments that when agency or relief staff are serving meals they have no idea what the residents like or the portion sizes. Another example was that they have no idea what you can do for yourself and “waste time doing things that you can do and not doing things that you need”. One resident said the agency staff need more training and direction in what they should be doing. A further resident said that the residents who are admitted for intermediate care are quite demanding which puts a strain on the level of service other residents receive. Meadway Court DS0000008567.V283191.R01.S.doc Version 5.1 Page 18 Three care staff are usually on duty upstairs with two downstairs; the needs of residents being, in the main, greater upstairs. One resident was discharged from hospital and needed three staff to assist them; this has an impact on the care and support provided to the remaining residents. The acting manager said that they were requesting health care interventions for this resident. On the inspection a member of staff didn’t turn in for duty, which had an impact on the support provided to residents. A resident said she used the call bell system at 8:15am and the response wasn’t quick. Staff on duty were working hard to meet the needs of residents. The acting manager said she had been made aware of this and was discussing with head office the steps that need to be taken. A number of new staff have been appointed which should reduce the need for agency or staff from one of the company’s other homes coming in. Residents commented that it was much harder when agency staff are on duty, as they don’t know them like the regular staff do. Staff files were not examined on this inspection. The requirement made on the last inspection in relation to staff application forms is repeated and will be evaluated at the next inspection. Meadway Court DS0000008567.V283191.R01.S.doc Version 5.1 Page 19 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): 38 The health and safety of staff and residents was safeguarded. EVIDENCE: Examination of the records maintained by the kitchen were up to date. The daily kitchen-cleaning schedule needs to be completed when staff undertake the cleaning duties on each occasion. A monthly visit is undertaken by a representative from head office who looks at specific records in line with regulations and speaks to service users and staff. A report of this visit is routinely sent to the Commission, as this is required by the regulations. Meadway Court DS0000008567.V283191.R01.S.doc Version 5.1 Page 20 Examination of the fire safety records identified that the checks to fire safety equipment are undertaken in line with fire regulations. All staff were reported to have undertaken recent fire drill training. Meadway Court DS0000008567.V283191.R01.S.doc Version 5.1 Page 21 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 1 8 X 9 1 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 X X X X X X X X X STAFFING Standard No Score 27 2 28 X 29 2 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X X X X 2 Meadway Court DS0000008567.V283191.R01.S.doc Version 5.1 Page 22 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 OP7 Regulation 23 Timescale for action The registered person should risk 20/04/06 assess the use of cot sides and include the decision making on why these are to used which is verified and confirmed with other professionals and families. The registered person must 30/04/06 further develop the care plan to include all aspects of the health, personal and social care needs of service users. The registered person must 30/04/06 ensure that the care plans are reviewed and the care amended to reflect the service users’ assessed needs. The registered person must ensure that the daily recordings are more meaningful to the reader and record the results of any treatments. The registered person must ensure that risk assessments are undertaken and that they detail the identified risks, how these are minimised and a record of their review. 30/04/06 Requirement 2 OP7 15 3 OP7 15 4 OP7 17 5 OP7 13, 14 30/04/06 Meadway Court DS0000008567.V283191.R01.S.doc Version 5.1 Page 23 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. 6 Standard OP9 Regulation 13, 17 Requirement The registered person must ensure that an accurate signed and dated record is maintained of all medication received by the home. The registered person must undertake risk assessments for all residents who self-administer their medication, which are reviewed on a regular basis. The registered person must ensure that medication administration records are completed contemporaneously. The registered person must discuss with the fire authority the practice of retaining fire doors open and risk assessment the action to safeguard service users and staff. The registered person must ensure that the staff at the home are familiar with the needs and abilities of residents and provide care as defined within the care plan. Timescale for action 20/04/06 7 OP9 13 20/04/06 8 OP9 13 20/04/06 9 OP10 23 30/04/06 10 OP27 14 30/04/06 Meadway Court DS0000008567.V283191.R01.S.doc Version 5.1 Page 24 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 OP7 Good Practice Recommendations The registered person should ensure that systems and routines are in place when weighing service users that a check is made of weight gain or loss and actions are taken to safeguard service users. The registered person should weigh service users monthly or more frequently if the care plan indicates a need for this and make a record of the weights. The registered person should ensure that a formal system is in place to identify residents prior to medication administration. The registered person should ensure that only recognised symbols are used to record the omission of medication The registered person should ensure that when medication is handwritten on the medication records by staff this is verified by a second staff member who also signs the record. The registered person should further develop the recording in the complaints record to demonstrate the complaint received. The registered person should amend the job application form to ask for full employment history from leaving school or full time education and explain any gaps. The registered person should arrange for staff to complete the kitchen-cleaning schedule when undertaking kitchen cleaning. 2 3 4 5 OP7 OP9 OP9 OP9 6 7 8 OP16 OP29 OP38 Meadway Court DS0000008567.V283191.R01.S.doc Version 5.1 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.V283191.R01.S.doc Version 5.1 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!