Inspection on 16/08/05 for Meresworth

This inspection was carried out on 16th August 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Meresworth 29/06/07

Meresworth 20/09/06

Meresworth 24/11/05

Meresworth 21/03/05

Meresworth 03/06/04

Meresworth 09/03/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Meresworth Dell Wood Field Way Rickmansworth Hertfordshire Lead Inspector Marian Byrne Unannounced 16 August 2005 th 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 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. Meresworth I52 s19465 Meresworth v244555 160805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Meresworth Address Dell Wood, Field Way, Rickmansworth, Hertfordshire, WD3 7EJ Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01923 714300 01923 714351 Quantum Care Limited Mrs Patricia Smith Care Home 51 Category(ies) of DE(E) Dementia - over 65 51, OP Old age registration, with number 51, PD(E) Physical dis - over 64 51 of places Meresworth I52 s19465 Meresworth v244555 160805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 21/03/05 Brief Description of the Service: Purpose built in 1998, Meresworth is a modern design, two-storey building with a ground floor and first floor wing either side of the main entrance. Accommodation is offered in four units, providing for 51 elderly people requiring long stay residential care. All rooms are single with en-suite facility. Each unit has a lounge and a dining area; these are located in the centre of each unit off a large lobby area. There is also a fully fitted kitchenette and medication storage station in this central location on each unit. Other facilities available to service users include a ground floor sunroom, first floor hairdressing salon and activities room. Each unit has an assisted bathroom and assisted shower room. The home has a fully stainless steel equipped kitchen with appropriate storage rooms, cold storage equipment and a well-equipped laundry. The reception desk and administration office is by the main entrance. The gardens extend around all sides of the home except for the front of the building and are screened from the road and other residences by mature trees. There are pleasant patio areas where service users can sit out. Meresworth I52 s19465 Meresworth v244555 160805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was carried out on the 15th August 2005. The Registered Manager was not present at the time of the inspection. The inspection was conducted by two inspectors. The service users were well presented and spoke well of the care they receive. The inspectors observed good interaction between staff and service users. Feedback was given to the Deputy Manager and the Shift Leader. What the service does well: What has improved since the last inspection? What they could do better: The Registered Manager must ensure that service users have access to call bells at all times. The Registered Manager must ensure that staff are not appointed prior to a CRB check being completed. Care must be taken to ensure Meresworth I52 s19465 Meresworth v244555 160805 Stage 4.doc Version 1.40 Page 6 that the home’s medication policy is followed. Lunch appeared to be overcooked care must be taken to ensure that lunch is delivered when the nutrition and flavour is optimum. The home does not have separate laundry staff it is recommended that this policy is reviewed as the dual aspect of the roles could be confusing to service users. 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. Meresworth I52 s19465 Meresworth v244555 160805 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Meresworth I52 s19465 Meresworth v244555 160805 Stage 4.doc Version 1.40 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 standard(s) These standards were not inspected. EVIDENCE: Meresworth I52 s19465 Meresworth v244555 160805 Stage 4.doc Version 1.40 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 standard(s) 7,8,9 10. Of the care plans inspected one did not reflect the care needs of the service user therefore his needs could not be met. Medication was stored inappropriately. Where observed service users were treated with respect and dignity. Call bells were in-accessable to service users. EVIDENCE: One service user was suffering from eplipesy. This was not highlighted on his care plan resulting in no instructions on how staff could meet his care needs. The home was not following its own policy on the administration of medication. Medicines were not dated on opening and the inspector was unable to conduct on audit to reconcile medicines administered. The temperature of the area where medicines are stored was too high. Medicines must be stored at a temperature not higher that 25 degrees centigrade to ensure that medicines do not deteriorate. Gloves were being worn by staff for more that one task. This is poor hygiene and could lead to the spread of infection. Call bells were out of reach of service users this means that service users would be unable to call for assistance at a time of need and could compromise their dignity, safety and comfort. Meresworth I52 s19465 Meresworth v244555 160805 Stage 4.doc Version 1.40 Page 10 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 14 The lunch on the day of the inspection looked discoloured and appeared to be over cooked. EVIDENCE: On the day of the inspection the lunch served to service users appeared to be overcooked and looked un-appititising. However, the inspector tasted it and found it to be tasty. Food for older people with delicate appetites needs to look appealing and inviting. Lunch on the day of the inspection did not meet this criteria. The glasses on the table were small sherry glasses which were unsuitable for purpose. The home does not have an activity organiser. On the day of the inspection the inspectors did not observe any activities. Meresworth I52 s19465 Meresworth v244555 160805 Stage 4.doc Version 1.40 Page 11 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) The information to assess falls and accidents was not available. The inspected required the home to sent the information to the Commission the details will be included in the next inspection. EVIDENCE: Meresworth I52 s19465 Meresworth v244555 160805 Stage 4.doc Version 1.40 Page 12 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19,20,23,24,25 26. In the main the environment was clean and fresh, however two rooms had odours. Service users rooms were personalised. The home is laid out to encourage interaction between service users and staff. EVIDENCE: On the day of the inspection the home was - with the exception of two bedrooms – clean, fresh and hygienic. The home adequately meets the requirements for communal space. The home’s furnishings were clean and set out thoughtfully to include service users in the everyday activities within the home. All rooms inspected were personalised and service users have the option to lock their rooms. One service user spoken with used this option. The ventilation in the home was adequate. The gardens were well maintained. Two bedrooms had odours, one that could be associated with incontinence and a stale smell that must be identified and eliminated. Meresworth I52 s19465 Meresworth v244555 160805 Stage 4.doc Version 1.40 Page 13 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,29 30. In the main service users are protected through the recruitment processes. Moving and handling did not always reflect current good practice. It was unclear if the number of staff on duty was sufficient. The practice of using trained care staff to carry out laundry duty could be confusing to service users. There was not any evidence of infection control training available. EVIDENCE: The inspector inspected three staff files. Two contained the appropriate documentation. One did not contain a current CRB (Criminal Records Bureau) for a member of staff who had commenced her induction training. A POVA (Protection Of Vulnerable Adults) first check had been completed, the home must not appoint a staff member on a POVA first check alone without consulting this Commission. This had not been done. The Home has been asked to produce staffing rotas for June and July 2005 to enable the inspector to determine the effectiveness of the staffing levels of the home. Training records were not inspected at this inspection the inspectors observed staff moving and handling service users they were using techniques that could cause injury to service users. The home uses trained care staff to carry out laundry duties. This could cause distress to the service users who may not be able to understand the dual role aspect of staff. There was no evidence that infection training had been completed by staff. The implication of this is that the dual roles staff perform could lead to the spread of infection. The lack of dedicated laundry staff has lead to inconsistency of the quality of laundering of clothes. Meresworth I52 s19465 Meresworth v244555 160805 Stage 4.doc Version 1.40 Page 14 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) These standards were not inspected. EVIDENCE: Meresworth I52 s19465 Meresworth v244555 160805 Stage 4.doc Version 1.40 Page 15 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x x x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 2 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 2 COMPLAINTS AND PROTECTION 3 x x x 3 3 3 2 STAFFING Standard No Score 27 x 28 x 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x x x x x x x x x x Meresworth I52 s19465 Meresworth v244555 160805 Stage 4.doc Version 1.40 Page 16 No 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. Standard 7&8 Regulation 15(1), (2) (b) 12(1)(a) 16(2)(i) Requirement The Registered Manager must ensure that care plans reflect service users needs and that the service users needs are met. The Registered Manager must ensure that the food served to service users is appetising and cooked appropriately. The Registered Manager must ensure that there is consistency in the quality of the laundry provided to service users in the home. The Registered Manager must ensure that all staff have a current CRB clearance prior to commencing employmet. An immediate requirement was left to comply with this. The Registered Manager must ensure that staff have up to date training on moving and handling and infection control. The Registered Manager must ensure that stale odours and odours that could be associated with incontinence are eliminated. The Registered Manager must ensure that all medicines are stored appropriately and that staff follow the homes policy on Timescale for action Henceforth and ongoing Henceforth and ongoing Henceforth and ongoing From 16/08/05 and Henceforth 30/10/05 2. 15 3. 26 16(2)(e) 4. 29 Schedule 2&4 5. 10 & 30 18(1)(c )(i) 16(2)(k) 6. 26 Henceforth and ongoing From 16/08/05 and Henceforth Page 17 7. 9 13(2) Meresworth I52 s19465 Meresworth v244555 160805 Stage 4.doc Version 1.40 8. 27 18(1)(a) 9. 18 17(1)(a) Schedule 3(0) 10. 8 & 10 12(1)(a) the administration of medicines. An immediate requirement was left to comply with this. The Registered Manager must submit staffing rotas for June and July 2005 to this office. An immediate requirement was left to comply with this. The Registered Manager must ensure that records of all falls that occured within the home since April 2005 are sent to this office. An immediate requirement was left to comply this. The Registered Manager must ensure that all call bells are within reach of the service users to ensure that their needs dignity and privicy are met. An immediate requirement was left to comply with this. From 16/08/05 and Henceforth From 16/08/05 and Henceforth From 16/08/05 and Henceforth 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. Refer to Standard 26 Good Practice Recommendations It is recommended that the home have dedicated laundry staff Meresworth I52 s19465 Meresworth v244555 160805 Stage 4.doc Version 1.40 Page 18 Commission for Social Care Inspection Mercury House 1 Broadwater Road Welwyn Garden City Hertfordshire, AL7 3BQ 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 Meresworth I52 s19465 Meresworth v244555 160805 Stage 4.doc Version 1.40 Page 19 - 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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