Inspection on 24/11/05 for Meresworth

This inspection was carried out on 24th November 2005.

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

Meresworth 29/06/07

Meresworth 20/09/06

Meresworth 16/08/05

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 WD3 7EJ Lead Inspector Marian Byrne Unannounced Inspection 23rd November 2005 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 Meresworth DS0000019465.V267245.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. Meresworth DS0000019465.V267245.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Meresworth Address Dell Wood Field Way Rickmansworth Hertfordshire WD3 7EJ 01923 714300 02923 714351 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) Quantum Care Limited Mrs Patricia Smith Care Home 51 Category(ies) of Dementia - over 65 years of age (51), Old age, registration, with number not falling within any other category (51), of places Physical disability over 65 years of age (51) Meresworth DS0000019465.V267245.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 16th August 2005 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 DS0000019465.V267245.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was carried out by one inspector throughout a morning and afternoon. A new manager has been recently appointed but was not present at the inspection. The deputy manager was present and was welcoming and helpful as were all the staff. The home has been without a dedicated manager for some time. Good interaction was observed between staff and service users and service users were very complimentary about the staff and the care they receive. In the main the environment was clean, fresh and odour free (except for one room). Storage must be addressed as it is unacceptable to store equipment in the corridor. The staff were welcoming and friendly to the inspector. What the service does well: What has improved since the last inspection? What they could do better: Care plans must be reviewed to ensure that they reflect the needs of the service users. The preparation and service of the food in the home must be reviewed and there must be a system in place where food is tasted prior to it being served to service user. Pureed food must be served in an acceptable manner. Moving and handling training must be updated and the training must be enforced in the home to ensure the safety of service users. Equipment must be stored in a manner that ensures the safety of service users. Doors must not be wedged open. Call bells must be available to service users at all times. Criminal Records Bureau checks must be conducted by the home prior to staff commencing employment. Infection control must be enforced through the appropriate use of protective clothing. Staffing must be reviewed on the dementia unit as one service user had to be assisted by the inspector as no staff was available. Meresworth DS0000019465.V267245.R01.S.doc Version 5.0 Page 6 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 DS0000019465.V267245.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 Meresworth DS0000019465.V267245.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 The home assesses the needs of service users prior to admission. EVIDENCE: On the day of the inspection the shift leader was away from the office conducting an assessment. She decided that Merersworth could not meet the service the prespective service user needed. Meresworth DS0000019465.V267245.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): These standards were not inspected. EVIDENCE: On the day of the inspection the home was installing storage for controlled drugs, the deputy manager informed the inspector that they had not yet met the requirement on care plans left at the last inspection. Both of these will be inspected at the next inspection. Meresworth DS0000019465.V267245.R01.S.doc Version 5.0 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 the following standard(s): 12,13,14,15. The home lacks interactive activities. Contact is maintained with the local community. Service user’s call bells were out of reach giving little control over their lives. The food served at lunch lacked flavour and food pureed was served in an unappitising manner. EVIDENCE: When asked service users how they spend their day they replied its ‘too quiet’, ‘watch the box’, one said that they used to have people in but that has stopped. The home does not have an activity organiser, throughout the inspection no activities were observed. There was a constant stream of visitors in the home throughout the day. The inspector observed lunch. When the lunch trolley was brought in to the dining room it was not plugged in until the inspector mentioned it. The food itself tasted salty, and lacked flavour. Service users who required pureed food had the food pureed together resulting in an unappitising ‘blob’ of food. The mashed potatoes were cold. The inspector was unable to find a member of staff who had tasted the main course for lunch prior to it being served to the service users. Tea was served to service users in cups without saucers. Meresworth DS0000019465.V267245.R01.S.doc Version 5.0 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 the following standard(s): 16,18. The home has a complaints procedure. Service users are protected from abuse. EVIDENCE: The home follows a complaints procedure. There had been no complaints since the last inspection. Staff spoken with were aware of ‘whistle blowing’ and the protection of vulnerable adults. Meresworth DS0000019465.V267245.R01.S.doc Version 5.0 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 the following standard(s): 19,24,26. With one exception the home was clean fresh and odour free. Bedrooms were personalised. EVIDENCE: The home was clean fresh and with the exception of room 47 was odour free. Rooms were decorated and furnished to reflect the personality of the service user. Meresworth DS0000019465.V267245.R01.S.doc Version 5.0 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 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): 27,28,29,30. Staffing levels on the dementia unit must be reviewed. In the main the recruitment protects the service users. Staff are not trained effectively to meet the service users needs in moving and handling. EVIDENCE: The inspector observed two carers assist a service user in a manner that could cause them an injury. Staffing on the dementia unit needs to be re-assessed to ensure the needs of the service users with dementia are being met. Some service users were wearing slippers that didn’t fit well this could them to lose their balance and fall. A high number of call bells were either missing or were out of reach this could put service users at risk. A requirement was left aboutthis at the last inspection. Meresworth DS0000019465.V267245.R01.S.doc Version 5.0 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 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): 36,38. Staff receive supervision regularly. The health and safety of service users was put in jeopardy through the use of door wedges. Equipment was stored in a manner that could cause injury to service users. EVIDENCE: A new manager has been appointed, she was not available during the inspection, it was therefore not possible to inspect all of these standards. The inspector observed staff wearing protective gloves in the home. To prevent the spread of infection gloves should be worn for one task only and then disposed of. Equipment – hoists and wheelchairs - was stored at the end of a corridor one service user who has dementia managed to get into this area between hoists and wheelchairs and could not find her way out the inspector guided her out as there was not a member of staff present. Meresworth DS0000019465.V267245.R01.S.doc Version 5.0 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 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 x HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 X 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 1 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X 3 X 2 STAFFING Standard No Score 27 2 28 2 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X X 3 X 2 Meresworth DS0000019465.V267245.R01.S.doc Version 5.0 Page 16 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 OP8OP7 Regulation 15 Requirement The registered Manager must ensure that care plans reflect service users needs and that the service users needs are met. This requirement was left at the last inspection The Registered Manager must ensure that the food served to service users is appetising and served at an appropriate temperature in a manner that maintains dignity. This requirement was left at the last inspection. 3 OP29 18 The Registered Manager must ensure that all staff have a current CRB clearance prior to commencing employment. This requirement was left at the last inspection. 4 OP30 18 The Registered Manager must ensure that staff have up to date training on moving and handling and infection control training. DS0000019465.V267245.R01.S.doc Timescale for action 31/01/06 2 OP15 16 (2) (i) 24/11/05 24/11/05 31/01/06 Meresworth Version 5.0 Page 17 This requirement was left at the last inspection. 5 OP26 16 The Registered Manager must ensure that stale odours and odours that could be associated with incontinence are eliminated. This requirement was left at the last inspection. The Registered Manager must ensure that all medicines are stored appropriately and that staff follow the homes policy on the administration of medicines. An immediate requirement was left to comply with this. This standard was not inspected at this inspection. The Registered Manager must ensure that all call bells are within reach of the service users to ensure that their needs dignity and privacy are met. An immediate requirement was left to comply with this at the last inspection. This requirement was not met failure to address this requirement could lead to a notice of legal action being taken. The Registered Manager must ensure that the safety of service users is not compromised through the use of door wedges. The Registered Manager must ensure that the safety of service users is not compromised by them using badly fitting slippers/footwear. The Registered Manager must ensure that the service users have access to activities throughout the day. The Registered Manager must DS0000019465.V267245.R01.S.doc 25/11/05 6 OP9 13 25/11/05 7 OP8 12 25/11/05 8 OP38 12 25/11/05 9 OP38 12 30/11/05 10 OP12 16 25/11/05 11 OP27 18 31/12/05 Page 18 Meresworth Version 5.0 12 OP38 12 13 OP38 12 ensure that the staffing levels in the dementia unit is sufficient to ensure the safety and stimulation of the service users. The Registered Manager must ensure the safety of service users by having a fire escape plan. The Registered Manager must ensure that equipment in the home is stored in a manner to ensures the safety of service users. 31/12/05 25/11/05 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 Meresworth DS0000019465.V267245.R01.S.doc Version 5.0 Page 19 Commission for Social Care Inspection Hertfordshire Area Office 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. 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