Inspection on 10/08/05 for Mills Meadow

This inspection was carried out on 10th August 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 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

Mills Meadow 16/09/08

Mills Meadow 17/09/07

Mills Meadow 25/08/06

Mills Meadow 23/01/06

Mills Meadow 21/03/05

Mills Meadow 03/09/04

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 Mills Meadow Fore Street Framlingham Suffolk IP13 9DF Lead Inspector John Goodship Announced 10 August 2005 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. Mills Meadow I54 - I04 S38816 Mills Meadow V232080 050810 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Mills Meadow Address Fore Street Framlingham Suffolk IP13 9DF 01728 724580 01728 724959 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) Suffolk County Council Mrs Lucy Roughley Care Home 32 Category(ies) of DE Dementia (12) registration, with number OP Old Age (32) of places Mills Meadow I54 - I04 S38816 Mills Meadow V232080 050810 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: Mills Meadow Framlingham is a residential care home for older people, which is owned and managed by Suffolk County Council, Department of Social Care. The home has a total of 32 registered care beds – 20 of which are for residential care and 12 of which are for dementia care. Included in the numbers of residential care beds are respite and 2 intermediate care beds.The home is situated in the centre of Framlingham, a small market town in rural Suffolk. As such, the home is close to shops, and other community facilities and resources. It also benefits from having its own transport, used for outings, appointments, and activities.The home is all single storey, divided into a number of ‘Hamlets’ – self contained units providing residential care. Poppy Hamlet accommodates 12 service users with dementia / special needs. Rose, Viola and Iris Hamlets each accommodate 6 residential service users. Iris Hamlet is also used to accommodate some respite care service users. In addition, there are two self-contained flats, The Street Flat and The Garden Flat. These are used to support people who require a short-term focused admission to improve their confidence, capabilities, and skills, towards living more independently in the community. There is also a 20 place Day Centre which is not subject to inspection. Mills Meadow I54 - I04 S38816 Mills Meadow V232080 050810 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection was the first in the current inspection year. The acting manager was present. The inspector toured parts of the building and spoke to residents and staff. Residents all said how much they appreciated the care by the staff. This was confirmed by the comment cards from residents, which emphasised that they liked the food, were treated well and had their privacy respected. One said that they felt safe living in the home. What the service does well: What has improved since the last inspection? What they could do better: The provider is looking at ways of recruiting staff to fill vacancies in this rural area. An open day has been arranged to attract applicants. Mills Meadow I54 - I04 S38816 Mills Meadow V232080 050810 Stage 4.doc Version 1.40 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. Mills Meadow I54 - I04 S38816 Mills Meadow V232080 050810 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 Mills Meadow I54 - I04 S38816 Mills Meadow V232080 050810 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) 1,2,3,4,5,6 Residents can expect to receive adequate information to make a choice about the home as a suitable place for them to live. They will be confident that their needs have been fully assessed and will be reviewed after a trial period to make certain that both the resident and the home are happy with the placement. EVIDENCE: From a review of care plans, it was confirmed that all prospective admissions had a pre-admission assessment by the manager or a team leader. Visits were arranged for the person and their family to decide on the suitability of the home. New admissions were reviewed after 6 weeks to ensure that the placing was appropriate for the service user. The statement of purpose and the service users’ guide were up-to-date and contained all the information required by the regulations to enable prospective residents to make an informed choice, and to know how the home worked and their involvement in its daily life. The Home had two purpose-designed flats for people requiring intermediate care, that is care to prepare them to return to their home usually after a stay Mills Meadow I54 - I04 S38816 Mills Meadow V232080 050810 Stage 4.doc Version 1.40 Page 9 in hospital. The flats were self-contained, but their occupants could mix with the service users in Iris hamlet if they wished. There was little demand for these facilities and the provider was considering incorporating the rooms into the special needs unit. Mills Meadow I54 - I04 S38816 Mills Meadow V232080 050810 Stage 4.doc Version 1.40 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 standard(s) 7,8,9,10,11 Residents can expect to have their health and care needs identified, monitored and met. Residents are protected by the safe medication procedures. Residents are treated with dignity and courtesy at all times. EVIDENCE: Residents had access to services in the community, including general practitioners, dentists, and chiropodists. Appointments were also made for service users with hearing or sight impairment. Care plans were comprehensive and up-to-date. They were reviewed regularly. They and the daily record were kept on the relevant hamlet. In addition, there was a team leaders’ book in their office to flag up significant events. The lunchtime medication round on Viola hamlet was observed and was undertaken correctly. A resident with mild dementia had a habit of hiding tablets in their mouth and taking them out later. 3 had been found under her pillow, although the chart had been signed as given. Staff were aware of this behaviour but found it difficult to stop. The manager said that she would speak to the GP for advice Mills Meadow I54 - I04 S38816 Mills Meadow V232080 050810 Stage 4.doc Version 1.40 Page 11 on alternative ways of administering the medication, and to review the frequency and volume of medication prescribed. Staff were observed to be courteous and caring, and to knock and wait for an answer, before entering a service user’s personal bedroom. Intimate personal care was delivered in service users’ bedrooms / en-suite areas, or in the communal bathrooms located on each Hamlet of the home. The home’s policy and practice in respect of issues associated with terminal illness, death and dying, were covered in the induction and foundation training provided to all care staff working at Mills Meadow. The policy covered the sensitivities relating to removal of personal effects and clearing the room of a deceased resident. Mills Meadow I54 - I04 S38816 Mills Meadow V232080 050810 Stage 4.doc Version 1.40 Page 12 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) 12,13,14,15. Residents can expect to have their preferences for the activities of their daily lives to be met as far as possible. Residents have control over their lives as much as their abilities allow. Residents can expect a good catering service which meets their preferences and contributes to their health. EVIDENCE: Care plans list the preferences of residents in matters such as getting up and going to bed times, activities and food. One resident had chosen to stay in bed late on the day of the inspection, and was just getting up at 11.00am. Religious services were being held every fortnight. Information on the needs of other faiths was available to the home through the inter-faith group at Suffolk College. The Home arranged various activities in the home for residents e.g. entertainers, keep fit, bingo, outings etc. The home had its own transport, which was used for outings. Photos of recent outings were on display in the hall. Outings were usually arranged for every 5 / 6 weeks. The home’s Newsletter was used to publicise outings, and relatives were also invited to come along, to give additional support. Mills Meadow I54 - I04 S38816 Mills Meadow V232080 050810 Stage 4.doc Version 1.40 Page 13 As far as practicable, the home arranged activities to suit the needs of the residents living there. It benefited from the fact that a Day Service operated from the same site, and residents living at Mills Meadow were welcomed and encouraged to attend Day Service activities, subject to their preferences and choices. Notice boards located throughout the home provided residents and any visitors with a list of activities and social events that were planned to take place. Residents also benefited from “Beckets Parlour”- a small pleasant lounge which had been created using memorabilia including photographs, pictures, furniture, and equipment from days gone by, including a piano, gramophone, and sewing machine. The room was furnished and decorated to the early / mid 1900’s style. There was also a ‘ library’ area which had been created in a corridor area, between the Hamlets. This was well stocked with books, and with comfortable chairs. There were also some reminiscence items displayed. Staff were planning to present an Old Time Music Hall show for residents, which everyone was looking forward to. The arrangements for catering at the home were observed. Personal choices and preferences were taken into account. Although residents were expected to choose their main meal of the day the previous afternoon, in the event that they wanted to change their mind, this could be accommodated. If residents did not want the main lunch dish, there was a list of 12 alternatives which could be provided. The Inspector observed lunch being served on one of the four Hamlets. The meal had been prepared in the main kitchen, and was then served from heated trolleys – one of which was delivered to each of the Hamlets in the home. Residents were asked about portion size and choices; the meal was kept hot; and the food looked appetising when it was served. One resident managed their own finances, the County Council managed on behalf of 6 residents and relatives managed the remainder. Mills Meadow I54 - I04 S38816 Mills Meadow V232080 050810 Stage 4.doc Version 1.40 Page 14 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) 16,18. Residents can expect that their complaints will be investigated under the County Council’s procedure and action taken as necessary. Residents can be confident that staff are trained in the prevention of abuse to vulnerable people. EVIDENCE: 2 complaints had been received in the previous 12 months. One concerned a medication error, and the other the inappropriate behaviour of one resident towards another. Both had been investigated by the home and the complainants informed of the result. The home followed the County Council policy and procedure for the protection of vulnerable adults. Training in this area was included in the induction and foundation training for all new staff. Mills Meadow I54 - I04 S38816 Mills Meadow V232080 050810 Stage 4.doc Version 1.40 Page 15 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) 19,20,21,22,23,24,25,26. Residents live in purpose-built accommodation, with all the required facilities, personalised according to their choice. Special action has been taken to reduce any risk of cross-infection to ensure that residents are protected from illhealth. EVIDENCE: There was an on-going programme to upgrade the bathrooms. 3 had been refurbished, and one had been converted to a shower room. The bathrooms were equipped with assisted baths. Hot water temperatures were regularly checked. A sample were tested on the inspection and found to be at the correct level. To reduce the risk of cross-infection, dry anti-bacterial gel dispensers had been placed at the entrance to each hamlet which visitors were urged to use. Mills Meadow I54 - I04 S38816 Mills Meadow V232080 050810 Stage 4.doc Version 1.40 Page 16 The home had a range of specialist equipment including hoists, low pressure cushions, wheelchairs and hand and grab rails. All other environmental standards had been inspected previously and there had been no change since then. Mills Meadow I54 - I04 S38816 Mills Meadow V232080 050810 Stage 4.doc Version 1.40 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 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) 27,28,29,30. Residents can expect to be cared for by competent staff, who are appointed according to the required safeguards. EVIDENCE: The records for the most recently appointed member of staff was examined. All identification and protection documentation had been obtained. There was a full programme of training available to the home, including aspects of dementia care and Unisafe training, the latter being done by all staff to level 1, and by care staff to level 2. Although the home had some long-serving staff, there was a constant difficulty in recruiting to such a rural location. At the date of the inspection, there were vacancies for 4 care workers and 2 domestic staff. The home had arranged an open day at the end of August in an effort to attract applicants. There were 3 carers on each daytime shift on Poppy because of the special needs of the residents. The other hamlets had 1 carer each, with a duty team leader on each shift and a senior manager on duty each weekday. Mills Meadow I54 - I04 S38816 Mills Meadow V232080 050810 Stage 4.doc Version 1.40 Page 18 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) 31,34,35,38. Residents can be confident that the home is managed by a registered person, with proper accounting practices, and following all health and safety regulations. EVIDENCE: The Environmental Health Officer had inspected the kitchen in March 2005. No requirements were necessary, and 2 suggestions had been made. Some sitting areas have heating vents which are raised proud of the floor. These were a hazard and to reduce the risk, the provider had installed vertical bars up to waist height in front of them. The manager was now registered with the Commission. She was on maternity leave at the time of the inspection, and an acting manager had been appointed to cover her absence. Mills Meadow I54 - I04 S38816 Mills Meadow V232080 050810 Stage 4.doc Version 1.40 Page 19 One resident managed their own finances, the County Council managed on behalf of 6 residents and relatives managed the remainder. Entry to the home was by a swipe card system for staff. All other visitors had to ring the bell and be admitted by a member of staff. Special arrangements had been made for one resident who was taken out by their spouse to use a door to which they had the key. Mills Meadow I54 - I04 S38816 Mills Meadow V232080 050810 Stage 4.doc Version 1.40 Page 20 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 3 3 3 3 3 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 x x 3 3 x x 3 Mills Meadow I54 - I04 S38816 Mills Meadow V232080 050810 Stage 4.doc Version 1.40 Page 21 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 Regulation NONE Requirement Timescale for action 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 NONE Good Practice Recommendations Mills Meadow I54 - I04 S38816 Mills Meadow V232080 050810 Stage 4.doc Version 1.40 Page 22 Commission for Social Care Inspection 5th Floor St Vincent House Cutler Street Ipswich IP1 1UQ 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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