Inspection on 16/09/08 for Mills Meadow

This inspection was carried out on 16th September 2008.

CSCI found this care home to be providing an Good service.

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 17/09/07

Mills Meadow 25/08/06

Mills Meadow 23/01/06

Mills Meadow 10/08/05

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 13/03/2009.

CARE HOMES FOR OLDER PEOPLE Mills Meadow Fore Street Framlingham Suffolk IP13 9DF Lead Inspector John Goodship Unannounced Inspection 16th September 2008 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 Mills Meadow DS0000038816.V372704.R02.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Mills Meadow DS0000038816.V372704.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Mills Meadow Address Fore Street Framlingham Suffolk IP13 9DF 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) 01728 724580 01728 724959 lucy.roughley@socserv.suffolkcc.gov.uk Suffolk County Council Manager post vacant Care Home 35 Category(ies) of Dementia - over 65 years of age (16), Old age, registration, with number not falling within any other category (35) of places Mills Meadow DS0000038816.V372704.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. One named service user aged over 65 years of age, whose name was given to the Commission on 05/07/06 who requires care by reason of dementia and is living on Rose Hamlet. 17th September 2007 Date of last inspection 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 Adult Social Care. The home has a total of 35 registered care beds. The home is registered to provide care for older people; up to 16 of these may require dementia care. Included in both categories are short-term 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 - selfcontained units providing residential care. Poppy Hamlet accommodates 15 residents with dementia / special needs. Rose, Viola and Iris Hamlets each accommodate 6 residents. One named person with dementia is cared for on the mainstream hamlets. Iris Hamlet is also used to accommodate some respite care residents. There is also a 20 place Day Centre which is not subject to inspection. The fees at the date of the inspection were £381.00 per week. Mills Meadow DS0000038816.V372704.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is two star. This means the people who use this service experience good quality outcomes. This was a key unannounced inspection which concentrated on the outcomes for the people using the service. These outcomes were related to the key national minimum standards listed under each Outcome Group in the report. The inspection visit took place on a weekday and lasted six hours. We toured the building, visiting each hamlet. We spoke to two residents on Rose, Iris and Viola hamlet, and observed residents on Poppy, the special needs unit. We interviewed two care staff as well as the manager, and a visiting relative. We also spoke to other staff as we went round including catering and laundry staff. Before the inspection, a questionnaire survey, called: ‘Have your say about Mills Meadow’, was sent out by the Commission, via the manager, for residents, relatives and staff to use to give us their views on aspects of the home. We received back five survey forms from residents, seven from relatives and six from staff. Their answers to the questions and any additional comments have been included in the appropriate sections of this report. A self-assessment form was required to be completed by the manager, giving us details of how the home believed it met the national minimum standards. This form is called the Annual Quality Assurance Assessment and is referred to in the report as the AQAA. This form was fully completed, even though it was requested during a change over of managers. What the service does well: Comprehensive assessments are made of the needs of residents, and care plans in place are regularly reviewed to ensure that people’s changing needs are picked up and met. The home provides residents with a homely environment where they are able to carry out social activities that meet their needs and to receive visitors to maintain family and social contacts. Families are encouraged to be involved in residents’ lives and take residents out for social activities as if they were in their own home. Comments by relatives included: “Has a nice friendly atmosphere.” “Staff often sit and talk to my relative as work allows.” “ The Mills Meadow DS0000038816.V372704.R02.S.doc Version 5.2 Page 6 home advises me as soon as possible of any falls or knocks.” “They often anticipate my relative’s needs, and put them at ease when confused.” Residents, families and friends can be assured that any complaints and comments are taken seriously and dealt with effectively and in line with the provider’s guidance and policy. A relative told us: “They have taken immediate action if I have queried anything.” The home is purpose built, safe and well maintained with communal areas and access to safe grounds. The staff employed by Mills Meadow are appropriately trained and suitable to care for the needs of older people. Over 80 of staff have an NVQ relevant to the role they perform. The home has a well trained catering service, with regular consultation with residents on their likes and dislikes. It ensures that each person’s nutritional and dietary needs are met. What has improved since the last inspection? What they could do better: No requirements or recommendations have been made as a result of this inspection. The AQAA listed areas where the home is planning to improve its care. The most important area is to continue its recruitment drive, to fill all the vacant hours on the staffing establishment. This would reduce the times when agency staff are needed, and mean that residents would be cared for by people they knew and who were trained to know about them and their needs. The manager hopes that the five-year property improvement plan will continue, in particular the replacement of windows and carpets. Mills Meadow DS0000038816.V372704.R02.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. Mills Meadow DS0000038816.V372704.R02.S.doc Version 5.2 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 Mills Meadow DS0000038816.V372704.R02.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1,3. Standard 6 is not applicable to this home. Quality in this outcome area is good. Residents can expect to have sufficient information prior to deciding whether to live in the home. They can be assured that their needs will be fully assessed to make sure that the home can meet their needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: We saw that the Statement of Purpose and Service Users’ Guide contained all the information required by the regulations to give prospective residents the information they would need when selecting the home. This information included the organisation of the home, the qualifications of staff and the range of needs which the home was registered to meet. A relative told us that they had received these documents on behalf of their relative. We noted that a copy of the Service Users Guide was pinned on the noticeboard in each hamlet. Mills Meadow DS0000038816.V372704.R02.S.doc Version 5.2 Page 10 We noted that all the residents’ files that we saw had a copy of their contract. Two of the residents who replied to our survey said they had received contracts. The others could not remember. The AQAA also confirmed that all new admissions were given contracts. The statement of fees was included in the Service Users’ Guide. The home only admits residents assessed and supported by Suffolk County Council through the Adult Social Care service. The fees were set at the figure equivalent to the level of support given to councilsupported residents in all care homes. We noted that the AQAA stated that prospective residents were fully assessed prior to moving into the home, had a fully informed choice about where they wished to live, and that no admission took place without the home having received a Community Care Assessment of need and an assessment carried out by the home. Both of the residents we tracked had pre-admission assessments. These covered a comprehensive range of daily living needs and medical information about each person. Five places were usually available for short-term respite care. The same assessments were made for these residents, although some care staff said that the information from other sources prior to admission was not always complete. Mills Meadow DS0000038816.V372704.R02.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10. Quality in this outcome area is good. Residents can be assured that their health, personal and social care needs will be identified, monitored and reviewed regularly. They can be assured that they are protected by the home’s medication procedures. This judgement has been made using available evidence including a visit to this service. EVIDENCE: We examined the care plans of two residents and spoke to them or their relative. Both residents had full care plans in place, which covered all aspects of care such as personal care, moving and handling, continence management,nutrition and night care arrangements.The plans contained photographs of the residents, and risk assessments covered moving and handling, smoking, nutrition and weight loss as appropriate. Other agencies had been involved in these residents’ care, including a chiropodist, a community psychiatric nurse, a physiotherapist and a complementary therapist. Mills Meadow DS0000038816.V372704.R02.S.doc Version 5.2 Page 12 Information about one of the residents who had Parkinson’s disease was written in the first person, to give staff a person-centred view of their needs, likes and dislikes. This asked staff to care for the person in particular ways that suited them. One person had been weighed monthly showing a weight loss over two years. However their weight had stabilised since August 2008. The screening tool had been reviewed and weekly weighing was required. We saw that this had been done. Information was also included on continence management, diet and a record of any falls. The manager told us that a falls adviser was due to run training sessions in all County Council homes shortly. Where appropriate the files held consents to, for example, the staff administering medication, and to the use of a wheelchair belt for safety. The daily record completed at the end of each shift contained good information on what had happened to the resident during the shift, including, as appropriate, what personal care had been given, fluid intake, whether they had had any visitors, and the resident’s general demeanour. We saw evidence that these care plans were reviewed regularly, usually monthly. In addition there were annual reviews. The record of these reviews showed that the residents and their relatives, as well as key staff were present. One of the team leaders was responsible for auditing that these reviews took place. We discussed one of the resident’s care plan with their key worker. They were able to show us a full understanding of the person’s needs, and their preferences for how they were cared for. We observed the lunchtime medication round in one of the hamlets. The proper procedure was followed with the record being signed after the medication was administered. We saw no gaps in signatures for previous administrations. A team leader told us that it was the responsibility of team leaders to check the medication records at each handover to identify any gaps. No medication errors had been reported to us since the previous inspection. The AQAA also told us about the checking and auditing systems in place to ensure the safety of residents. The AQAA told us that staff were trained in areas of dignity and privacy during induction training and throughout NVQ training. This was re-inforced in supervisions where necessary. The staff we interviewed confirmed that they had a good awareness of these issues. All the relatives who replied to our survey said that the home always or usually met the needs of their relative. Residents who responded said they received the care and support they needed. Comments on relatives’ surveys included: Mills Meadow DS0000038816.V372704.R02.S.doc Version 5.2 Page 13 “Has a nice friendly atmosphere.” “Staff often sit and talk to my relative as work allows.” “ The home advises me as soon as possible of any falls or knocks.” “They often anticipate my relative’s needs, and put them at ease when confused.” “The carers have made a big issue of being aware of my relative’s history so they can be prompted to remember the family.” “The key worker is always approachable to help with adjusting any care needs.” We spoke to one person while their relative was having their hair done. This person was complementary about the home and the staff. They told us that the home always rang them if their relative was unwell, or if the GP had been called. They described some of the physical care that was carried out. They had noticed that their relative’s eyes had not always been cleaned, but other tasks were carried out properly. The home employed at the date of inspection five male carers out of thirty-five care staff. The AQAA stated that the home would always respect the right of a resident not to have a male carer if they so wished, as long as it was feasible to do so. Mills Meadow DS0000038816.V372704.R02.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15. Quality in this outcome area is good. Residents can be assured that they can choose how to spend their time, with opportunities for social activities, and receiving visitors. They can expect to receive a wholesome diet suited to their needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Three of the five residents who replied to our survey said there were always activities in the home that they could take part in. One said that sometimes there were activities they could take part in. One said there were activities but they did not like them as they were lazy. The manager told us that they were trying to develop more activities. They did not have funding for an activities organiser, but did have an activities committee, which now included a family member. Bingo and film nights had been introduced and had been well supported. We saw monthly activities sheets on the noticeboards in each hamlet. These advertised weekly fitness sessions in the day centre, flower arranging and a trip to Felixstowe. There were photos of previous outings in the entrance hall. The dates of church services in the home were displayed on Mills Meadow DS0000038816.V372704.R02.S.doc Version 5.2 Page 15 noticeboards around the home. A relative told us: “They are always organising outings.” The day centre that was part of the building was run separately from the residential home. Residents were not able to use the centre unless there was a member of the care staff with them. However users of the day centre joined up with residents for outings. It was noted that the home had purchased many jigsaws as the manager told us that several residents were getting enjoyment from completing these. One jigsaw was being done on a table in one of the quiet areas of a hamlet. The resident was not there at the time but was able to leave the jigsaw partly completed for their next attempt. All six of the relatives who replied to our survey said that they were always or usually kept up-to-date with important issues affecting their relative. One person commented that the home had been considerate in respecting the family’s wishes regarding who the home should contact on any issue. One relative wondered if the home could do more to encourage relatives to get involved, perhaps in a support group. All the residents who replied to our survey said they always liked the food. One wrote: “If you don’t like the main meal there is always something else to your liking, or they will leave something out of a dish. Excellent.” Two residents in one of the hamlets told us: “The food is good. There is always a choice.” The main lunch dish on the day of our visit was chicken casserole with cherry crunch as dessert. We did not see anyone with an alternative. All the residents we spoke to were enjoying their meal. A relative told us: “My relative thoroughly enjoys their food and usually has two helpings of each.” We spoke to the cook who was on duty that day. The manager told us that they were a catering service trainer for other County Council homes. There had been an inspection by the environmental health officer in April, but no requirements or recommendations needed to be made. The cook told us about the special diets that were being prepared that day, and how the staff catered for the preferences of residents. The cooks were included in residents’ meetings and received a monthly Comments sheet where staff recorded comments made by residents about each meal. Comments included praise and criticism, such as the amount of salt used in the cooking, the quality of the meat, and how nice a particular dish was. We were told that action would be taken to correct any shortfalls if possible. The kitchen also supplied lunches for the day centre and for meals on wheels. Mills Meadow DS0000038816.V372704.R02.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18. Quality in this outcome area is good. Residents can be assured that their complaints will be properly dealt with, and they will be protected from abuse by appropriate training and procedures. This judgement has been made using available evidence including a visit to this service. EVIDENCE: All but one resident said in the survey that they knew how to make a complaint. All the relatives who replied said that the home always or usually responded appropriately if they had raised concerns. One wrote: “They have taken immediate action if I have queried anything.” Another wrote: “The key worker is always approachable to help with adjusting any care needs.” The complaints procedure was included in the Statement of Purpose and the Service Users Guide, and complaint forms were available in the hall. The AQAA told us that the home had received three formal complaints this year. All had been responded to within 28 days, and one had been upheld. We examined the complaints log where details of these complaints were recorded. The AQAA told us that at the end of each year this record was passed to the provider’s customer rights team. The six staff who replied to our survey all said that they knew what to do if someone raised a concern or complaint with them. Many staff had received Mills Meadow DS0000038816.V372704.R02.S.doc Version 5.2 Page 17 basic training in the protection of vulnerable adults (POVA) during their induction. Others had had this re-inforced during their study for an NVQ. The manager showed us the dates later that month for POVA training for all staff. One staff member told us of their training, and was able to give examples of situations where abuse might have taken place. Mills Meadow DS0000038816.V372704.R02.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19,24,25,26. Quality in this outcome area is good. Residents can be assured that the home is safe, with rooms personalised as they wish. They can be assured that the home provides a clean and hygienic environment. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home was a single storey building so all areas were accessible, including the gardens. The home had been helped by the local Rotary Club to reorganise and set out some of the internal gardens to make them more accessible and interesting with raised beds. Two areas were completely enclosed to enable people with dementia to walk freely and securely. Mills Meadow DS0000038816.V372704.R02.S.doc Version 5.2 Page 19 The AQAA told us that the building was in need of new windows and decoration (including carpets) which was part of the county council 5 year property improvement plan. We saw that some rooms had been redecorated. All bedrooms were for single occupation and had en-suite toilet and washbasin facilities. There was a communal bathroom on each hamlet with some having assisted bathing and/or shower facilities. Bathrooms had liquid soap and paper towels, and supplies of protective clothing. A sample of hot water temperatures showed that all were within the safe range. Antibacterial hand gel was available at the entry to each hamlet. We saw some of the residents’ rooms. All were personalised with their own possessions and in some cases an item of furniture. A relative told us: “When X was admitted, staff encouraged us to bring in items and pictures to make it more homely so that they could settle down quickly.” Most bedrooms had a door sign that included the name of the resident and in many instances a picture of their choice. All doors marked ‘keep locked’ or ‘keep closed’ were fastened as required. There was a locked sluice room on each hamlet and a launderette with sluice facilities. The home had a large laundry room with two washing machines each with a sluice cycle, and a tumble drier. There was a separate sewing room, used as a store and for ironing, and a linen room used for sorting residents’ clothes. The laundry assistant told us that the home used red alginate bags for soiled items. This enabled the bags to be put directly into the washing machine without staff handling the items. This reduced the risk of cross infection. All the residents who replied to our survey said that the home was always fresh and clean. We noted that one room that was not occupied had been prepared for a new resident. There was a notice on the door stating that it was clean and ready to use. Mills Meadow DS0000038816.V372704.R02.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30. Quality in this outcome area is good. Residents are cared for by well-trained staff, whose care and concern is appreciated by residents. Residents can expect that they will be protected by the home’s policy on recruitment. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The staffing rota showed us that the planned staffing levels during the daytime was three carers on Poppy hamlet, for fifteen people with special needs, and three carers covering the other eighteen residents in three hamlets. A team leader managed each shift, and during the week, the manager was available. At night there were two carers and a team leader on duty. On the day of our visit, there were three resident vacancies on the special needs unit which cares for people with dementia. The manager told us that all night vacancies had now been filled. There was still 50 hours vacant on the day shifts. Some interviews were taking place during our visit. All the staff surveys identified that the home had been through a difficult time with vacant posts and long-term sickness. Staff told us that agency staff had not always been reliable and staff felt residents wanted staff that they knew, especially in the special needs unit. The AQAA told us Mills Meadow DS0000038816.V372704.R02.S.doc Version 5.2 Page 21 that just over 10 of shifts had been covered by agency staff in the last three months. However permanent staff had also helped by doing extra shifts. The manager acknowledged that the location of the home increased the difficulty of attracting staff, who had to have their own transport to meet shift times. Some staff in the survey felt that there should be more hours allocated to providing activities and entertainment for residents. One person also said that if the dementia unit was short, staff were pulled in from the other units. This could leave two carers covering 18 residents in three widely separated hamlets. One care worker felt that residents were becoming increasingly frail and took more staff time to meet their needs. The AQAA told us that there were nine residents, at the date the AQAA was completed, that needed two staff to help with their care both during the day and at night. In reply to the survey question: ‘Are staff available when you need them’, four residents said they always or usually were. One said sometimes, when they were short of staff “otherwise they are very quick.” We noted that call bells were answered within a reasonable time. We examined the recruitment files for two members of staff, who had been appointed this year. All contained two references, complete application forms, identification documents and Criminal Records Bureau certificates. These checks helped to protect residents. The files also contained information about the person’s induction training, supervision and further training. These were confirmed in interviews with two staff. They also confirmed that staff meetings were held, although one person would have liked them to be held more regularly. At the previous inspection, there was a shortfall in the renewal of Food Hygiene training for some staff. We saw the training records which showed that the training for all staff in this topic was now within date, with three yearly renewals programmed. One staff member wrote in their survey form: “I am always consulted on any training needs and it is reviewed regularly during supervision meetings.” The AQAA told us that 80 of care staff had achieved NVQ Level 2 or above. The two staff we interviewed both confirmed that they had completed an NVQ Level 2. Mills Meadow DS0000038816.V372704.R02.S.doc Version 5.2 Page 22 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,35,36,38. Quality in this outcome area is good. Residents and relatives can expect the home to be well run, by competent staff. Their safety is assured by the home’s health and safety practices. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The previous managers, who worked the post as a job share, moved to another home at the beginning of April 2008. There were then two acting managers until the permanent manager was appointed from August 1st 2008. Staff surveys referred to the unsettling nature of this period although several of them found the acting managers supportive and positive. Mills Meadow DS0000038816.V372704.R02.S.doc Version 5.2 Page 23 The new manager had previously been at another home for older people run by Suffolk County Council. They had been registered with the Commission in that post and were waiting to be registered for Mills Meadow. A staff member said: “We see the new manager everyday. She does come to see us on the hamlets.” The manager was supported by Team Leaders, each of whom had a special area of responsibility such as infection control, moving and handling, safeguarding training, care plan reviews, and short term care. The provider had been reviewing how its homes should be run in the future and by whom. Although there had been extensive consultation and communication, staff and residents expressed some concern over their future. Information about the residential review was placed on a notice board at the front of the home. The AQAA told us that the provider had now extended to review until 2010. The AQAA told us that regular residents meetings were held where residents had the opportunity to attend and comment on the service provided. Areas of concern were reported to the appropriate people and resolutions found where possible. A monthly visit was carried out by the Residential Service Quality Advisor to ensure that the service was operating effectively and a written monthly report was provided. Residents were asked about the home,the care they received, and they were observed within their day to day life. Any comments, compliments or complaints would be included in the written report received and passed on to the manager to action. We saw the most recent report which was kept in the home. A questionnaire to residents and relatives had been sent out in November 2007. One outcome had been the inclusion of a relative on the activities/entertainments committee after comments in the questionnaire.The manager did show us some cards from relatives thanking the home and its staff for their care. One said “Thank you for looking after our relative so well. They enjoyed their last years here.” We saw evidence that staff were properly trained and supervised. Staff confirmed to us that regular supervision meetings were arranged with them, although some were behind the planned schedule. One person told us that they found the sessions helpful. The manager told us that no personal cash was held on behalf of residents, but that all residents were funded through Social Care Services and the personal allowances could be paid into a personal account administered by the County Council. We examined the fire log. All regular checks were up to date on equipment and alarm systems. The Fire Risk Assessment had been reviewed in February 2008. Mills Meadow DS0000038816.V372704.R02.S.doc Version 5.2 Page 24 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 3 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X 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 3 3 3 X 3 3 X 3 Mills Meadow DS0000038816.V372704.R02.S.doc Version 5.2 Page 25 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. Standard Regulation 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. Refer to Standard Good Practice Recommendations Mills Meadow DS0000038816.V372704.R02.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Mills Meadow DS0000038816.V372704.R02.S.doc Version 5.2 Page 27 - 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!