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Inspection on 10/05/07 for Queens Meadow Care Home

Also see our care home review for Queens Meadow Care Home for more information

This inspection was carried out on 10th May 2007.

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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The service provides a homely environment for those who live there. People said the staff were caring and responded to their needs. The home has clear admission procedures, assessments and care plans to make sure it can meet the needs of service users. The home is run with an open door policy, which gives it a welcoming feel. The staff felt supported in their work through training and supervision. Over 50% of care staff have achieved an N.V.Q. in care at level 2 or 3.

What has improved since the last inspection?

Care plans now contain all of the information needed to ensure each resident gets the assistance they need to live safely and people said they know the service they can expect. The manager is monitoring the temperature of the room where medication is stored to make sure it is within the correct limits. An activities coordinator has recently been appointed. Staff and the people who live in the home all said she had made a big improvement in how they spend their day. The programme of refurbishment has been completed to provide a good, homely environment for the people who live there. Some rooms have had bay windows added and all bedroom doors have been widened. Locks have now been fitted to all of the bedroom doors. Bathrooms have been upgraded.

What the care home could do better:

The terms and conditions document must contain reference to the charges made for personal transport. A copy of the report following a Regulation 26 visit must be available within the home. There was no evidence to confirm that the electrical wiring or the nurse call system had been checked. Bedroom doors were kept open by unauthorised means. These issues potentially place the people in the home at risk of harm. The registered provider was sent a letter after the inspection requiring that these issues be attended to as a matter of urgency.

CARE HOMES FOR OLDER PEOPLE Queens Meadow Care Home 327 Stockton Road Hartlepool TS25 5DA Lead Inspector Mrs Sue Lowther Unannounced Inspection 10th May 2007 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Queens Meadow Care Home DS0000000181.V337064.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. Queens Meadow Care Home DS0000000181.V337064.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Queens Meadow Care Home Address 327 Stockton Road Hartlepool TS25 5DA 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) 01429 267424 01429 405167 T L Care Ltd Mrs Julie Ann Armstrong Care Home 56 Category(ies) of Dementia - over 65 years of age (21), Old age, registration, with number not falling within any other category (35) of places Queens Meadow Care Home DS0000000181.V337064.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home only - Code PC To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP, maximum number of places: 35 Dementia, over 65 years of age - Code DE(E), maximum number of places: 21 The maximum number of service users who can be accommodated is: 56 9th May 2006 2. Date of last inspection Brief Description of the Service: The home was purpose built in 1991. Accommodation is provided for up to 56 older people who require help with personal care. There are two units with upstairs providing care to older persons who also have dementia. The home is situated close to Hartlepool Town centre. It stands in it’s own grounds with a secure and pleasant large garden area at the back. All of the bedrooms have en-suite toilet and hand washing facilities. There are sufficient toilet and bathroom areas located throughout the home, some with specialist adaptations for people who are less mobile. Several spacious lounge and dining areas are also available. The fees charged at the time of inspection ranged between £391 and £395 per week. This does not include charges for hairdressing, chiropody, toiletries, personal newspapers and private transport. Queens Meadow Care Home DS0000000181.V337064.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection of Queens Meadow took place on the 10th May 2007. A research student accompanied the inspector. Records were examined and a tour of the building took place. Time was spent talking to service users, staff and relatives. The manager supplied some information on a pre inspection questionnaire. The inspection focussed on key standard outcomes for service users and to check whether requirements from the previous report had been met. What the service does well: What has improved since the last inspection? Care plans now contain all of the information needed to ensure each resident gets the assistance they need to live safely and people said they know the service they can expect. The manager is monitoring the temperature of the room where medication is stored to make sure it is within the correct limits. An activities coordinator has recently been appointed. Staff and the people who live in the home all said she had made a big improvement in how they spend their day. The programme of refurbishment has been completed to provide a good, homely environment for the people who live there. Some rooms have had bay windows added and all bedroom doors have been widened. Locks have now been fitted to all of the bedroom doors. Bathrooms have been upgraded. Queens Meadow Care Home DS0000000181.V337064.R02.S.doc Version 5.2 Page 6 What they could do better: 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. Queens Meadow Care Home DS0000000181.V337064.R02.S.doc Version 5.2 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 Queens Meadow Care Home DS0000000181.V337064.R02.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 2 & 3. The home does not provide intermediate care and therefore assessment of Standard 6 is not required. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Assessment procedures are in place to ensure that the home can meet all of the needs of the people who go to live there. EVIDENCE: All of the people who live in the home have a contract. However there is no reference in these to the charges made for private transport. This information needs to be made clear so that people know that they will have to pay for this. Everyone is assessed prior to living in the home. In addition to social service care manager assessments the manager normally visits the person in their current place of residence. She advised the inspector that she would Queens Meadow Care Home DS0000000181.V337064.R02.S.doc Version 5.2 Page 9 sometimes take another person with her if she feels this is needed. If she were on holiday this would be done by one of the senior care staff. The file of one person recently admitted to the home was found to contain comprehensive information. The family confirmed that they had looked around the home and had been supplied with all of the information they needed to make a decision about whether or not their relative would like to live there. One person said “My son looked around seven other homes and then brought me here to have a look. I liked it and decided to stay”. Queens Meadow Care Home DS0000000181.V337064.R02.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Good systems are in place to ensure that health care needs of the people who live in the home are met. People can be confident that their privacy and dignity is protected and that they are treated with respect. EVIDENCE: Each person has a care plan in place to cover health and personal needs. Social profiles are available and when the new activities organiser has completed her induction she intends to put individual social care plans in place. Evidence was seen in files of involvement with other people for example district nurses, doctors, and care managers to confirm that other professionals are involved. One health care professional visiting on the day of inspection confirmed that staff consult her on a regular basis. She said, “Staff tend to use common sense approach when dealing with clients. Will utilise expertise when Queens Meadow Care Home DS0000000181.V337064.R02.S.doc Version 5.2 Page 11 they have explored other avenues and followed policies and procedures. They also accept advice and support relating to care”. The medications of four people were checked. The last report required that the temperature in the rooms used for storage of medication should be checked daily to ensure it does not exceed 25°C. The manager said that this is done on a daily basis and that the temperature is maintained within the required limits. People said that staff treat them with dignity and respect. They said that staff always knock on bedroom doors and call them by their preferred name. One person said “Staff are lovely to me they are always polite and knock on door. It is absolutely perfect home from home”. One visitor said, “ Staff are polite, friendly and very approachable”. The visiting professional confirmed that staff always consider ethics, religion and capacity of the people who live in the home. Queens Meadow Care Home DS0000000181.V337064.R02.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The activities are varied and provide recreation for some of the people living in the home. Family and friends can visit the home at any time and are made to feel welcome. The meals are of a good standard. Menus are varied and service users are given a choice. EVIDENCE: Most of the people said that activities are suitable. The inspector saw a large group of people enjoying a quiz. The activities organiser told the inspector that she tries to vary the activities. Once she has completed her induction she intends to talk to people on an individual basis about what they would like to do. One member of staff said, “The activities coordinator is good. She asks the people what they want to do and they are really enjoying them”. Another said, “The activities coordinator is good we are working together on a programme”. A visiting professional said, “I am always pleased to see activities being carried out in the home. Well structured activity programme”. Some people said that they did not want to rake part in the activities. They prefer to spend time in Queens Meadow Care Home DS0000000181.V337064.R02.S.doc Version 5.2 Page 13 their own rooms or out in the garden. They said that staff would take them into the garden when they want to go out. Relatives said that they could visit at any time and that they are always made welcome. One said, “Staff are always very pleasant, we can visit at any time and we are always offered a cup of tea”. People said that they have a choice about how they like to spend their day. They can also choose what time to get up and go to bed and when they would like to have a shower or bath. One service user said, “ I can get up at 5:30 am-my choice and have my shower”. Another said “I can get up and go to bed when I want I just ring the buzzer. Staff come fairly quickly. I get a bath every other morning o.k. for me”. The evening meal looked nice. People are now consulted with regard to food portions and have a choice. One service user said “The food is ‘out of this world you get a choice but there is too much”. Another said, “The food is excellent”. Queens Meadow Care Home DS0000000181.V337064.R02.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The people who live in the home can be confident that their concerns and complaints are dealt with appropriately and that safeguards are in place to protect them from abuse. EVIDENCE: Information about complaints, how and who to make them to, is made available to the people who live in the home and their families through information displayed in the entrance to the home and in the ‘Service Users Guide’. One person said, “If I had a problem I would tell the manager”. One relative said “I would approach any member of staff at any time and feel that problems would be addressed”. There were two complaints recorded in the home since the last inspection. These have been appropriately addressed using the procedure available within the home. Views are obtained through regular contact and an ‘open door policy’. Residents meetings are held to discuss any concerns or potential difficulties. Resident Surveys have also been carried out within the home. The home has detailed adult protection procedures. Copies of these were seen to be available for staff use. Staff interviewed voiced a commitment to the people they work with and to upholding the rights of the people who live in the Queens Meadow Care Home DS0000000181.V337064.R02.S.doc Version 5.2 Page 15 home. One staff member said, “ I would be aware of abuse and would have no hesitation with regard to whistle blowing. If there is something I don’t like I say- I am here for the residents”. Queens Meadow Care Home DS0000000181.V337064.R02.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 21, 24 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is clean and well maintained. It is decorated and furnished to a good standard and provides a homely environment for the people who live there. EVIDENCE: During the tour of the building and whilst talking to people in their bedrooms, the inspector saw that people could bring in their own furniture and belongings should they wish to do so. New doors have been fitted to every bedroom. The registered manager told the inspector that all now have locks fitted. There was a range of specialist equipment seen around the home. Queens Meadow Care Home DS0000000181.V337064.R02.S.doc Version 5.2 Page 17 The last inspection report required replacement of baths and repairs to en suite rooms. The inspector saw that this work had been carried out. During the tour of the building, the inspector found the building to be clean, tidy and free from offensive odours. Queens Meadow Care Home DS0000000181.V337064.R02.S.doc Version 5.2 Page 18 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. This judgement has been made using available evidence including a visit to this service. The home has a settled and well-led staff team, in sufficient numbers to meet the needs of the people who currently live in the home. EVIDENCE: Examination of duty rotas indicated that there is a minimum of 1 senior supervisor in the home throughout the day. There is also a supervisor on each unit in addition to carers. At night there is a supervisor plus carers. Staff said that this is adequate. One relative commented, “The staff are nice, helpful and laugh and joke a lot”. The home had staff files in place, which provided evidence that the appointment of a new staff member is made through proper recruitment processes. This includes the vetting of staff through the use of references, POVA first checks and Criminal Record Bureau (CRB) checks. There is a commitment at the home to having a trained workforce with 18 out of the 24 care staff having completed NVQ level 2 or 3 training in care. One member of staff has commenced level 4. Catering, domestic and laundry staff have also been enrolled on an NVQ programme. Queens Meadow Care Home DS0000000181.V337064.R02.S.doc Version 5.2 Page 19 Recent training has taken place in first aid, moving and handling, food hygiene, health and safety, infection control, fire safety and dementia awareness. Staff said they found the dementia training particularly helpful in improving their day-to-day practice. The catering staff have had recent training with regard to nutrition. Queens Meadow Care Home DS0000000181.V337064.R02.S.doc Version 5.2 Page 20 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, 33, 35 & 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home has a registered manager who provides support and guidance to staff and residents. Health & Safety practices within the home may potentially place the people who live there at risk. EVIDENCE: There was an open and friendly culture between the management team and the staff at the home. Staff said that they felt well supported in their work and evidence in staff files confirmed that regular supervision of staff takes place and that staff are appraised. Service users and relatives confirmed that the manager was approachable and that they would go to her if they had any concerns. Queens Meadow Care Home DS0000000181.V337064.R02.S.doc Version 5.2 Page 21 Regular meetings are held and the company have a number of systems in place to consult service users. The manager confirmed that monthly audits by the company take place but there was no recent written evidence to confirm this. The administrator is responsible for the record keeping with regard to service user finances. She was able to identify the amount that each resident had in his or her account. The records for two people were checked and found to be in order. The manager confirmed that all equipment in the home is regularly checked. The maintenance certificates that were available at this inspection were found to be in order. However there was no evidence to confirm that the electrical wiring or the nurse call system had been checked. Bedroom doors were kept open by unauthorised means. These issues potentially place the people in the home at risk of harm. The registered provider was sent a letter after the inspection requiring these issues to be attended to as a matter of urgency. Queens Meadow Care Home DS0000000181.V337064.R02.S.doc Version 5.2 Page 22 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 2 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 3 X X 3 X 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 X 2 X 3 X X 2 Queens Meadow Care Home DS0000000181.V337064.R02.S.doc Version 5.2 Page 23 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 OP2 Regulation 5(1) Requirement The terms and conditions document must contain reference to the charges made for personal transport. A copy of the report following a Regulation 26 visit must be available within the home. (This is an outstanding requirement from the last inspection). Bedroom doors must not be kept open by unauthorised means. Several were held open with wedges and some had not been closed. The home must seek advice from the fire and rescue services with regard to this. The home must have an electrical wiring certificate. The manager told the inspector that this work was currently underway. A copy of the certificate must be supplied to the CSCI as a matter of urgency. (Regulation 13(4)). The certificate with regard to the maintenance of the nurse call DS0000000181.V337064.R02.S.doc Timescale for action 31/07/07 2. OP33 26 31/07/07 3. OP38 23(4) 11/05/07 4. OP38 13(4) 11/06/07 5. OP38 12 & 16 11/06/07 Queens Meadow Care Home Version 5.2 Page 24 system was out of date. This matter requires urgent attention. 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 Queens Meadow Care Home DS0000000181.V337064.R02.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Darlington Area Office No. 1 Hopetown Studios Brinkburn Road Darlington DL3 6DS 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 Queens Meadow Care Home DS0000000181.V337064.R02.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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