Inspection on 19/05/09 for Queens Meadow Care Home

This inspection was carried out on 19th May 2009.

CQC found this care home to be providing an Adequate service.

The inspector found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Queens Meadow Care Home 23/05/08

Queens Meadow Care Home 10/05/07

Queens Meadow Care Home 09/05/06

Queens Meadow Care Home 04/10/05

Queens Meadow Care Home 10/05/05

Queens Meadow Care Home 22/11/04

Queens Meadow Care Home 23/08/04

Similar services:

Turret Villa Retirement Home

Moor House

Mendip House

Beaconsfield Court Care Home

Little Sisters Of The Poor

Manor House

Middleton Hall Ltd

Middlesbrough Intermediate Care Centre

Extracts from inspection reports are licensed from CQC, this page was updated on 15/11/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Queens Meadow Care Home 327 Stockton Road Hartlepool TS25 5DA     The quality rating for this care home is:   one star adequate service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Jane Bassett     Date: 0 2 0 6 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: Queens Meadow Care Home 327 Stockton Road Hartlepool TS25 5DA 01429267424 01429405167 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : T L Care Ltd care home 59 Number of places (if applicable): Under 65 Over 65 0 43 dementia old age, not falling within any other category Additional conditions: 16 0 The maximum number of service users who can be accommdoated is: 59 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: 43 Dementia, over 65 years of age - Code DE, maximum number of places 16 Date of last inspection Brief description of the care home The home was purpose built in 1991. Accommodation is provided for up to 59 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 its 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 Care Homes for Older People Page 4 of 28 Brief description of the care home mobile. Several spacious lounge and dining areas are also available. Care Homes for Older People Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. This inspection was a key inspection. As a key inspection, all of the key standards were looked at or discussed. This was to check that the home meets the standards that the Care Quality Commission ( CQC) say are the most important for the people who use services, and that it does what the Care Standards regulations say it must. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations - but only when it is Care Homes for Older People Page 6 of 28 considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. The inspection took place over 2 days. The visit on the first day was unannounced. The inspection visit lasted a total of nine hours. During this time the inspector looked at a range of documentation including, service user and staff files. The inspector spoke to five people who live at the home, two family members, a community nurse, four staff members and the manager. Three people who live at the home returned surveys to CQC. The manager of the home completed an Annual Quality Assurance Assessment (AQAA). At the time of the inspection the home was providing services to 42 people. The last key inspection took place on 23/05/08. What the care home does well: What has improved since the last inspection? What they could do better: The registered person must ensure a comprehensive assessment including all areas of need ie continence is carried out, to ensure peoples needs are fully met. Assessments, risk assessments and plans of care should be developed further to include details of the persons abilities and preferences in relation to the identified need and how this is to be met. Reviews of plans of care and risk assessments should be developed further to include a more comprehensive evaluation. Records for people who live at the home would benefit from further development to include peoples social needs and how these are met. The date of opening of medicines with a limited use, should be recorded , to make sure that medicines are not used beyond the date recommended by the manufacturer. Appropriate training must be given to staff who administer creams and ointments. All policies and procedure should be reviewed to ensure they are relevant and reflect the service provided. The policy and procedure in relation to reporting concerns and safeguarding would benefit from further development to include details of local arrangements and contact details for reporting concerns to the appropriate authority. Consideration should be given to refurbishment of bathrooms and shower rooms and this should include the provision of a suitable and safe heating system. Where possible references must be sought from the persons last employer, to promote the safety and wellbeing of people who use the service. Risk assessments should be carried out and recorded in relation to concerns identified during the recruitment of any staff. Staff should receive six formal supervisions in 12 months and these recorded. Care Homes for Older People Page 8 of 28 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 28 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home has procedures that should ensure that prospective service users have their needs assessed. Evidence: During discussion with the manager she was able to describe the process that is followed to obtain information about a prospective service users needs including, an assessment from the care manager if that person is funded by a local authority. The manager told the inspector people are encouraged to visit the home where ever possible prior to admission. The inspector examined the file for one person who had recently been admitted as an emergency. This was found to contain information from the persons care manager and other health professionals. Care Homes for Older People Page 11 of 28 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People have access to health care services both within the home and in the local community. There is evidence of plans of care, assessments and interventions, however there are some gaps in information. Staff generally think in a person centered way when considering an individuals care needs. Medication records are generally up to date. Evidence: During the visit the inspector looked at the files of 4 people who live at the home. Each was found to contain life histories and evidence of assessment of need that had been carried out and reviewed regularly. However these did not include an assessment for that persons continence. Files seen contained evidence that people did require some assistance with this. Moving and handling assessments seen stated the correct hoist and sling must be used, however there was no detail as to which hoist and sling where appropriate. There was some evidence that people and their families had been involved in reviews. Plans of care and risk assessments seen were pre printed with gaps to add some detail Care Homes for Older People Page 12 of 28 Evidence: such as the persons name. These were seen to be generic and contained little or no detail of the needs of that individual, their abilities and how staff meet that need. For example plans of care state needs assistance but does not give specific details of what assistance or how to give it. One file contained a risk assessment in relation to the use of bed rails, this stated the person must be observed at all times which may not be realistically achievable. The risk assessment also stated that bed rails were only to be used with the written permission of the next of kin. There was no evidence that this had been obtained. Care plans and risk assessments were seen to be reviewed regularly, however these would benefit from development to include more detail of evaluation. A number of documents in the files were not dated or signed, it was therefore not possible to establish if the information was current and relevant. Files contained evidence of involvement from GPs, Community nurses and other health professionals. Staff who spent time with the inspector were able to demonstrate a good knowledge of peoples needs, and how they prefer needs to be met. A number of people who live at the home spent time with the inspector and confirmed they were happy with how the care is given. One person said staff are wonderful another said staff are really good, they are always helpful. The inspector observed good interactions between staff and people who live there. Requests were seen to be dealt with in a friendly but respectful manner. During the visit a member of the community nurse team spoke to the inspector. She commented on the good standard of care they had observed and the proactive approach of the staff. Comments in surveys returned to CQC by people who live at the home and their representatives included overall the staff are very caring,and the majority of the carers are excellent. Information in the AQAA returned to CQC indicated the home has a policy in relation to the safe handling of medication. The inspector was told by staff that it is only senior care staff who have completed safe handling of medication training who administer medication. An sample audit of MAR (medication administration records) found no gaps in recording and charts clearly indicated if the medication was not contained in the blister packs. A senior care assistant told the inspector that they sign for the application of creams but it is not always them that administers this. Staff who administer creams and ointments must have the appropriate training and must sign for the administration. A number of open eye drops and tubes of ointments were found not to have a date of opening or details of who the medication had been prescribed for. The senior care staff on duty disposed of these. A controlled drug was found to be stored in the medication trolley. The senior care Care Homes for Older People Page 13 of 28 Evidence: staff on duty carried out stock audit of this medication, recorded it in the appropriate records and stored it in the appropriate cupboard. All other controlled medication was seen to be recorded and stored appropriately. Care Homes for Older People Page 14 of 28 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service are able to make choices about their lifestyle. Social and recreational activities meet individuals expectations. Evidence: During the visit the inspector examined the files of four people who live at the home, these were seen to include little detail of the persons social needs and how these are to be met. The home employs an activities co ordinator 5 days per week. People who live at the home told the inspector they were satisfied with the activities that were provided and these meet their needs. One person spoke of frequent sing a longs, quizzes and bingo. Another told the inspector they had regular visits from entertainers and film shows. One gentle man showed the inspector the garden area where he does some gardening. People who live at the home and some family members who spoke to the inspector told her there was always a warm welcome, staff are very friendly and get to know everyone very well. Comments in surveys returned to CQC included nice atmosphere when you go in, friendly staff and there are plenty of activities for all to join in if you wish. Care Homes for Older People Page 15 of 28 Evidence: The inspector was told people can make choices in their lifestyles and how they spend their days. Staff who spent time with the inspector demonstrated a good knowledge of individuals, their likes and dislikes. The inspector noted people were given the opportunity to participate in the electoral process if they so wished. People who spent time with the inspector told her the meals are of a good quality and there are always choices. One person said the food is magic. A lunch time meal was observed this was seen to be well presented, served in pleasant surroundings and unrushed. Staff were seen to be available to assist as required. Care Homes for Older People Page 16 of 28 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service are able to express their concerns and have access to a complaints procedure, are protected from abuse and have their rights protected. Evidence: Information in the AQAA returned to CQC indicated the home has a policy in relation to handling complaints and had received 2 complaints in the previous 12 months, one of which was upheld. Records seen by the inspector indicated complaints are recorded appropriately. People who spoke to the inspector told her they were aware of how to raise any concerns if they should have any. All said they were satisfied with the care and support they receive, one person said they feel perfectly comfortable with everything. Comments in surveys returned to CQC included staff talk and listened to all residents and family, deal with any complaints. Staff records seen on the day of inspection indicate staff have received training in relation to prevention of abuse and safeguarding. Information in the AQAA indicated there had been one referral made to safeguarding in the previous 12 months and staff at the home had taken appropriate action. Staff who spoke to the inspector confirmed they had received training and were able to demonstrate through response to questions the actions they would take to report any concerns. All demonstrated a commitment to promoting peoples safety and wellbeing. The policy and procedure in relation to reporting concerns and safeguarding would Care Homes for Older People Page 17 of 28 Evidence: benefit from further development to include details of local arrangements and contact details for reporting concerns to the appropriate authority. Care Homes for Older People Page 18 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides a clean and comfortable environment for the people who live there. People are generally satisfied with the facilities provided however refurbishment of bathrooms and shower rooms would further enhance peoples comfort. Evidence: During the visit the inspector walked around the building. On the day of inspection the home was found to be clean, and odour free. Peoples rooms were seen to be personalized to taste. One person told the inspector they liked their nice room. Another person said its always clean and tidy. Comments in surveys returned to CQC indicated the home was usually always clean, however toilets can be smelly. The inspector noted the bathrooms and shower rooms were impersonal and would benefit from refurbishment. A number of bathrooms had no heating. One ground floor shower room had a step into the shower tray, restricting its use. The enameling on one bath and the attached seat were seen to be damaged. Comments in one survey returned to CQC included there is no heating in the bathroom which can be very cold in the winter. Information in the AQAA returned to CQC indicated the home and equipment are maintained as required. Care Homes for Older People Page 19 of 28 Care Homes for Older People Page 20 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff at the home are trained and in sufficient numbers to support the people who use the service. Evidence: During the visit the inspector examined the files of 4 staff members. Two of these files were for people who had recently been recruited to work at the home. Both were found to contain evidence of application form, references and CRB (Criminal Record Bureau) check carried out prior to employment commencing. However references in one of the files included a reference from a colleague at the last place of employment and not the employer. The inspector discussed with the manager the need to develop a policy and procedure regarding the documentation of risk assessment in relation to any concerns identified during the recruitment process. Evidence in staff files and other documentation seen by the inspector indicated staff have undergone training in fire safety, moving & handling, first aid, safeguarding, health & safety and infection control. A number of staff have completed training in relation to the mental capacity act, equal opportunities, safe handling of medication, and dementia awareness. Staff who spoke to the inspector confirmed this. Information in the AQAA indicated 18 of the 24 care staff have completed NVQ at level 2 or above. Care Homes for Older People Page 21 of 28 Evidence: Staff who spoke to the inspector confirmed that some formal supervision has taken place and there were regular opportunities for informal supervision. People who spoke to the inspector told her there were sufficient staff to meet their needs. A staffing rots seen by the inspector indicated there were usually 6 care staff on duty on a morning (including 2 senior care), 5 care staff (including 2 senior care) on an afternoon and evening, and 4 care staff (including 1 senior) overnight. Care Homes for Older People Page 22 of 28 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The management and administration of the home is based on openness and respect and has quality assurance systems. Evidence: The manager is suitably qualified and experienced. Staff who spoke to the inspector told her communication is good and they have regular informal supervision. The manager told the inspector formal supervision has commenced. The inspector saw evidence of Regulation 26 visits and reports, however these had not been carried out on a monthly basis. The manager carries out audits of care plans and medications. People who live at the home and relatives who spoke to the inspector all said they were satisfied with the care and support they receive. All said that the manager and staff were approachable and any issues raised are acted upon. Comments in surveys returned to CQC by people who live at the home and their representatives included The staff talk and listen to all residents and family and the Care Homes for Older People Page 23 of 28 Evidence: majority of carers are excellent. One person who spoke to the inspector told her the staff are great and helpful another said the boss is very fair. Records seen indicated that accidents are recorded appropriately and analysis takes place. A sample audit of monies held by the home on behalf of people who live there found no discrepancies between amounts recorded and money held. Records seen contained two signatures and receipts. Information contained in the AQAA returned to CQC indicated the home has a range of policies and procedures. Policies should be reviewed to ensure they reflect the care provided by the home, for example the file seen contained a policy in relation to catheterisation. Staff at the home are not trained or qualified to carry out this procedure. Other information seen indicates the home and equipment are maintained as required. Care Homes for Older People Page 24 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 25 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 7 14 The registered person must ensure a comprehensive assessment including all areas of need ie continence is carried out. To ensure peoples needs are fully met. 30/09/2009 2 9 13 The registered person must 30/09/2009 ensure staff who administer prescribed creams and ointments recieve the appropriate training and sign for each administration. To promote the health and wellbeing of people. 3 9 13 Prescribed creams, 30/07/2009 ointments and eye drops must be administered from a named container. To promote the health and wellbeing of people. Recommendations These recommendations are taken from the best practice described in the National Care Homes for Older People Page 26 of 28 Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 7 Assessments, risk assessments and plans of care should be developed further to include details of the persons abilities and preferences in relation to the identified need and how this is to be met. Records of care needs assessment, risk assessment and plans of care should be dated and signed to identify if the information is current and relevant. Reviews of plans of care and risk assessments should be developed further to include a more comprehensive evaluation. The date of opening of medicines with a limited use, should be recorded to make sure that medicines are not used beyond the date recommended by the manufacturer. Records for people who live at the home would benefit from further developement to include peoples social needs and how these are met. The policy and procedure in relation to reporting concerns and safegurading would benefit from further development to include details of local arrangements and contact details for reporting concerns to the appropriate authority. Consideration should be given to refurbishment of bathrooms and shower rooms and this should include the provision of a suitable and safe heating system. Regulation 26 visits should take place on a monthly basis. Policies and procedure should be reviewed to ensure they are relevant and reflect the service provided. Staff should receive six formal supervisions in 12 months and these recorded. 2 7 3 7 4 9 5 12 6 18 7 19 8 9 10 33 33 36 Care Homes for Older People Page 27 of 28 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 28 of 28 - 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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