Inspection on 23/05/08 for Queens Meadow Care Home

This inspection was carried out on 23rd May 2008.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Queens Meadow Care Home 19/05/09

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 28/09/2008.

CARE HOMES FOR OLDER PEOPLE Queens Meadow Care Home 327 Stockton Road Hartlepool TS25 5DA Lead Inspector Tanya Newton Key Unannounced Inspection 09:45 23rd May 2008 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.V366032.R01.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.V366032.R01.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 59 Category(ies) of Dementia (16), Old age, not falling within any registration, with number other category (43) of places Queens Meadow Care Home DS0000000181.V366032.R01.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: 43 Dementia, over 65 years of age - Code DE, maximum number of places 16 The maximum number of service users who can be accommodated is: 59 10th May 2007 2. Date of last inspection Brief Description of the Service: 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 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 £424 and £429 per week. This does not include charges for hairdressing, chiropody, toiletries, personal newspapers and private transport. Queens Meadow Care Home DS0000000181.V366032.R01.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 1 star. This means the people who use this service experience adequate quality outcomes. This unannounced inspection of Queens Meadow took place on the 23rd May 2008. An observer from CSCI accompanied the inspector. Records were examined and a tour of the building took place. Time was spent talking to people living at the home, staff and visitors. The manager supplied some information prior to the inspection on a form called an AQAA. This is an annual quality assurance assessment for home’s to provide information about their service. The inspection focussed on key standard outcomes for people living at the home. We also checked whether requirements from the previous report had been met. What the service does well: What has improved since the last inspection? An activities coordinator has recently been appointed. This will provide additional social stimulation for people. The programme of refurbishment has been completed to provide a good, homely environment for the people who live there. The changes to the premises have improved the building. Policies have been updated and include whistle blowing, adult protection and complaints. These help to protect people. Queens Meadow Care Home DS0000000181.V366032.R01.S.doc Version 5.2 Page 6 Previous requirements from the last inspection report have in the main been met. 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.V366032.R01.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.V366032.R01.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. People who use the service experience adequate quality outcomes in this area. Assessment procedures are in place to ensure that the home can meet the needs of the people who live there. We have made this judgment using a range of evidence, including a visit to this service. EVIDENCE: All of the people who live in the home have a contract. Contracts provide people with information about the level of fees and what is included within them. Contracts had been updated to reflect the cost of private transport. Everyone is assessed prior to living in the home. In addition to social services assessments the manager normally visits the person in their current place of residence. Queens Meadow Care Home DS0000000181.V366032.R01.S.doc Version 5.2 Page 9 Three assessments were viewed. Assessments provide staff with basic information about how people’s needs will be met by the home. Some of the assessments viewed had gaps in the recording of information these should be updated. One person who had been admitted to the home recently said, “I was given lots of information and I have settled well,” another said, “ I was able to look around before moving in”. The home does not admit people for intermediate care. Queens Meadow Care Home DS0000000181.V366032.R01.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. People who use the service experience adequate quality outcomes in this area. Documentary evidence within care plans needs to be improved to ensure people’s health and personal care needs are met fully. We have made this judgment using a range of evidence, including a visit to this service. EVIDENCE: Three care plans were viewed. They contained varying levels of detail and although they contained assessments to determine risks such as waterlow for pressure care, nutrition and manual handling where high risks were identified they did not always have sufficient risk management to demonstrate what the home were doing to minimise those risks. Social assessments were blank in some files and there was little evidence of input from people living at the home or their relatives. One person said, “Care plans, yes I know I have one”. Queens Meadow Care Home DS0000000181.V366032.R01.S.doc Version 5.2 Page 11 Evidence was seen in files of involvement from other people for example district nurses, doctors, and care managers to confirm that other professionals are involved. One person said, “We are well cared for and always have nice clean beds. We can see people like GP’s, as we need them”. The medication records of three people were checked. One of the people’s medications had been signed as attempted but not given; the reasons for this had not been recorded on the back of the MAR sheet. The manager and staff member said that normally the reasons why would be recorded, but due to other difficulties during the shift that day that this had been overlooked. All controlled drugs were checked, the amounts tallied with the Controlled drugs book. The drug fridge needed to be defrosted to make sure that medication is stored safely. People spoken to during the inspection said that they were treated with dignity and respect. They said that staff always knock on bedroom doors and call them by their preferred name. Staff also gave examples of ways in which people’s privacy and dignity were being maintained. One person said, “Privacy and dignity is great no problems they are they are all very good to us”. Queens Meadow Care Home DS0000000181.V366032.R01.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. People who use the service experience adequate quality outcomes in this area. People would like further opportunities to be involved in social activities. Records should demonstrate how people are able to make choices and decisions about their lives. We have made this judgment using a range of evidence, including a visit to this service. EVIDENCE: The home has just employed an activities co-ordinator for 20 hrs per week. This person is not yet in post. On the day of the inspection the manager confirmed that staff are currently providing activities for 1.5 hours each day. Comments about the activities being provided were varied some people said that they enjoyed them and that there was plenty going on others said that they were bored and that they would like more opportunities for social activities. Activities include bingo, sing a longs, quizzes and trips out. People also said that they were able to sit outside when the weather was nice. Comments included “Socially could do with more entertainment, we do need Queens Meadow Care Home DS0000000181.V366032.R01.S.doc Version 5.2 Page 13 more. We go in the garden and you can go out its not a problem” and “Sitting here morning till night, not much going on, a couple of turns not very often”. People were asked about visiting arrangements, which are flexible. One of the comments from a visitor included, “We are made welcome to the home, its lovely I will put my name down”. Visitors can see people in their own rooms or in any of the communal areas available throughout the home. Although most of the people spoken to during the inspection said that they could make choices and decisions documentary evidence within care plans did not support this. A number of people had “none” recorded under social needs. One person said, “Well we please ourselves we can make choices”. Comments about the food were good. The menu on the day of the visit was fish and chips and people said that they were tasty. Specialist diets are catered for and include menus for diabetics and soft menus. Staff supported those who needed help during mealtimes in a sensitive manner. One person said, “The food is good, no complaints”. Queens Meadow Care Home DS0000000181.V366032.R01.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. People who use the service experience good quality outcomes in this area. The people who live in the home can be confident that their concerns and complaints are dealt with appropriately and sufficient safeguards are in place to protect them from abuse. We have made this judgment using a range of evidence, including a visit to this service. 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”. The home had received six complaints since the last inspection. All complaints are recorded along with any action taken. The manager says that she has an open door policy. One person said, “I could tell someone if there was a problem as the manager is very pleasant”. The home had a basic adult protection procedure, which did not contain sufficient information to support staff in making a referral should this be required. The manager said that all of their policies were being reviewed and updated by an external company. A copy of the updated policy on adult protection was received following the inspection. The policy on whistle blowing also needed to be updated. Again a copy of the updated policy was received Queens Meadow Care Home DS0000000181.V366032.R01.S.doc Version 5.2 Page 15 following the inspection. The staff spoken to during the inspection were asked about abuse and what they would do if they saw or heard anything inappropriate. All said that they would tell the manager or make a referral themselves. Training is provided for all staff in adult protection. Queens Meadow Care Home DS0000000181.V366032.R01.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 & 26. People who use the service experience good quality outcomes in this area. 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. We have made this judgment using a range of evidence, including a visit to this service. EVIDENCE: There have been a number of positive changes to the premises. A new dining room has been added to the dementia unit and a spacious lounge area is now provided. Bays have been fitted onto windows and the garden area has been improved making it a nice place for people to sit outside in the warmer weather. All bedrooms that were seen were personalised with people’s own items. All rooms have en-suite facilities. Queens Meadow Care Home DS0000000181.V366032.R01.S.doc Version 5.2 Page 17 There was a range of specialist equipment seen around the home to support people with bathing and mobility. 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.V366032.R01.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. People who use the service experience good quality outcomes in this area. 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. Training is provided for all staff. We have made this judgment using a range of evidence, including a visit to this service. EVIDENCE: There is a minimum of one 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. Some staff felt that the staffing numbers were insufficient due to the needs of the people living at the home. One person said, “Staff numbers are not always sufficient most people need support from two carers. This has been raised with the manager. 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. Queens Meadow Care Home DS0000000181.V366032.R01.S.doc Version 5.2 Page 19 There is a commitment at the home to having a trained workforce with 16 of the 22 staff having an NVQ at level 2 or above. Training is provided for all staff. As well as mandatory training staff can identify personal training needs. Staff comments in this area were positive. Comments from staff included “Morale is good and there are lots of opportunities for training” and “Good training, we are able to support each other”. Queens Meadow Care Home DS0000000181.V366032.R01.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, 36 & 38. People who use the service experience good quality outcomes in this area. The home’s registered manager provides clear leadership, support and guidance to those living and working at the home. We have made this judgment using a range of evidence, including a visit to this service. EVIDENCE: The manager has the required qualifications and experience and is competent to run the home. She promotes equal opportunities. There was an open and friendly culture between the management team and staff working at the home. Staff said that they felt well supported in their work. There was some evidence in staff files to show that supervision was Queens Meadow Care Home DS0000000181.V366032.R01.S.doc Version 5.2 Page 21 taking place and that the staff were being appraised. However supervision should take place more frequently. All staff should receive a minimum of six sessions every year. People living at the home and visitors who were spoken to during the inspection confirmed that the manager was approachable and that they would go to her if they had any concerns. Regular meetings are held and the company have a number of systems in place to consult with people living at the home. The manager confirmed that monthly Regulation 26 audits by the company do take place but there was no recent written evidence to confirm this. This was raised in the previous two inspection reports and must be addressed. The AQAA contained very limited information. This was discussed with the manager during the inspection. A random check was carried out on three people’s money, all contained receipts and were accurately recorded. 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. Health and Safety checks are carried out regularly to safeguard people living and working at the home. Queens Meadow Care Home DS0000000181.V366032.R01.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 3 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X 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 2 X 3 Queens Meadow Care Home DS0000000181.V366032.R01.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 OP7 Regulation 15 Requirement All care plans must contain sufficient evidence to ensure people’s health and personal care needs are met fully. This must include risk management strategies. All care plans must contain sufficient evidence to ensure people’s health and personal care needs are met fully. This must include risk management strategies. Social activities must be provided for people and be based on their interests. Autonomy, choice and decisionmaking must be included within care plans. A copy of the report following a Regulation 26 visit must be available within the home. (This is an outstanding requirement from the last 2 inspections). A copy must also be sent to the Commission each month. DS0000000181.V366032.R01.S.doc Timescale for action 15/07/08 2. OP8 15 15/07/08 3. OP12 16 m & n 15/07/08 4. OP14 12 15/07/08 5. OP33 26 30/06/08 Queens Meadow Care Home Version 5.2 Page 24 Previous timescale of 31/07/07 not met. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. Refer to Standard OP3 OP9 OP36 Good Practice Recommendations All assessments should contain sufficient detail to ensure that people’s health and personal care needs are met fully. The drug fridge should be defrosted regularly to make sure that medication is stored safely. All staff should receive a minimum of six supervision sessions each year. Queens Meadow Care Home DS0000000181.V366032.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB 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.V366032.R01.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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