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Inspection on 09/05/06 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 9th May 2006.

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

Service users spoken to said that they liked living in the home and that staff generally treat them well. Comments included "The staff are great, you can ask them to do anything and it isn`t a trouble". "I really like living here, I wouldn`t want to move". "You can have a bath whenever you fancy, I had one this morning before I had my breakfast". "It`s smashing here, you can get the bus into town if you like, as long as you tell the girls where you are going, I feel really happy and safe". "We can choose when we go to bed, I like to be in my room after tea, ready for bed so I can watch T.V, the staff make sure I`m ok on a night time". The home has a good staff training programme in place.

What has improved since the last inspection?

There has been an improvement in the care planning process, however there is little evidence to confirm that service users have been consulted about them. Service users are now asked about the size of food portion they would like and have been involved in the recent change in menu. Most staff have now been trained in abuse, with the exception of new staff. The programme of refurbishment is ongoing, but the areas completed are to a good standard. A formal system for staff supervision is now in place. Some radiator guards have now been replaced.

What the care home could do better:

Each service user must receive a contract so that they are aware of the service that they can expect to receive. Service users must be consulted with regard to their care plans and evidence must be available to confirm that they have agreed to them. The temperature in the rooms where drugs are stored must be monitored on a daily basis. Suitable activities must be arranged which meets individual needs. The current programme of refurbishment must continue. All bedroom doors must be fitted with a lock. The damaged bath in the upstairs bathroom must receive attention. One of the bedrooms had damage to the wall and ceiling of the en suite facility, which must be repaired. A report must be available within the home following the Regulation 26 visit by the Registered Provider or their representative. Maintenance certificates must be available for inspection.

CARE HOMES FOR OLDER PEOPLE Queens Meadow Care Home 327 Stockton Road Hartlepool TS25 5DA Lead Inspector Mrs Sue Lowther Unannounced Inspection 10:00 9 May 2006 & 5th June 2006 th 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.V292325.R01.S.doc Version 5.1 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.V292325.R01.S.doc Version 5.1 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 61 Category(ies) of Dementia - over 65 years of age (31), Old age, registration, with number not falling within any other category (30) of places Queens Meadow Care Home DS0000000181.V292325.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. One named individual who is under the age category is allowed to reside in the home. One specified bedroom to be used to allow service users under the age of 65 years to have periods of rolling respite care. 1st November 2005 Date of last inspection Brief Description of the Service: The home was purpose built in 1991. Accommodation is provided for up to 61 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 £343 and £347 per week. Hairdressing and chiropody are not included in this. Queens Meadow Care Home DS0000000181.V292325.R01.S.doc Version 5.1 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 9th May 2006 & 5th June 2006. 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 and five service users and four relatives returned surveys to the CSCI. The inspection focussed on key standard outcomes for service users. What the service does well: What has improved since the last inspection? There has been an improvement in the care planning process, however there is little evidence to confirm that service users have been consulted about them. Service users are now asked about the size of food portion they would like and have been involved in the recent change in menu. Most staff have now been trained in abuse, with the exception of new staff. Queens Meadow Care Home DS0000000181.V292325.R01.S.doc Version 5.1 Page 6 The programme of refurbishment is ongoing, but the areas completed are to a good standard. A formal system for staff supervision is now in place. Some radiator guards have now been replaced. 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. Queens Meadow Care Home DS0000000181.V292325.R01.S.doc Version 5.1 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.V292325.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2, 3 & 4 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Some service users have not received a contract. Admissions to the home are well managed. Service users receive appropriate information about the home and their needs are assessed prior to admission. The home does not provide intermediate care and therefore assessment of Standard 6 is not applicable. EVIDENCE: Two of the people spoken to during the inspection process said that they had not received a contract and were unaware of the service they could expect to receive. Queens Meadow Care Home DS0000000181.V292325.R01.S.doc Version 5.1 Page 9 All service users are assessed prior to coming into the home. In addition to social service care manager assessments the manager normally visits the service user in their current place of residence. She advised the inspector that she would 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 service user recently admitted to the home was found to contain comprehensive information and 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. Queens Meadow Care Home DS0000000181.V292325.R01.S.doc Version 5.1 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Each service user has an individual care plan in place. However those examined did not contain evidence to confirm that they had been written with their agreement. Service user health needs are met by providing access to a range of other health and care professionals. The management of medication within the home is adequate with the exception of storage. Generally service users say that they are treated with respect and that their privacy is upheld. EVIDENCE: Queens Meadow Care Home DS0000000181.V292325.R01.S.doc Version 5.1 Page 11 The manager confirmed that all of the service users had care plans. Four were looked at during the course of the inspection. All could be more detailed in their content, but they give a reasonable idea of basic needs. The inclusion of social needs and individual likes and dislikes would improve the plans and give care staff more direction to meet all of the needs of the individual. Two of the service users spoken to said that they were aware of their plan of care, however where possible they should be signed to confirm that they have been written with their agreement. 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. The medications of four service users were checked. The temperature in the rooms used for storage of medication should be checked daily to ensure it does not exceed 25°C. The inspector spoke to four people who said that they usually receive the support and care they need. Service users said that staff are always polite to them and call them by the name they prefer. They also said that staff knock on bedroom doors and wait to be invited in. Queens Meadow Care Home DS0000000181.V292325.R01.S.doc Version 5.1 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Activities do not always match the expectations and preferences of service users. Service users are not always helped to have a choice about their lives. Relatives and friends can visit at any time. The meals are of a good standard. EVIDENCE: Four service users commented on activities. Three said that they were sometimes suitable and one said that they were never suitable. The manager told the inspector that the activities organiser had been on sick leave for sometime and staff arrange these at the moment. Relatives said that they could visit at any time and that they are always made welcome. However there is no evidence in the care plan to confirm that service users have been consulted about their care. Queens Meadow Care Home DS0000000181.V292325.R01.S.doc Version 5.1 Page 13 The lunchtime meal looked nice. Service users are now consulted with regard to food portions and have a choice. One service user said “The food is nice there is normally something on the menu for everyone’’. However one service user commented on the survey form “Sunday tea is a disgrace, it’s a buffet tea and most goes to waste. No one likes it”. The manager said that this had been brought to her attention and that she had changed the menu. Queens Meadow Care Home DS0000000181.V292325.R01.S.doc Version 5.1 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 17 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Complaints and adult protection systems in the home help to protect service users. EVIDENCE: Information about complaints, how and who to make them to, is made available to service users and their families through information displayed in the entrance to the home and in the ‘Service Users Guide’. Service users’ and families’ 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. One person said that they did not know how to make a complaint. The manager said that she would reinforce the process at the next meeting. The home has detailed complaints and adult protection procedures. Copies of these were seen to be available for staff use. Staff interviewed voiced a commitment to the service users they work with and to upholding service users’ rights. Policy and procedure documents relating to adult protection provide information and guidance to staff. Queens Meadow Care Home DS0000000181.V292325.R01.S.doc Version 5.1 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 21, 24 & 26 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home is currently being refurbished. Those areas completed were considered to be of a good standard. The bathroom facilities require review. EVIDENCE: During the tour of the building and whilst talking to people in their bedrooms, the inspector saw that service users could bring in their own furniture and belongings should they wish to do so. New doors are currently being fitted to every bedroom. The registered manager told the inspector that all would have a lock on completion, as required in the previous inspection report. Queens Meadow Care Home DS0000000181.V292325.R01.S.doc Version 5.1 Page 16 There was a range of specialist equipment seen around the home however the bath in one of the upstairs bathrooms was damaged. The en suite in one bedroom had damage to the wall and the ceiling. This was brought to the immediate attention of the manager. During the tour of the building, the inspector found the building to be clean, tidy and free from offensive odours. The people who responded to the questionnaire said that the home is always fresh and clean. One service said ‘’ I like my bedroom, it’s nice and clean, it gets done every day’’. Queens Meadow Care Home DS0000000181.V292325.R01.S.doc Version 5.1 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. 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 service users currently accommodated. Recruitment practices are robust and protect service users. There is a good staff training programme in place. EVIDENCE: Examination of duty rotas indicated that there are six staff on duty throughout the day on the upstairs unit and six staff on the downstairs unit. There is a minimum of 1 senior supervisor in the home throughout the day. There is also a supervisor on each unit. At night there is a supervisor and a carer on each floor with another carer working between the two floors. Staff said that this is adequate. Three service users said on the survey that staff are always available when they are needed and 1 said that they were usually available. One relative commented, “All staff are most caring and pleasant, cannot fault one, from the manager to the cleaners. All are exceptional in their care and duties, worth their weight in gold”. Queens Meadow Care Home DS0000000181.V292325.R01.S.doc Version 5.1 Page 18 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 17 out of the 32 care staff having completed NVQ level 2 or 3 training in care. Catering, domestic and laundry staff have also been enrolled on an NVQ programme. Staff said they found the training helpful in improving their day-to-day practice. Recent training has included infection control, dementia care, and the protection of vulnerable adult procedures, first aid, health and safety, team building and fire safety. Queens Meadow Care Home DS0000000181.V292325.R01.S.doc Version 5.1 Page 19 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36 & 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. There are policies in place to ensure service users’ financial interests are safeguarded. A system is in place to ensure staff are appropriately supervised. Health & Safety practices within the home may potentially place service users at risk. EVIDENCE: Queens Meadow Care Home DS0000000181.V292325.R01.S.doc Version 5.1 Page 20 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. One member of staff who had recently been promoted said that there was always plenty of support from the manager. Service users and relatives 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 service users. The manager confirmed that monthly audits by the company take place but there was no 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 were not available at the last inspection. Those which were available at this inspection were checked and found to be in order The manager said that all of the companies had been contacted and that plans were in place for the work to be done again and new certificates issued for those which could not be located. There are no outstanding issues from the Fire and Rescue service inspection. The Environmental Health Officer also visited the home on the first day of this inspection and requested amendments to some policies. Queens Meadow Care Home DS0000000181.V292325.R01.S.doc Version 5.1 Page 21 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 3 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 1 13 3 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 2 X 2 X X 2 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 3 X 2 Queens Meadow Care Home DS0000000181.V292325.R01.S.doc Version 5.1 Page 22 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)(b) Requirement Timescale for action 31/07/06 2. OP7OP14 15 Each service user must be supplied with a statement of terms and conditions in respect of accommodation to be provided for service users including the amount and method of payment of fees. All care plans must contain 31/08/06 evidence that service users have been consulted with regard to their care. (Previous requirement – timescale 31/01/06 not met) The temperature of the rooms 31/07/06 where medication is stored must be monitored on a daily basis to ensure that it is maintained below 25°(c) A suitable programme of 31/08/06 activities must be available for all service users. The programme of refurbishment 31/08/06 must continue to provide an adequate standard of accommodation for all service users. 3. OP9 13 4. 5. OP12 OP19 16(2)(m) &(n) 13, 16 & 23 Queens Meadow Care Home DS0000000181.V292325.R01.S.doc Version 5.1 Page 23 6. OP19 13, 16 & 23 All service users must be provided with locks on bedroom doors. Information must be available within care plans to confirm where a service user has requested not to have one. Where a discussion has taken place and a service user is considered to not able to use one, this information must also be contained in the plan. The damaged wall and ceiling in the en-suite of one bedroom must be repaired. The damaged bath in the upstairs bathroom must be repaired. A copy of the report following a Regulation 26 visit must be available within the home. The Registered Person must ensure that maintenance records are available for inspection. (Previous requirement-timescale of 31/01/06 not met.) 31/08/06 7. 8. 9. 10. OP19 OP21 OP33 OP38 23 23 26 17 & Schedule 4 31/08/06 31/08/06 31/07/06 31/08/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP24 Good Practice Recommendations It is recommended that the home continue to replace radiator guards to provide a more homely environment for service users. Queens Meadow Care Home DS0000000181.V292325.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Darlington Area Office No. 1 Hopetown Studios Brinkburn Road Darlington DL3 6DS National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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