Inspection on 11/10/05 for River Meadows Nursing Home Limited

This inspection was carried out on 11th October 2005.

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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

River Meadows Nursing Home... 15/08/07

River Meadows Nursing Home... 02/03/07

River Meadows Nursing Home... 25/10/06

River Meadows Nursing Home... 01/02/06

River Meadows Nursing Home... 11/10/04

River Meadows Nursing Home... 18/06/04

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Maple Lodge

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Inspirations

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Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE River Meadows Nursing Home Limited Edgebolton Shawbury Shrewsbury Shropshire SY4 4EL Lead Inspector Keith Salmon Announced Inspection 11th October 2005 09:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address River Meadows Nursing Home Limited DS0000022268.V256440.R01.S.doc Version 5.0 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. River Meadows Nursing Home Limited DS0000022268.V256440.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service River Meadows Nursing Home Limited Address Edgebolton Shawbury Shrewsbury Shropshire SY4 4EL 01939 250700 01939 250118 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) Golbourne Healthcare Limited Ms Ann Elizabeth May McMullen Care Home 44 Category(ies) of Dementia (1), Old age, not falling within any registration, with number other category (33), Physical disability (10) of places River Meadows Nursing Home Limited DS0000022268.V256440.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. The home must comply with the Staffing Notice issued by Shropshire Area Health Authority dated 24 October 2001. The home may accommodate a maximum of 44 service users. The home may accommodate a maximum of 43 Elderly Persons, of whom 10 may be Persons with a Physical Disability. The home may accommodate one person, aged under 65 with Dementia, who is named in the attached Schedule (not to be displayed). 11th October 2004 Date of last inspection Brief Description of the Service: River Meadows is a Care Home Registered with the Commission for Social Care Inspection to provide accommodation, nursing care and personal care, for a total of up to 44 older people and young adults. The Home is in the village of Edgebolton, on the outskirts of Shawbury with good road links to the larger towns in North Shropshire. Set in its own grounds, the Home enjoys views of the surrounding countryside from most aspects of the building. The accommodation comprises an original two storey converted country house, and a more recently added purpose built single storey wing. All areas are maintained and furnished to a high standard, providing welcoming and comfortable surroundings. The Home is set in well-maintained grounds with lawns, flowerbeds, and seating areas, which are accessible to Residents of various physical abilities. River Meadows Nursing Home Limited DS0000022268.V256440.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This Announced Inspection commenced at 09.00, lasted 5 hours, and was undertaken by one Inspector. This Report is a product of observations made during a tour of the Home and through discussions with the Area Manager, Registered Manager, other members of Staff, and a total of 10 Residents. In addition, a review of care related documentation, staff recruitment/ deployment records, and a range of documents/records reflecting the general operation of the Home was also undertaken. Prior to the change of ownership the Home enjoyed a reputation for providing generally good standards of direct care provision, delivered competently and sensitively with Service Users expressing their satisfaction with the manner in which they are treated. Under the new Ownership and Management care provision standards have been maintained, with some areas of management practice showing a marked improvement. The overall ambience of the Home presents a very friendly and open atmosphere. This is strongly reflected in 23 ‘comment cards’ received from Residents and their Relatives, and in ‘one to one’ discussions with Residents. Comments written or made verbally to the Inspector included…. “Care and treatment has been excellent…”, “…The Staff are always available and make great efforts to help us…”, “…There is a good atmosphere at the Home…” ”…I enjoy my food. I have just what I like. I have been a Resident for many years, and I love it…” What the service does well: What has improved since the last inspection? There has been an overall improvement in the organisation and performance of management practices particularly in relation to medicines administration, staff training and care planning documentation. River Meadows Nursing Home Limited DS0000022268.V256440.R01.S.doc Version 5.0 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. River Meadows Nursing Home Limited DS0000022268.V256440.R01.S.doc Version 5.0 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 River Meadows Nursing Home Limited DS0000022268.V256440.R01.S.doc Version 5.0 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): 1,2,3,4 & 5 Prior to admission to the Home prospective Residents are enabled to reach an informed choice, and to fully understand the service they can expect. Processes to ensure appropriate, thorough, and effective care needs assessment are diligently undertaken and applied. EVIDENCE: The Home has a Statement of Purpose and User Guide, both of which are concise and easy to read, with content, which clearly meets the requirements of the Standard. Service Users are provided with a Statement of Terms and Conditions detailing the accommodation to be provided. Evidence from 10 randomly selected Care Plans, and discussions with Residents, clearly demonstrated the Registered Manager, or Deputy Manager, assess all prospective Residents/Service Users prior to admission, and new Residents have the opportunity to visit the Home, or enter the Home on a trial basis, prior to admission. River Meadows Nursing Home Limited DS0000022268.V256440.R01.S.doc Version 5.0 Page 9 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 The model of Care Plan utilised by the Home is of an excellent design. It is diligently, and effectively, utilised in aiding the provision of care, pertinent to Residents’ assessed care needs. Care provided by the Home successfully meets the Residents’ assessed care needs. Staff relate to Residents in a friendly and respectful manner. Practices relating to the storage, administration and disposal of medicines have improved markedly since the previous Inspection and are now fully in accordance with accepted good practice. EVIDENCE: Residents’ care documentation includes:- full pre-admission assessment carried out by suitably qualified staff, well-organised, clearly written and up-todate care plans, and recently revised Policies and Procedures. Individual discussions held by the Inspector with Residents and ‘Comment Cards’ completed by Residents and Relatives confirmed that Resident’s needs are being met. A detailed Inspection of practices relating to the management of medicines showed marked improvement in this area. River Meadows Nursing Home Limited DS0000022268.V256440.R01.S.doc Version 5.0 Page 10 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 Commendably the Home works hard and effectively at involving all Residents in a comprehensive range of leisure opportunities, consistent with each Resident’s capabilities. Residents are actively assisted in maintaining contact with relatives, friends and the local community, and the continuation of religious practices. The Home provides a daily choice of attractive and nutritious meals. EVIDENCE: Individual care plans show a detailed record of each Resident’s involvement in a wide range of leisure activities, both within the Home and in the local community. Leisure activities are planned and conducted by two members of staff employed as Activities Co-ordinators who, between them, cover Monday to Friday. The Home has a 5 week menu cycle, planned by the chef, which provides two full menu choices per day, and is responsive to individual likes and dislikes. Residents expressed total satisfaction with the meals provided at the Home. River Meadows Nursing Home Limited DS0000022268.V256440.R01.S.doc Version 5.0 Page 11 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 The interests of Residents are protected through ready access to the Home’s Complaints Procedure, and information relating to advocacy services. Staff are aware of their role in protecting Residents from abuse. EVIDENCE: Complaints procedure details are included in the Service User Guide and are displayed prominently for the benefit of visitors. There are policies and procedures in place intended to provide protection for vulnerable people. These fully meet the requirements of this standard and the topic is covered both at induction and through on-going staff training. River Meadows Nursing Home Limited DS0000022268.V256440.R01.S.doc Version 5.0 Page 12 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): 19,20,21,22,23,24,25 & 26 The Home’s lounge/sitting and dining areas offer a good variety of size and outlook, with furnishings being of good order, and presenting a ‘domestic’ ambience. Much of the carpeting, whilst still being serviceable and satisfactory in appearance, will need replacement in the near future. (The management recognises this need and all ‘public area’ carpets are to be replaced during the coming months). Infection control policies/procedures are satisfactory. Specialist equipment is available to facilitate provision of care consistent with the needs of the Service Users, and with the demands of tasks carried out by Care Staff. The gardens provide a safe environment, easily accessible to all Service Users at all times of year. EVIDENCE: The Home has a full range of maintenance contracts in place, and an on-going refurbishment/redecoration programme for bedrooms as they become vacant. Extensive redecoration of ‘public areas’ is almost complete. The Home has recently installed a sluice machine, incorporating a disinfecting cycle, and the standard of cleanliness in the Home is excellent. The garden has level paved areas enabling easy walks or wheelchair use. River Meadows Nursing Home Limited DS0000022268.V256440.R01.S.doc Version 5.0 Page 13 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. Staff numbers and skill-mix on duty were consistent with that shown on the rota, and were sufficient to meet the assessed care needs of the current Residents. Recruitment and employment practices are consistent with safeguarding of Residents. The new ownership/management has established an excellent commitment to providing introductory and on-going NVQ training for Care Staff. EVIDENCE: The current Staff Rota, and those from the immediately preceding weeks, were examined and confirmed staffing levels to be in accordance with Conditions of Registration. A sampling of Staff Personnel Files demonstrated evidence of full compliance with the Standard and Schedule 2 of the Regulations. The Home previously had a poor record in encouraging/enabling staff to undertake NVQ studies. Staff ‘Training Files’ now indicate all Staff are now subject to a thorough, and relevant, 12 weeks orientation/induction programme. The Home now requires all Staff, following orientation/induction, to undertake NVQ training at a level appropriate to work undertaken, e.g. Care Staff at a minimum of Level 2, and Support Staff having the opportunity to commence Level 1. As a result, 75 of Care Staff who have not yet completed NVQ Level 2, are currently working towards that attainment. Comments made by Residents and Visitors, relating to Staff, were very positive reflecting appreciation of care provided. River Meadows Nursing Home Limited DS0000022268.V256440.R01.S.doc Version 5.0 Page 14 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): 31,32,33,36 & 38. The Home has excellent leadership from the Manager, who is very well supported by the Parent Company. The ambience of the Home is warm, friendly and inclusive. Operationally, the Home is very well organised, with the clear central purpose being ‘the best interests of Residents’. Lines of accountability are clearly set and observed. Staff are subject to effective support with regular ‘supervision, and appear involved and happy in their work. EVIDENCE: The Registered Manager has been in-post since January 2005, and has successfully completed the NVQ Level 4 (Management) qualification. The Inspector observed Residents and Staff were able to approach the Manager with a range of issues, which were received in an interested and involved manner. In turn the Registered Manager is well supported by the Company’s Area Manager. In the context of health, safety and welfare of Residents, Visitors, and Staff the Home’s practices were seen to be in accordance with the Regulations. River Meadows Nursing Home Limited DS0000022268.V256440.R01.S.doc Version 5.0 Page 15 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 4 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 x x 3 x 3 River Meadows Nursing Home Limited DS0000022268.V256440.R01.S.doc Version 5.0 Page 16 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP28 Good Practice Recommendations That a minimum of 50 of care staff achieve an NVQ 2 in care award. River Meadows Nursing Home Limited DS0000022268.V256440.R01.S.doc Version 5.0 Page 17 Commission for Social Care Inspection Shrewsbury Local Office 1st Floor, Chapter House South Abbey Lawn Abbey Foregate SHREWSBURY SY2 5DE 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. Extracts may not be used or reproduced without the express permission of CSCI River Meadows Nursing Home Limited DS0000022268.V256440.R01.S.doc Version 5.0 Page 18 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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