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Inspection on 15/08/07 for River Meadows Nursing Home Limited

Also see our care home review for River Meadows Nursing Home Limited for more information

This inspection was carried out on 15th August 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

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

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

What the care home does well

The home has very good information and admission procedures to enable anyone thinking about choosing to live at River Meadows will meet their needs. The home has the benefit of a core of committed staff that works hard on a day-to-day basis to meet the practical needs of the people living at River Meadows. The staff team build good relationships with the people who live at the home, their families and supporters. One person who lives at the home stated, ` I like the people here, I am very happy living at River Meadows care home.` One of the home`s major strengths is the excellent way the team make sure residents are encouraged to participate in a variety of activities which suit their tastes, preferences and abilities.

What has improved since the last inspection?

It is positive to report that the ongoing efforts of the management team has resulted in all seven statutory requirements made at the key inspection in March 2007 being fully met. Care plans are now set up in an easy to use format which benefits both the residents, their relatives and staff as there are now written records to show what care has been planned and carried out. These records also show evidence of regular involvement of the person they are written about. The full introduction of the Springcare company policies now mean the home has satisfactory systems in place to safeguard all aspects of a person`s lifestyle. The ongoing plans to maintain and improve the home continue. The reception area is in the process of a revamp, and the provision of garden furnishings and seating to patio areas has provided pleasant external space for residents to enjoy. The appointment of two `in-house` trainers by the company has meant mandatory training for staff has improved, and a lot of additional specialist training is planned for the coming months. The ongoing support and monitoring by the company area managers has enhanced the update of the home health and safety policies to ensure any accidents are properly managed.

What the care home could do better:

There were no requirements made at this inspection. It is considered that River Meadows has raised its standards and is setting its own objectives for continual improvement with the full involvement of its residents.

CARE HOMES FOR OLDER PEOPLE River Meadows Nursing Home Limited Edgebolton Shawbury Shrewsbury Shropshire SY4 4EL Lead Inspector Janet Adams Key Unannounced Inspection 15th August 2007 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address River Meadows Nursing Home Limited DS0000022268.V342745.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. River Meadows Nursing Home Limited DS0000022268.V342745.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service River Meadows Nursing Home Limited Address Edgebolton Shawbury Shrewsbury Shropshire SY4 4EL 01939 250700 01939 250118 river.meadows@hotmail.co.uk 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) Springcare (River Meadows) Ltd Mrs Ann Elizabeth May McMullen Care Home 44 Category(ies) of Old age, not falling within any other category registration, with number (44), Physical disability (13) of places River Meadows Nursing Home Limited DS0000022268.V342745.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home may accommodate a maximum of 44 persons, of whom 13 may be persons with a Physical Disability. 2nd March 2007 Date of last inspection Brief Description of the Service: River Meadows is a Care Home Registered with the Commission for Social Care Inspection (CSCI) to provide accommodation, nursing and personal care, for a total of up to 44 older people and young adults, of whom one may have learning disability, and ten may have a physical disability. The home also currently accommodates two pet cats. The home is in the village of Edgebolton, on the outskirts of Shawbury with good road links to the larger towns in North Shropshire. There is a limited bus service which runs near the home from Wellington and Shrewsbury. Set in its own grounds, the home enjoys views of the surrounding countryside from most aspects of the building. It is a prime site for bird watching. The accommodation comprises an original two storey converted country house, and a more recently added purpose built single storey wing. The home is divided into two ‘wings’ and has a variety of communal areas comprising of three communal lounges, and a conservatory. Work is due to start on an eleven bedded extension to the home in the very near future. The majority of bedrooms are for single occupancy, and many benefit from en suite facilities. All areas are maintained and furnished to a good standard, providing welcoming and comfortable surroundings. The home is set in wellmaintained grounds with lawns, flowerbeds, and seating areas, which are accessible to residents of various physical abilities. The home is owned by Springcare Ltd, the Managing Director being Mr Lee Cox. Springcare Ltd makes the services of River Meadows known to prospective residents in their statement of purpose, and its brochure/service user guide. A copy of the most recent CSCI report is also freely available at the entrance of the home for people to look at. The current fees charged vary between £405 and £680 per week depending on the care, support and accommodation provided. Additional charges to service users are for hairdressing, toiletries, and newspapers. River Meadows Nursing Home Limited DS0000022268.V342745.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection was carried out by one inspector and lasted seven hours. The main purpose of the inspection was to follow up progress made since the last inspection at the beginning of March 2007, which resulted in the home having to provide CSCI with a detailed plan of how systems in the home were to improve. Some time before the inspection was carried out, CSCI wrote to the home to request comment cards is circulated to residents, relatives and any visiting professionals, to assist with this process. This meant that although River Meadows knew the inspection was imminent, they were not aware of the date or time the inspection would be carried out. The inspection included observing activity within the home, inspecting the premises, an ‘in depth look’ at records for residents and staff, as well as observing, talking and listening to over half of the 40 people living there. Several of the staff on duty at the time of the inspection also shared their views about working at River Meadows. Discussions with people were carried out in private with people on their own, or together in groups in the lounges. Everyone was happy to share valid comments, which are included in the main body of the report. A total of eleven residents made written comments about the home to CSCI. Everyone, including residents and staff, was very welcoming and helpful throughout the inspection. A total of 28 out of a possible 38 National Minimum Standards for Older People were assessed on this occasion. Discussions with the management team took place throughout and feedback about the conclusions of the inspection was given at the end of the inspection day. What the service does well: The home has very good information and admission procedures to enable anyone thinking about choosing to live at River Meadows will meet their needs. The home has the benefit of a core of committed staff that works hard on a day-to-day basis to meet the practical needs of the people living at River Meadows. The staff team build good relationships with the people who live at the home, their families and supporters. One person who lives at the home stated, River Meadows Nursing Home Limited DS0000022268.V342745.R01.S.doc Version 5.2 Page 6 ‘ I like the people here, I am very happy living at River Meadows care home.’ One of the home’s major strengths is the excellent way the team make sure residents are encouraged to participate in a variety of activities which suit their tastes, preferences and abilities. What has improved since the last inspection? 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. River Meadows Nursing Home Limited DS0000022268.V342745.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 River Meadows Nursing Home Limited DS0000022268.V342745.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): 1,3 & 4. Quality in this outcome area is good. Admission procedures clearly demonstrate the home can meet needs of people thinking about moving into River Meadows. This makes sure if prospective residents and relatives choose this home, it will meet their needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Springcare, the Registered Providers for the service have introduced a new corporate styled information pack for prospective residents, which contains the home Statement of Purpose and Service User Guide. It is presented in an eye catching, easy to read and understand folder. It has been fully updated to comply with recent changes of The Care Homes Regulations of September 2006.Copies of this information were seen available on display in the reception area of the home. An in depth look at the admission records of 2 people admitted to the home since the last inspection confirmed that good standards of recordkeeping have River Meadows Nursing Home Limited DS0000022268.V342745.R01.S.doc Version 5.2 Page 9 been maintained for this matter. Details seen written down confirm staff collect as much information as is necessary for the home to decide whether they can meet the person’s personal and health care needs before they move in. In addition to using a comprehensive form to record a detailed assessment of a person’s needs, the home also use an ‘admission checklist’ when the person moves into the home which the staff sign and date to demonstrate any newcomer gets welcomed with the right information about River Meadows. All eleven people who sent written comments to CSCI confirmed they received enough information about the home before they moved in. One person wrote, ‘I was able to visit the home prior to moving in and my family had also visited several times.’ River Meadows Nursing Home Limited DS0000022268.V342745.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 Quality in this outcome area is good. The health and personal care carried out by River Meadow’s support team is based on the specific needs of the person, making the individual feel valued and unique. The principles of respect, dignity and privacy are put into practice. The medication at this home is safely managed to make sure it promotes good health for residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The majority of written comments received about the care carried out for the residents of River Meadows were complimentary. 100 of the people who made comments to CSCI stated they received the medical support they need, and 90 of comments received confirmed the staff listen and act on what the residents say although 9 of comments indicated River Meadows Nursing Home Limited DS0000022268.V342745.R01.S.doc Version 5.2 Page 11 there was a problem with people having to wait for call bells to be answered on occasions. One person wrote to CSCI to say, ‘They are always ready to help me’, whilst another wrote,’ ‘ I am happy here in general. There are times when things don’t go to plan but that is life! Information provided by the home before the inspection stated ‘All service user documentation has been updated and changed to corporate company standards’ In order to check out this comment, an in depth look at the records of three people living at the home who have a variety of support and nursing needs was carried out. Residents were happy to spend time to share the contents of their care records and talk about them to CSCI.A ten minute discussion with one person living in the home confirmed she knew all about her care records and what was written down about her since she was admitted to the home earlier this year. All relevant risk assessments had been kept up to date, and contained enough detail to keep the individual safe whilst promoting personal well-being and independence. One person pointed out the details of the nutritional risk assessment for her special diet and volunteered that she had been fully involved in the paperwork being completed for this matter. Attention to details in the care records now show there is a good ‘pen picture’ of peoples daily needs being carried out, and the records describe any health care needs being met. For example, the records for a person requiring wound care for an abscess had clear details to describe how it was being treated, and the progress of how the wound was healing. In another set of care records the paperwork to monitor blood glucose testing for a person with diabetes was meticulous. All care records had evidence of monthly checking by senior team members including the home manager and two company area managers. It was positive to see ongoing improvements in the care plan paperwork in response to this auditing. The above positive findings confirmed that health and personal care and its necessary paperwork had greatly improved. Three requirements made to get these matters put right at the March 2007 inspection have now been fully met. Assessment of the home medication management systems showed they also continue to improve .One very knowledgeable staff member took the time to show how they were following good practice guidance recommended by CSCI in order to improve their monthly audits of medication. It is positive to report the company conducted its own ‘in –house’ medication audit to make sure systems could be improved even further. The home has robust systems in River Meadows Nursing Home Limited DS0000022268.V342745.R01.S.doc Version 5.2 Page 12 place to make sure all drugs no longer in use are safely destroyed, as well as thorough monitoring systems for syringe use. River Meadows Nursing Home Limited DS0000022268.V342745.R01.S.doc Version 5.2 Page 13 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14, &15 Quality in this outcome area is excellent. People who use services are able to make choices about their life style, and supported to develop their life skills. Social, educational, cultural and recreational activities meet individual’s expectations. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Inspection findings were of a similar high standard to those standards seen at the last 4 inspections. Three staff members currently share the responsibility of planning and organising activities at River Meadows. One person wrote ‘my relative enjoys the activities, is often taken on outings and the staff are very enthusiastic’. Another commented ‘ I am not a sociable person but if I want to do things I can’ In addition, the three sets of files looked at had evidence that activities are now being focussed on the personal interests and well-being. River Meadows Nursing Home Limited DS0000022268.V342745.R01.S.doc Version 5.2 Page 14 This improvement to record keeping now shows that activities are based on people’s preferences and needs and social contact they wish to make with families and friends. All people spoken to said the best recent changes to activities were the increased number of outings that were carried out. Complementary therapy including reflexology has also been introduced more regularly as people who are less active enjoy this treatment. The home also takes advantage of being a member of the Shropshire Senior Citizen forum to share and explore ideas to vary day-to-day life at the home. The owners of River Meadows, Springcare also produce a newsletter – Issue 2 was seen to be freely available around the home. This also contains activities and competitions as well as raising people’s awareness to the company news. Observations and discussions with staff on duty confirmed they were knowledgeable about people’s dietary needs, and the best way to serve their residents’ food so they can dine independently. All residents who made comments about the meal provision were in agreement that the food was very good, and they always had plenty of choice of alternative options if they did not fancy the main meal of the day. One person who accepted the offer of second helpings of his favourite dish of sweet and sour pork commented ‘now that can’t be bad, can it!’ Discussion with the cook confirmed she gets regular verbal and written comments about the quality of the meals, and she always incorporates any suggestions when the seasonal menus are prepared. One resident also wrote, ‘We are fortunate in having an excellent chef who copes very well with all different diets people require. She will always do her best to meet special requests’. However some other residents made comment that there were a lot of casseroles and stews on the menu at present, and when asked about how food was served two people made comments that the cruet sets sometimes only contained pepper. River Meadows Nursing Home Limited DS0000022268.V342745.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 &18 Quality in this outcome area is good. People who use the service are able to express their concerns, and have access to a robust, effective complaints procedure, are protected from abuse, and have their rights protected. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Review of the complaints management system shows that the company welcomes this type of issue in order to improve the service it provides. The information to welcome complaints and comments is clearly displayed in communal areas of the home. The service has a complaints procedure that is up to date, clearly written, and is easy to understand. All written comments received from people living at the home and those spoken with said they would know who to talk to if they wanted to make a complaint. One person commented, ‘I have always found speaking to directly to the matron gets things sorted rather than if I spoke to a nurse or a carer.’ Two concerns have been raised within the home since the last inspection, and are clearly accounted for in the home complaints register, and confirm the River Meadows Nursing Home Limited DS0000022268.V342745.R01.S.doc Version 5.2 Page 16 comments in the information the home sent to CSCI before the inspection that they: • Respond and react to complaints quickly and efficiently. • Endeavour to ensure any little issue raised is attended to before it becomes a complaint. The home has fully implemented the ‘Springcare’ company complaint tracking and auditing systems. A company area manager checks these at least monthly. Improvement in staff training and the home management now show the home works hard to make sure satisfactory systems are in place to safeguard residents. It is positive to be informed that 35 out of 42 staff members have attended training for safeguarding adults this year, and the remaining 7 have their training dates booked. Improvements in communication in the home ensure all new and temporary staff including agency workers gets an appropriate health and safety introduction to the home. The company have a policy and forms to complete for temporary staff members for this matter, for both trained nurses and carers complete. These were seen completed for new staff names seen on rotas. River Meadows Nursing Home Limited DS0000022268.V342745.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 21 22, & 26. Quality in this outcome area is good. The physical design and layout of the home enables people who use the service to live in a safe, well-maintained and comfortable environment, which encourages independence. This judgement has been made using available evidence including a visit to this service. EVIDENCE: All residents who made comments to CSCI about the home were unanimous to confirm the home always smelled fresh and had a welcoming, clean and tidy appearance. One person wrote, ‘We have very hardworking housekeeping staff who not only keep the rooms nice and clean but help the residents’. River Meadows Nursing Home Limited DS0000022268.V342745.R01.S.doc Version 5.2 Page 18 The home has an ongoing programme to keep it maintained, and ongoing work to improve internal and external areas of the home were seen in progress during the tour of the home. The entrance area to home was in process of being revamped to give more of a hotel reception atmosphere, and to create more space for wheelchair access. A courtyard area has a new gazebo, potted shrubs and raised flower beds to give residents a pleasant outlook from various parts of the home. However staff did express disappointment of poor workmanship of another newly laid patio area – The company engaged to carry out the work had done such a bad job it had been deemed unsafe for people to access. At the end of July 2007 as a result of a flood, one of the heating boilers had been damaged and was still awaiting repair. Discussions with staff confirmed lifestyle in home not been disrupted by this incident too much, although residents have to use bathing facilities on the ground floor of the home instead of their preferred choice of bathroom. This incident had not affected the hot water temperatures. Random testing of these showed they remain maintained within safe limits in the region of 43 degrees Centigrade, and the home records confirmed they continue to get checked at least weekly. It was seen that damaged bath surfaces in communal bathrooms have received some temporary attention to ease cleaning until they can be replaced. Some of the specialist seating in the home, which had signs of wear and tear at the last inspection, have deteriorated and now pose an infection control and fire safety risk. A pressure relieving cushion and two armchairs were seen in this condition during the tour of the home, however immediate action was taken to rectify this and within two days of the inspection the registered manager wrote to CSCI to confirm they had been either repaired or replaced. The inspector saw in excess of 14 bedrooms. All were well furnished, decorated, maintained and adapted to meet the wishes of the people who occupied them. A shared bedroom seen had good systems to keep people’s belongings including toiletries separate. Residents met in their rooms stated that they were satisfied with the cleanliness and décor. It was positive to see where bedrails were installed on a bed, that a thinner mattress had been used with a pressure relieving mattress to ensure the bedrails height was adequate. Inspection of the laundry and kitchen showed that all health and safety measures were being carried out to make sure these important areas were being kept in a safe clean and hygienic condition. Some areas of unsatisfactory storage of combustible waste and paint tins seen in the grounds of the home were safely disposed of by the end of the inspection. River Meadows Nursing Home Limited DS0000022268.V342745.R01.S.doc Version 5.2 Page 19 The Springcare newsletter also confirmed that work is to start shortly on an eleven bedded extension, which has been in the planning pipeline for some time. River Meadows Nursing Home Limited DS0000022268.V342745.R01.S.doc Version 5.2 Page 20 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 Quality in this outcome area is good. Staff in the home are trained, skilled and in sufficient numbers to support the people who use the service, in line with their terms and conditions, and to support the smooth running of the service. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Rotas examined for the fortnight before and after the inspection confirmed the home is adequately staffed with the appropriate skills of nurses and carers to meet the needs of residents. It is positive to comment the rotas clearly identified the full names, roles and responsibilities of staff including the hours worked in the home by the manager. Some agency staff are still employed at the home, and during the week of the inspection four shifts had been covered by these staff on day and night duty. Examination of the records of the only new starter since last inspection demonstrated a robust recruitment and vetting process for this matter. It was positive to see a ‘New Employee Training Programme’ record in the person’s records. River Meadows Nursing Home Limited DS0000022268.V342745.R01.S.doc Version 5.2 Page 21 It is also positive to report that many aspects of staff training has improved in recent months. The information the home provided before the inspection confirmed that 52 of the care team have the minimum expected care qualification, and that 32 of the care team are in the progress of attaining this qualification. Springcare, the company who owns the home have employed two trainers to assist with this process and it was reported they were settling well into their new roles. Feedback from staff who had attended the training they have already provided was reported to be positive. The home now have devised a new ‘at a glance’ training tracker form which has been kept up to date and shows progress the staff team have made with their training and development. Review of four sets of staff records confirmed that training certificates seen in their files matched the training recorded in the training tracker tool. The files of two members of staff who had worked at the home for some time had appropriate recordkeeping to show they had received appraisals and had identified their training needs to keep them up to date with meeting the needs of the people they care for at River Meadows. River Meadows Nursing Home Limited DS0000022268.V342745.R01.S.doc Version 5.2 Page 22 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): 31,32, 33, 35,36, 37 &38 Quality in this outcome area is good The management and administration of the home is based on openness and respect, with effective corporate quality assurance systems. A competent company management team closely supports the manager to ensure the effective running of the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Following the last inspection in March 2007, although some progress had been made to improve standards at River Meadows, CSCI were concerned at the length of time it was taking for permanent changes to happen. As a result the home were requested to provide an improvement plan to demonstrate actions they would be taking to get the home ‘back on track.’ River Meadows Nursing Home Limited DS0000022268.V342745.R01.S.doc Version 5.2 Page 23 Findings at this inspection confirmed all the efforts, actions and work the home committed to carry out as they stated on the improvement plan in April 2007 have been completed. The combined efforts of the management team and its staff have resulted in major improvements in all aspects of the home management systems. It is positive the home has had the support and guidance of two Springcare Area Managers who carried out monthly quality audits that identified remedial actions the home had to achieve in order to meet the targets they had set themselves to show it was being run for the best interests of all the people living, visiting and working there. Thorough auditing on all aspects of home management including care plan records, medications, complaints, accidents, and the environment itself has been carried out. Records of staff meetings and supervision sessions show the staff team have been motivated and encouraged to embrace all training offered. A system launched to keep a check that all staff get the supervision they need has been successfully established. A revised method of the way the home manages all monies and valuables held in safekeeping for its residents now assures CSCI this aspect of resident well being is safeguarded. Review of the paperwork and records for the regular maintenance of essential equipment such as lifts and hoists show this to be all in order. The home has its own maintenance man who has been issued with a corporate maintenance record book to make sure all essential checks for tasks such as emergency lighting are carried out. It is positive that several aspects of Health and Safety management have improved. Excellent recordkeeping systems to monitor accidents are now in place and assure people that all steps are taken to prevent them from happening again. For example, anyone who has a fall has a diary to record such an incident and the resident is fully involved in decision making about what can be done to prevent any further falls. The home is also making good progress to meet the requirements of the last inspection by Shropshire Fire and Safety Service in October 2006. River Meadows Nursing Home Limited DS0000022268.V342745.R01.S.doc Version 5.2 Page 24 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 X 3 3 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 4 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 4 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X 3 3 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 4 3 X 3 3 3 4 River Meadows Nursing Home Limited DS0000022268.V342745.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? NO 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. 4. Refer to Standard OP22 Good Practice Recommendations All bathroom facilities used by service users must be easy to clean and in good repair. This includes the surfaces of the baths. River Meadows Nursing Home Limited DS0000022268.V342745.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Shrewsbury Local Office 1st Floor, Chapter House South Abbey Lawn Abbey Foregate SHREWSBURY SY2 5DE 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 River Meadows Nursing Home Limited DS0000022268.V342745.R01.S.doc Version 5.2 Page 27 - 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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