CARE HOMES FOR OLDER PEOPLE
Streets Meadow Hanham Road Wimborne Dorset BH21 1AS Lead Inspector
Trevor Julian Unannounced Inspection 28th November & 6th December 2005 01:15 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 Streets Meadow DS0000032210.V270047.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. Streets Meadow DS0000032210.V270047.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Streets Meadow Address Hanham Road Wimborne Dorset BH21 1AS 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) 01202 884620 01202 849906 Dorset County Council Marie Foden Care Home 49 Category(ies) of Dementia - over 65 years of age (15), Old age, registration, with number not falling within any other category (34) of places Streets Meadow DS0000032210.V270047.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. All works specified by Dorset Fire and Rescue Service must be undertaken and confirmed as satisfactory by 31 July 2003. One person, whose name and circumstances are known to the Commission, and who has mental health needs may be accommodated and provided with personal care. Staffing levels must be those determined in accordance with guidance recommended by the Department of Health. 28th June 2005 3. Date of last inspection Brief Description of the Service: Streets Meadow is a residential care home operated by Dorset County Council. Marie Foden manages the home. The purpose built premises date back to the 1970s. Work was well advanced to replace the existing accommodation with a new home that will achieve national minimum standards. The registration allows for the accommodation of 34 older people and up to 15 older people with dementia. While the building work is in progress the home has voluntarily restricted numbers to a maximum of 41. The staff provide personal care and support, the community nursing team carries out any nursing tasks. The home is close to the town centre of Wimborne and has good public transport links available nearby. The accommodation is provided on three floors. The bedrooms are all offered for single occupancy, communal lounges are sited on each floor. A passenger lift provides level access to each floor. A temporary garden, with seating, had been established at the rear of the property. Streets Meadow DS0000032210.V270047.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The unannounced inspection was started on Monday 28th November 2005 and was concluded on 6th December 2005. The visit was the second of two statutory inspections; for key standards not covered in this report please refer to the previous visit. As the home was to be replaced early in 2006 accommodation standards were not assessed in detail. During the visit, information was gained through discussion with residents, visitors and staff. Further evidence was gathered through a tour of the premises and examination of records. For the purpose of this report, the terms resident and service user are interchangeable. What the service does well:
Residents felt there were good levels of choice in their daily lives. The home did not manage the finances for any of the residents and no one had support from independent advocacy services although the manager would seek support for individuals if needed. Most people deposited personal allowances with the home’s administration staff for personal expenditure e.g. hairdressing, chiropody etc. The staff kept records of expenditure along with receipts, staff carried out internal checks to ensure that any errors could be rectified. The organisation had a training programme for the staff which included specialist training in a range of subjects including Dementia. Staff said the training programme offered good quality training and was accessed through discussion at supervision meetings. Residents said that the home was well managed and the senior team were approachable. Streets Meadow DS0000032210.V270047.R01.S.doc Version 5.0 Page 6 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. Streets Meadow DS0000032210.V270047.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 Streets Meadow DS0000032210.V270047.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): Not assessed during this inspection. Please refer to the previous inspection. EVIDENCE: Streets Meadow DS0000032210.V270047.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): Not fully assessed during this inspection. EVIDENCE: During the previous visit it was noted that some care plans were not updated after there had been changes in equipment provided for individual service users. Following that inspection there had been a review of all files to ensure the care plans accurately identified any specialist equipment provided. Streets Meadow DS0000032210.V270047.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): 14, 15 Residents are encouraged to make choices according to their individual circumstances. The quality of food provided was of a good standard although there were issues raised about the portion size and choice of some meals. EVIDENCE: During the visit, several residents said they were able to express good levels of choice in the home. The manager did not assist any of the residents with their finances instead it was managed by their family, friends and solicitors. None of the residents used independent advocacy services. Several residents commented that the home’s choices for breakfast could be improved. The matter was discussed with the Authority’s catering manager who felt that the situation would improve once the new premises were operational as there would be better stock levels. The catering budget was discussed, this was set below the industry average and provided challenges to the chef. The inspector was advised that the budget was flexible and there could be overspend if needed.
Streets Meadow DS0000032210.V270047.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): Not assessed during this inspection. EVIDENCE: Streets Meadow DS0000032210.V270047.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): Not assessed during this visit. EVIDENCE: Streets Meadow DS0000032210.V270047.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): 28 The home’s staff were appropriately trained to meet the needs of the residents. EVIDENCE: The home had met the target with at least 50 of care staff trained to NVQ level 2 in care or above. In addition, the staff had access to a range of specialist training including Dementia Care, Adult Protection, Fire Safety, etc. Staff felt the training programme offered a good range of courses for their development. They discussed training needs during supervision meetings with their line managers. Residents said that the staff were competent at their jobs and they were confident in their abilities. Streets Meadow DS0000032210.V270047.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, 33, 35 The home is well managed by the senior team who are experienced in managing residential services. The home has systems for obtaining the views of the residents these need to be extended to other stakeholders. Procedures were in place to protect the residents from the risk of financial abuse within the home. EVIDENCE: The senior management team at the home had a variety of qualifications and experience. An audit should be carried out to ensure that the team have the relevant qualifications. The manager had managed the home for some time and was highly thought of by the residents.
Streets Meadow DS0000032210.V270047.R01.S.doc Version 5.0 Page 15 The Authority had a system for monthly monitoring visits to the home in order to ensure standards were being maintained. Copies of the reports were sent to the home’s manager and CSCI. The home had not carried out a Quality Assurance survey but one is planned in 2006 once the move to the new premises had been completed. Following the survey a development plan will be drawn up. Most residents had deposited personal allowances with the home’s administration staff for hairdressing, chiropody, etc. A sample showed transaction records were up to date, and there were receipts for expenditure. Balances held matched the transaction records and there were internal audits to identify any errors. Streets Meadow DS0000032210.V270047.R01.S.doc Version 5.0 Page 16 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 X X X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 X 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X X X X X X X X X STAFFING Standard No Score 27 X 28 3 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 X X X Streets Meadow DS0000032210.V270047.R01.S.doc Version 5.0 Page 17 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. 1 2 3 Refer to Standard OP15 OP31 OP33 Good Practice Recommendations The register provider should give consideration to a review of the catering budget to ensure that residents are afforded choice of food and portion size at all times. There should be an audit to ensure that the management team have appropriate qualifications. The home should carry out a quality assurance survey in order to develop an annual service improvement plan. Streets Meadow DS0000032210.V270047.R01.S.doc Version 5.0 Page 18 Commission for Social Care Inspection Poole Office Unit 4 New Fields Business Park Stinsford Road Poole BH17 0NF National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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