Inspection on 31/08/06 for Streets Meadow

This inspection was carried out on 31st August 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 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

Streets Meadow 13/01/09

Streets Meadow 28/11/05

Streets Meadow 28/06/05

Streets Meadow 08/03/05

Streets Meadow 17/06/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Streets Meadow Hanham Road Wimborne Dorset BH21 1AS Lead Inspector Trevor Julian Unannounced Inspection 31st August 2006 10:15 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.V310380.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. Streets Meadow DS0000032210.V310380.R01.S.doc Version 5.2 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 60 Category(ies) of Dementia - over 65 years of age (60), Old age, registration, with number not falling within any other category (60) of places Streets Meadow DS0000032210.V310380.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Staffing levels must be those determined in accordance with guidance recommended by the Department of Health. One person in the category MD(E) may be accommodated to receive care. The home may from time to time, admit persons between the ages of 60 and 65 years of age. 28th November 2005 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 were completed in March 2006. 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 home consists of 4 units each accommodating a maximum of 15 residents. Two of the units are designed to accommodate people with specialist, dementia needs. The accommodation is provided on two floors. Each bedroom offers full ensuite including shower, each unit has its own specialist bathroom, communal lounges and dining rooms. Two passenger lifts provide level access to the first floor. At the time of the inspection the home had three of the units operational and were anticipating opening the forth unit at the end of September 2006 subject to staffing. Weekly fees, at the time of the inspection, were £360. Streets Meadow DS0000032210.V310380.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place on the 31st August 2006 between 10:15 and 16:30. Before the inspection, comment cards were received from residents (16), relatives (3), GPs (3), Community Healthcare team (5) and Care managers (4) giving their views of the home. The manager had completed a pre inspection questionnaire giving general information on staffing and levels of care. During the visit further information was obtained through discussion with residents, visitors, staff and management of the home. Records and procedures were also reviewed. The purpose of the visit was to monitor the service’s compliance with the key standards. What the service does well: Residents who had moved from the old building into the new premises told the inspector that the new rooms were extremely comfortable and well appointed. The comment cards received showed continued high levels of satisfaction with the care and support offered in the home. One person on respite care commented, “If possible I will probably come again. I thoroughly enjoyed my staff and found the staff very helpful”. The new premises were commented on by most of the people responding one likened the service to a 5 star hotel. New residents are only offered a placement once the senior staff have carried out an assessment to ensure that the needs of the resident can be met. Residents and visitors described the admission process as thorough and all responses showed they were provided with sufficient information about the home before deciding to accept the placement. The comment cards also showed that prospective residents were given a contract prior to admission. Care records were well maintained and there was evidence of residents’, or their representatives, involvement in the process. Comments from the GP’s and care managers showed the home maintained good links with community services one GP commented, “Well run, good staff – efficient and polite, high standards are achieved and the residents are well treated.” Streets Meadow DS0000032210.V310380.R01.S.doc Version 5.2 Page 6 The home encourages residents to join in with activities in the home. At the time of the visit most residents from one unit were going out for a pub lunch, other residents said this was an established feature and all those who took part enjoyed the outings. In addition to the trips out activities are organised in the units and are open to other units to join in. Entertainers also visited the home. With the forth unit to open the Authority had approved an additional part time activity co-ordinator post. People living in the home felt there was more than enough to keep themselves occupied. They also felt the standard of food was generally good with good variety and choice within the menu. During the visit chef was seen in one of the unit checking how the residents had found the meal. The home had systems for recording compliments and complaints and there was a procedure and training for staff in responding to signs of abuse. The home benefits from having a stable workforce providing good continuity of care for the residents. The recruitment procedures ensure that any new staff have the required clearances and references before starting their induction training. During the visit staff were seen spending time with the residents and a comfortable rapport was noted. The home is well managed and the Authority have systems to monitor the standards remain high. Fire safety precautions and training were up to date. Staff were trained in safe moving and handling techniques, food hygiene and health and safety. Accidents reports were monitored for any resident having falls and referrals made to community healthcare teams. 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.V310380.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 Streets Meadow DS0000032210.V310380.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The needs, wishes and preferences of people considering moving into the home are thoroughly assessed. This enables the home to make an informed decision about whether the home is able to meet assessed needs and supports residents to make a decision about moving into the home. EVIDENCE: The files of two new residents showed that the placement was offered following an assessment to ensure the home could meet the identified care needs. The assessment included all the recommended topics and helped the staff ensure that the home had the necessary resources to meet those needs. The home had recently admitted a short stay resident, her family were visiting and told the inspector that the placement had been arranged through the social work team and they had been happy with the process and were grateful that their relative was being well cared for. Streets Meadow DS0000032210.V310380.R01.S.doc Version 5.2 Page 9 The initial assessment allowed a care plan and risk assessment to be set up before admission. Streets Meadow DS0000032210.V310380.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 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 good. This judgement has been made using available evidence including a visit to this service. Care plans provide the staff with information about how individual care needs are addressed. The home maintains good links with community healthcare teams to help address any healthcare issues. The home has good systems in place in order to help protect the residents from medication errors. People living at Streets Meadow are treated with respect for their privacy and dignity. EVIDENCE: A random sample of records showed the good levels of care planning and risk assessment. Those files seen had regular reviews to ensure the documents remained current. There was also evidence of the care plan being agreed with Streets Meadow DS0000032210.V310380.R01.S.doc Version 5.2 Page 11 the resident or their representative. The care plan included information about social care but did not record spiritual/religious needs. Comment cards from the community healthcare teams and care managers demonstrate communication links with the home remain very good. Residents said that GPs and community nurses were called for any healthcare needs. The care records showed when referrals had been made and the outcome. During the inspection one community nurse was working with the staff to address an issue affecting a resident. The records showed regular nutritional monitoring. The home’s medication system was well thought out. Only senior staff who had completed accredited training were given the responsibility distribute the medication. Those residents able to manage their medication were assisted to maintain their independence. Stock levels were managed and held securely. There was a locked fridge for the storage of temperature sensitive medication. The medication records seen were up to date. When handwritten amendments were made these were checked by a second person to ensure there were no transcription errors. Photographs of the residents were available to help staff to identify the resident receiving the medication. The residents spoken to said that the staff were considerate and respectful. Throughout the visit the staff were seen treating the residents with dignity and respect while offering support as needed, this was also seen in the specialist care unit where some of the residents were helped with their meals in a relaxed and unobtrusive manner. There was plenty of discussion between the residents and staff. One visitor said she was impressed that clothing was generally returned to the rightful owner. Streets Meadow DS0000032210.V310380.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected 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 good. This judgement has been made using available evidence including a visit to this service. The home’s activity programme encourages the residents to join in with their preferred pastimes and it also aims to promote social interaction. Links with the family and community are encouraged to help the residents maintain their involvement and interest. The food provided in the home provided variety and choice for the residents and encouraged a balance diet. EVIDENCE: During the inspection, a group of residents left the home for a pub lunch. Other residents said that trips out were a regular feature in the home with different units being offered outings on rotation. One resident also commented that staff came in during their own time to assist. The home had recently organised a fish and chip supper for those people who preferred not to leave the home, the weather had been good so the meal was enjoyed in the rear garden. The home had one full time activity organiser and they were advertising for a part time assistant. Streets Meadow DS0000032210.V310380.R01.S.doc Version 5.2 Page 13 The residents said that the home provided and arranged regular activities to provide physical and mental stimulation. In one unit there was an organ which was played by an entertainer who visited the home regularly. There was also a table with partly completed jigsaw puzzle, the residents explained that they could all go to it and add a few pieces when they wished. Several people had daily newspapers delivered to the home. The salvation army were regular visitors to the home and there were arrangements for residents to receive communion. The home maintains links with local churches and can arrange support from a number of denominations. Church visitors collect some residents to help them attend Sunday services. The chef writes the daily menu in each of the dining rooms to help remind the residents of the choices offered. Records of the meals taken by individual residents were maintained. Comments cards showed the residents were generally very positive about the variety and quality of the food in the home. The meal seen at lunchtime was served from heated trolleys. The portions were varied according to the known preferences of the individual. One new resident told the carer that she had a food allergy and the member of staff made sure a suitable alternative was available while the information was checked for future meals. Fresh fruit was provided in each of the units and was accessible to the residents, staff said the fruit stocks were checked and replenished by the kitchen staff as part of a daily routine. One person did comment that the home had introduced a cooked breakfast once a week and hoped that this could be made available more often. Streets Meadow DS0000032210.V310380.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has systems for responding to complaints and adult protection issues. These systems and training help staff to respond correctly and to protect the residents. EVIDENCE: The home had a complaint’s procedure. Two complaints had been recorded and investigated within the home’s published timescale. The home also records the compliments from residents and families. The residents and visitors spoken to had not needed to use the formal complaints procedure and all said that any problems were promptly attended to by the manager and staff. All staff receive training in responding to adult protection matters and those spoken to were aware of their responsibilities. The Commission had not received and complaints or adult protection referrals for Streets Meadow. Streets Meadow DS0000032210.V310380.R01.S.doc Version 5.2 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 & 26 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The purpose built premises offer the residents’ high quality accommodation and a clean environment. EVIDENCE: The premises were opened early in 2006. The standard of accommodation is extremely good. All rooms exceed the spatial standards and each en-suite has easy access walk-in shower areas. The home has good access for wheelchair users. All areas of the home were well equipped and the premises had been assessed by an Occupational Therapist to ensure that relevant specialist equipment was in place. The residents and visitors were all very pleased with the accommodation, residents said they had settled into the new building and were enjoying the Streets Meadow DS0000032210.V310380.R01.S.doc Version 5.2 Page 16 extra space. They said that the gardens at the rear of the property were used by some of the residents during the warmer weather. During the tour of the premises, the home was clean and well aired. Through the design stage consideration had been given to infection control systems. The laundry was sited well away from food storage areas, all surfaces were easy clean and the room was equipped with commercial washing machines and dryers. Streets Meadow DS0000032210.V310380.R01.S.doc Version 5.2 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. Staffing levels were appropriate to meet the needs of the residents. The induction and ongoing training programme helps to ensure that the have the knowledge and experience to provide good standards of care. The recruitment process ensure the home employs suitable staff. EVIDENCE: The home had three of the four units open at the time of the visit. The forth unit was equipped and admissions were expected to start at the end of September, subject to staff recruitment. The staffing rosta showed staffing levels were appropriate to the needs of the residents. The home uses agency staff to cover unallocated shifts, during the previous eight weeks the average agency cover amounted to a full time care post. An agency member of staff said that she had regular shifts in the home and was Staffing records show the home benefits from a stable workforce, which helps good continuity of care for the residents. Records show that a high proportion of care staff have completed or are undertaking NVQ in care. Staff described Streets Meadow DS0000032210.V310380.R01.S.doc Version 5.2 Page 18 the training provided as very good any training needs were considered during their supervision meetings. The recruitment records showed that staff do not start work until the required clearances and references have been received. All new staff work through a structured induction programme. Streets Meadow DS0000032210.V310380.R01.S.doc Version 5.2 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 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who live at Streets Meadow live in a home that is well-managed by a senior team who possess the professional qualifications and experience to enable them to carry out there duties effectively, promoting high standards of service delivery. The home has procedures in place, which informally seek people’s views, feedback from which is used to promote the best interests of residents. However, the formal survey was due to be carried out within the first year. Residents’ financial interests are satisfactorily safeguarded. The health and safety of residents and staff are promoted. Streets Meadow DS0000032210.V310380.R01.S.doc Version 5.2 Page 20 EVIDENCE: The management team have the required skills qualification and experience to manage the home effectively. All the residents said that the senior staff were approachable and they were confident that they could discuss issues with any of the staff. The Authority carry out monthly visits to the home to ensure that standards are being maintained, reports of the visits were available in the home for inspection. Plans were in place to carry out a quality assurance survey, in January 2007, of the residents and others involved with the home. The home does not manage the finances for any of the residents, most residents do deposit cash with the administration staff to cover additional costs e.g. newspapers, hairdressing and chiropody. A check of the records and balances for a small sample showed the records were up to date and matched the balances held. There were internal audits in place to check for errors. Fire safety training and precautions were up to date and the records show the systems were maintained by approved contractors. During the registration checks were carried out to ensure that safety equipment used in the home was appropriately commissioned. The home had an accident reporting system in place and there was a falls chart to check for trends for individual residents. It was also suggested that the accident analysis be extended to monitor if accidents were occurring at particular times or in specific units. Streets Meadow DS0000032210.V310380.R01.S.doc Version 5.2 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 X 3 X X 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 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Streets Meadow DS0000032210.V310380.R01.S.doc Version 5.2 Page 22 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 Refer to Standard OP38 Good Practice Recommendations It was recommended that accident and incident reports analysis is developed to help identify further trends. Streets Meadow DS0000032210.V310380.R01.S.doc Version 5.2 Page 23 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 © 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 Streets Meadow DS0000032210.V310380.R01.S.doc Version 5.2 Page 24 - 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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