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Inspection on 10/02/06 for The Mead

Also see our care home review for The Mead for more information

This inspection was carried out on 10th February 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

Since the previous inspection a lot of work has been done to improve all aspects of the home. The new manager has implemented new policies and procedures in order to raise standards of care. Feedback from service users was very good. One service user said ` I have been here for six weeks and I love it! The carers are like angels, they are very kind and they look after me very well`. Care plans offer comprehensive information about service users needs and regular reviews are now taking place in order to ensure that service users changing needs can continue to be met. Care practice observed was sensitive and dignified.

What has improved since the last inspection?

The refurbishment of most of the areas within the home offers a bright, clean atmosphere. Soft furnishings, pictures and ornaments provide a homely environment. The morale of service users and staff has lifted and the ambience in the home was light and relaxed. Service users were observed enjoying the company of carers. Procedures relating to universal Infection control have improved and staff were observed following safe procedures in order to prevent the spread of infection and malodours. The home appears to have a better working relationship with GP`s and district nurses. Nurses visiting the home are offering preventative advice to carers, which reduce the risk of pressure areas and other issues.

What the care home could do better:

One service user was observed walking around with no slippers on and staff did not know if the reasoning was included in the service users care plan. Service users also generally appeared to require more assistance and prompting with oral hygiene.

CARE HOMES FOR OLDER PEOPLE The Mead Castleford Close Borehamwood Hertfordshire WD6 4AL Lead Inspector Alison Jessop Unannounced Inspection 10th February 2006 17:00 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 The Mead DS0000019580.V282950.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. The Mead DS0000019580.V282950.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service The Mead Address Castleford Close Borehamwood Hertfordshire WD6 4AL 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) 0208 953 8573 0207 313 3961 www.quantumcare.co.uk Quantum Care Limited 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 Physical disability over 65 years of age (60) The Mead DS0000019580.V282950.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 27th July 2005 Brief Description of the Service: The Mead is a two storey, purpose built residential care home for older people. It is situated in a quiet residential area of Borehamwood. Access to local shops, public transport and other local amenities are a short walk away. The home is built in a horseshoe shape around a courtyard garden, there is ample off road parking. Four separate suites each offer accommodation to fifteen residents. Bedrooms are designed for single occupation and each has an en-suite toilet and wash hand basin. There is one communal lounge and a dining area in each suite. Communal bathrooms are spacious and accommodate assisted baths and showers. There is a hairdressing salon and a guest room. The home also has a day centre however this is not inspected by the Commission for Social Care Inspection. The Mead DS0000019580.V282950.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This Unannounced Inspection was undertaken over three hours by one Regulatory Inspector. This was the fourth visit to the home during the current inspection year. The purpose of the visit was to follow up requirements made during these inspections. The atmosphere in the home throughout the visit was relaxed. Time was spent gaining feedback from service users, staff and visitors, all of which was very positive. What the service does well: What has improved since the last inspection? The refurbishment of most of the areas within the home offers a bright, clean atmosphere. Soft furnishings, pictures and ornaments provide a homely environment. The morale of service users and staff has lifted and the ambience in the home was light and relaxed. Service users were observed enjoying the company of carers. Procedures relating to universal Infection control have improved and staff were observed following safe procedures in order to prevent the spread of infection and malodours. The home appears to have a better working relationship with GP’s and district nurses. Nurses visiting the home are offering preventative advice to carers, which reduce the risk of pressure areas and other issues. The Mead DS0000019580.V282950.R01.S.doc Version 5.1 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. The Mead DS0000019580.V282950.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection The Mead DS0000019580.V282950.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3&4 Prospective service users are assessed prior to moving into the home, this ensures that the service will be able to meet the service users current needs and prevents future issues that the home may not be able to deal with. EVIDENCE: The manager or another suitably trained person undertakes a thorough needs assessment prior to a prospective service users admission. Previously a number of unsuitable people were admitted to the home and have since moved on. The new manager has clear boundaries on admission criteria. On going reviews of service users needs ensure that service users changing needs can continue to be met. The Mead DS0000019580.V282950.R01.S.doc Version 5.1 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 Service users Care Plans have been reviewed and contain relevant information in relation to service users needs. EVIDENCE: The standard of care observed appears to have improved since the previous inspections. One service user who has dementia but who is very unsteady was walking with the assistance of a carer. The carer was chatting to the service user and the conversation was dignified and respectful. One service user was observed walking around with no slippers on and staff did not know if the reasoning was included in the service users care plan. Service users also generally appeared to need more assistance with oral hygiene. One service user who has dementia was continually getting stuck in the lift. A keypad has since been fitted to the lift preventing further issues. The Mead DS0000019580.V282950.R01.S.doc Version 5.1 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 The atmosphere in the home during the evening was relaxed, some service users sat in the lounge watching television, others chose to sit in their bedrooms. The ambience was appropriate to the time of day. EVIDENCE: In one of the lounges, service users reactions to one particular carer were observed. They looked bright and happy as the carer cheerily chatted to everyone as he entered the room, a laugh and a joke was shared by all, which appeared to be enjoyed. A visitor was chatting to her relative quietly in the corner of the lounge. Feedback from the visitor in relation to her relatives care was very positive. The Mead DS0000019580.V282950.R01.S.doc Version 5.1 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): 18 Managers and Senior Care Workers appeared competent in dealing with allegations of abuse, demonstrating that they were fully aware of the Protection of Vulnerable Adults Procedure. EVIDENCE: On the day of the inspection a service user who has dementia had made an allegation of abuse by another person in the home. The duty manager dealt with this in accordance with the Hertfordshire Protection of Vulnerable Adults Procedure. Although after having gained information it appeared to be unlikely that the abuse had occurred, the manager continued to follow the procedure and take steps to ensure that the service user felt safe. The Mead DS0000019580.V282950.R01.S.doc Version 5.1 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, 25 & 26 The home has undergone extensive refurbishment, communal areas have been decorated, new carpets have been fitted and new soft furnishings offer a bright, clean and homely atmosphere to service users. EVIDENCE: Since the initial inspection in July, the home has undergone extensive refurbishment. The communal areas have been decorated, new carpets, curtains and decorative items have been purchased. The kitchenettes on each unit have been replaced and are clean and hygienic. This has boosted morale within the home and staff appear to be conducting themselves more respectfully. The area previously used for service users to smoke has been decorated and offers a clean, smoke free environment for service users and visitors entering the unit. Universal Infection Control Procedures were being carried out and new clinical waste units reduce the spread of infection and malodours The Mead DS0000019580.V282950.R01.S.doc Version 5.1 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 All staff that have a responsibility for administering medication have undergone comprehensive training and competency assessments, this was to reduce risks of further errors. EVIDENCE: The home has commissioned a dedicated person to work on Polices and Procedures and staff training relating to medication. Staff have not only been trained, but they have been offered extensive support enabling them to become more confident in this area. The Mead DS0000019580.V282950.R01.S.doc Version 5.1 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): None of these standards were inspected on this occasion. EVIDENCE: The Mead DS0000019580.V282950.R01.S.doc Version 5.1 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 X X 3 3 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 X 10 2 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 3 3 X X X X X 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 X X X X X X X X The Mead DS0000019580.V282950.R01.S.doc Version 5.1 Page 16 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. 1. Standard OP8 Regulation 12 (4)(a) Requirement Service Users must be encouraged to wear appropriate footwear, unless specified in the plan of care. The registered person must ensure that the care home is conducted in a manner that respects the dignity of service users, basic personal care and oral hygiene must be provided. Timescale for action 28/02/06 2. OP10 12(4) (a) 28/02/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations The Mead DS0000019580.V282950.R01.S.doc Version 5.1 Page 17 Commission for Social Care Inspection Hertfordshire Area Office Mercury House 1 Broadwater Road Welwyn Garden City Hertfordshire AL7 3BQ 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 The Mead DS0000019580.V282950.R01.S.doc Version 5.1 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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