Inspection on 16/12/08 for The Meadows

This inspection was carried out on 16th December 2008.

CSCI found this care home to be providing an Excellent service.

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

The Meadows 20/11/06

The Meadows 06/01/06

The Meadows 12/07/05

The Meadows 20/01/05

The Meadows 10/09/04

The Meadows 09/12/03

Similar services:

Snydale Care Home

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Larchfield Manor

Hawkhills

Beeches The - North Yorkshire County Council

The Grove Waltham

Carentan House

Ravensworth Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 27/03/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: The Meadows 88 Louth Road Grimsby North East Lincs DN33 2HY     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Theresa Bryson     Date: 1 6 1 2 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 25 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 25 Information about the care home Name of care home: Address: The Meadows 88 Louth Road Grimsby North East Lincs DN33 2HY 01472823287 FP01472823287 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Marilyn Robinson Type of registration: Number of places registered: Shire Care (Nursing and Residential Homes) Ltd care home 30 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users who can be accommodated is: 30 The registered person may provide the following category of service only: Care home only - Code PC, to service users of the following gender: Either, whose primary care needs on admission to the home are within the following category: Old age, not falling within any other category - Code OP Date of last inspection Brief description of the care home The Meadows is a 30-bedded care home providing care for people with general problems of old age. It is situated on one of the main roads into the fishing town of Grimsby, in a residential area, with access to local amenities. The accommodation is on ground floor level and many rooms have en-suite facilities. There are adequate numbers of bathroom and toilet facilities. The home has a large communal dining room and several other sitting areas. There are gardens around the home and adequate car Care Homes for Older People Page 4 of 25 Over 65 30 0 Brief description of the care home parking facilities. Staff working in the home have their own rest area and the manager her own office. There is also a kitchen with storerooms and a purpose built laundry area. The home has the advantage of belonging to a small local group of homes, with the support of other managers, who are also professionally trained nurses, as is The Meadows manager and a Director of Operations who is also a nurse. Information about the home is on display in the main entrance and will also be sent to prospective service users. The home borders two local authority catchment areas and will accept those funded by them and also privately funded service users. There are extra payments for such items as hairdressing, chiropody, papers and magazines. Care Homes for Older People Page 5 of 25 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This inspection took place over one day in December 2008. Prior to this a number of surveys were sent out to people who use the service, relatives and staff and a large number were returned. We also looked at the previous inspection report and any other information sent to us over the last year. The home also sent in their Annual Quality Assessment Audit so we could see what they had been doing in the last year. On the day of the site visit we looked at a number of documents and records, toured the building and spoke to some people resident in the home, relatives and staff. The manager was present through out the day and the feed back was given to the manager and owner of the home. Care Homes for Older People Page 6 of 25 Care Homes for Older People Page 7 of 25 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 25 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 25 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are holistically assessed to ensure the home can meet their needs. Evidence: Documentation was tracked whilst on the site visit of the latest admission to the home. This was a comprehensive document and showed that each person is holistically assessed prior to them coming into the home. The assessment is used to inform staff about the persons immediate needs to help them plan, with that person, how to look after them. People spoken to stated how this had helped them settle is as one person said I felt staff knew so much about me and it comforted me. the home does not give intermediate care and therefore Standard 6 is not applicable. Care Homes for Older People Page 10 of 25 Care Homes for Older People Page 11 of 25 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples needs are being met and staff involve other health care professionals when they need to. Evidence: The care documentation kept at the home is comprehensive, legible and appeared to be accurate. Care is taken by staff that each plan of care is updated regularly and this involves both the person themselves (where they are able to contribute), their relatives and outside agencies. Ample evidence was seen that this process is well documented and there was excellent follow through when for example someone had an accident, the detail of the event and who was involved in the after care and monitoring. In some plans for example where a need had been identified that someone was suffering from memory loss, effort had been made to involve specialist health care professionals such as Community Psychiatric Nurses and the Memory Clinic. Events such as quality time given to that individual were recorded by the key worker and that persons involvement in such activities as reminiscence groups and where staff had sat reading the daily newspaper to all help to assist their current memory. Safe practices Care Homes for Older People Page 12 of 25 Evidence: were observed in the giving of medication and staff had been trained to do their job well and had an updated policy manual to follow. All documenting is audited by the team leaders and the manager of the home to ensure the records are accurate and that they can be understood by all staff and that where possible when the individual themselves can contribute their views are sought. The policy for care planning and auditing of them was reviewed in August 2008 and staff stated they were aware of this and felt that the care plans help us to deliver the right care, at the right time, to the right person. Prior to the site visit we sent out a number of survey forms and a large number were returned with very positive comments made. On the day people spoken to also commented on the delivery of care to themselves saying such things as staff are kind and they are all lovely to me and another I have nothing in life to grumble about. During the course of the day staff were observed giving personal care to a number of people which they did in a calm and relaxed manner, showing dignity and respect in the way they approached each person and how they spoke to them. Of the 7 staff spoken to on the day and of the staff surveys returned all stated they felt there was sufficient training in place to enable them to beware of their job roles and felt supported by senior management. All of these elements contribute to the current needs of people being met and that the staff are very aware of how to access other health care professionals when they need to, to ensure people are free from harm. Care Homes for Older People Page 13 of 25 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples social, cultural and religious expectations were being met. Evidence: People we spoke to and on the surveys returned to us, said how each individuals social, cultural and religious needs and expectations were being met by the home. This include the possibilities for joining in groups events such as entertainers, arts and crafts and bingo. To accessing community events such as Church events and Christmas shopping events. One person said It is my choice to stay in my room and staff respect this and help me access things in here such as reading, crosswords and just coming to talk to me, as well as me having the TV. The records kept showed good documentation about what had taken place over the last year and who taken part in events. This has helped the staff to plan for the future. Each individual also had a social needs assessment as part of the care planning process. This detailed document included a life history (where people felt able to contribute to), family history, likes and dislikes and interests and hobbies. This all has helped staff to ensure they have a detailed history of a person and that their expectations have been fulfilled. Care Homes for Older People Page 14 of 25 Evidence: Prior to our visit the local Environmental Health Officer had completed an inspection and given the home a 4-star rating. Locally they encourage providers to display the awards as proof of the standard of service provided. On the site visit day food was being prepared in a clean and safe environment using good practice guidelines. People living on the home commented on the excellent food and variety of the 4-week cycle of menus. Care Homes for Older People Page 15 of 25 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A robust system is in place to ensure people are protected and free from harm. Evidence: The home manager has ensured that all staff are aware of the process to identify abuse of people in the home. Nearly all staff have completed their initial training, which was recorded but some staff were now attending refresher courses. Staff were also able to tell us the process they would follow should they need to make a referral to ensure people are free from harm. Since our last visit the CSCI records showed there had been no concerns raised to us and the homes own records showed they had also not dealt with any issues. When speaking to people in the home they felt confident that the senior team would deal with any issues quickly. Care Homes for Older People Page 16 of 25 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a comfortable and safe environment. Evidence: Since the last inspection a large amount of building work had taken place which was near completion. This has included the provision of more bedrooms, an enlarged dining area and new reception area and offices. All areas were being completed to complement the present structure and decoration. On the site visit day there was the minimal amount of disruption to areas used by people living in the home and all areas were being kept clean and tidy. People living in the home said how well the domestic staff were coping with the disruption. there was ample evidence that people were able to personalize their own rooms and people said how this had helped them settle into the home. the builders were ensuring that the garden areas were free from hazards and trying to keep noise to a low level. All equipment was in working order and all safety certificates were in place. Some beds appeared to be a little narrow but the manager was going to complete a reassessment of these to ensure they were fit for purpose. The whole home felt warm and welcoming and attention to detail was event in the Care Homes for Older People Page 17 of 25 Evidence: flower arrangements around and appropriate use of textiles and pictures to create a homely atmosphere so people could live in comfort. Care Homes for Older People Page 18 of 25 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A robust system is in place to ensure people are looked after by staff capable of doing their jobs. Evidence: Since the last inspection the staffing levels have improved in the home and staff stated to us on this occasion they felt there was sufficient time allocated to ensure they can deliver the correct care to people. There were no comments made from people resident in the home that their needs were not being met. The care staff are well supported by other departments in the home and this ensures that those allocated to specific caring roles can fulfill their job descriptions. The home has a very robust system for vetting staff prior to commencement of employment and once employed ensures they are monitored closely until such time as they feel able to work on their own. This ensure people are not put at risk from inexperienced staff looking after them. There was ample evidence in the staff personal files tracked that all checks are made and that staff are also made aware of the General Social Care Councils principles when they sign for the booklet. The training of staff commences at induction where staff have to sign an orientation list and complete the Skills for Care documentation. This is later followed by an Care Homes for Older People Page 19 of 25 Evidence: individually skill matrix on each staff member to see whether they need to complete extra training, specific to their job role, as well as all the mandatory training. We were able to examine documentation to show how this is followed through and staff later confirmed the types of courses they had completed and how this had helped their work. This system allows the senior staff to keep track as to whether staff are able to do their jobs or whether they require further training. A variety of resources are used for training including distance learning, the local authority training sessions and in house skills used. This will ensure people are looked after by people with the best knowledge base to ensure the care they deliver is correct. Care Homes for Older People Page 20 of 25 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a safe and comfortable environment suited to their needs. Evidence: The manager at this home has been in post for some years and ensures she keeps herself up to date with latest care practises and that the views of people using the service and staff are always taken into consideration when planning the running of the home. This was confirmed by the comments made by people using the service, relatives and other visitors to the home and staff. People made such comments as I feel safe here as I feel confident the manager will always listen to me and I am always informed about events to do with my wife and I feel the manager has a sound knoweldge base to help me in my work. The documentation and records seen to support the comments of people spoken to Care Homes for Older People Page 21 of 25 Evidence: and who replied to our surveys included the wide range of audits and surveys which take place and the reviewing processes for all documentation. For example when surveys are sent out for comments on the laundry, this is fed back to staff and if changes need to be made a review of polices takes place and if necessary new equipment purchased and added to the business action plan. There is also a business plan in place which looks at all aspects of the business and has an action plan attached to ensure promises can be fulfilled and followed through. All documentation was also seen to show that checks are constantly made to ensure the building is a safe place in which to live and work. The views of people are contiunally sought to ensure the home is being run for their benefit and they are happy. The atmosphere is very calm in the home and people looked well cared for and happy. As one person stated I wouldnt live any where else now because I feel safe and loved. Care Homes for Older People Page 22 of 25 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 23 of 25 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Older People Page 24 of 25 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 25 of 25 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!