Inspection on 08/12/09 for The Meadows

This inspection was carried out on 8th December 2009.

CQC found this care home to be providing an Poor service.

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Meadows 27/01/10

The Meadows 23/09/09

The Meadows 17/03/09

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bramley Avenue (73)

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Extracts from inspection reports are licensed from CQC, this page was updated on 18/02/2010.

Random inspection report Care homes for older people Name: Address: The Meadows Hatchett Village Brybank Road Haverhill Suffolk CB9 7YL zero star poor service The quality rating for this care home is: The rating was made on: 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 review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Mark Andrews Date: 0 8 1 2 2 0 0 9 Information about the care home Name of care home: Address: The Meadows Hatchett Village Brybank Road Haverhill Suffolk CB9 7YL 01440712498 01440762524 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Minster Haverhill Limited care home 53 Number of places (if applicable): Under 65 Over 65 0 53 0 dementia old age, not falling within any other category physical disability Conditions of registration: 53 0 53 The maximum number of service users who can be accommodated is 53 The registered person may provide the following categories of service only: Care home with nursing - Code N to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP Dementia - Code DE Physical Disability Code PD Date of last inspection Brief description of the care home The Meadows was registered with the Commission for Social Care Inspection 1st October 2008. The home is owned and managed by Minster Haverhill Ltd, a subsidiary Care Homes for Older People Page 2 of 9 Brief description of the care home of Minster Care Management Group, a national company with a large number of care homes. The Meadows is a new care home for frail older adult, older people with a dementia andor a physical disability. The home is situated in a village which is near to Haverhill in Suffolk. The home is a newly built property and the accommodation for people to live in is on the ground and first floor. The second floor of the home is used for staff rooms. The Service User Guide which we were given at the time of the inspection states that the current fees from GBP400 per week, it does not give a maximum fee but does state that fees are individually costed around the personal nursing and care needs of the individual person. Subject to conditions, people are able to bring their pets in with them. Care Homes for Older People Page 3 of 9 What we found: The above unannounced inspection was conducted by the Commissions pharmacist inspector Mark Andrews to examine the homes medicine management practices and follow up on medicine-related requirements made during previous inspections. Robert Titchener who informed us he was the project manager for Minster Healthcare was present at the home during the inspection and with whom the findings were discussed. On arrival for inspection we found the morning medicine round had been completed on the first floor. The senior carer said with the exception of two people receiving nursing care all people living on the first floor were now being administered their medicines by carers. The senior carer confirmed that all persons scheduled to receive medicines at the morning medicine round had received them. We looked at current medicine administration charts for all 11 people living on the first floor which started on 23rd November 2009. We noted three records of medicine administration relating to the morning medicine round that had not been completed and we found several others recently scheduled for administration in the current medicine chart period. For each gap we found that corresponding medicines had been removed from containers as if administered to people. We discussed the morning omissions with the senior person on duty who confirmed the medicines had been administered and who then completed the records. In addition, we noted that some records for the application of a topical cream to a person prescribed it were being recorded by ticks alone and not by signatures of the carers administering it. We also found that on two occasions, medicines remained in monitored dosage system containers when corresponding records had been completed indicating the medicines had been administered. We were told the home has systems in place to audit and identify such omissions arising and that the project manager was monitoring them. We found improvement in relation to records kept when medicines are not administered. The home has a daily medicine checklist alongside medicine administration charts for each person which includes mandatory stock levels signed by members of staff each day. We attempted to account for the use of medicines using records and quantities of medicines remaining and found that with one exception of one tablet all others could be fully accounted for. This indicates medicines are being administered as prescribed and so represents improved outcomes for people. In addition, we found no evidence that medicines had recently not been available for administration. We noted that for a person prescribed anticoagulant warfarin and for who we previously raised concerns that blood testing had not taken place as scheduled, information sheets were now alongside medicine administration charts showing testing had taken place and indicating up to date warfarin doses following the tests. The project manager showed us revised care plans for most people prescribed psychotropic medicines of a potentially sedative nature to manage their behavioural disturbances for use on an occasional basis (PRN -when required). The guidance is available for staff to refer to alongside relevant medicine administration charts, however, we noted that for one person prescribed antipsychotic medicine quetiapine 25mg tablets on a PRN basis there was still no written guidance in place. This medicine was supplied in monitored dosage system containers and was being offered for administration to the Care Homes for Older People Page 4 of 9 person twice daily on a routine basis. The project manager also informed us he has introduced forms to be completed by members of care staff when PRN psychotropic medicines are administered. These enable staff to record the incident arising, nonpharmaceutical measures taken and confirmation of the persons presentation leading to when the medicine is administered. The project manager said he collates and regularly monitors these forms. We found evidence that the use of these medicines for two people for who we raised concerns in previous inspections has been reduced. The project manager confirmed that five members of care staff who are authorised to handle and administer medicines at the home have received training. We saw copies of certificates of attendance at both internal and external training events providing evidence of this. The project manager also confirmed that the monitoring of the competence of authorised carers will be implemented in December 2009. We talked to members of care staff during the inspection who said that whilst they had received training in medicine management they did not feel they were being properly supported through this change in their duties and felt that medicine management is a new task placing additional pressure on their workload when caring for people at the home. During the inspection,we saw evidence that a person living at the home was walking along the corridor without adequate clothing and not properly dressed. We raised this matter with the senior carer on duty. What the care home does well: 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 2. Care Homes for Older People Page 5 of 9 Are there any outstanding requirements from the last inspection? Yes R No £ 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, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action 1 1 4 The contents of the Statement of Purpose must be reviewed, to ensure it is factual, and gives prospective service users a clearer understanding of the age range and the needs of the people they are able to look after. 25/11/2009 2 7 15 To reduce the chance of 25/11/2009 people being isolated and becoming anxious, care plans must give staff clear guidance on how to support people with their individual communication and behavioural needs. Care plans must give staff clear instructions, based on the residents individual physical and mental health needs. 25/09/2009 3 8 15 4 18 13 To safeguard the interests of 31/10/2009 people living at the home, any safeguarding issues must be reported in a timely manner. To ensure peoples assessed needs are being met, a 25/11/2009 5 27 18 Care Homes for Older People Page 6 of 9 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, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action review of the staffing levels against peoples dependency needs must be undertaken, and a copy of the report sent to The Commission. 6 31 9 To ensure the home is run in 25/12/2009 the best interests of the people living there, the home must be managed by a competent person, who has the required skills and knowledge. Care Homes for Older People Page 7 of 9 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, 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 1 9 13 Full and accurate records 11/01/2010 must be completed following safe procedures when medicines are administered To safeguard the health and welfare of people prescribed medicines. This is a repeat requirement from inspection of 8th October 2009 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 8 of 9 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. 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