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Inspection on 21/12/05 for The Meadows Care Home

Also see our care home review for The Meadows Care Home for more information

This inspection was carried out on 21st December 2005.

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.

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

Residents and visitors spoken to felt the staff were very kind, caring, and helpful and that they make the home a nice place to be. Comments from residents included " This is very good, can`t grumble, the staff are lovely", "very nice home, there are lots of things going on, especially at Christmas" A visitor commented that "this is a good home, we have no worries about our mum." There are planned daily activities that many of the residents said they enjoyed. Residents are given choice about activities, the food and their daily routines. Care plans and medication systems are effectively managed to ensure needs are met and staff demonstrated a good understanding of the needs of the residents and were observed to interact positively. There are effective systems in place for the overall management of the home and the staff spoken to stated it is a good place to work and they feel they can make a difference to the lives of the residents.

What has improved since the last inspection?

All the requirements and recommendations made at the statutory inspection in August 2005 have been met. This has included an update of pressure ulcer assessments and records, staff training in first aid and more detailed direction in care plans for behavioural needs to ensure staff give a consistent approach.

CARE HOMES FOR OLDER PEOPLE Meadows Care Home, The 48 Moorend Road Yardley Gobion Towcester Northants NN12 7UF Lead Inspector Mrs Moira Mosley Unannounced Inspection 21st December 2005 10:00 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 Meadows Care Home, The DS0000012651.V274615.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. Meadows Care Home, The DS0000012651.V274615.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Meadows Care Home, The Address 48 Moorend Road Yardley Gobion Towcester Northants NN12 7UF 01908 543251 01908 543234 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) Downing (Meadows) Limited Mrs Wendy Jean Fitzgerald Care Home 34 Category(ies) of Old age, not falling within any other category registration, with number (34) of places Meadows Care Home, The DS0000012651.V274615.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. That the home continues to be registered to accommodate 34 service users in the category of OP, for either Personal or Nursing Care 4th August 2005 Date of last inspection Brief Description of the Service: The Meadows is situated in Yardley Gobion a village location midway between Northampton and Milton Keynes. There are local shops and amenities and the home has good links with the community. The home is an extended original building set in its own grounds with extensive views of the local countryside from the rear of the property. It is registered for up to 30 service users with nursing needs and up to 10 service users requiring personal care, with a total of 34 service users accommodated. Accommodation is over two floors with a passenger lift and staircase for access to the first floor. There are a range of communal areas including two lounges and service users are able to enjoy the garden areas. Bedrooms are located on both floors and there are 21 single rooms with ensuite facilities, a further 2 single rooms with was hand basins and 5 double rooms available. Meadows Care Home, The DS0000012651.V274615.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a statutory unannounced inspection by one inspector, two hours were spent gathering information and planning for the inspection and three and a half hours were spent in the home. The care of four residents was reviewed to include care plans, risk assessments, medication and other records. In addition discussions were held with six residents, three members of staff and four visitors to the home and a period of observation undertaken. What the service does well: What has improved since the last inspection? All the requirements and recommendations made at the statutory inspection in August 2005 have been met. This has included an update of pressure ulcer assessments and records, staff training in first aid and more detailed direction in care plans for behavioural needs to ensure staff give a consistent approach. Meadows Care Home, The DS0000012651.V274615.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. Meadows Care Home, The DS0000012651.V274615.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 Meadows Care Home, The DS0000012651.V274615.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): These standards were not assessed on this inspection. EVIDENCE: Meadows Care Home, The DS0000012651.V274615.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 and 9 Care plans and risk assessments generally ensure that resident needs are met, however nutritional risk assessments are required to ensure residents dietary needs are fully addressed. EVIDENCE: Care plans seen were written to a generally high standard with regular reviews and updates. There was evidence of resident or their representative’s input into the care plans. Behavioural care plans have been improved since the last inspection and the instructions were clear for staff to consistently meet the identified needs. Healthcare assessments included pressure ulcer assessments along with falls risk assessments and there is evidence of involvement of the multi disciplinary team as required. Appropriate action including the provision of equipment was taken in response to any risk areas. Meadows Care Home, The DS0000012651.V274615.R01.S.doc Version 5.1 Page 10 The nutritional assessment in place does not identify risk areas, for example age, weight loss, pressure ulcers and other physical barriers to adequate nutrition. One resident identified has had significant weight loss and a care plan is in place for reluctance to eat, however the nutritional assessment did not identify any risk and there was a lack of documented action taken in response to her reduced intake. The medication was cross-referenced to the Medication Administration Records (MAR) and there were procedures in place to ensure the safe storage, administration and disposal of medication. Meadows Care Home, The DS0000012651.V274615.R01.S.doc Version 5.1 Page 11 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 and 15 Social interactions are well managed to provide daily interests and activities for the residents. Meals and mealtimes are well managed to provide residents with good nutritional intake. EVIDENCE: The residents spoken to were very positive about their care and the level of activity provided in the home. At the time of this inspection the Christmas preparations were in full swing with a packed social calendar for the festive season. There is a detailed assessment of resident’s life histories and their likes and dislikes, which is used to develop activities in the home. The residents spoke about in house activities including bingo and games and outings in to the community. The kitchen was well managed, menus are regularly reviewed and the cook confirmed that they provide alternatives to cater for likes and dislikes as well as providing specialised diets for a range of needs. Meadows Care Home, The DS0000012651.V274615.R01.S.doc Version 5.1 Page 12 The residents’ spoke very highly about the food provided and were observed to enjoy their lunch in pleasant dining facilities. Staff were available to provide support where needed and lunch was a relaxed and unhurried event. Meadows Care Home, The DS0000012651.V274615.R01.S.doc Version 5.1 Page 13 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 Effective systems are in place for the protection of the residents. EVIDENCE: The procedures for the reporting of any concerns raised about the treatment of the residents are in place and they have the Northants inter agency procedures for reporting concerns to the POVA (Protection of Vulnerable Adults) team. Staff were aware of how to report any concerns and there is an on call system to ensure a member of the management team is available to deal with any issues. Meadows Care Home, The DS0000012651.V274615.R01.S.doc Version 5.1 Page 14 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): 26 The home is clean, pleasant and hygienic. EVIDENCE: The staff were observed to have access to gloves and aprons for hygiene and systems were in place for the control of infection. The laundry facilities were well organised with appropriate systems and facilities in place. The residents spoken to said they were happy with the level of cleanliness in the home and felt their laundry was well managed. Meadows Care Home, The DS0000012651.V274615.R01.S.doc Version 5.1 Page 15 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): These standards were not assessed on this inspection. EVIDENCE: Meadows Care Home, The DS0000012651.V274615.R01.S.doc Version 5.1 Page 16 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, 37 and 38 There is an effective strategy in place for the management of the home and this provides staff with leadership and support. Resident monies are not being regularly audited to ensure appropriate management and the policies and procedures are lacking specific detail to ensure clear expectations are identified. EVIDENCE: The registered manager has worked in this home for over 6 years and is a qualified nurse with experience of providing care for this resident group. She has just completed her registered managers award and demonstrates a good understanding of her management responsibilities. Staff, residents and visitors spoke highly about the management of the home and felt they were kept informed and involved in developments and changes. Meadows Care Home, The DS0000012651.V274615.R01.S.doc Version 5.1 Page 17 There is a Quality Assurance system and questionnaires are sent annually to the residents and their families, the manager will look to extending this to other stakeholders to assess their views of the home. The results are collated and the outcomes with any identified actions needed are published and available to all in the home. The resident’s monies records had individual recording sheets, however the balance of cash in the home and that in the bank accounts was not distinguished and the residents money was pooled in the safe so making an audit very difficult. In addition there was only one signature on transactions and no documented evidence of the registered person auditing the balances to ensure any discrepancies are quickly acted upon. The homes policies and procedures were not dated signed or showing evidence of review of the registered person. They are of a corporate nature and need to be updated to reflect the specific procedures in this home. For example the fire policy did not identify the actual procedure in the home, the smoking policy did not identify where staff, visitors and residents could smoke, the complaints procedure was different to that displayed on the wall in the home and the money policy does not identify clearly how this home actually manage residents money. There were systems in place to monitor and maintain the health and safety of residents and staff. The requirement for staff with first aid training has been met and records demonstrated a proactive response to any health and safety issues. Meadows Care Home, The DS0000012651.V274615.R01.S.doc Version 5.1 Page 18 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X X X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 3 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 3 X X X X X X X 3 STAFFING Standard No Score 27 X 28 X 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 2 X 2 3 Meadows Care Home, The DS0000012651.V274615.R01.S.doc Version 5.1 Page 19 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(1)(a)( b) Requirement Nutritional assessments must be sourced and fully completed to detail any action identified. Timescale for action 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. 1 2 3 Refer to Standard OP35 OP35 OP37 Good Practice Recommendations Residents’ money should be individually stored to assist with audit and two signatures on transactions to minimise risk of discrepancies arising. The registered person should regularly audit resident’s monies kept in the home. The policies and procedures should be regularly reviewed and signed as current practice by the registered person. Meadows Care Home, The DS0000012651.V274615.R01.S.doc Version 5.1 Page 20 Commission for Social Care Inspection Northamptonshire Area Office 1st Floor Newland House Campbell Square Northampton NN1 3EB 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 Meadows Care Home, The DS0000012651.V274615.R01.S.doc Version 5.1 Page 21 - 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. 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