Inspection on 28/11/06 for The Meadows Care Home

This inspection was carried out on 28th November 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

The Meadows Care Home 06/02/06

The Meadows Care Home 28/09/05

The Meadows Care Home 10/09/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE Meadows Care Home (The) Mansfield Road Alfreton Derbyshire DE55 7JL Lead Inspector Sue Richards Key Unannounced Inspection 09:30 28th November 2006 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) DS0000020054.V304814.R02.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. Meadows Care Home (The) DS0000020054.V304814.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Meadows Care Home (The) Address Mansfield Road Alfreton Derbyshire DE55 7JL 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) (01773) 520452 Mr Keith Sidney Dobb Mr Gerald Hudson Mrs Julia Davies Care Home 70 Category(ies) of Old age, not falling within any other category registration, with number (70), Physical disability (10) of places Meadows Care Home (The) DS0000020054.V304814.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 1 place for DE(E) for individual as named in the Notice of Proposal. Date of last inspection 6th February 2006 Brief Description of the Service: The Meadows Care Home is located in the town of Alfreton on a local bus route and also within a short distance from the train station and with easy access to the M1. Alfreton town centre and all local amenities are close by. The home comprises of two separate purpose-built, single storey units each set within their own grounds with adequate car parking and level access to well kept gardens with seating provided. Rose Court provides nursing care for up to forty older persons with thirty-four single and three shared bedrooms and Lavender Court provides personal care only for up to thirty older persons, having twenty-eight single rooms and one shared room. The home is situated in Alfreton and is close to the town centre. It is on a local bus route and is a short distance from the train station. There are also ten places included in the overall registration for persons with physical disabilities. Each unit has a range of spacious lounge, dining and seating areas with a choice of bathroom and toilets and separate kitchen and laundry facilities. Dedicated staff teams of care and hotel services staff are provided in each unit, with registered nurses, headed by a senior nurse for Rose Court and with a senior care officer in charge for Lavender Court. The home is led by a registered manager and is part of a group of care homes, having good support via external management arrangements. There are excellent arrangements for service user to engage in occupation/recreational and leisure activities and to maintain contacts with their families and friends and the local community, in accordance with their individual lifestyle preferences. Access to outside health care professionals in accordance with their health-assessed needs The range of fees charged by the home is as follows: £320.00 to £525.00 (The above is as information provided by way of the pre-inspection questionnaire dated 28/08/06) Meadows Care Home (The) DS0000020054.V304814.R02.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. As part of this unannounced inspection, the quality of information given to people about the care home was looked at. People who use services were also spoken to, to see if they could understand this information and how it helped them to make choices. The information included the service user’s guide (sometimes called a brochure or prospectus), statement of terms and conditions (also known as contracts of care) and the complaints procedure. These findings will be used as part of a wider study that CSCI are carrying out about the information that people get about care home for older people. This report will be published in May 2007. Further information on this can be found on our website www.csci.org.uk. Case tracking was also used as part of the methodology. This involves the random sampling of a small number of service users who care and services they receive is inspected more closely. This involves discussions with them and their representatives as available, examination of their care and associated records and inspection of their private and communal accommodation. What the service does well: Service users (or where appropriate their representatives) are suitably consulted with and involved throughout their admission and provided with clear information about the home and its terms and conditions and their needs are effectively assessed and well met. Service users health personal and social care needs are well accounted for in consultation with them. There are excellent arrangements to enable service users to engage in their chosen daily living routines and lifestyle preferences, in accordance with their capacities thereby promoting their right to choice and control over their lives. Service users rights to complain are upheld and complaints made are taken seriously and acted upon and they are protected from abuse. Service user live in a clean and comfortable environment, which is kept in a good state of repair and generally meets their needs. There is a pro-active approach to staff training and development and its staffing arrangements ensure that service users needs are well met by staff who are trained and competent to do their jobs. The home is well managed and run in the best interests of service users. Meadows Care Home (The) DS0000020054.V304814.R02.S.doc Version 5.2 Page 6 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. Meadows Care Home (The) DS0000020054.V304814.R02.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 Meadows Care Home (The) DS0000020054.V304814.R02.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): 1, 2, 3,4 & 6 Quality outcome in this area is excellent. This judgement has been made using evidence available, including a site visit to the home. Service users are suitably consulted with and involved throughout their admission, provided with clear information about the home and its terms and conditions and their needs are effectively assessed and well met. EVIDENCE: Case tracking was undertaken for a total of four service users. This involved individual discussions with them about the arrangements for their admission to the home, how information was provided for the about the home, both in respect of services provided and individual terms and conditions and also as to whether their needs were discussed with them prior to their admissions. Individuals recorded needs assessment documentation was also examined for each of those service users. Meadows Care Home (The) DS0000020054.V304814.R02.S.doc Version 5.2 Page 9 As referred to under the summary section of this report, specific questions were asked to each of those service users in respect of the above and responses were collated as follows: Each service user said they had been provided with information about the home and their care needs were discussed with them or their representative, which was in accordance with their choice and the circumstances of admission. For example, one service user was admitted under the home’s emergency admission procedures by way of social services arrangements. Appropriate reviews and discussions were held and information provided in accordance with the home’s policy. Another service user was happy for their relative to arrange their admission. This service user was registered blind and advised that information was explained verbally, which she preferred. Welcome packs are also provided in each bedroom, which include copies of the home’s brochure. Three of the service users each had a named family member or external representative who dealt with their financial arrangements, including terms and conditions of their residence, which was in accordance with their individual choices. The remaining service user was provided with terms and conditions of residence and consulted regarding changes to fees. Copies of written terms and conditions were in place for each of those residents and were either signed by them or their representative as appropriate. Five out of the 10 pre-inspection surveys, forwarded to individual service users, from the Commission were returned. All of these, with the exception of one who could not remember, said that they were provided with written contracts and had received enough information about the home before they moved in to enable them to choose. All said that they received the care and support they needed. Individual’s recorded needs assessment information was examined. These were formulated in accordance with a recognised assessment model and were signed and dated. These were comprehensive and person centred and included details of individual’s daily living preferences. Copies of the single assessment and care plan summary were also provided for service users admitted by way of care management arrangements as were nursing determinations from NHS nurses for those service users receiving nursing care in the home. All service users spoken with said that there needs were very well met and that care was to a high standard. Copies of 12 letters of thanks/plaudits received by the home over the preceding 12 months were examined. These were from a range of service users representatives, including relatives, social services and GPs. These all conveyed views of the high level of care and support provided for named service users, the hard work and motivation of staff and the dedication to staff training and development by the home. Meadows Care Home (The) DS0000020054.V304814.R02.S.doc Version 5.2 Page 10 The home does not provided for intermediate care. Meadows Care Home (The) DS0000020054.V304814.R02.S.doc Version 5.2 Page 11 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 outcome in this area is good. This judgement has been made using evidence available, including a site visit to the home. Service users health care (personal and social) care needs were well accounted for in consultation with them. EVIDENCE: The written care plans of service users case tracked were examined and the care they received discussed with them. Care plans were formulated in accordance with individual’s risk assessed needs. They were person centred and reflective of individual’s lifestyle and daily living preferences relevant clinical guidelines concerned with the care of older persons. They had recorded monthly reviews and were signed by service users. Service users spoken with said that they received the care they needed and that staff was usually available when they needed them. Five responses were received to the Commission’s pre-inspection survey sent to service users. These all indicated that service users always received the medical support they needed. Meadows Care Home (The) DS0000020054.V304814.R02.S.doc Version 5.2 Page 12 Individual’s health care needs were accounted for and records were maintained of inputs from outside health care practitioners, including for the purposes of routine health care screening. There are regular opportunities for service users who are able, to engage in gentle exercise groups. The arrangements for the management and administration of medicines were examined for those service users case tracked. These were satisfactory, although one issue raised by a service user case tracked with regard the administration of their prescribed eye ointment at night, was discussed with the manager. A discussion was held with the registered manager regarding the arrangements for the storage of oxygen cylinders, which were kept in the clinical room, where only staff access, although some were left free standing, which is not safe practise. Staff responsibilities regarding service users medicines were discussed with them. All had recently undertaken updated medicines training, with a full review of the home’s medicines policy and procedures. Service users spoken with said that staff treated them with respect and maintained their privacy. All knew how to access the telephone and their mail and some had their own telephones in their rooms. Comments are made under the Staffing section of this report in respect of the home’s policy/practise and training in terms of care of the dying person. Meadows Care Home (The) DS0000020054.V304814.R02.S.doc Version 5.2 Page 13 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 outcome in this area is excellent. This judgement has been made using evidence available, including a site visit to the home. The excellent arrangements for service users to engage in their chosen daily living routines and lifestyles preferences is in accordance with their capacities and promotes their right to choice and control over their lives. EVIDENCE: The arrangements for service users to engage in social and recreational activities, to maintain their family and community contacts and their daily living routine were discussed with them and also with staff. There are excellent ongoing arrangements in place in respect of social and recreational activities for service users, both within and outside the home. Responsibilities for co-ordinating this are identified and service users and their families are kept well informed and actively consulted with in terms of the planning and choice of these. A newsletter is regularly produced and residents/relatives committee meetings are held. Minutes of the last meeting taken by a relative and Christmas plans were discussed, together with food menus. There is a planned programme of Christmas festivities and entertainments, which is provided for all service users and their relatives as Meadows Care Home (The) DS0000020054.V304814.R02.S.doc Version 5.2 Page 14 consulted with them. As well as a regular programme of in house and external activities and entertainments, there are regular monthly outings. These have included lunches out, visit to a local flower festival, a trip to Carsington Water, a boat trip and a visit to Matlock Bath Illuminations. Seasonal celebrations are well organised, with recent events for both Halloween and Bonfire Night and the 101st birthday party held for a service user. Friends and families are welcomed in the home and invited to joint seasonal celebrations and visiting to the home is open. Plaudits, from relatives and friends of service users praise the welcoming atmosphere, inclusion and arrangements for activities, occupation and leisure. Service users are supported to maintain personal hobbies and religious beliefs as they wish, for example one service user is a keen and talented painter and continues with this hobby. Some service users had been on holiday during the summer to various locations, with staff support provided. Notice boards in display a variety of information regarding activities, meetings and consultation with service users and their representatives, including recent survey outcomes. All information, including the newsletter, is provided in large print. There is a reminiscence corner in Lavender Court with a variety of materials provided from the past. Information regarding advocacy is provided with access facilitated recently for one service user via Age Concern. One of the service users case tracked is supported via social services to manage their own finances and all service user case tracked had brought in a variety of personal possessions with them into the home, including furniture. One of the service users case tracked felt that staff did not always seek her views to establish and promote her choice of daily living routines in respect of her preferences with regard to bathing or showering and her preferred night time routine, including retirement time and administration of their prescribed eye ointment. Feedback from other service users was positive in respect of the promotion of their autonomy and choice. Copies of menus were provided with the pre-inspection questionnaire. These indicate a balanced and nutritious diet. All service users spoken with (and their representatives) said that the food was very good and that they enjoyed meals provided and ate well. They said that if they wanted something, which was not on the menu, their requests were always met. Daily menus had recently been introduced in large print for each dining table. There were no service users with diverse dietary/religious needs due to culture or religion. Diets are catered for in accordance with individual’s assessed nutritional and health care needs. Meadows Care Home (The) DS0000020054.V304814.R02.S.doc Version 5.2 Page 15 Lunches were observed being served. Service users were properly assisted and supported and chose where to take their meals. Meadows Care Home (The) DS0000020054.V304814.R02.S.doc Version 5.2 Page 16 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 outcome in this area is good. This judgement has been made using evidence available, including a site visit to the home. Service users rights to complain are upheld. Complaints are taken seriously and acted upon and there are suitable systems and arrangements in place to promote the protection of any service user from abuse. EVIDENCE: The complaints procedure for the home is openly displayed and provided in large print. Information is also provided regarding how to complaint within the home’s service user guide/brochure. Service users spoken with knew how to complain, although felt that any issues raised were usually dealt with without the need to formally complain. Survey feedback from five service users/representatives indicated that they knew how to complain. The home has received three complaints over the preceding 12 months. Two investigated, including one investigated via social services joint agency adult protection procedures were not upheld and one was partially upheld and is recorded in the home’s records as being satisfactorily resolved. Comprehensive records were provided in respect of complaints made, including their investigation and outcomes, with considerable time dedicated to ensuring these were thoroughly and properly dealt with. Staff spoken with was conversant with the home’s procedure in respect of reporting complaints and also safeguarding adults procedures and all staff undertaken training in the latter. Meadows Care Home (The) DS0000020054.V304814.R02.S.doc Version 5.2 Page 17 Meadows Care Home (The) DS0000020054.V304814.R02.S.doc Version 5.2 Page 18 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, 21, 22, 23, 24, 25 & 26 Quality outcome in this area is adequate. This judgement has been made using evidence available, including a site visit to the home. Service users live in a clean and comfortable environment, which is kept in good state of repair. However, there are some of areas within the environment, which do not meet with the overall high quality and standards of the home and two areas, which may potentially place service users at risk if not dealt with. EVIDENCE: A tour of each unit was undertaken and the private and communal accommodation of service users case tracked, (two from each unit), were inspected. All areas of each unit were clean, safe and reasonably well decorated and maintained. At the previous inspection of this service in February 2006 a number of requirements were made in respect of identified environmental Meadows Care Home (The) DS0000020054.V304814.R02.S.doc Version 5.2 Page 19 risks. These were complied with via recorded risk assessments - further radiator covers were planned in accordance with those risk assessments. Annual maintenance of equipment details were also provided and were up to date, including that for the maintenance of hot and cold water systems, and prevention of risk from Legionella. There is an ongoing programme of redecoration of the home, which is to a reasonable standard. At the previous inspection of this service a requirement was made regarding provision of appropriate dining furniture in Rose Court. The registered manager advised that this had been ordered, with replacement imminent. The Inspector will assess provision at the next inspection for this service. An additional hoist had been purchased since the previous inspection. However, there were around nine wheelchairs, used for transferring service users, which had footrests, which did not fit correctly. These were discussed with staff and require review and repair/replacement as necessary. Service users are encouraged to bring in personal items of furniture as they choose into their own rooms and many rooms were personalised and well decorated. Detachable signs were provided to bedroom doors for service users to indicate ‘do not disturb.’ However, some bedrooms in Rose Court were basically furnished having very old hospital beds and hospital lockers, with no chest of drawers provided. Some bedrooms did not have over bed lights or bedside lamps. Two service users spoken with via case tracking did not have these and said that they would like them, one particularly felt this would assist in their independence and safety for reading in bed. With the consent of a service user, a discussion was held with the manager regarding their room size, which was raised by them during discussions as a problem in that it restricted their independence and ability to manoeuvre, given the lack of space and their physical disability. This room was inspected. Two of the service users case tracked used the large walk in shower near to their bedrooms, which they said was satisfactory, although both said that they would like to be able to take a bath more often, but felt this may be a problem due to their mobility/moving and handling needs. This was raised with the manager during the inspection, who agreed to discuss this with them, although there was no specialist bath which may enable accommodation of those service users wishes, who were both physically disabled. At the previous inspection for this service a requirement was made regarding the provision of a mechanical sluicing disinfector. This was discussed with the registered manager and the arrangements for hand sluicing/cleaning and disinfection inspected and also discussed with staff. These were satisfactory, although time consuming for staff. There had been no outbreaks of infection in relation to the handling of body waste. Meadows Care Home (The) DS0000020054.V304814.R02.S.doc Version 5.2 Page 20 Some waste bins were overflowing and were not fully occlusive and without lids. Discussions with staff indicated that the capacity of bins were also insufficient. This was also discussed with the manager during the inspection who advised that immediate action would be taken to replace these. Meadows Care Home (The) DS0000020054.V304814.R02.S.doc Version 5.2 Page 21 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 outcome in this area is excellent. This judgement has been made using evidence available, including a site visit to the home. The home’s pro-active approach to staff training and development and its staffing arrangements ensure that service users needs are well met by staff who are trained and competent to do their jobs and that they are in safe hands and suitably protected. EVIDENCE: The arrangements for staff recruitment, induction, deployment and training were discussed with the manager and staff and associated records examined. Information was also provided by the manager on the home’s pre-inspection questionnaire regarding staff employed, staff turnover and the training undertaken by them over the preceding 12 months and also planned. Discussions were also held with service users regarding staffing arrangements and availability and feedback via the Commissions pre-inspection questionnaire as completed by service users or their representatives on their behalf was also taken into account, which was positive and indicated that staff listen to service users and are usually available when they need them. Service users are also kept up to date and informed regarding staff training via the home’s newsletter. Approximately eighty percent of care staff had achieved at least NVQ level 2 or above with further due to complete. Meadows Care Home (The) DS0000020054.V304814.R02.S.doc Version 5.2 Page 22 The home’s programme and arrangements for staff induction have been reviewed since the previous inspection with a revised induction pathway being introduced. This includes a more comprehensive approach to individual assessment staff competency assessment with a group aim to develop common systems of training across all of their homes via a dedicated training co-ordinator. There is a programme for access to core/key training for all staff from induction and a rolling programme of development and update training, together with that related to the care and clinical/medical needs of service users accommodated. All staff has undertaken varying levels of dementia care training, with all registered nurses and senior care undertaking more in depth training. All staff has undertaken palliative care training and the Liverpool Care Pathway has been implemented and practised for three service users at their end of life stage. The personal files of four of the most recent staff starters were examined. These contained all records relevant to their recruitment and employment, including required recruitment processes and checks. Service users are actively involved in staff recruitment and selection by way of the interview process and details of this are provided in the home’s newsletter. The home employs a number staff, registered nurses and care staff from diverse backgrounds. Equal opportunities monitoring is undertaken in respect of staff recruitment in accordance with the home’s equal opportunities policy. Meadows Care Home (The) DS0000020054.V304814.R02.S.doc Version 5.2 Page 23 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, 32, 33, 35, 36, 37, & 38 Quality outcome in this area is excellent. This judgement has been made using evidence available, including a site visit to the home. The home is well managed and run in the best interests of service users EVIDENCE: The manager is a Registered Nurse who successfully manages the home. Evidence of her continuing personal and professional development was provided by her and discussed. She has significant management experience and training and works hard to maintain her professional and personal development knowledge. Discussions with service users and staff indicate that there are clear strategies for communication in the home with a sound sense of direction and leadership from the registered manager. Staff said they are continually encouraged to Meadows Care Home (The) DS0000020054.V304814.R02.S.doc Version 5.2 Page 24 access training and personal development activities, and are provided with relevant codes of conduct and practise. There are clear lines of accountability within the home and also via external management arrangements. There are clear strategies for self monitoring and development of the home by way of key monitoring and audit systems, which include regular consultation with service users and their representatives, including other stakeholders about all aspect of the home’s services and provision. Results of service user surveys are published and information about these is openly displayed within the home, where these can easily be accessed. Plaudits received by the home from a variety of sources, including service users, their families and external agencies/representatives were seen during the inspection. The home has a history of progression within agreed timescales to implement requirements identified in the Commission’s reports. There is one outstanding requirement from the previous inspection with an extended timescale given in respect of the replacement of dining furniture in Rose Court, which had been ordered. The systems and arrangements for the management and handling of service users monies were discussed with service users case tracked and also the manager and administrator and records examined. These were satisfactory and in accordance with the home’s policy. There is a formal system of individual supervision for care staff and key staff who engage in the formal supervision of individual staff have received formal training in relation to this. A number of records, which must be kept in the home were examined during the course of the inspection and are referred to under the relevant sections of this report. These include individual care records (including needs assessment information and care plans), medicines records, service user guide (brochure), accounts of residents’ monies, monthly reports by registered provider, staff employment records, staff duty rotas, complaints records, accident and incident records, menus, maintenance records, visitors record. All of these were properly kept and safely stored, with service user access as appropriate. The arrangements for ensuring safe working practises in the home were discussed with the manager and staff and relevant records examined (including staff training and risk assessments). These are satisfactory. Observations were also made in respect of health and safety during a tour of the premises. Meadows Care Home (The) DS0000020054.V304814.R02.S.doc Version 5.2 Page 25 Staff spoken with was conversant with the home’s policy and systems for the reporting and recording of accidents and untoward incidents and accident records were sampled in accordance with case tracking. These were satisfactory. Meadows Care Home (The) DS0000020054.V304814.R02.S.doc Version 5.2 Page 26 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 4 3 3 4 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 4 8 3 9 3 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 4 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 4 17 X 18 3 3 X 3 2 3 2 2 2 STAFFING Standard No Score 27 3 28 4 29 4 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 4 4 X 3 3 3 3 Meadows Care Home (The) DS0000020054.V304814.R02.S.doc Version 5.2 Page 27 Are there any outstanding requirements from the last inspection? YES 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 OP20 Regulation 16(2)(c) Requirement The registered persons must provide appropriate dining furniture, which is safe to use and domestic in nature. (Rose Court- ordered therefore timescale extended). Unnecessary risks to the health and safety of service users must be identified and so far as possible eliminated. In this instance a review of the state of repair of wheelchairs/footrests. Single rooms, which accommodate wheelchair users, must have at least 12 sq m usable floor space. (This should be reviewed with the service existing service user with the aim of offering alternative private accommodation, which provides sufficient space as soon as is reasonably practicable). Suitable arrangements must be made to prevent infection, toxic conditions and the spread of infection in the home. In this instance the replacement of some waste receptacles to provide fully occlusive ones. DS0000020054.V304814.R02.S.doc Timescale for action 28/02/07 2. OP22 13 28/02/07 3. OP23 23 31/03/07 4. OP26 13 31/01/07 Meadows Care Home (The) Version 5.2 Page 28 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 OP21 Good Practice Recommendations The registered person should review with individual residents, their choice of using bath or shower facilities and accommodate that choice wherever possible in accordance with their risk assessed needs. Consideration should be give to reviewing bathing facilities with a view to providing a suitable specialist bath to maximise the independence and choice of service users with severe physical disabilities. A review of furnishings (Rose Court) and light fittings in bedrooms should be undertaken and a programme of replacement/renewal identified as necessary. 2. OP22 3. OP24 Meadows Care Home (The) DS0000020054.V304814.R02.S.doc Version 5.2 Page 29 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT 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. 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