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Inspection on 28/09/05 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 28th September 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

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

The home fosters good relationships between residents and their families and staff members. Staff members are polite, kind and support the dignity and choice of residents. The health care needs of residents are identified and close links are maintained with local practitioners to ensure that those needs are met.

What has improved since the last inspection?

Since the last inspection there have been significant improvements in care plans, which now address the social and recreational needs of residents comprehensively. The manager has ensured that the needs of younger disabled people living in the home have been addressed in line with the National Standards issued for younger adults. The manager has undertaken a systematic approach to staff training and a high proportion of staff, are or have undertaken NVQ training, including 11 who are taking or have qualified to NVQ3. Ongoing attention is being paid to redecoration and refurbishment of the building.

What the care home could do better:

Although there has been improvement to furniture in the home, dining furniture in Rose Unit is still plastic patio style furniture. Both Lavender Unit and Rose Unit have sluice facilities but Rose Unit does not have a disinfecting sluice as required in care Homes providing nursing care.

CARE HOMES FOR OLDER PEOPLE Meadows Care Home (The) Mansfield Road Alfreton Derbyshire DE55 7JL Lead Inspector Eileen McHale Unannounced Inspection 28th September 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) DS0000020054.V250990.R01.S.doc Version 5.0 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.V250990.R01.S.doc Version 5.0 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.V250990.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 3 March 2005 Brief Description of the Service: The meadows Care Home provides two large, single storey, detached, purpose built units, each set in its own grounds. Lavender Court provides accommodation with care for older people aged 65 or over. The unit offer 28 single rooms and one shared room, all without en suite facilities. The service provided includes 24-hour care services with social activities in addition to full board and personal care. Rose Court provides nursing care for a maximum of 40 people of which up to 10 places can be for younger disabled people. The unit consists of 34 single rooms, 3 double rooms with large lounges and a dining area. The home is situated in Alfreton, close to the town centre. It is on a local bus route and is a short walk from the train station. Meadows Care Home (The) DS0000020054.V250990.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Most of the focus of this inspection was on the service within Rose Unit, although records seen covered all parts of the home. Care plans, staffing rotas and records of training were examined and the inspector spoke to service users, a visitor and some staff members. What the service does well: What has improved since the last inspection? Since the last inspection there have been significant improvements in care plans, which now address the social and recreational needs of residents comprehensively. The manager has ensured that the needs of younger disabled people living in the home have been addressed in line with the National Standards issued for younger adults. The manager has undertaken a systematic approach to staff training and a high proportion of staff, are or have undertaken NVQ training, including 11 who are taking or have qualified to NVQ3. Ongoing attention is being paid to redecoration and refurbishment of the building. Meadows Care Home (The) DS0000020054.V250990.R01.S.doc Version 5.0 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) DS0000020054.V250990.R01.S.doc Version 5.0 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.V250990.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3,6 Residents admitted to the home had their needs assessed in order that the home could ensure that those needs could be met. EVIDENCE: Since the last inspection assessments and care plans developed by the home had been reviewed. All assessments and care plans, which were examined by the inspector, were for residents of Rose Unit. The assessment information seen was comprehensive identifying all aspects of residents personal care and health care needs. There had been a development of seeking further information on each resident’s personal history and social and recreational needs. The home sought the assistance of family members in providing this information. For some residents this provided the home with extensive information to assist care planning, although this was not always the case. Risk assessments were undertaken for moving and handling, tissue viability, nutrition, risk of falls and any specific risks for individual residents. The home did not provide intermediate care. Meadows Care Home (The) DS0000020054.V250990.R01.S.doc Version 5.0 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): 7,8,9,10 Care plans are developed in consultation with residents and their families and reflect their preferences. EVIDENCE: A sample of care plans from Rose unit was examined which included care plans for some younger disabled people. Care plans were both detailed and extensive identifying all aspects of residents’ personal and health care needs with associated risk assessments in place. Social care, recreational and cultural needs were identified and personal histories were in place where the resident and /or their family provided information. Care plans were reviewed monthly. Full records were maintained of all health care inputs and these demonstrated that health care issues were addressed. The administration of medication was inspected within Rose Unit. The home had the MDS system of medication. in most cases the photograph of the resident was included with medication records. Storage of medication was appropriate. At the time of the inspection no controlled drugs other than Temazepam were administered although the home had storage and an appropriate controlled drug book. Records were maintained including records of refusals. Where refusals were frequent the GP would be informed and asked Meadows Care Home (The) DS0000020054.V250990.R01.S.doc Version 5.0 Page 10 to review medication. At the time of the inspection no resident managed their own medication although arrangements were made when this was the wish of the resident. Residents and family members confirmed that they were treated with respect and courtesy. Other residents seen briefly by the inspector indicated that they were happy in the home. Since the last inspection the manager had acquired a copy of the national standards for younger adults and could demonstrate how she and the staff had reflected on these and changed elements of the service to the younger disabled residents. It was pleasing to note that where a resident was undertaking rehabilitation with a view to returning home, a larger room had been provided to assist in the development of independence skills. Meadows Care Home (The) DS0000020054.V250990.R01.S.doc Version 5.0 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): 12,13 Residents are benefiting from a more holistic approach to meeting their needs and the development of a wider range of activities. EVIDENCE: Service users and their families confirmed that activities were provided. There has been a development of activities since the last inspection particularly in the morning. The manager indicated that in Rose unit there had been fewer activities than in Lavender unit where a range of activities had been identified at the time of previous inspections. However there was ongoing development of a programme for Rose unit. With improvements in care planning they have established what residents like and are developing more individual programmes. Younger disabled residents are given the opportunity to out shopping and undertake daytime activities where their health permits. There was evidence at the time of the inspection of frequent visitors to the home. Discussion with one family member confirmed that visitors are made welcome and their views are sought. Meadows Care Home (The) DS0000020054.V250990.R01.S.doc Version 5.0 Page 12 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 Residents are protected by clear procedures to respond to complaints and any concerns regarding the abuse of vulnerable adults. EVIDENCE: The home had complaints procedures, which were made available for residents and their families. Complaints were investigated and responded to. A family supporter indicated that the manager was responsive to concerns expressed. Since the last inspection the home had developed new policies and procedures. 12 staff members had received training and the development manager had planned to undertake training for trainers, in order to provide training on adult protection to all homes within the company. Meadows Care Home (The) DS0000020054.V250990.R01.S.doc Version 5.0 Page 13 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): 19,26 Residents benefit from accommodation, which is accessible and well maintained and work is on going to ensure that the home is furnished to good domestic standards. EVIDENCE: The home comprises of two single storey units, which are accessible for residents. It is maintained to a good standard and there is an on-going programme of redecoration and improvement. Since the last inspection armchairs have been replaced in Rose unit but the dining room furniture in that unit remained inappropriate being plastic patio style furniture. This had been raised at previous inspections but it was anticipated by the manager that this would be replaced as part of the on-going programme of refurbishment. The home was managed to a good standard of cleanliness. Although sluicing facilities were in place, Rose Unit, which provided nursing care, did not have a sluicing disinfector. This had been raised at previous inspections. Meadows Care Home (The) DS0000020054.V250990.R01.S.doc Version 5.0 Page 14 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): 27,30 Residents in the home benefit from a committed, well trained staff group. EVIDENCE: The home maintains appropriate staffing levels. Levels of training in the home are very good with records showing that there is an ongoing programme to ensure that staff have mandatory training. There is evidence of a strong commitment to NVQ training, of the 41 care staff employed 21 have or are completing NVQ2 and a further 11 have or are completing NVQ3. Three staff members were undertaking NVQ Assessor training. Historically staffing within Lavender Unit was stable but there was a higher staff turnover within Rose Unit. At the time of the inspection staff turnover within Rose Units had reduced to a low level, ensuring that the home benefited from the commitment to staff training. Meadows Care Home (The) DS0000020054.V250990.R01.S.doc Version 5.0 Page 15 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 Improvements to the running of the home have been focused on providing an improved and consistent quality of service to residents. EVIDENCE: The manager has completed the Registered Managers Award. She has significant experience as a manager of Lavender Unit and has overseen significant improvements in the performance within Rose Unit since the change in registration of the home. The manager is well supported within the company and within the management team of the home. The manager has worked to ensure that there is a consistent level of care throughout the home and that work is still continuing. This has included attention to staff training, activities for residents and the needs of younger adults accommodated within the home. Meadows Care Home (The) DS0000020054.V250990.R01.S.doc Version 5.0 Page 16 The manager had ensured that assessments of the quality of the service had been made and these included seeking the views of visiting professionals as well as residents and their families. Records of precautions taken to reduce the risks of Legionella are still not held in the home. Meadows Care Home (The) DS0000020054.V250990.R01.S.doc Version 5.0 Page 17 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 x x 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 x COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 2 x x x x x 2 STAFFING Standard No Score 27 3 28 x 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 x 3 x x 2 Meadows Care Home (The) DS0000020054.V250990.R01.S.doc Version 5.0 Page 18 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 Timescale for action 31/03/06 2 OP26 23(2)(k) 2 OP38 13(4)(a)& (c) The registered person must provide appropriate dining furniture, which is safe to use and domestic in nature. This requirement is outstanding from previous inspections. The registered person must 31/03/06 provide sluicing disinfecting facilities. This is outstanding from previous inspections. The registered manager must 31/12/06 ensure she has access to records of precautions taken to reduce the risks of Legionella and that these are available for inspection. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Meadows Care Home (The) DS0000020054.V250990.R01.S.doc Version 5.0 Page 19 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. Extracts may not be used or reproduced without the express permission of CSCI Meadows Care Home (The) DS0000020054.V250990.R01.S.doc Version 5.0 Page 20 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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