Please wait

Please note that the information on this website is now out of date. It is planned that we will update and relaunch, but for now is of historical interest only and we suggest you visit cqc.org.uk

Inspection on 04/08/05 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 4th August 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

The questionnaires completed by the service users all indicated they felt well cared for, safe, staff treat them well and their privacy is respected. Comments made by the service users during the inspection were also positive about the home and the care received including "the people are nice, they help us day or night", "staff are kind and helpful" and "its our home, I like it here". There is a consistent and stable staff team who demonstrated a good understanding of the needs of the service users and they felt supported by the management team to provide a good service. Staff training is encouraged and supported to ensure they have the skills and knowledge to meet needs.

What has improved since the last inspection?

Care plans have been updated and were signed and dated by the nurse and by the service user or their representative. An activity organiser has been employed and a weekly plan of activities is available on notice boards. The service users spoken to were happy with the level of activity available and enjoyed in house games and activities both in groups and 1:1 sessions along with external entertainers coming into the home. The staff files have been updated to include all the necessary information to ensure a detailed recruitment process is followed and staff are suitable to work in this area.

CARE HOMES FOR OLDER PEOPLE The Meadows Care Home 48 Moorend Road Yardley Gobion Towcester NN12 7UF Lead Inspector Moira Mosley Unannounced 4 August 2005 12.30 th 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 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. The Meadows Care Home C51 C08 S12651 The Meadows V243022 040805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service The Meadows Care Home Address 48 Moorend Road Yardley Gobion Towcester Northants NN12 7UF 01908 543251 01908 543234 Telephone number Fax number Email 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 with Nursing 34 Category(ies) of OP Old Age (34) registration, with number of places The Meadows Care Home C51 C08 S12651 The Meadows V243022 040805 Stage 4.doc Version 1.40 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 Date of last inspection 5th October 2004 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 accomodated. Accomodation 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. The Meadows Care Home C51 C08 S12651 The Meadows V243022 040805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a statutory unannounced inspection; 2 hours were spent gathering information and planning for the inspection and 3.5 hours were spent in the home. The care of three service users was reviewed to include their care plans, risk assessments and other records. A period of observation and discussion with five of the service users was undertaken along with discussions with three staff members and two visitors to the home to ascertain how care is provided. Questionnaires were returned to the Commission for Social Care Inspection from five of the service users. What the service does well: What has improved since the last inspection? Care plans have been updated and were signed and dated by the nurse and by the service user or their representative. An activity organiser has been employed and a weekly plan of activities is available on notice boards. The service users spoken to were happy with the level of activity available and enjoyed in house games and activities both in groups and 1:1 sessions along with external entertainers coming into the home. The staff files have been updated to include all the necessary information to ensure a detailed recruitment process is followed and staff are suitable to work in this area. The Meadows Care Home C51 C08 S12651 The Meadows V243022 040805 Stage 4.doc Version 1.40 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. The Meadows Care Home C51 C08 S12651 The Meadows V243022 040805 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection The Meadows Care Home C51 C08 S12651 The Meadows V243022 040805 Stage 4.doc Version 1.40 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 standard(s) 3. Service users are fully assessed to ensure their needs can be met prior to admission. EVIDENCE: A detailed pre admission assessment ensures that needs are assessed and input was evident from other relevant professionals including care management and nursing where appropriate. Staff spoken to confirmed they are given information about prospective service users prior to an admission. The Meadows Care Home C51 C08 S12651 The Meadows V243022 040805 Stage 4.doc Version 1.40 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 standard(s) 7,8,10. Overall care plans and risk assessments identify service user needs however behaviour care plans are inadequate to ensure a safe and consistent approach. Healthcare needs are generally well managed but pressure ulcer assessments need to identify action taken in response to risks identified. EVIDENCE: Care plans are available for most identified needs; these are signed and dated with evidence of regular review. Service users or their representatives have signed agreement to the care plans in place. There was one service user identified who had episodes of verbal aggression towards staff and other service users. There was no specific care plan in place to identify action to be taken by staff for a consistent approach. There were behaviour recording sheets (ABC records) in place, but no guidelines of how they were to be used, who would review these and what action would be taken as a result of them. The Meadows Care Home C51 C08 S12651 The Meadows V243022 040805 Stage 4.doc Version 1.40 Page 10 Healthcare assessments were available in the service user files and these included nutritional and falls risk assessments. Although Waterlow pressure ulcer assessments were available the action taken in the event of an identified need was not documented. Two service users had a high risk of pressure sores identified with no evidence of whether pressure-relieving equipment was in use. Both the service users identified had pressure-relieving mattresses in place, but there was no care plan to identify what measures and action were required by staff to minimise the risk of pressure ulcers developing. The questionnaires completed by service users all indicated that their privacy and dignity is maintained and discussions with two of the service users also confirmed this. One service user spoke about how staff knocked the bedroom door and always asked and explained what they were going to be doing. All the service users and the two visitors spoken t praised the staff for their approach to the service users. The Meadows Care Home C51 C08 S12651 The Meadows V243022 040805 Stage 4.doc Version 1.40 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 standard(s) 12,13 and 14 Social interaction and activities are well managed to provide daily interest and variation for the service users. EVIDENCE: An activity organiser is employed and a weekly plan of activities is available on the notice boards. Service user files contain information about the service users history, their interests and hobbies, which are used to develop appropriate activities they may enjoy. The service users spoken to were very happy with the activities provided and spoke about the quizzes, bingo, manicures and visiting entertainers that come to the home. The visitors spoken to confirmed they are welcome to visit at any time and the service users said they were encouraged and supported to maintain contact with family and friends, with them always welcomed into the home. One of the service users spoke about how they are able to make decisions on a daily basis and this included times for getting up and going to bed, choices on meals and snacks and how they wish to spend their time, whether it was in The Meadows Care Home C51 C08 S12651 The Meadows V243022 040805 Stage 4.doc Version 1.40 Page 12 their own room, in one of the communal areas including the gardens or participating in activities. The Meadows Care Home C51 C08 S12651 The Meadows V243022 040805 Stage 4.doc Version 1.40 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 standard(s) 16 There is an effective system in place to respond appropriately to complaints made. EVIDENCE: The complaints procedure is available within communal areas and the service users spoken to said they were aware of how to raise any issues or concerns. They also said that the staff and the manager were responsive to any issues raised. The Meadows Care Home C51 C08 S12651 The Meadows V243022 040805 Stage 4.doc Version 1.40 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 standard(s) 19,21 and 24. The home provides an overall safe and comfortable environment for the service users. EVIDENCE: The home was clean and tidy and both the service users and visitors spoken to said they were happy with the facilities. The home is compliant with fire and environmental health requirements and records support this. Many of the bedrooms have their own en suite facilities and in addition there are four bathrooms with assisted bathing facilities. The service users spoken to confirmed they like their bedrooms and have the facilities and equipment needed. Bedrooms seen were nicely decorated and personalised by the service users. There are no locks available on service user bedrooms however the service users spoken to stated they did not feel a need to have these provided. The manager stated they could be provided if requested. The Meadows Care Home C51 C08 S12651 The Meadows V243022 040805 Stage 4.doc Version 1.40 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,28,29 and 30. The staff team have the experience, skills and knowledge and are supported by systems to ensure they are able to meet service user needs. EVIDENCE: Staff spoken to confirmed there are sufficient numbers on duty to meet the service user needs. The manager has completed the calculations of staff required and they provide the necessary cover. The service users spoke highly about the staff team and comments included “the staff are very nice” and “they are always helpful and kind”. There are currently 37.5 of staff qualified with the National Vocational Qualification (NVQ) at level 2 with a further 4 staff currently working on level 2 and 3 doing their level 3 qualification. A detailed recruitment process is implemented and staff files contain the necessary documentation to ensure staff are fully assessed and have the necessary checks to ensure they are suitable for this employment. A detailed induction programme is in place to ensure staff are given instruction and training when they commence employment. The Meadows Care Home C51 C08 S12651 The Meadows V243022 040805 Stage 4.doc Version 1.40 Page 16 Staff confirmed they are supported and encouraged to access training to ensure they have the skills and knowledge to meet the identified needs of the service users. The Meadows Care Home C51 C08 S12651 The Meadows V243022 040805 Stage 4.doc Version 1.40 Page 17 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32,36 and 38. There is an effective management system in place to give clear guidance and support to the staff team and to the service users. Service users health and safety is compromised due to the lack of qualified first aid staff to respond to illness or accident. EVIDENCE: Staff, service users and visitors spoken to were positive about the management of the home and said the manager was supportive and approachable. One service user spoke about how the manager had come and explained to them a new process that was being implemented with the opportunity for discussion and input into the decisions made. Staff confirmed they have regular formal supervision with their line manager and yearly appraisals to assess their role and look for developments both for them personally and for the home. The Meadows Care Home C51 C08 S12651 The Meadows V243022 040805 Stage 4.doc Version 1.40 Page 18 Manual handling plans were available for all service users and gave detailed instructions for staff. Staff confirmed they have received all statutory training including manual handling, fire and food hygiene. Fire records showed regular fire drills and the maintenance of equipment to ensure fire safety legislation is met. Maintenance records and certificates for regular checks on all equipment and facilities are available. There are only two qualified first aid staff available in the home and they were unable to ensure a first aider is available at all times to respond to accidents and illness. The Meadows Care Home C51 C08 S12651 The Meadows V243022 040805 Stage 4.doc Version 1.40 Page 19 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 x COMPLAINTS AND PROTECTION 3 x 3 x x 2 x x STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x x 3 x x x 3 x 2 The Meadows Care Home C51 C08 S12651 The Meadows V243022 040805 Stage 4.doc Version 1.40 Page 20 no Are there any outstanding requirements from the last inspection? 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. 2. Standard 8 38 Regulation 12(1)(a)( b) 12(1)(a) and 13(4)(c) Requirement Pressure ulcer assessments must be fully completed and detail of any action taken documented. There must be a qualified first aider on duty at all times. Timescale for action 30/09/05 30/10/05 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 7 24 Good Practice Recommendations Identified behavioural needs should have care plans written to give clear direction and a consistent approach by staff. Service users should be offered the provision of a suitable door lock to their bedrooms and their decision recorded. The Meadows Care Home C51 C08 S12651 The Meadows V243022 040805 Stage 4.doc Version 1.40 Page 21 Commission for Social Care Inspection 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 The Meadows Care Home C51 C08 S12651 The Meadows V243022 040805 Stage 4.doc Version 1.40 Page 22 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!