Inspection on 06/02/06 for The Meadows Care Home

This inspection was carried out on 6th February 2006.

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 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 28/11/06

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 Andrew Bailey Unannounced Inspection 6th February 2006 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.V281067.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) DS0000020054.V281067.R01.S.doc Version 5.1 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.V281067.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 28th September 2005 Brief Description of the Service: The Meadows Care Home comprises two separate purpose-built, single storey units (Lavender Court & Rose Court), each set within its own grounds. The home is situated in Alfreton, close to the town centre. It is on a local bus route and is a short distance from the train station. The Meadows is registered to provide nursing care and also admits up to ten younger persons with physical disability. The combined registration is for seventy service users. Lavender Court provides 28 single rooms and one shared room. Personal care services are offered at this unit. Rose Court provides 34 single rooms and three shared rooms. Nursing care services are offered at this unit. Both units have spacious lounges and dining areas. Meadows Care Home (The) DS0000020054.V281067.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection and the duration of the inspection was approximately five hours. Discussions were held with staff and seven residents. There were no relatives available to speak with during the inspection. A number of records were examined, including care plans (as part of the case tracking process, which is used to help determine how the home meets the needs of individual residents). The focus of this inspection was on key National Minimum Standards and the follow up of requirements from previous inspection of this service. Efforts were made to obtain the opinions of as many of the residents as possible about the quality of the service. What the service does well: What has improved since the last inspection? Consultation with residents has included residents’ meetings and this provides a mechanism for residents and/or their representatives to shape their life at the home. The management reported further advancement in the training of staff, including National Vocational Qualification (NVQ) levels 2 & 3, safe working practices and medication training. Acknowledgement is given for the training that has taken place to further equip staff to meet the needs of residents with dementia. This is important because residents can present with dementia, where this is not the primary Meadows Care Home (The) DS0000020054.V281067.R01.S.doc Version 5.1 Page 6 need for admission (the registration at this home is not for residents with an overriding need for dementia care). The senior officer in charge, based at Lavender Court, has commenced management training since the last inspection. This is not mandatory and therefore demonstrates the proactive approach to staff development. In addition, two staff had undertaken a course in supervision. There has been continuation of the on-going maintenance/redecoration programme, with further bedrooms decorated since the last inspection. New lounge chairs have also been purchased. 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.V281067.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) DS0000020054.V281067.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): None EVIDENCE: (All key standards were assessed at the last inspection, with no requirements or recommendations made) Meadows Care Home (The) DS0000020054.V281067.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): None EVIDENCE: (All key standards were assessed at the last inspection, with no requirements or recommendations made) Care plans were examined at this inspection in respect of the case tracking process only. Meadows Care Home (The) DS0000020054.V281067.R01.S.doc Version 5.1 Page 10 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): 14 & 15 Residents spoken with confirmed that choices and control over their lives are promoted and supported by staff. Feedback from residents indicates that most feel that that the meals offered are of a good standard. Residents confirmed that there is a choice of meals. EVIDENCE: Seven residents were spoken with during the inspection of the two separate units that comprise The Meadows. Their feedback confirmed that staff treat them as individuals and strive to assist the residents to be as independent as possible. Staff, as far as possible, assume a supportive role. This was particularly noticeable in Lavender Court where the residents spoken with tended to be more physically capable. In Rose Court the increased dependency of the residents dictates that many require significant assistance from staff to meet identified needs e.g. moving and handling. In both units it was apparent from residents comments that choices are upheld, for example in seeking meal preferences. The inspector witnessed residents being consulted about the food alternatives for the forthcoming evening meal. Many of the residents had personalised their rooms with their own possessions. Meadows Care Home (The) DS0000020054.V281067.R01.S.doc Version 5.1 Page 11 The views of residents are sought about the quality of the catering service (and other daily life issues), for example through residents’ meetings. Residents confirmed that their views were made known to management and staff (and responded to) through one-to-one interaction with staff as well as the periodic review systems and meetings. The feedback from residents, obtainable on the day of the inspection, was positive overall about the quality of the food. One resident felt that insufficient salt was used in cooking, but most were satisfied with the quality of the meals and the choices available. A rolling four-weekly menu is in operation and special diets are provided where appropriate. The menu is changed in response to resident feedback. Meadows Care Home (The) DS0000020054.V281067.R01.S.doc Version 5.1 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): None EVIDENCE: (All key standards were assessed at the last inspection, with no requirements or recommendations made) Meadows Care Home (The) DS0000020054.V281067.R01.S.doc Version 5.1 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): 20, 25 & 26 The Meadows provides a comfortable, easily accessible and well-maintained environment for residents. There is potential to improve the dining area furnishings in Rose Court for the benefit of residents. The preventive/safety systems for water services and waste services need to be reviewed to ensure that residents are fully protected. EVIDENCE: Residents indicated that they were satisfied with the standard and level of comfort provided at the care home. One resident spoken with had recently moved to another bedroom due to the view from the window being more to the resident’s choosing. The management stated that there are provisional plans to upgrade areas of the home, as part of on-going maintenance/development plans. The planned improvements include the dining area in Rose Court. There is a current requirement (timescale not expired) in respect of the dining furniture. Meadows Care Home (The) DS0000020054.V281067.R01.S.doc Version 5.1 Page 14 Further bedrooms have been redecorated since the last inspection and new lounge chairs have been purchased, demonstrating that the providers seek to improve the environment on a continual basis. The registered manager has requested the registered providers to purchase a new hoist for moving and handling of residents. The manager reported that this is under consideration by the providers. There is a current requirement for the provision of a sluicing disinfector (timescale not expired). Management reported that they are considering this requirement; the Development Manager stated that there was an intention to consult formally with the Environmental Health Officer on this issue. The heating system in Rose Court is predominantly of the electric storage type, with the potential for the covers to become very hot. A risk assessment process has been undertaken to identify risk of heat injury to vulnerable residents, with protective covers fitted where indicated. This will need regular review to ensure that residents remain safe, for example if a resident were to wander. Risk assessment is needed to ensure that vulnerable residents do not suffer scalds from hot water. This is relevant to Rose Court, where water outlets are not thermostatically controlled on wash hand basins (only on baths/showers). Preventive action will be needed, where/if indicated from the risk assessment process e.g. by the fitting of thermostatic valves. Hot water warning signs need to be placed at any outlets not governed by thermostatic valves. Meadows Care Home (The) DS0000020054.V281067.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): 28 & 29 The training programme prepares staff to meet the needs of the residents. Thorough pre-employment processes promote the protection of the residents. EVIDENCE: There has been continued progress in staff undertaking training in National Vocational Qualifications (NVQ), Levels 2 & 3. There are currently more than fifty-percent trained members of care staff (NVQ Level 2, or equivalent). Two members of care staff have undertaken distance-learning study on the subject of supervision. The senior officer in charge, based at Lavender Court, has commenced management training since the last inspection. This is not mandatory and demonstrates a proactive approach to staff development. A number of staff had completed distance-learning training on dementia, with further staff commencing this. Whilst the home does not carry registration status for dementia it is commendable that this training is being undertaken, since many residents are admitted with dementia (where dementia is not be the primary identified care need). Residents spoken with commended the care and support provided by friendly and professional staff. A sample of staff recruitment documentation was examined at this inspection and there seemed to be a thorough approach to pre-employment checks. Meadows Care Home (The) DS0000020054.V281067.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): 38 Overall, safe working practices systems promote the health and safety of the residents. EVIDENCE: Staff training in safe working practices has continued since the last inspection, with first-aid and basic food hygiene providing examples of recent training undertaken by staff. There was generally documentary evidence that services had been regularly serviced/inspected (a sample of records was examined at this visit). However, there must be further assurance that control measures for the prevention of Legionella follow a risk assessment and action plan (detailed and specific to this care home), with up-to-date and consistently documented evidence that checks have followed an action plan e.g. temperature checks and tank cleaning Meadows Care Home (The) DS0000020054.V281067.R01.S.doc Version 5.1 Page 17 schedules. At this inspection, some of the most recent records for tank cleaning/chlorination appeared to relate to 2001, although the maintenance person gave verbal assurance that checks had not lapsed. Also, the risk assessment and action plan included potentially subjective terminology, which could be open to interpretation in respect of timescales. Notwithstanding these documentary shortfalls, the overall approach to safe working practices indicated that satisfactory efforts were being made to promote the health and safety of the residents, staff and other persons visiting the premises. Meadows Care Home (The) DS0000020054.V281067.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 N/A HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 X 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X X 2 X X X X 2 2 STAFFING Standard No Score 27 X 28 3 29 3 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X X X X 2 Meadows Care Home (The) DS0000020054.V281067.R01.S.doc Version 5.1 Page 19 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. (This requirement is carried over from the last report and is within the timescale issued at the last inspection) 2. OP25 13(3,4) The registered persons must undertake risk assessments to identify potential scalding risks from hot water temperatures and assess the vulnerability of residents who have access to bathing and washing facilities. Preventive action to be taken, where indicated. The registered persons must provide sluicing disinfecting facilities. (This requirement is carried over from the last report and is within the timescale issued at the last inspection) 31/03/06 Timescale for action 31/03/06 3. OP26 23(2)(k) 31/03/06 Meadows Care Home (The) DS0000020054.V281067.R01.S.doc Version 5.1 Page 20 4. OP38 13(4) The registered persons must review the design solutions to control risk of Legionella and develop a comprehensive written risk assessment, action plan and an on-going record of steps taken to control risk. 31/03/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Meadows Care Home (The) DS0000020054.V281067.R01.S.doc Version 5.1 Page 21 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.V281067.R01.S.doc Version 5.1 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. 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