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Inspection on 10/05/05 for The Meadows Nursing Home

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

This inspection was carried out on 10th May 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

What has improved since the last inspection?

The inspector discussed the requirements from the last inspection with the registered manager. All staff receive manual handling training as part of their induction and have separate training in addition. Staffs practice is monitored in supervision. Staffing rotas were seen and the needs of residents are clearly paramount when planning staffing. All staff receive comprehensive training packages. All files tracked contain Waterlow assessments for risk of developing pressure sores. These are followed up with specific risk assessments. At the time of the inspection only one resident had a pressure sore and this had been acquired during a stay in hospital. With the exception of the areas detailed below, all aspects of the storage, recording and administration of medication were found to be appropriate. Files tracked indicated that residents` continence needs are managed appropriately. Residents are enabled to access doctors when they need to. All care plans regarding diabetic residents were found to be comprehensive and useful. Care plans examined on the day of the inspection had all been evaluated, none more than a month before the inspection. Residents who spoke with the inspector indicated that they are treated as individuals and with dignity. Call bell response times are recorded and these appeared to be within reasonable limits. Communication between staff and residents appeared appropriate, as did that between staff and relatives. Residents` views of the service are sought regularly and made available to any interested parties. All risk assessments regarding health and safety were up to date and accurate. All files tracked contained risk assessments regarding risk of falling. The inspector saw a chlorination certificate and signing relating to oxygen cylinders. Any issues relating to the protection of vulnerable adults are reported to the appropriate authorities.

CARE HOMES FOR OLDER PEOPLE The Meadows Nursing Home 94 Loughborough Road Thringstone Coalville Leicester, LE67 8LR Lead Inspector Steve Hunnybun Unannounced 10 May 2005 at 09:30am 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 Nursing Home C51 The Meadows Nursing Home V226771 100505.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service The Meadows Nursing Home Address 94 Loughborough Road Thringstone Coalville Leicestershire LE67 8LR 01530 223800 01530 223833 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) Park Care Home (No 2) Ltd Mrs Anne Elizabeth Pyecroft Care Home 34 Category(ies) of OP Old age (34) registration, with number of places PD(E) Physical disibility - over 65 (34) The Meadows Nursing Home C51 The Meadows Nursing Home V226771 100505.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: none Date of last inspection 22nd December 2004 Brief Description of the Service: The Meadows Residential and Nursing Home is a care home providing accommodation for up to thirty-four service users with Nursing needs. It is located in the village of Thringstone near Coalville Leicestershire. The home can be accessed by car from Loughborough, Coalville and Ashby de la Zouch. Bus services run regularly through the village. Local beauty spots include Charnwood Forest and Bradgate park. The home is within easy access of the M1 and M42 motorways.The building itself is a modern purpose built property set in its own grounds and is located in a residential area. Accommodation is available on ground and first floors. A passenger lift provides access to the first floor. All areas of the home and grounds are accessible for people with limited mobility. The Meadows Nursing Home C51 The Meadows Nursing Home V226771 100505.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over approximately seven hours and was the first statutory unannounced inspection for this year. Four residents files were examined, the registered manager, area manager and other staff spoke with the inspector, as did three residents and one relative. The inspector also received a tour of the building. Comments received included, ‘the home is lovely’, ‘we are well looked after’, ‘food is great’ and ‘my family visit every day and we can always have privacy’. The relative who spoke with the inspector stated that she feels her dad is well looked after and that the staff are very nice. What the service does well: Residents’ needs are assessed and the home is proactive in ensuring that such needs are met. Residents and their families in turn feel that their needs are met. Assessments are backed up by comprehensive care plans that set out exactly how residents’ specific needs are to be met. Residents’ health care needs are included within the assessment and care plan and they are supported to access the GP and any specific healthcare services. Where appropriate residents are enabled to administer their own medication and risk assessments are completed when this occurs. Other medication is generally stored, administered and recorded appropriately. Residents are offered suitable activities and are supported to access the local community. All residents are enabled to maintain contact with friends and families. One resident stated that his family are able to visit him at any time and they are able to meet in privacy. A resident’s daughter was visiting on the day of the inspection and was very positive about the home. Residents who spoke with the inspector state that the food is very good. The inspector saw the dining rooms before lunch and they appeared very pleasant and homely. All residents and relatives who spoke with the inspector stated that they feel able to complain and are confident that their views will be listened to. The home has a robust and comprehensive protection procedure and residents appear to feel safe in the home. The property has a very homely feel. Rooms are decorated to a high standard and residents are able to choose the décor if they wish. The environment is safe and clean and adaptations are provided to meet residents needs where appropriate. The home benefits from a well-trained staff team with sufficient numbers to meet residents’ needs. Recruitment procedures are The Meadows Nursing Home C51 The Meadows Nursing Home V226771 100505.doc Version 1.30 Page 6 designed to protect residents by screening out potential abusers through CRB checks and references. The home is well managed with residents’ interests at heart. Residents’ financial affairs are managed in a way that prevents financial abuse or exploitation. Policies and procedures are in place to ensure that health and safety of all who use the home. What has improved since the last inspection? What they could do better: Any medication taken into the home must have an appropriate pharmacy label on it. The Meadows Nursing Home C51 The Meadows Nursing Home V226771 100505.doc Version 1.30 Page 7 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 Nursing Home C51 The Meadows Nursing Home V226771 100505.doc Version 1.30 Page 8 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 Nursing Home C51 The Meadows Nursing Home V226771 100505.doc Version 1.30 Page 9 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 Residents’ needs are assessed on or before admission to the home and they feel that they will be met. EVIDENCE: All files tracked contained comprehensive assessments of residents needs. These included general assessments of daily living as well as care needs assessments and specific assessments such as nutrition and moving and handling. The assessments were cross-referenced to care plans and other documents and had all been recently updated. Residents who spoke with the inspector stated that they feel their needs are being met. The Meadows Nursing Home C51 The Meadows Nursing Home V226771 100505.doc Version 1.30 Page 10 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) 7,8,9,10 Residents’ care plans are comprehensive and set out their care needs. Residents are confident that their health care needs are met when appropriate. Residents are enabled to administer their own medication and this is risk assessed when necessary. For those who cannot or choose not to, medication is generally stored, recorded and administered appropriately except that the home must ensure that all medication carries an appropriate pharmacy label. EVIDENCE: All files tracked contained comprehensive care plans that were based on information gained in the assessment process. They were very individualised and contained information on areas such as nutrition, skin care, personal care and social needs. One resident takes an anti-depressant medication and had a care plan for this that included information about his support needs while depressed, not just about taking the medication. All care plans examined had been evaluated no more than a month prior to the inspection. All files tracked contained extensive information about residents’ health care needs, two files were of people with diabetes and there was useful information about this. A resident who spoke with the inspector was diabetic and he stated that the staff provide him with the support he needs. All residents are The Meadows Nursing Home C51 The Meadows Nursing Home V226771 100505.doc Version 1.30 Page 11 registered with a GP and all appointments are recorded along with any advice or outcomes. Any access to other health professionals is also recorded. One file tracked was for a resident who administered his own medication and this was clearly covered in his care plan and risk assessment. The inspector examined medication records including the controlled drug book and found them to be in order. The drug cupboards were clean and tidy and medication was stored appropriately except for two bottles of prescription medication that did not carry a pharmacy label. Staff who administer medication are assessed as competent by the registered manager and the inspector was shown records of this. All files tracked contained information about how residents’ dignity is maintained. During the day the inspector observed staff addressing residents respectfully and politely. Residents who spoke with the inspector stated that they are afforded privacy when they receive visitors. The Meadows Nursing Home C51 The Meadows Nursing Home V226771 100505.doc Version 1.30 Page 12 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) 12,13,15 Residents are offered a lifestyle that matches their needs. Residents are able to maintain contact with their families and friends. Residents receive a healthy nutritious diet in pleasant surroundings. EVIDENCE: Files tracked contained a wealth of information about residents’ social needs. One resident who spoke with the inspector stated that he does not feel the need to join in organised activities but is happy to do his crossword and ‘put a couple of bob on the horses’. There were posters up around the home about various musical events that occur in the home including a ‘Songs of Praise’ evening. Staff and the relative who spoke with the inspector stated that these are well attended. During the inspection the registered manager received a call offering her ten places on a coach trip. These places were quickly filled. All files tracked contained useful information about contact details for friends and families. Residents and relatives who spoke with the inspector stated that visitors are able to go to the home when they wish and are always made to feel welcome. Residents and the relative who spoke with the inspector stated that the food is very good. The inspector was present during tea and observed staff offering residents a choice of pilchards or sandwiches. Residents appeared to enjoy their choices when they arrived. The dining rooms were very well appointed The Meadows Nursing Home C51 The Meadows Nursing Home V226771 100505.doc Version 1.30 Page 13 and pleasantly decorated rooms. One resident stated that the cook is ‘smashing’. The Meadows Nursing Home C51 The Meadows Nursing Home V226771 100505.doc Version 1.30 Page 14 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) 16,18 Residents and their families or friends feel confident to complain and that their complaints will be listened to. Residents are protected from abuse. EVIDENCE: One resident who spoke with the inspector stated that his daughter has complained on his behalf in he past but that such complaints have always been dealt with promptly and to his and his daughter’s satisfaction. The relative that spoke with the inspector stated that she has never had cause to complain but that she is confident that she would be listened to if she ever did. The home has a comprehensive adult protection policy and uses the MultiAgency Vulnerable Adult Protection document No Secrets. All staff receive training on abuse through their induction, as part of their NVQ and as standalone training. All files tracked contained risk assessments relating to protection issues such as financial vulnerability. Recruitment procedures are designed to keep residents safe from abuse, all new recruits are required to provide two references and a clear Criminal Records Bureau check. The Meadows Nursing Home C51 The Meadows Nursing Home V226771 100505.doc Version 1.30 Page 15 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) 19,22,26 The home is safe and well maintained and offers necessary adaptations to meet residents’ needs. The home is clean and tidy and high standards of hygiene are maintained. EVIDENCE: The home is pleasantly decorated throughout with many rooms having been personalised to their occupants’ individual taste. One resident was pleased that he has been able to bring some furniture from home to further personalise his room. Communal areas such as dining rooms and lounges were also very homely. All residents who need specialist equipment such as special beds or chairs can have this and an occupational therapist will be involved in advising such purchases. On the day of the inspection the home was clean and tidy. Staff clearly work very hard to keep it that way. The Meadows Nursing Home C51 The Meadows Nursing Home V226771 100505.doc Version 1.30 Page 16 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) 27,29,30 The home has sufficient skilled staff to meet residents’ needs. Recruitment policies and procedures are designed to ensure staff are protected from abuse. Staff are trained in all areas required to meet the needs of residents. EVIDENCE: The registered manager stated that the home provides one member of staff to every five residents throughout the working day. Residents who spoke with the inspector stated that the staff are always very helpful and respond to their needs as quickly as possible. All recruitment is managed centrally, at head office. The organisation has a robust recruitment procedure that is designed to protect residents. All new recruits are required to provide two referees. These are verified by telephone. A clear Criminal Records Bureau clearance is also required prior to employment. The registered manager interviews new staff and always offers a tour of the home prior to interview. The inspector was shown a training plan with a comprehensive programme of courses on it. In addition to a thorough induction and NVQ training staff also attend courses on subjects such as; diabetes, infection control, palliative care and moving & Handling. The Meadows Nursing Home C51 The Meadows Nursing Home V226771 100505.doc Version 1.30 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) 33,35,38 The home is run with regard to the best interests of residents. The home is proactive in protecting residents’ financial interests. The health and safety of residents is given due consideration. EVIDENCE: Residents’ views regarding the home are sought regularly. Ten percent of the resident group are offered questionnaires each month and the results are published. Relatives and other stakeholders’ views are also sought. All files tracked contained comprehensive risk assessments regarding residents’ monies. The home has a comprehensive policy regarding residents’ finances. Staff training covers a range of areas specifically relating to health and safety; these include the Control of Substances Hazardous to Health, fire safety and food hygiene. Water temperatures are monitored and recorded and the water is tested for leigionella. The inspector was shown a certificate for this. Regular fire drills are carried out and the home has a fire risk assessment. The Meadows Nursing Home C51 The Meadows Nursing Home V226771 100505.doc Version 1.30 Page 18 The Meadows Nursing Home C51 The Meadows Nursing Home V226771 100505.doc Version 1.30 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 3 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 3 COMPLAINTS AND PROTECTION 3 x x 3 x x x 3 STAFFING Standard No Score 27 3 28 x 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 3 x x 3 x 3 x x 3 The Meadows Nursing Home C51 The Meadows Nursing Home V226771 100505.doc Version 1.30 Page 20 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. Standard Regulation none Requirement Timescale for action 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 9 Good Practice Recommendations It is recommended that medication is not accepted into the home unless it has a correct pharmacy label on it. The Meadows Nursing Home C51 The Meadows Nursing Home V226771 100505.doc Version 1.30 Page 21 Commission for Social Care Inspection The Pavilions 5 Smith Way Grove Park, Enderby Leicester, LE19 1SX 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 Nursing Home C51 The Meadows Nursing Home V226771 100505.doc Version 1.30 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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