Inspection on 08/03/07 for WCC - Lower Meadow

This inspection was carried out on 8th March 2007.

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.

Other inspections for this house

WCC - Lower Meadow 27/01/09

WCC - Lower Meadow 05/03/06

WCC - Lower Meadow 26/09/05

WCC - Lower Meadow 25/02/05

WCC - Lower Meadow 14/10/04

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Ashcroft Hollow Nursing Home

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

CARE HOMES FOR OLDER PEOPLE WCC - Lower Meadow Drayton Avenue Stratford upon Avon Warwickshire CV37 9LF Lead Inspector Justine Poulton Key Unannounced Inspection 11:15 8th March 2007 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 WCC - Lower Meadow DS0000035959.V325970.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. WCC - Lower Meadow DS0000035959.V325970.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service WCC - Lower Meadow Address Drayton Avenue Stratford upon Avon Warwickshire CV37 9LF 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) 01789 268522 01789 414521 paulgaskell@warwickshire.gov.uk Warwickshire County Council, Social Services Department Paul Gaskell Care Home 35 Category(ies) of Old age, not falling within any other category registration, with number (35) of places WCC - Lower Meadow DS0000035959.V325970.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Manager`s Qualifications That Paul Gaskell achieves the required NVQ level 4 by the year 2005. 5th March 2006 Date of last inspection Brief Description of the Service: Warwickshire County Council manages Lower Meadow. The home is a local authority care home registered to provide personal care and support for up to 35 Older People. Lower Meadow is situated about one mile from Stratford Upon Avon town centre, where all community and health facilities offered in the town can be found. There is a bus service to the town every 15 minutes. The ground floor provides long term care for fourteen older people; respite care is also accommodated for, with one room on the ground floor. Within this area there is one lounge/kitchenette, and there is now a separate dining area. Day care for older people living in their own homes is provided within a dining/sitting area with attached conservatory area. The first floor accommodates twenty residents. Communal areas on the first floor consist of a lounge/kitchenette, and a further sitting room. The home has a pleasant appearance and a homely feel. The communal areas are well decorated and furnished attractively. All bedrooms contain en-suite facilities comprising of a toilet and wash hand basin. Two bedrooms also contain a shower. The home has a shaft lift. Car parking is provided to the front of the building. WCC - Lower Meadow DS0000035959.V325970.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was the first key inspection in relation to Inspecting for Better Lives. Identified key standards were looked at, along with a review of the organisations progress towards meeting requirements made at the previous inspection of this service. The pre fieldwork documentation was completed, as well as a site visit to the home, during which time staff, service users and the manager were spoken with. Three residents were identified for close examination by reading their care plans, risk assessments, daily records and other relevant information. This is part of a process known as ‘case tracking’ where evidence is matched to outcomes for residents. Other records, policies and procedures were also examined and the environment was looked at. Each resident in the home was sent a survey for voluntary completion prior to the inspection. Thirteen of these were returned. The views portrayed in these surveys are reflected within the body of this report. Similarly a number of relatives/visitors comment cards were also sent out, of which thirteen were returned. Again the views portrayed in these comment cards are reflected within this report. The inspector would like to thank the residents, manager and staff for their hospitality and co-operation during the inspection. The maximum current fees for the home are £380.24 per week. What the service does well: Prospective residents needs are assessed and considered prior to a place being offered in the home. This ensures that the home is confident that it will be able to meet the needs of those residents that are offered a place. Comprehensive service plans that detail the care and support needs of the residents are compiled shortly after the resident moves in to ensure that staff have accurate and relevant information about how best to support and care for the residents. The home has a friendly and relaxed atmosphere which residents and visitors appeared to appreciate. Residents views about the running of the home are sought via monthly residents meetings and more informal conversations. The health and safety of residents, visitors and staff are promoted through the up to date maintenance of equipment and systems throughout the home. Staff are competent and confident in their role, respectful and courteous to residents and visitors, ensuring that privacy and dignity are maintained. WCC - Lower Meadow DS0000035959.V325970.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. WCC - Lower Meadow DS0000035959.V325970.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection WCC - Lower Meadow DS0000035959.V325970.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Quality in this outcome area is good. Information is available to confirm that residents assessed needs can be met by the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Two residents have moved into the home since the previous inspection. One of these was chosen for case tracking purposes. An assessment completed by the placing social worker was in place and available in the individual files. A completed Homes Assessment and Capacity to Meet Need document was also in place however it was noted that this was not signed by the staff member that filled it in. This was discussed with the manager during the inspection who undertook to ensure that staff sign all documents they complete in the future. Visits to the home by prospective residents or their representatives are encouraged before the decision to move in is made. As well as permanent care the home has one respite bed that was being used at the time of the inspection. WCC - Lower Meadow DS0000035959.V325970.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9, 10 Quality in this outcome area is good. Information in service plans ensure that residents needs are met. Medication is managed safely on the residents behalf. Residents are treated with dignity and respect. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Staff spoken with said that a service plan is completed for each resident shortly after they move into the home. This is based on the information provided in the initial assessment and information gleaned by the staff from supporting and talking to the residents and their families. Two service plans were looked at, both of which were found to be detailed and informative, covering areas such as eating and drinking, mental health, mobility, leisure, social and lifestyle and communication to name a few. Future review dates were recorded, as were the actual dates of any reviews and the signature of the staff member undertaking the task. Information was available within the care plans looked at to confirm that the routine and more specialised healthcare of the residents is maintained and monitored. WCC - Lower Meadow DS0000035959.V325970.R01.S.doc Version 5.2 Page 10 Completed risk assessments were available in all the care plans examined. As well as manual handling assessments, other risk assessments examined included nutrition, walking unaided and smoking. As with the care plans looked at they were dated and signed, with review dates included. Medication prescribed to the residents is provided by Boots in a multi dosage system (MDS) which is accompanied by medication administration record chards (MARS). One member of staff is responsible for managing the medication within the home, which includes ordering it, booking it in when it arrives and arranging returns. This staff member talked through the medication procedure within the home in a confident and knowledgeable manner. The medication is stored within two lockable trolleys that are kept in a locked room. One the day of the inspection no errors were noted on the charts looked at, however it was noted that where codes are used for none administration on the chart, the explanation for this was not recorded on the back as the chart specifies. This was discussed with the manager during the inspection who undertook to ensure that staff record the use of codes appropriately in the future. It was pleasing to see that staff were respectful of residents and their visitors, knocking on doors before entering bedrooms, crouching to talk to residents using wheelchairs and ensuring that any personal care needed was offered discreetly. WCC - Lower Meadow DS0000035959.V325970.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15 Quality in this outcome area is good. Activities are available for residents to participate in that take into account individual preferences. Visitors are welcomed into the home. Meals are well presented, wholesome and provide residents with a nutritious and balanced diet. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager said in discussion that the home does not employ an activities co-ordinator, or have a formal plan of activities for residents to participate in each week. However activities and social events both in house and in the community are planned and are available to residents on a more informal basis should they wish to join in with them. Residents have monthly meetings during which activities that have been available and what activities they would like in the future are discussed. Residents surveys received prior to the inspection indicate that activities are ‘usually’ available within the home, however one stated that activities are only available if there is money available, which is generally once per month. Signs and notices available within the home informed the residents about an imminent fashion show that was going to take place. Residents visitors were made welcome in the home during the inspection. Those spoken with spoke very highly of the care and support that their WCC - Lower Meadow DS0000035959.V325970.R01.S.doc Version 5.2 Page 12 relatives receive. All of the relatives and visitors surveys received confirm that the manager and staff are very welcoming. This was also confirmed in conversation with visitors in the home during the inspection. At the time of the inspection the homes dining room was being decorated so alternative arrangements had been put in place for meal times. These did not seem detrimental to the residents in the short term. A brief look at the kitchen showed it to be clean, well ordered and well stocked. Health and safety measures appropriate to the kitchen were in place and up to date with the exception of the Hazard Analysis which required reviewing. This was brought to the attention of the manager who undertook to ensure that this was completed. The cook said that the menus are planned around the seasons and take into account feedback on the meals provided from the residents meetings. Lunch on the day of the inspection looked appetising, with choices being offered to the residents. All of the residents spoken with praised the food provided. It must be noted that the home had recently been awarded the Food Hygiene Inspection Rating Gold Award, and achievement that the manager, staff and residents were extremely proud of. WCC - Lower Meadow DS0000035959.V325970.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 18 Quality in this outcome area is good. Clear policies and procedures are in place that ensure that residents views are listened to and acted upon appropriately, and that residents are safeguarded from potential abuse. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a detailed complaints procedure which is available and accessible to residents, staff and visitors in the home. A record of complaints is also maintained, which is audited monthly. No complaints were recorded within the record. One anonymous complaint concerning changes in the environmental eating arrangements was received by the Commission for Social Care Inspection since the last inspection. This was referred back to the provider for investigation. A comprehensive policy on the protection of adults from abuse was available within the home. Staff spoken with were able to clearly state what they would do should they suspect any incidents of abuse. Staff training records provided subsequent to the inspection confirm that four of the staff team have undertaken specific training in abuse since 2005. WCC - Lower Meadow DS0000035959.V325970.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 26 Quality in this outcome area is good. Residents live in a comfortable and homely environment that presents as clean and hygienic. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home provides accommodation and care for 35 residents. This is divided into fourteen bedrooms on the ground floor along with one respite care bed, one lounge/kitchenette. Day care for older people living in their own homes is also provided within a dining/sitting area with attached conservatory on the ground floor. The first floor has twenty bedrooms along with a communal areas lounge/kitchenette, and a further sitting room. A separate large dining room is also available for use by all of the residents on the ground floor. The home has a pleasant appearance and a homely feel. The communal areas are well decorated and furnished attractively. All bedrooms contain en-suite facilities comprising of a toilet and wash hand basin. Two bedrooms also contain a shower. The home has a shaft lift. Car parking is provided to the front of the building. WCC - Lower Meadow DS0000035959.V325970.R01.S.doc Version 5.2 Page 15 On the day of the inspection the dining room was in the process of being redecorated so alternative eating arrangements were in place, however these did not appear to inconvenience the residents. The home was clean and tidy throughout, with no unpleasant odours apparent. WCC - Lower Meadow DS0000035959.V325970.R01.S.doc Version 5.2 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 consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29, 30 Quality in this outcome area is good. The numbers and skill mix of staff on the day of inspection were sufficient to meet the needs of residents accommodated in the home. The home’s recruitment policies and procedures support and protect the residents from harm. Staff receive training appropriate to their role within the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home employs ten care assistants, six permanent night staff, three care officers, duty manager, assistant manager and the home manager. In addition a number of casual bank staff are also available to cover shifts as needed. Supporting the care team are a team of seven ancillary staff. This information was taken from the pre inspection questionnaire received prior to the inspection. Rota’s provided along with the pre inspection questionnaire indicated that six care staff cover the home on each day shift and two staff over night. Staff on duty confirmed this on the day of the inspection. Staff were seen to be respectful towards the residents and their visitors throughout the inspection. The atmosphere was relaxed in the home, with residents appearing comfortable in approaching the staff. It was not possible during the inspection to confirm what training staff had undertaken over the previous 12 months as the records were not complete. Complete staff training records have been received subsequent to the inspection however. These records confirm that staff are on a rolling programme to ensure that the mandatory areas such as fire safety, first aid WCC - Lower Meadow DS0000035959.V325970.R01.S.doc Version 5.2 Page 17 and manual handling are updates at the required intervals. Staff have also undertaken more specific training in areas such as dementia awareness, mental health awareness, equality and diversity and infection control. Information recorded in the pre inspection questionnaire states that 32 of the staff team have achieved their NVQ level II or above as at November 2006. Three staff files were looked at during the inspection. All of the documentation required to confirm that recruitment practices safeguard the residents were in place. WCC - Lower Meadow DS0000035959.V325970.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 38 Quality in this outcome area is good. The home has an effective management structure in place, which results in effective leadership and a clear ethos that safeguards and promotes service users best interests. The homes maintenance systems and procedures ensure that the health and safety of residents, staff and visitors is maintained. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The manager of the home has successfully completed the required NVQ IV qualification. The condition relating to this can now be removed from his registration with the Commission for Social Care Inspection. Staff and residents spoken with talked highly of the manager. Staff were positive about the style of management employed and said that he was always approachable, open and willing to assist should they require help. WCC - Lower Meadow DS0000035959.V325970.R01.S.doc Version 5.2 Page 19 The residents have monthly meetings during which they discuss aspects of the home that they feel relevant. Residents spoken with confirmed that they had been involved in choosing the new décor for the dining room, and said that they get to contribute towards the homes menus ands any activities that are planned. It was pleasing to note that all of the residents spoken with felt that the home was ‘their home’, and that they were listened to and consulted with. The home has no responsibility for residents monies other than for their personal spending money, should they wish. The manager said that all of the residents finances are looked after either by relatives or Age Concern. For those residents that choose to have their personal spending moneys looked after by the home, clear individual records were maintained. Those looked at were up to date and accurate with recorded balances matching monies available. Information provided in the pre inspection questionnaire received prior to the inspection confirmed that all of the necessary maintenance checks and tasks are undertaken as required. A small sample consisting of the homes fire safety procedures and servicing of the hoists were looked at and were up to date. WCC - Lower Meadow DS0000035959.V325970.R01.S.doc Version 5.2 Page 20 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 x 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 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 x x x x x x 3 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 3 x 3 x 3 x x 3 WCC - Lower Meadow DS0000035959.V325970.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? NO 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. Standard Regulation 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. Refer to Standard Good Practice Recommendations WCC - Lower Meadow DS0000035959.V325970.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Leamington Spa Office Imperial Court Holly Walk Leamington Spa CV32 4YB National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 WCC - Lower Meadow DS0000035959.V325970.R01.S.doc Version 5.2 Page 23 - 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!