Care Home: Long Meadow Care Home

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What the care home does well The home operates an organised and planned approach to identifying what help people need and to making sure that the home is right for them before things are finally decided about moving in. People`s health and personal care needs are well met and other professionals concerned with their care are routinely involved. There are suitable management and auditing systems in place for monitoring health care systems and medicine management is safely organised. Staff recognise the importance of promoting people`s known lifestyles, and they are supported to express preferences and choices in their daily living routines; this extends to meal preferences and any special diets that might be needed.People know how to complain and are confident to do so and complaints are taken seriously by the manager and the company and acted on accordingly. People live in clean and comfortable environment, which generally suits their needs; these are well met by a staff team that is properly recruited, inducted and trained. The home is well managed in the best interests of people who live there and people`s health, safety and welfare is properly promoted and protected. Relationships with the home`s staff and management are friendly yet professional, and feedback from everyone was very positive about the service at the home and the care received: `They keep me busy and I`ve got plenty to do; I can`t think that anywhere else could be better` `I haven`t got a bad word for anyone, they always do their best` `Meals are very good, the laundry is very efficient and the home is always clean` `It`s a good life here, everybody`s so sweet` `I`ve settled well and I`ve got lots of friends here now` `The small size (of the dementia house) is a big positive and it always looks nice, with a relaxed atmosphere` `It`s a safe place for mum to live and nobody can wander off` `These are good people and they`ve helped him settle (into the dementia house) so very quickly`. What has improved since the last inspection? The opening of Meadow View, a special facility for people with dementia has been a major step forward, and the unit will be a valuable addition to the local network of services that support people and their families. Documentation in use by the home`s staff that helps them carry out their work in efficient and planned ways has continued to develop. The introduction of the `This is My life` document has allowed a greater insight into what each individual person likes, dislikes and enjoys, ensuring that all are offered an individualised programme of care and activities. A programme of refurbishment and redecoration of the home has been substantially progressed and the home is starting to look more modern and comfortable for the people living there to enjoy. All of the requirements made at the last inspection have been attended to and staff work with medicines in a safe and consistent way. CARE HOMES FOR OLDER PEOPLE Long Meadow Care Home Bakewell Road Matlock Derbyshire DE4 3BN Lead Inspector Brian Marks Unannounced Inspection 9th July 2008 09:00 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 Long Meadow Care Home DS0000069677.V368062.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. Long Meadow Care Home DS0000069677.V368062.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Long Meadow Care Home Address Bakewell Road Matlock Derbyshire DE4 3BN 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) 01629 583986 01629 760527 Southern Cross Healthcare (Focus) Limited Mrs Denise Margaret Spencer Care Home 40 Category(ies) of Dementia (40), Old age, not falling within any registration, with number other category (40) of places Long Meadow Care Home DS0000069677.V368062.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home only - Code PC To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP Dementia - Code DE The maximum number of service users who may be accommodated is 40. 15th August 2007 2. Date of last inspection Brief Description of the Service: Long Meadow is a care home registered to provide personal care and accommodation for up to 40 older people. The home is located close to the town of Matlock in a countryside setting and has a variety of lounges and dining areas as well as a designated smoking lounge and a quiet room/library. Accommodation is provided over three floors with a passenger lift. The home has 36 single and 1 double room; the shared room is currently used as a single so that the home currently can take a maximum of 37 people. Whilst 34 rooms have en suite facilities, there is a choice of bathroom facilities, including showers and assisted baths and toilets that have disabled access. All areas have an emergency call button and there is a variety of aids and environmental adaptations, including handrails and moving and handling equipment. Gardens provide ramped access and car parking space is provided. Since December 2007 the lower ground floor has been upgraded to accommodate 12 people who have been diagnosed as having dementia and the home’s registration changed accordingly. This unit is known separately as Meadow View or the dementia house. The current range of weekly fees for accommodation is £305.00 - £450.00. Items not covered by this fee included for hairdressing, chiropody, private transport, personal toiletries and newspapers, (this information was provided at the time of this inspection visit). Long Meadow Care Home DS0000069677.V368062.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. This was a Key unannounced inspection that took place at the home over one day. Additionally, time was spent in preparation for the visit, looking at key documents such as previous inspection reports, the most recent report about the home’s registration, records held by us and the written Annual Quality Assurance Assessment document (AQAA), which was returned before the inspection. All of the above material assisted with the preparation of a structured plan for the inspection. For administrative reasons no written surveys were sent out to staff or people living at the home. At the home, apart from examining documents, care files and records, time was spent with the manager of the home, who was in charge during the visit, and we also talked to seven of the staff working on the day shifts. The care records of four people who live at the home were examined in detail and two of these were interviewed along with six others. Three relatives who were at the home on the day of the inspection were also spoken to and a local care professional, involved with people living at the home, was spoken to by telephone. No other inspection visits have been made to the home since the last Key unannounced inspection on 15 August 2007 and the assessment was made against the key National Minimum Standards (NMS), identified at the beginning of each section of this report, as well as other Standards that were felt to be most relevant What the service does well: The home operates an organised and planned approach to identifying what help people need and to making sure that the home is right for them before things are finally decided about moving in. People’s health and personal care needs are well met and other professionals concerned with their care are routinely involved. There are suitable management and auditing systems in place for monitoring health care systems and medicine management is safely organised. Staff recognise the importance of promoting people’s known lifestyles, and they are supported to express preferences and choices in their daily living routines; this extends to meal preferences and any special diets that might be needed. Long Meadow Care Home DS0000069677.V368062.R01.S.doc Version 5.2 Page 6 People know how to complain and are confident to do so and complaints are taken seriously by the manager and the company and acted on accordingly. People live in clean and comfortable environment, which generally suits their needs; these are well met by a staff team that is properly recruited, inducted and trained. The home is well managed in the best interests of people who live there and people’s health, safety and welfare is properly promoted and protected. Relationships with the home’s staff and management are friendly yet professional, and feedback from everyone was very positive about the service at the home and the care received: ‘They keep me busy and I’ve got plenty to do; I can’t think that anywhere else could be better’ ‘I haven’t got a bad word for anyone, they always do their best’ ‘Meals are very good, the laundry is very efficient and the home is always clean’ ‘It’s a good life here, everybody’s so sweet’ ‘I’ve settled well and I’ve got lots of friends here now’ ‘The small size (of the dementia house) is a big positive and it always looks nice, with a relaxed atmosphere’ ‘It’s a safe place for mum to live and nobody can wander off’ ‘These are good people and they’ve helped him settle (into the dementia house) so very quickly’. What has improved since the last inspection? What they could do better: Two requirements have been made that relate to improvements in the home’s physical fabric and comfort, and which will also ensure that people can have their privacy if they want to Long Meadow Care Home DS0000069677.V368062.R01.S.doc Version 5.2 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 summary of this inspection report can be made available in other formats on request. Long Meadow Care Home DS0000069677.V368062.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection Long Meadow Care Home DS0000069677.V368062.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3 and 6. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People do not come to live at the home without the care they need being properly identified. EVIDENCE: Since Southern Cross took over the ownership of the home, the care records of all the people living there have been transferred to the full company format and new admissions follow the same extensive documentation route and assessment process. The manager told us in the AQAA how, following an initial enquiry, they send out a brochure pack that includes all the key documents required by law including the company’s most recent newsletter. These now include an indication of the range of fees charged, as required at the last inspection. They also encourage visits at any time by the future service user, family and friends. During the inspection we looked in detail at the care records of four people, including two who came to live at the home recently and one living in the new dementia house. Their records have all been completed to the same standard, Long Meadow Care Home DS0000069677.V368062.R01.S.doc Version 5.2 Page 10 and include a wide range of information obtained before, during and just after the people came to the home. The records of the two people who had been living at the home when Southern Cross took over had documents indicating a re-assessment of the strengths and needs of the people involved. All records have additional assessments of the areas of risk facing people, such as skin breakdown and pressure sores, general dependency, safe moving and handling, nutrition, continence and falls. Where there has been specific involvement of Healthcare or Social Services people, their assessments are also included in care records. During the period of admission a document called ‘This is my life’ is given out to be completed with family and friends, and this allows the home’s staff to see the person in terms of their positive life achievements rather than just the problems they are facing at present. The people spoken to said that the home’s staff ‘work hard meet the needs of the people who live here’ and that ‘they are so thorough and have a special eye for the important details’. The process for admission is the same throughout the home including those people living in Meadow View. The home does not provide intermediate care so Standard 6 does not apply. Long Meadow Care Home DS0000069677.V368062.R01.S.doc Version 5.2 Page 11 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 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The people living at the home have care plans and risk assessment records that promote safety and consistency, and staff are encouraged to work in ways that respect individuality, privacy and dignity. EVIDENCE: The manager told us in the AQAA how each resident has an individual care plan in place that is developed from the admission assessment and the identified areas where people need help. They told us how these are aimed at promoting independence, and how monthly evaluations are taken to rectify any problems. She described how the individual care plans are now in more depth, along with the ‘This is my Life’ document (described above), which helps to enhance personalised holistic care. The care records looked at contain clear and comprehensive descriptions of the areas where people need help or where they experience risk, as well as the areas in which they are independent. Care activities to be carried out by staff are identified, and each element of the risk assessments and care plans contained a written confirmation that they had been are looked at and evaluated monthly to make sure that all information is correct and up-to-date. Long Meadow Care Home DS0000069677.V368062.R01.S.doc Version 5.2 Page 12 The staff spoken to described how the documentation is routinely used by them and also that ‘communication systems have been improved and I always have somebody to go to if things are not working or have been changed’. All of the care records looked at showed how contact is maintained with external healthcare services, particularly the local doctors and district nurses, and a number of healthcare services, such as the local cottage hospital, have been involved regularly with people before and since they moved to the home. Local private services such as optician, dentist and chiropodist are also regularly involved with people and these can be seen outside in Matlock or through visits to the home. From the written records and direct comments from people, the staff at the home work hard to care in sensitive and dignified ways, and to help them stay as independent as possible. A period of time was spent in the dementia house observing activities and all interactions between staff and residents were sensitive, positive and demonstrated a patient approach to caring for the people there and maintaining wellbeing. People told us that: ‘Everybody I’ve come into contact with since coming here has been perfect; it’s a home from home’. ‘I can get around under my own steam in my wheelchair and although one door is a bit narrow all the rooms are on one level and I can get in and out quite easily’. ‘Although I don’t need a lot of personal care the staff are always careful to respect my privacy’. Examination of the arrangements for the receipt, storage and administration of medicines indicated these to be generally satisfactory and all entries in the written records had been made properly. Medication is stored securely and the home uses a Monitored Dosage System for administration. The manager regularly carries out an audit of medicines herself and brings any deficiencies to the notice of relevant staff. There are a number of people living at the home who are using controlled drugs and storage and administration arrangements has now been made satisfactory as required at the last inspection. A copy of the home’s medicines policy is available in the storage rooms. The list signatures of staff responsible for medicines had not been fully updated and some of the handwritten entries on the record sheets had not been dated. Long Meadow Care Home DS0000069677.V368062.R01.S.doc Version 5.2 Page 13 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 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People at the home enjoy lifestyles and routines that suit them and have the opportunity to take part in organised leisure and social activities. EVIDENCE: In the AQAA the manager told us how the home provides a structured range of activities including outside entertainers and about the dominoes challenge, in which people living at the home visit and host other homes in the area to play a dominoes tournament. It also told about increased use of the garden areas and we saw the recently planted ‘raised beds’ that had been created by old baths removed from the home. The home has recently employed a second activities coordinator and this has allowed more time to be dedicated to the people living in Meadow View, much of it on a one-to-one basis. He described how he had researched information on the Internet to design activities for this group and how challenging it had been to get things right for them. He has also been involved in designing a better version of the ‘This is my Life’ booklet for each person and how more information about activities and social interests are obtained at the time people come to live at the home. Long Meadow Care Home DS0000069677.V368062.R01.S.doc Version 5.2 Page 14 The people spoken to confirmed that they are generally happy with life at the home and they are able to do very much what they like. They develop their own routines, including spending their time in their rooms or in the communal areas; this extends to a small number who have their meals separately as well. We joined a small group in the main lounge that had organised their own game of dominoes and they talked about their lives at the home: ‘They keep us very busy here and we have a good life’ ‘We’ve got some new chickens over there that will be going out to live in the garden soon’ ‘There’s always someone to talk to and we’re going to have a few games of bingo next’ ‘We could do with a minibus so that we could get out and about a bit more’. The family members spoken to talked about the welcome they always receive from the staff: ‘They said I could come in any time, even mealtimes’ ‘We come every day and help out with activities’. Members of the local Methodist church visit monthly to hold a service for anyone who wants to attend. A brief visit was made to the kitchen and the cook described current arrangements. Good standards in the catering service have continued, and a new 4-week menu is being followed, which is now displayed daily in the entrance hall and dining room; people who regular take their meals in their rooms also receive a copy. There is a choice at the main meals of the day and a hot option is available for breakfast and teatime; people spoken to confirmed that supper is available for those that want it: ‘there is a genuine choice at all main meals and they are of the highest quality’. The cook was keen to emphasise that all the meals served are cooked from fresh ingredients and it was noted that arrangements for purchase, storage and stock control are satisfactory. The cook routinely deals with people who have special dietary needs, and at the time of the inspection these included diabetic and vegetarian. Long Meadow Care Home DS0000069677.V368062.R01.S.doc Version 5.2 Page 15 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 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home responds to complaints made by residents and their representatives according to a written procedure, and aims to protect them from harm. EVIDENCE: The AQAA told us how the home’s procedures ensure that any complaints reach the manager’s attention quickly and the company’s comment cards are now in reception for general use. To support this quick response to problems, the home’s manager is available at all times and on call out of hours. There is a written complaints procedure for the home, which is openly displayed and information about how to complain is provided within the home’s service users guide. Records indicated that there had been no formal complaints made about the home since the last inspection. All the people spoken to were clear about getting problems resolved and confident that they would be listened to: ‘If I had any problem I would take I straight to staff or the manager; they are all very approachable’. Staff records and the AQAA indicate that the manager has arranged for staff to receive training in their responsibilities to safeguard the vulnerable people living at the home and only a small number of new staff have not attended the annual top-up training. The policies and procedures in place from the company are in line with the statutory procedure on safeguarding adults. Long Meadow Care Home DS0000069677.V368062.R01.S.doc Version 5.2 Page 16 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 and 26. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home’s interior is in the process of being improved to increase the comfort privacy of people living there but the programme has not been completed. EVIDENCE: The AQAA told us how the home’s gardener and housekeeper ensure that the gardens and inside of the home are kept to the highest standard and that cleanliness and hygiene are maintained. It also described the twelve-month environmental action plan that is in place for all areas and that progress has been made in the past four months in particular. From a brief tour of the building and visits to the rooms of people being interviewed, the improvements described above were noted, particularly in the ground floor where most of the corridors and communal areas have been redecorated and fitted with new carpets. The manager also described how each bedroom is redecorated and fitted with new furniture and furnishings as they become vacant and some bedrooms have already been provided with Long Meadow Care Home DS0000069677.V368062.R01.S.doc Version 5.2 Page 17 modern furniture as part of the improvement plan. Additionally the lower ground floor has been completely refurbished to accommodate the dementia house and adapted to meet the needs of people with dementia. The patio door from the lounge leads into a safe, secure garden area and a sensory and tactile garden has been created in this area. Throughout the unit special touches have been provided with murals on the corridor walls and a ‘house front door’ look to each bedroom door. Areas have been colour coded and visual cues and signs have been provided to assist people living in the unit to recognise their surroundings. These give them recognisable ‘landmarks’ and make the area less confusing. There are still areas on the ground and first floors that have not been improved, with unpainted walls and old and stained carpets in evidence; the manager agreed an estimated timescale of the end of 2008 for this to be done. It was also noted that the majority of bedroom doors did not have locks for people to use and one person who showed us his room remarked that he would welcome this to keep his possessions safe. On the day of the inspection the home was clean, tidy and free from odours and the residents spoken to had no complaints about the laundry service; all residents observed in the home wore clean and well-presented clothing. Long Meadow Care Home DS0000069677.V368062.R01.S.doc Version 5.2 Page 18 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 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has adequate numbers of staff that support a safe environment in which to live and work, and they have received training that helps them do their jobs in a more professional way. EVIDENCE: The AQAA indicated a very low turnover of care staff in the past twelve months and all the staff spoken to felt that morale was high and that they were happy working at the home. Whilst most care staff complete at least one long shift (12 hours) during a week’s duty, nobody found this caused them any difficulties and all felt that the workload they were given was satisfactory: ‘this home is very positive and we all work well as a team’. Examination of the duty roster and information provided in the AQAA indicated satisfactory levels of care staff on duty during the week of the inspection, and all the people living at the home felt that ‘there always plenty of staff around’ and that ‘they don’t ignore you when you want something like at the other place I was staying at’. The relatives of people living in the dementia house agreed this was the case there as well. The AQAA indicates that the numbers of care staff achieving or currently undertaking the National Vocational Qualification (NVQ) level 2 have exceeded the national target of 50 staff qualified and a number of staff have proceeded on to NVQ level 3. We were also told that all staff, regardless of their job roll within the company, take an extensive programme of training and the staff records supported this, although small numbers had not completed Long Meadow Care Home DS0000069677.V368062.R01.S.doc Version 5.2 Page 19 annual updates in safe personal handling, control of infections and safeguarding vulnerable people. Records also indicated that newly appointed staff receive an extended induction programme of basic training based in the protocols promoted by Skills for Care, a national training agency, and the manager described how all staff will attend an extensive training programme Yesterday, Today and Tomorrow – which will give them a good grounding in working with people who have impairment of memory skills or dementia. We looked at the files of two recently appointed staff for evidence of the procedure that had been followed for their recruitment, and they contained safe and satisfactory information showing that proper checks had been carried out. These included two written references and a check by the Criminal Records Bureau obtained before they started work. Long Meadow Care Home DS0000069677.V368062.R01.S.doc Version 5.2 Page 20 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, 36 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is a well-managed and safe environment in which to live and work. EVIDENCE: The manager has been in post for some years and has a wealth of skills knowledge and experience in the operation of care services for older people. The AQQA told how both she and her deputy hold the required qualification for managers and how they make sure that they are always available for people living at the home, relatives and staff. The company’s regional manager is in regular contact with the home and was briefly there on the day of the inspection, and she offers additional management support and monitoring of the home’s services. People spoken to were positive about the way the home is run and how the manager ‘is very informative, right from the outset, and is always helpful and available if there are any difficulties’ and that ‘she’s a good manager and recently organised a meeting for families to socialise and talk about the home’. Staff also said that the ‘manager is very supportive and Long Meadow Care Home DS0000069677.V368062.R01.S.doc Version 5.2 Page 21 approachable’ but, although the system for planned meetings between manager and staff is in place, the arrangements are not yet occurring regularly enough to meet the National Standard. The manager described the extensive range of internal audits of activity at the home that take place and these cover such areas as catering, medication, the completion of care plans and staff training. The regional manager regularly completes the monthly visit to the home that is required by law, and written reports of these have been seen on file. The company requires the manager to carry out a regular survey of the views of people living at the home and their relatives; these take place twice a year. The company also keeps in touch with everybody through a regular newsletter. The systems for the safe keeping of residents’ personal spending money have been retained and improved, and the AQAA told us how most people living at the home now have their own bank account. The AQAA indicated good standards of health and safety activity and regular servicing of equipment, and the home’s handyman makes sure that any problems are dealt with quickly. Observations made around the building and a sample of fire safety and servicing records indicate that the home is hazard free. Long Meadow Care Home DS0000069677.V368062.R01.S.doc Version 5.2 Page 22 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 3 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X 2 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 2 X 3 Long Meadow Care Home DS0000069677.V368062.R01.S.doc Version 5.2 Page 23 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. 1. Standard OP19 Regulation 23(2)(d) Requirement The programme of redecoration and refurbishment of the home must be completed in order to improve the comfort and facility of people living at the home. All bedroom doors in the home must be fitted with safe and appropriate locks that allow the people living there the opportunity to retain their private space. If they do not wish to lock their rooms and retain a key, the reasons for this must be recorded in their care file. Timescale for action 31/12/08 2. OP24 12(4)(a) 30/09/08 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 OP9 Good Practice Recommendations Medicines administration practice should be made fully safe and available for audit by updating the list of staff signatures and making sure that all new medicines and DS0000069677.V368062.R01.S.doc Version 5.2 Page 24 Long Meadow Care Home 2. OP36 instructions for their use are clearly dated. Staff supervision should take place every two months and include career development needs, and philosophy of care in the home. Long Meadow Care Home DS0000069677.V368062.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE 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. 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