Care Home: Meadow Court

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What the care home does well Peoples` needs were known to the service prior to admission. The two assessments ensured that the service had sufficient information to assess if the service was able to meet the person`s needs. Accurate care plans will contribute to the delivery of care. People identified that they were satisfied with the care and service they received. People were able to exercise their right of choice within the service, therefore this provided stimulation and enhanced their quality of life. People receive their medication in a safe manner and independence with medication was promoted. Again people had the opportunity to exercise choice. The complaints procedure was available in various forms and easily accessible. People were able to express their concerns and these were acted upon. The environment, monitored at this inspection, had been maintained to the required standard to provide a well maintained environment for people who lived at a service. The recruitment process regarding the checking of staff will contribute towards the protection of people. The manager in the acting position had considerable experience which will contribute to the effective organisation and operation of the service. What has improved since the last inspection? The service had complied with the requirements listed in the last inspection report. What the care home could do better: There was not a registered manager in post. The manager identified that she was to apply to become the registered manager. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Meadow Court Off Doncaster Road Hooton Roberts Rotherham South Yorkshire S65 4PF     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Ivan Barker     Date: 2 1 0 1 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 25 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 25 Information about the care home Name of care home: Address: Meadow Court Off Doncaster Road Hooton Roberts Rotherham South Yorkshire S65 4PF 01709853875 01709853706 meadowcourt@hotmail.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Voyage Ltd Name of registered manager (if applicable) Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 8 Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: Date of last inspection Brief description of the care home 8 Meadow Court is a care home for up to eight adults aged 18 to 65 with learning disabilities. It is located in a small village near to the town of Rotherham, in a converted building behind the Earl of Strafford public house. There is a bus service to Rotherham and to Doncaster. The home overlooks farmland and has its own private garden. The rooms are spacious and have en-suite bathrooms or showers. There are two individual flats in the home with their own bathrooms and kitchen/lounge areas. There is a communal lounge and a large kitchen dining room. A laundry room is available. Fees vary considerably, dependent on the individual care packages provided at the home. Care Homes for Adults (18-65 years) Page 4 of 25 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations -but only when it is considered that people are not being brought at significant risk of harm. In future, if any requirement is repeated, it is likely that enforcement action will be taken. Only a limited number of the National Minimum Standards were examined at this inspection (with emphasis on the key standards), and the previous requirements. The person present at the inspection was: Y Brown manager. Care Homes for Adults (18-65 years) Page 5 of 25 Within this site visit, which occurred over a five hour period we toured the building, examined requirements relating to the previous inspection, case tracked 3 people (case tracked means looking at the care and service provided to specific people living at the home; checking records relating to the health and welfare, care plans and other records; by talking to the specific people; viewing the personal accommodation as well as communal living areas). Spoke with other people and also 3 staff and examined assessments, care plans, risk assessment, menus, complaints files, staff files and quality monitoring documents. The history of the service was examined prior to the site visit. This included the AQAA (Annual Quality Assurance Assessment) a self assessment document, telephone contacts, letters and notifications. The last Annual Service Review (ASR) was undertaken on the 23/6/08. People who use the service will be referred to within this report as people. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 7 of 25 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 8 of 25 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples needs were known to the service prior to admission. The two assessments ensured that the service had sufficient information to assess if the service was able to meet the persons needs. Evidence: On examination of the care management assessments within three care plans, it was established that the assessments for the people who had resided in the service for some time, could not be located. The people who had been admitted since the appointment of the new manager, had assessments. The manager advised that she undertook the assessments for the service. The information provided within both assessments assisted in providing sufficient information for the staff to decide if the service could meet the persons needs. It also provided sufficient information for care plans to be drawn up. Care Homes for Adults (18-65 years) Page 9 of 25 Care Homes for Adults (18-65 years) Page 10 of 25 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Accurate care plans will contribute to the delivery of care. Evidence: The care plans were very person centred. The care plan documentation and risk assessments were signed by the people and the staff. The care plans had been evaluated on a monthly basis. Each care plan had a daily record sheet. The staff made daily entries into the appropriate care plan. However it was established that the care plans did not have an overall daily entry. On discussing this fact with the manager she advised that the care plans were operating as the company policy, however she accepted there should be at least one daily entry. She identified that she would raise this issue with the staff. On speaking with the staff it would establish that they were fully aware of the persons needs. Care Homes for Adults (18-65 years) Page 11 of 25 Evidence: The people who we spoke with, expressed that they were satisfied with the care. Care Homes for Adults (18-65 years) Page 12 of 25 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People were able to exercise their right of choice within the service, therefore this provided stimulation and enhanced their quality of life. Evidence: The manager advised that activity sheets were drawn up with each individual person on a Sunday morning. The programme included activities, jobs to be undertaken and outings and visits for the following week. For example an individual might undertake a hobby, or activity within the service, dust and clean their room, visit the shops and visit friends or relatives. The hobbies and activities available to the people were falconary, visiting a farm, visiting a nightclub, guitar lessons and swimming, as well as having themed nights, karaoke and disco night within the service. The manager advised that each person had a choice for their birthday celebration. Examples given were that one individual had chosen a barbecue party and another had chosen a Care Homes for Adults (18-65 years) Page 13 of 25 Evidence: Mcdonalds party. We saw the individual programmes which were for the week the inspection occurred. There was an activities room within the service, however this was being monopolised by one individual by having all of his equipment all around the room. The manager agreed to speak to this individual and ask him to tidy away his equipment to allow other people access to the pool table and other equipment available within the room. There was a relaxation room within the service. On discussing the use of the room with the manager it was agreed that this facility was under used. It was suggested that the relaxation room could be built into the individual programmes for some people. A house meeting occurred on a monthly basis. Notices were displayed around the service. We saw minutes of the meetings. Regarding the meals, there was a meeting on a Sunday and a menu was created for the following week. Shopping for the meals was undertaken on a Monday morning and a Friday. People were given the opportunity to participate in the shopping, with the assistance of staff. The comments which we received were that the people were very keen to participate in outings and activities and felt that they had were able to exercise their right of choice. Care Homes for Adults (18-65 years) Page 14 of 25 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People receive their medication in a safe manner and independence with medication was promoted. Again people had the opportunity to exercise choice. Evidence: People are able to state their own preferences and choose their own clothes etc and to undertake their agreed programme of activities and outings etc. People were able to access their GP and other NHS facilities. The medication storage was examined. The medication administration records (MARs) had been completed. The ordering and disposal of medications was explained to us and the explanation was satisfactory. However whilst examining the contents of one of the medication cupboards an envelope contained some medication, was found. A member of staff explained that this individual, who was named on the envelope, often refused to take his medication. However if they were approached again, for example 20 minutes later, they may take the medication. As the medication was removed from a blister pack and could not be returned, the envelope was thought to be the best Care Homes for Adults (18-65 years) Page 15 of 25 Evidence: practical solution. We accepted the explanation but advised that they should consult the pharmacist, to see if there was a better solution. There was one person who was self administering medications. The medications were locked within a drawer in his room. The individual locked his room and had his own personal key. The drug storage fridge was positioned on the floor. This is both hazardous to staff and not in a hygienic position. It was agreed that the fridge would be relocated onto a table. Care Homes for Adults (18-65 years) Page 16 of 25 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The complaints procedure was available in various forms and easily accessible. People were able to express their concerns and these were acted upon. Evidence: The complaints procedure was printed within the Service User Guide and Statement of Purpose. The complaints procedure was also in pictorial form within each of the bedrooms and within the kitchen area. Within the complaints file there were two complaints, both had been completed. The complaints procedure was available in many languages, for example Urdu, Gujarat, Hindi, Somali and Welsh. There were no complaints received by the Commission Social Care Inspection during the visit. Any concerns which were raised by the people were written in the care plans. The service had policies and procedures regarding Safeguarding Adults. These policies and procedures were available to all staff. The training record of the staff were examined and it was established that staff had attended training on Safeguarding Adults. Care Homes for Adults (18-65 years) Page 17 of 25 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The environment, monitored at this inspection, had been maintained to the required standard to provide a well maintained environment for people who lived at a service. Evidence: On touring the building it was observed that the rooms have been personalised by pictures, posters and included items which would be in a younger persons room. i.e. stereos, and game stations. The home was clean, well maintained, well decorated and odour free. One of the bedroom doors had a problem with the door closure. The mechanism had to be lifted by hand, to enter or exit the room. This would clearly restrict the exit from the room in case of fire. On raising this repair with the manager she immediately contacted the repair contractors and the door was fixed before the completion of this inspection. The atmosphere within the service was warm, friendly and relaxed. Care Homes for Adults (18-65 years) Page 18 of 25 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The recruitment process regarding the checking of staff will contribute towards the protection of people. Evidence: On examination of the staff on duty and the rotas it was established that the staffing was as follows: A.M. 1 senior carer and 3 carers. P.M. 1 senior carer and 3 carers. N. 2 carers. Plus a manager. In addition to the 2 carers working on nights, there was a carer sleeping within the service. This carer was to provide extra cover because of the behavioural issues with one of the individuals who resided at the service. An examination of the room where the carer slept there was no equipment provided to contact the individual in an Care Homes for Adults (18-65 years) Page 19 of 25 Evidence: emergency, which was the purpose of this individual sleeping overnight. On discussing this with the manager she provided evidence that a bleep system was to be introduced. The carers, as well as providing care to the people, undertook the duties of cleaning, cooking, laundry with the involvement of the people lived at the service. On examination of the staff training records, the staff had received training in fire, moving and handling and other clinical training. On examination of 3 staff files it was established that all 3 staff had a Criminal Records Bureau check. The other information required within Schedule 2 could not be located within the file. However there was a checklist which indicated that the relevant information i.e. application forms and references had been obtained. The manager advised that there had been an agreement for the staff files to be stored in the central Human Resource Department. We are aware that discussions are taking place between our provider relationship manager and senior members within the company regarding the storage of files. Therefore the staff files were not fully inspected on this visit. Care Homes for Adults (18-65 years) Page 20 of 25 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There was not a registered manager in post. However the manager in the acting position had considerable experience which will contribute to the effective organisation and operation of the service. Evidence: The manager had 15 years experience in care and 7 years experience in management. She had a Criminal Record Bureau check and was awaiting to undertake the fit person process to become a registered manager. The service was operating a credit and debit system regarding peoples personal monies. Regarding Quality Assurance, the manager undertook daily monitoring of the home and also completed a quality audit. The operations manager when undertaking a regulation 26 visit, monitored the quality audit and action plans were put in place. Care Homes for Adults (18-65 years) Page 21 of 25 Evidence: Regulation 37 notices, which documents that are sent to the Commission regarding untoward occurrences, including falls, accidents etc; have been received by the CSCI. (Commission for Social Care Inspection). Care Homes for Adults (18-65 years) Page 22 of 25 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 23 of 25 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 2 20 37 Medications need to be stored in a clean and safe conditons. There needs to be a registered manager within the service. Care Homes for Adults (18-65 years) Page 24 of 25 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. 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