Care Home: Meadow Lodge Care Home

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What the care home does well The managers and staff were keen to provide a good service for the people living at Meadow Lodge. One resident said, the staff and owners are wonderful and the deputy manager is is brilliant. People completing surveys told us the following on what they felt the home did well: "The home keeps me warm,safe, clean, and fairly well fed" - "Most of the carers are very helpful and always inform my family of any problems that concern me"- "Looking after me very well"- "Good care, homely environment, staff are kind and helpful - "Great effort was made to help personalize my room - "Committed staff" -"The standards have been maintained as has the hands on approach of the current owners" - They keep the home clean. People were getting attention from health care professionals in response to their individual needs and circumstances. Personal care and support was being provided sensitively, peoples` dignity and privacy was being respected. Residents meetings were being held so people could voice opinions and make suggestions. To help protect people and keep them safe, the home had policies on the prevention of abuse and neglect, and safeguarding training had been arranged. To help make sure people living at Meadow Lodge get effective care and support, staff training and development was ongoing. What the care home could do better: Progress needed to be made with the residents care plans, to make sure people getindividual care and attention in the way they prefer. Action needed to be taken to ensure some health care needs are more effectively considered, monitored and planned for. To make sure people are properly and safely supported with their medication, some practices and records needed to be given attention. To make sure people have clear information about how to go about raising concerns, the complaints procedure needed updating. Some guidelines for managers and staff needed to be improved, to make sure people using the service are properly protected. Random inspection report Care homes for older people Name: Address: Meadow Lodge Care Home Whalley Road Padiham Burnley Lancashire BB12 8JX two star good service The quality rating for this care home is: The rating was made on: 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 review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Jeffrey Pearson Date: 2 6 0 5 2 0 1 0 Information about the care home Name of care home: Address: Meadow Lodge Care Home Whalley Road Padiham Burnley Lancashire BB12 8JX 01282772596 01282772596 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Susan Smith Type of registration: Number of places registered: Conditions of registration: Category(ies) : Mrs Surinder Kaur Sharma,Mr Satya Pal Sharma care home 14 Number of places (if applicable): Under 65 Over 65 14 old age, not falling within any other category Conditions of registration: 0 The maximum number of service users who can be accommodated is: 14. 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. Date of last inspection Brief description of the care home Meadow Lodge Care Home is registered with the Commission for Social Care Inspection to provide personal care for 14 older people. The home is a large semi detached Care Homes for Older People Page 2 of 10 Brief description of the care home property in an elevated position, situated in a residential area of Padiham. There are garden areas and car parking spaces to the front of the home. The accommodation is provided on two floors, there are one double and twelve single rooms. Two of the bedrooms have en- suite facilities. The home has two lounges, dining room and kitchen and a separate conservatory. There is a stairlift to assist with access to the first floor accommodation. At the time of this inspection visit, the range of fees charged were between £435.00 and £443.00 per week, there were additional charges for some hairdressing. Written information about the home was available in the entrance hallway. Care Homes for Older People Page 3 of 10 What we found: An inspection which included an unannounced visit to the service was conducted at Meadow Lodge on the 26th May 2010. The purpose of the inspection was to assess outcomes for people in relation to Health and Personal Care and Complaints and Protection. Prior to the inspection people using the service were invited to complete surveys, to tell the Commission what they think about the support and care provided by the home, some were returned to us. Before the visit the owners were asked to complete and return to us an AQAA (Annual Quality Assurance Assessment). This was to enable the service to show how they were performing and provided details about arrangements, practices and procedures at the home. During the visit we spoke with residents, the deputy manager and staff. Various documents, including care plans, case files, policies, procedures and records were looked at. Parts of the home were viewed. The residents spoken with made positive comments about life in the home and indicated they were satisfied with the services and care provided at Meadow Lodge. The deputy manager said each person had a written care plan and the AQAA showed that residents and their families, as appropriate were being involve in the care planning process. We found care plans included some good person centered information about peoples specific individual needs and wishes with instructions for staff to follow on responding to such matters. We noted some needs, for example in relation to social activities, had not properly included in the care planning process. However, we were told in the AQAA, that person centered care planning was an area for improvement at Meadow Lodge. Records showed care plans were being reviewed each month. Care notes seen were reflective of peoples care and circumstances. The home had policies and procedures in relation to health and personal care. Residents completing surveys indicated they always get the medical care and attention they need. Records and discussion showed people were getting attention as necessary from health care professionals such as GPs and District Nurses. Peoples personal safety and mobility risks had been considered and planned for, however, although care plans showed pressure areas were being monitored and people were being weighed monthly, specific individual assessments had not been routinely carried out in respect of nutritional screening or skin integrity, which meant it was not clear that these matters had been effectively considered. During the inspection we were made aware of an accident which had occurred in the home, appropriate action appeared to have been taken in respect of this matter, however, the Commission had not been notified of the incident in accordance with regulation 37 of The Care Home Regulations 2001. The registered persons therefore needed to take action in respect of this matter. Care Homes for Older People Page 4 of 10 Staff responsible for medication administration had received training, which included a competence based assessment. Medication storage was seen to be clean and secure. The deputy manager explained that consideration was being given to providing a more appropriate medication storage area. Records showed the temperatures in the storage area were being monitored. Most medication administration records seen were clear and up to date. However, there was one gap in relation to one prescribed item which meant it was not clear if the person had had there medication or not, the deputy manager agreed to pursue this matter. We found that hand written entries on MAR charts had not always been verified as correct by two people, which would help promote safe administration practices. Agreements were in place should residents choose to manage their own medication, however, it was advised these be further developed to assess each persons capacity and preferences in managing their medication. It was also advised that the monitoring and support practice in respect of medication matters, be more effectively incorporated in individual care plans as appropriate. Individual instructions were in place for when necessary and variable dose medication, it was suggested further details be noted to provide further clarity and ensure an appropriate response. It was suggested the Royal Pharmaceutical Guidance, The Handling Of Medicines In Social Care be used for reference, when reviewing and updating the homes medication policies and procedures. The home had introduced a key worker system which links a resident with a particular staff member to provide a more personal service. The residents spoken with did not express any concerns about how they were treated, one comment made was, The staff are very good. The AQAA showed that staff had received training on equality and diversity and that dignity in care training was to be accessed. Observations of care practices, showed peoples privacy needs were respected. Staff were seen to provide support and interact with people in a friendly and courteous manner. People were being supported to take an interest in their appearance, a hairdresser was in attendance at the home during the inspection visit. Most people completing surveys, told us they were aware of how to make a formal complaint. The residents spoken with said they had no complaints about the home. Residents meetings were being held so people could be consulted, voice opinions and make suggestions. The complaints procedure was included in the homes guide, it was suggested a copy should also be displayed in the home. The procedure included instructions for people to follow, but needed updating to include the national contact details of the Care Quality Commission. There had not been any recent complaints at Meadow Lodge. Systems were in place to record and respond to any issues raised in a complaints log, however, it was advised such records be kept individually to promote confidentiality and more effective complaints management. Complaints processes were discussed with the deputy manager, including being objective and ensuring appropriate investigation strategies are devised and accountable records kept, to show clearly how complaints have been managed. Care Homes for Older People Page 5 of 10 Safeguarding information and protocols had been obtained from the Local Authority Social Services Department. The deputy manager and owners had recently attended safeguarding training, arrangements had been made for staff be provided with this training at the home. We looked at the homes polices and procedures on safeguarding people from abuse, which included some good guidance on looking for potential signs and indicators. But, there were no clear step by step procedures for managers and staff to follow in the event of an allegation, suspicion or incident of abuse. This could result in lack of appropriate action being taken to safeguard people using the service. However, the deputy manager did express an awareness of the action to be taken and of the relevant agencies to contact. The reporting bad practice procedure included some useful guidance for staff, but needed to include the contact the contact details of the Care Quality Commission. The policies and guidance in relation to physical intervention and restraint were unable to be located. At the time of the inspection visit, the deputy manager was in the process of applying for registration as manager with Care Quality Commission. What the care home does well: What they could do better: Progress needed to be made with the residents care plans, to make sure people get Care Homes for Older People Page 6 of 10 individual care and attention in the way they prefer. Action needed to be taken to ensure some health care needs are more effectively considered, monitored and planned for. To make sure people are properly and safely supported with their medication, some practices and records needed to be given attention. To make sure people have clear information about how to go about raising concerns, the complaints procedure needed updating. Some guidelines for managers and staff needed to be improved, to make sure people using the service are properly protected. 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 2. Care Homes for Older People Page 7 of 10 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, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 8 of 10 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, 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 7 When developing care plans, action should be taken to ensure all health and social care needs are identified, with staff being given clear written directions on responding to such needs. Appropriate health care assessments should be carried out in respect of each person, in accordance with the specifications of standard 8 of the National Minimum Standards - Care Homes For Older People. This will ensure peoples health care needs are more effectively considered and responded to. Hand written entries on Medication Administration Records, should be checked and signed by two people to make sure they are correct. Action should be taken to ensure all safeguarding policies and procedures provide clear instructions for managers and staff to follow in line with agreed Local Authority protocols. Procedures should include all appropriate contact details of the relevant agencies, such as Social Services, the Police (Public Protection Unit) and CQC. 2 8 3 9 4 18 Care Homes for Older People Page 9 of 10 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got 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 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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