Care Home: Meadow View

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What the care home does well The home offers family style accommodation and integration into family life. The resident is offered a supportive home environment which promotes and helps to maintain good levels of stability in their well being and general health. The home by providing one-to-one care is able to be flexible to the needs of this individual and respond to any changes required. A good rapport and relationship has developed between the resident and the family with a clear understanding about the individual needs and preferences.Feedback from the Inspection Team in Wales stated that "Mrs. Douglas provided the service user with a good quality of life, taking her out and about as part of the family and taking her on lots of holidays and trips. I found her to be co-operative and inspections showed no issues of concern with the care and support she provided for the service user in her care. " And feedback from the Family Scheme social worker stated " I am impressed at how Mr & Mrs Douglas treat X as part of the family. It is a pleasure to see someone so "at home" and well cared for". What has improved since the last inspection? NA What the care home could do better: There were no areas for improvement identified in this report. CARE HOME ADULTS 18-65 Meadow View Meadow View Gullome Holme Milburn Nr Penrith Cumbria CA10 1TL Lead Inspector Liz Kelley Key Unannounced Inspection 7th July 2008 3:30 Meadow View DS0000071179.V368097.R01.S.doc Version 5.2 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 Meadow View DS0000071179.V368097.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 Adults 18-65. 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. Meadow View DS0000071179.V368097.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Meadow View Address Meadow View Gullome Holme Milburn Nr Penrith Cumbria CA10 1TL 01768 361030 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) Mrs Jacqueline Diana Douglas Care Home 1 Category(ies) of Learning disability (1) registration, with number of places Meadow View DS0000071179.V368097.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following categories of service only. Care home only - code PC, to people of the following gender:- Either. Whose primary care needs on admission to the home are within the following categories: Learning disability - Code LD The maximum number of people who can be accommodated is: 1 Date of last inspection Brief Description of the Service: Meadow View provides accommodation, care and support for one resident who has lived in the home for 17 years. The resident originally began living with the family as part of a family respite scheme in Flintshire, Wales. The registered manager is the main carer and provides care in a family environment with the resident being treated as an addition to her own family. The home is situated in a rural location east of Penrith. The premises are an older terraced cottage with enclosed front courtyard and rear garden. The resident has a large bedroom and shares the family bathroom facilities. Shared space is available in the form of a sitting rooms, a large family kitchen with dining area and a conservatory. Fees are paid from Flintshire Social Services where the contract was set up and the home was previously based. Meadow View DS0000071179.V368097.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. We (Commission for Social Care Inspection, CSCI) spent time in the home talking to the resident about their experiences. We also met with the owners, Mr and Mrs Douglas, and looked at records relating to the running of the home. We also sent out surveys as part of this inspection to get feedback from people living in the home, and other professionals involved with the home. Before the visit the manager completed an Annual Quality Assurance Assessment, which provided information about all aspects of the running of the home. This included a self-assessment against the National Minimum Standards (NMS) recording what the home does well, what has improved and plans for the future. Last year the home was relocated from Wales, where Mr and Mrs Douglas were part of a scheme that allowed for people to live and be cared for in a family setting, living as part of a family. A similar scheme did not exist in Cumbria therefore the home was registered as a Care Home with the Commission for Social Care Inspection (CSCI). One person has been cared for the past 17 years. Mrs Douglas has identified that she does not intend to continue to provide care if the individual currently living in the home is no longer accommodated there. What the service does well: The home offers family style accommodation and integration into family life. The resident is offered a supportive home environment which promotes and helps to maintain good levels of stability in their well being and general health. The home by providing one-to-one care is able to be flexible to the needs of this individual and respond to any changes required. A good rapport and relationship has developed between the resident and the family with a clear understanding about the individual needs and preferences. Meadow View DS0000071179.V368097.R01.S.doc Version 5.2 Page 6 Feedback from the Inspection Team in Wales stated that “Mrs. Douglas provided the service user with a good quality of life, taking her out and about as part of the family and taking her on lots of holidays and trips. I found her to be co-operative and inspections showed no issues of concern with the care and support she provided for the service user in her care. “ And feedback from the Family Scheme social worker stated “ I am impressed at how Mr & Mrs Douglas treat X as part of the family. It is a pleasure to see someone so “at home” and well cared for”. 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. Meadow View DS0000071179.V368097.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR 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) Scoring of Outcomes Statutory Requirements Identified During the Inspection Meadow View DS0000071179.V368097.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager does not intend to take any further service users. The manager carries out appropriate measures in assisting the resident to make a choice of where to live. EVIDENCE: When the home and family last relocated from Wales the resident was fully involved in the decision to move. She had her social worker as an advocate to help her make the choice. The move also enabled her to move closer to family who lived locally. She said that she was pleased to have moved and liked the new house, she particularly like the conservatory and gardens with the frequent visits of red squirrels. A contract has been drawn up between Mr and Mrs Douglas and Flintshire Social services, who continue to do annual monitoring visits. Meadow View DS0000071179.V368097.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7 and 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents care needs were well met, and good levels of independence and decision-making are achieved. EVIDENCE: The manager keeps a care plan which details the changing needs of the resident, and makes adjustments to the level of support that is required. The home is run in a way that is beneficial to the resident being on a small, domestic scale with administration having a low profile. The registered manager has created an open and inclusive atmosphere within the home, which was confirmed by observation and by discussions with the resident. Meadow View DS0000071179.V368097.R01.S.doc Version 5.2 Page 10 Mrs Douglas demonstrated that she has a thorough understanding of the needs of the person living in the home. Flintshire social services on their last monitoring visit in April 2008 commented “The objectives of providing suitable care and support for X are clearly met thanks to the approach taken by the Douglas’s”. Meadow View DS0000071179.V368097.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16 and 17 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The lifestyle experienced by the resident is of a high quality being afforded a good degree of control and choice. EVIDENCE: Mrs Douglas demonstrated that she supports the individual to live as part of her family and to access the local community in a safe manner which she enjoys. Mrs Douglas supports the individual to have contact with her birth family. The resident is encouraged and prompted to carry out personal care tasks and to retain independence skills. The home provides the resident with a life that has routine and predictability which is to her choosing and which promotes well-being and general good health. Meadow View DS0000071179.V368097.R01.S.doc Version 5.2 Page 12 Flintshire social services commented “ X has the benefit of both peace and quiet in the countryside plus the excitement of visiting and joining in family events”. X spoke of the family and was obviously very attached and regarded themselves very much a part of it, for example telling of new babies in the family, visit to various relatives at the seaside and playing with Mr and Mrs Douglas’s grandchildren. The resident is encouraged to have a number of hobbies and particularly enjoys crafts and going for walks. Meadow View DS0000071179.V368097.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 and 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents’ healthcare needs are well met leading to positive outcomes. EVIDENCE: Mrs Douglas has ensured that the individual has access to appropriate health care support and tries to encourage her to follow a healthy lifestyle. Flintshire Social Services commented: “medical treatment is organised by Mrs Douglas who has a good relationship with the village GP surgery.” This has led to an overall improvement in health, supported by a health life style. Meadow View DS0000071179.V368097.R01.S.doc Version 5.2 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The resident is safeguarded from abuse by the manager’s awareness of rights and open style of running the home. EVIDENCE: The manager was aware of the need to safeguard the health, safety and welfare of the service user. CSCI registration team undertook an interview with the manager to determine if she had the knowledge and skills to carry out this role. Mrs Douglas was approved and the registration officer said “The manager demonstrated a good awareness of different forms of abuse and the rights of the individual.” The resident feels able to discuss any issues with the manager, she is always given time alone with visitors to discuss their experience the home. When time was spent in private with the resident she was very happy in the home and said she could always speak Mrs Douglas about any worries. stated and of living in stated she to Mr and Meadow View DS0000071179.V368097.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The resident benefits from living in a well kept and safely maintained family home EVIDENCE: Mrs Douglas aims to provide care in a domestic, family type environment and the service is operated in a manner to meet this aim. Meadow View is Mrs Douglas’ home. She aims to provide care and accommodation to one person who lives as part of her family. Meadow View provides accommodation in the form of two bedrooms, one of which is for the private use of the individual living in the home. There is a family bathroom, sitting room, and dining kitchen. Mrs Douglas has installed a conservatory to the rear of the premises to further improve the facilities provided. Meadow View DS0000071179.V368097.R01.S.doc Version 5.2 Page 16 The resident said she is happy living there and likes her bedroom. Mrs Douglas said the individual was given a choice of which of the two bedrooms she wanted to use when they moved to Cumbria. The individual has her own possessions in her room and has arranged it as she wishes. Mrs Douglas says the individual enjoys spending some time in her room on her own and is able to do this as she chooses. During the visit to the service it was apparent that the individual has a free choice of where and how she spends her time in the home. Mrs Douglas has taken advice from the local fire officer regarding the fire detection and fire fighting equipment in the home. Smoke alarms are fitted on the ground and first floors of the premises and there is a fire blanket and domestic fire extinguisher in place. Meadow View DS0000071179.V368097.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents’ needs are well met by Mrs Douglas who provides supportive and enabling care. EVIDENCE: Mrs Douglas works alone and does not employ any staff. Care and support was observed to be offered in a relaxed and dignified manner, and a warm rapport was obvious between Mr and Mrs Douglas and the resident. Two way banter and joking created a family-like atmosphere. Flintshire social services commented “Mr and Mrs Douglas provide a stable, consistent approach to caring. I consider the ‘placement’ a success and X appears very happy at home with the Douglas’s.” Meadow View DS0000071179.V368097.R01.S.doc Version 5.2 Page 18 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39 and 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is run in a way that is beneficial to the resident being on a small, domestic scale with administration having a low profile. EVIDENCE: Mrs Douglas has extensive experience of carrying on a small care home. She has a clear aim for the service which is to provide a family, domestic environment for one individual to live in. Mrs Douglas has provided care for this person since 1993. Mrs Douglas has clearly stated that she does not intend to provide care for any other person and she has only applied for registration in order to be able to continue to care for this individual. Meadow View DS0000071179.V368097.R01.S.doc Version 5.2 Page 19 Mrs Douglas has been registered to carry on two other services similar to Meadow View. Both of these services were solely to provide care to the individual who lives as part of Mrs Douglas’ family. The services were subject to regular inspection by the appropriate regulating body. No concerns have been raised about the services Mrs Douglas has provided. Before moving to Cumbria Mrs Douglas was registered with the Care and Social Services Inspectorate for Wales. Mrs Doreen Barlow, Inspection Officer with the Care and Social Services Inspectorate for Wales, inspected the service carried on by Mrs Douglas in Prestatyn. Mrs Barlow assessed that the service was of a good standard and provided positive outcomes for the individual living in the home. Basic records are in place including a very brief care plan provided by Flintshire County Council and records of financial transactions made on behalf of the people living in the home. The home was covered by public liability insurance. The home and the manager, given the nature of the service, was therefore judged to be successfully meeting the needs of the resident and providing good outcomes for this person. Meadow View DS0000071179.V368097.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 Adults 18-65 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 x 2 3 3 x 4 x 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 x 26 x 27 x 28 x 29 x 30 3 STAFFING Standard No Score 31 x 32 3 33 x 34 3 35 x 36 3 CONDUCT AND MA GEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 x 3 x LIFESTYLES Standard No Score 11 x 12 4 13 3 14 x 15 3 16 3 17 3 PERSO L AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 x 3 x x 3 x Meadow View DS0000071179.V368097.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 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 Meadow View DS0000071179.V368097.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Regional Contact Team Unit 1, 3rd Floor Tustin Court Port Way Preston PR2 2YQ 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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