Care Home: Meadow View Care Centre

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What the care home does well The home has taken action to comply with many of the recommendations made to improve outcomes for people using the service. Good staffing levels are maintained to care for the number of people living at the home. What the care home could do better: Care planning and aspects of health care, medication and daily recording are to be improved to make sure there is clear information about how people are supported to meet their needs. Records should be kept that show the range of social activities provided and people living at the home need to be given more opportunities to go on outings. Random inspection report Care homes for older people Name: Address: Meadow View Care Centre Meadow View Care Centre Kibblesworth Gateshead Tyne and Wear NE11 0YJ one star adequate 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: Elaine Malloy Date: 2 7 0 4 2 0 1 0 Information about the care home Name of care home: Address: Meadow View Care Centre Meadow View Care Centre Kibblesworth Gateshead Tyne and Wear NE11 0YJ 01914103488 01914109908 mveuropeancare@aol.com www.europeancare.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Ms Susan Hodgson Type of registration: Number of places registered: Conditions of registration: Category(ies) : European Care (England) Ltd care home 22 Number of places (if applicable): Under 65 Over 65 21 2 3 dementia mental disorder, excluding learning disability or dementia sensory impairment Conditions of registration: Date of last inspection Brief description of the care home 0 0 0 Meadow View is a large, older building, which has been converted for use as a residential care home. There is an extension to the rear of the building. The home is registered to provide up to 21 places for older people with dementia that require assistance with personal care needs. It is also registered to provide care to older people who may have a sensory impairment or mental health needs. Nursing care is Care Homes for Older People Page 2 of 12 Brief description of the care home not provided. Single bedroom accommodation is provided. Six bedrooms have en-suite facilities. There are three lounge areas all of which include dining facilities. The home has a large landscaped garden area to the front of the building and there is level access to the rear. There are local shops, a public house and a bus route within walking distance. Details of weekly fees are available from the home. Additional charges are made for chiropody, hairdressing and personal items such as toiletries and newspapers. Copies of the homes inspection reports are available on request. Care Homes for Older People Page 3 of 12 What we found: The inspection was carried out by: Looking at information received since the last random inspection on 3rd November 2009. Getting the providers view of the service and how well they care for people. An inspector visiting the home unannounced on 27th April 2010. Talking to the manager and other staff about the service. Getting the views of people living at the home and staff by talking to them, and from surveys they completed. Observing the care and supervision provided to people living at the home. Looking at relevant records. Checking if improvements recommended from previous inspections had been made. The inspection was carried out over four hours. 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 who use the service are not put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. We found that: The home had reduced occupancy and there had been no new admissions since the last inspection. The manager confirmed the guide to the service was amended and said this would be updated further following the planned development of the home. Care records showed a range of tools were used to assess the needs of people living at the home and associated risks. A signed agreement to the care plan and risk assessments has been introduced. The manager said half of the care staff have received care plan training. New care plan documentation was in place based on Activities of Daily Living. The standard of recording within the new care plans was variable. Whilst there was some evidence of personalised planned support other care plans lacked detail and specific interventions. In some instances important information was either omitted or had not been transferred from previous plans. An example of this was an eating and drinking care plan that did not include the fact that the person was prescribed nutritional supplement drinks. Religious and spiritual needs and end of life care were not always addressed in Care Homes for Older People Page 4 of 12 care plans. Evaluations of the care plans were recorded monthly though these were often just bland statements of no change. Staff record a daily statement of well-being for each person however these reports did not correspond very well to individuals planned care to help evaluate care plans. Professional visitors records showed evidence of health checks within the last year such as visits by an optician and audiology tests. The inspector was informed that one person living at the home had been seen by a psychiatrist on two occasions, however there were no records of these visits. Daily charts that were linked to this persons behavioural care plan were inconsistently completed. The manager acknowledged the identified shortfalls to care and health recording. Training for staff on the Mental Capacity Act and Deprivation of Liberty was ongoing and the manager was waiting for revised documentation in order to record capacity assessments. Staff who administer medication have had updated training and the manager assesses their competency. Most of the previous recommendations about medication had been followed up. These included policy update, up to date reference guide, monitoring of room temperature, dating limited use medicines, clearer audit trail, and taking action to ensure people do not miss their medication because they are asleep. Directions for application of creams/gels and eye drops were still not always clearly recorded. On some of the medication administration charts handwritten entries had been added to directions for medication that were inaccurate. During the morning an aromatherapist visited and she gave people hand massages. In the afternoon staff were playing music and sitting talking with people.The home was currently without an activities co-ordinator but the post had been advertised and a new co-ordinator was being appointed. In the meantime care staff were taking responsibility for providing social activities. There was no recorded evidence of activities provision within either daily reports or a separate record. Previous recommendations about having person centred social care plans and giving staff training on activities suitable for people with dementia were not addressed. Activity resources such as DVDs and reminiscence material were available. A visiting entertainer was booked for the following week. The home has use of a shared minibus but there were currently no drivers. The manager said the new activities co-ordinator and new handy person will be able to drive the bus. She said people living at the home sometimes go out locally with staff but no trips out had taken place in recent months and none were planned. There is a four week menu and diabetic and pureed diets are provided. The days menu was written up on a board in the lounge/diner. During lunch people used two adjacent dining areas and were supported by the care staff. There was good portion size and people appeared to enjoy the meal. Previous recommendations about food and eating had been followed up. This included the cook having details of individuals preferences, assessment by professionals where a person has difficulty eating, appropriate staff support with eating, table settings and condiments and turning off televisions during meals. Care Homes for Older People Page 5 of 12 No complaints had been received about the service since the last inspection. Two safeguarding alerts were raised in recent months and were notified promptly to the relevant authorities. One alert had been concluded and had resulted in referral to the Independent Safeguarding Authority. The other alert was ongoing and concerns a persons mental frailty and behaviour. Staff now sign to confirm that they have read and understood the homes whistle blowing and safeguarding procedures. The manager said the provider company has the funding for building works and she was awaiting a start date for the development. She said this would involve a new build within the existing grounds and once this is complete the current residents would move in and the old building will have significant refurbishment and upgrade. During this time it is planned that a temporary kitchen will be provided. Previous recommendations about improvements to the building had been addressed. These were provision of lockable facilities in bedrooms, cords to be attached to the call system points, a risk assessment of the fish pond and an engineer to check the central heating boilers. The staff team consists of the manager, a team leader, five senior carers, ten carers, two cooks, two domestics and there is one domestic vacancy. Staffing levels were currently three carers including a senior across the waking day and two carers at night. The managers hours are mainly supernumerary to the rota. Staff told us that their employer carried out checks, such as a Criminal Records Bureau check and references, before they started work. They said they are given training that is relevant to their role, helps them understand and meet individuals needs, keeps them up to date with new ways of working and gives them enough knowledge about health care and medication. Staff said their manager gives them enough support and meets with them regularly to discuss how they are working. They told us what they feel the home does well is having good team work and caring for people as individuals. Some staff told us what the home could do better is to improve the facilities and they indicated they were looking forward to the planned development. One staff member also said there should be more recreational activities provided. Staff training was discussed with the manager. The previous recommendation about induction training has been followed up. The manager said she had submitted training requirements to a new internal trainer and this included update mandatory courses and further training on challenging behaviour. End of life training was taking place over the coming months. All staff have undertaken training on caring for people with dementia training. The team leader is to take on the role of Dementia Champion and is being booked to attend a two day course that will enable her to facilitate a new programme of dementia training. Previous recommendations concerning quality assurance had been addressed. Satisfaction surveys were carried out, an annual development plan has been devised and a report of the findings of the homes quality assurance was provided to the Commission. The manager said that a new quality assurance process is being introduced that is linked to the new essential standards for quality and safety that apply to health and social care services. Care Homes for Older People Page 6 of 12 What the care home does well: 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 2. Care Homes for Older People Page 7 of 12 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 12 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 1 7 15 Service user care plans must 27/05/2010 clearly identify how each persons health, personal and social care needs are to be met. To ensure that people have care plans that appropriately address their identified needs. 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 Ensure that: All staff complete Mental Capacity Act and Deprivation of Liberty training; An assessment of each persons capacity to make decisions is carried out. A written record of the outcome should be placed with their care records. (Outstanding Recommendation) Devise care plans that show how the home will meet peoples religious and spiritual needs. (Outstanding Care Homes for Older People Page 9 of 12 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 Recommendation) Service user care plans should be evaluated in greater detail to demonstrate whether the plans are working to meet the persons needs. Service user daily reports and associated charts should be further developed to cross reference to care plans. 2 3 8 9 Up to date records of all service user contact with health care professionals should be kept. Directions for application of creams/gels and eye drops should be clarified with General Practitioners and appropriately recorded on medication administration records. (Outstanding Recommendation) Inaccurate entries to directions on medication administration records should be removed. 4 11 Ensure that: Each person has an end of life care plan that has been agreed with their family, GP and any other relevant healthcare professional; End of Life care plans are subject to review by the multidisciplinary team, the service user and their carers/family, as and when peoples condition, or wishes, change; Where a person wishes to make an Advanced Decision about their end of life wishes and preferences, the home seeks advice from the persons care manager, GP and family; End of life care plans are available to all people who have a legitimate reason to access it; All staff receive training in end of life care; The providers end of life policy covers Advance Decisionmaking. (Outstanding Recommendation) Staff should receive training in how to provide specialist activity sessions for people with dementia. (Outstanding Recommendation) Records should be kept of the provision of social activities for service users. 5 12 Care Homes for Older People Page 10 of 12 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 6 13 Outings should be arranged for service users to maintain contact with the wider community. Care Homes for Older People Page 11 of 12 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. If you would like a summary in a different format or language please contact our helpline or go to our website. © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for noncommercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. Care Homes for Older People Page 12 of 12 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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