Care Home: Meadow View Nursing Home

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What the care home does well The premises were clean, tidy and odour free and well maintained. Staff feedback said they worked together as a `good team` and confirmed that there was a good training programme. Care plans were clear and well maintained. What the care home could do better: There must be a clearer system for recording the use of controlled drugs to ensure that there is no chance of errors and that there is a clear audit trail of those administered. Random inspection report Care homes for adults (18-65 years) Name: Address: Meadow View Nursing Home Church Lane Calow Chesterfield Derbyshire S44 5AG two star good service 27/01/2009 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: Janet Morrow Date: 1 4 0 6 2 0 1 0 Information about the care home Name of care home: Address: Meadow View Nursing Home Church Lane Calow Chesterfield Derbyshire S44 5AG 01246270235 F/P01246270235 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Enable Care & Home Support Limited Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 26 Number of places (if applicable): Under 65 Over 65 0 learning disability Conditions of registration: 26 The maximum number of service users who can be accommodated is 26 The registered person may provide the following category of service only Care Home with nursing N To service users of the following gender Both Whose primary care needs on admission to the home are within the following category Learning Disability Code LD Date of last inspection Brief description of the care home Meadow View is in the village of Calow, approximately three miles to the north east of Chesterfield within a residential area close to local amenities and public transport. The Care Homes for Adults (18-65 years) Page 2 of 8 2 7 0 1 2 0 0 9 Brief description of the care home service provides nursing and personal care for up to twenty-four adults with moderate to severe learning disabilities, some also having significant physical disabilities. The service comprises of four bungalows, each accommodating six residents. The bungalows are linked, although each has its own separate kitchen, lounge, dining, bathing and toilet facilities. They also have their own garden areas, which have seating provided. Single bedroom accommodation is provided throughout, with six bedrooms per bungalow. The premises are fully accessible for wheelchair users. There are several transport vehicles, including wheelchair accessible vehicles. Care Homes for Adults (18-65 years) Page 3 of 8 What we found: This inspection visit was undertaken to check progress made on requirements made at the previous inspection visit in January 2009. It also assessed the services response to complaints and accident reporting. We looked at the annual quality assurance assessment (AQAA) that was sent to us by the service. The AQAA is a self-assessment that focuses on how well outcomes are being met for people using the service. It also gave us some numerical information about the service. The AQAA stated that peoples care plans were reviewed and evaluated to include individual needs and preferences and people receive support from staff in a way they prefer. We looked at one persons care records. A care plan and risk assessments were in place and there were associated records that showed attention was paid to identified risks, such as nutritional risks, risk of falls and risk of pressure sores. The care plans were detailed and gave clear instructions to staff on what they should do. We looked at one persons medication records and these were completed accurately with the exception of one medicine that had no signature on one chart on 6 occasions when it had been administered. There were no controlled drugs on the premises at the time of the inspection visit but Temazepam was stored under controlled conditions. We looked at the controlled drugs record and found this was unclear as there was no running total maintained of the drugs in stock. The Temazepam stock examined for one person had an additional tablet in stock than recorded on the MAR chart in use. The nurse spoken with was unclear about why this was but stated a tablet may not have been administered at an earlier date and may be recorded as such on a previous MAR chart. This does not ensure clarity or accuracy about the controlled drugs system. The charts also showed that only one person was signing for the administration of the Temazepam. The nurse spoken with stated that only one person signed for controlled drugs at night time as there was only one nurse on duty. This was discussed with the manager who stated that the company policy was for two people to check and sign for the administration of controlled drugs. Staff medication training records were examined and showed that this had occurred in November 2009 and it also included a competency assessment. Staff spoken with confirmed that this had occurred. We spoke to one relative by telephone shortly after the inspection visit. They told us that they were very pleased with the service provided and said they do a brilliant job and the the person they were involved with was definitely happier since being at Meadow View. They also praised the staff team for addressing health issues and and said that they couldnt fault the service. We looked at the services complaint record to assess how complaints had been addressed. We found that they were recorded and it was clear from the record what action had been taken to address any concerns. The AQAA stated that We act on the views and concerns of service users and others and action any issues raised. Care Homes for Adults (18-65 years) Page 4 of 8 We spoke to staff about safeguarding procedures and they were aware of their responsibility to report any allegations of abuse. The main issue staff raised was shortages of staff and reliance on agency workers and that there was insufficient time to keep reviews of care plans up to date. A new manager had been appointed and confirmed that she would be making an application to register with the Care Quality Commission. We spoke with the manager about the number of incidents that had occurred during the previous twelve months, some of which had resulted in referral via safeguarding procedures. The manager was able to give a good account of the incidents, particularly in relation to the person whose care and support file was examined, and the incidents related to that person were clearly recorded. The manager had notified the Care Quality Commission about these incidents, as legally required. The AQAA stated that the home is run with the health and safety and welfare of services users, staff and visitors to the home. We also discussed staff training in mandatory health and safety areas including dealing with challenging behaviour and moving and handling. Mandatory training had occurred in 2009, which included moving and handling and dealing with challenging behaviour and training on alternatives to restraint was due. The manager stated that a number of staff required this training and that the service were awaiting dates for its availability. Staff spoken with confirmed that mandatory training took place and that they felt confident in dealing with any challenging situations that arose in the service. 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 Adults (18-65 years) Page 5 of 8 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 Adults (18-65 years) Page 6 of 8 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 20 13 There must be a clearer 16/07/2010 system for recording the use of controlled drugs. This is to ensure that there is no chance of errors and that there is a clear audit trail of those administered. 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 Care Homes for Adults (18-65 years) Page 7 of 8 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 Adults (18-65 years) 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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