Care Home: Meadow View Nursing Home

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What the care home does well This home actively involved people living in the home to improve the service. An example of this was that they were included on the interview panel during staff recruitment. Assessments and care planning took into account people`s wishes and preferences and also their families` knowledge. The home had a robust recruitment procedure. Staff training was monitored to ensure that all staff were trained and competent to do their jobs. What has improved since the last inspection? According to manager, resident meetings were now being held monthly and comment sheets were now available in people`s bedrooms to ensure that they and their relatives` wishes were known. What the care home could do better: The dining experience could improve by ensuring that people are treated as individuals. A choice should be available at all meals and condiments, cutlery, crockery and aprons should be based on people`s individual needs. Each unit should have menu boards that are clearly visible and in formats suited to people`s needs. Supplementary ways of helping people to understand the options should be considered. CARE HOMES FOR OLDER PEOPLE Meadow View Nursing Home Randerson Drive Highthorne, Kilnhurst Rotherham South Yorkshire S64 5UW Lead Inspector Christine Rolt Key Unannounced Inspection 11th August 2008 09:20 X10015.doc Version 1.40 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 Nursing Home DS0000003083.V369550.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 Older People. 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 Nursing Home DS0000003083.V369550.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Meadow View Nursing Home Address Randerson Drive Highthorne, Kilnhurst Rotherham South Yorkshire S64 5UW 01709 586603 01709 586060 meadow.view@craegmoor.co.uk 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) Yorkshire Parkcare Company Limited Mrs Jackie Thomas Care Home 49 Category(ies) of Dementia - over 65 years of age (17), Old age, registration, with number not falling within any other category (32) of places Meadow View Nursing Home DS0000003083.V369550.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. A separate 17 bedded unit is maintained within the home, specifically to cater for the DE(E) service users. The service may admit persons between the ages of 60 to 65 years. Date of last inspection 4th September 2006 Brief Description of the Service: Meadow View is on a residential estate in Kilnhurst, Rotherham. It is a care home with nursing that provides care for 49 people. The home can cater for people with dementia. Meadow View is a large home, on three floors, providing predominantly single bedroom accommodation, and there is a shaft lift to facilitate access to the 2nd floor. Externally the home has a large secure patio area, and also a grassy area around the perimeter of the home. There is a wire fence that has been erected, providing some security from the nearby banking leading down to a railway line close to the home. The fees ranged from £353:00 to £455:00 per week. Additional charges were made for hairdressing, private chiropody, toiletries and newspapers. The th home’s administrator supplied this information on 12 August 2008. The registered person makes information about the service available to residents and their families via the Statement of Purpose and the Service User Guide. Meadow View Nursing Home DS0000003083.V369550.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 stars. This means that the people who use this service experience good quality outcomes. This was a key inspection and comprised information already received from or about the home and a site visit. The site visit was from 9.20 am to 6.00 pm. The registered manager completed an Annual Quality Assurance Assessment before the site visit. This document gave her the opportunity to say what the home did well, what had improved and what they were working on to improve. Various aspects of the service were then checked during the site visit. Care practices were observed, a sample of records was examined, a partial inspection of the building was carried out and service provision was discussed with the registered manager. The majority of people living at the home were seen throughout the day and several were chatted to. The care provided for three people was checked against their records to determine if their individual needs were being met. Several visitors were asked for their opinions. Three members of staff were interviewed. Ten questionnaires were sent to the home and eight were completed and returned. All information, opinions and comments were considered for inclusion in this report. The inspector wishes to thank people living at the home, visitors, the staff and the registered manager for their assistance and co-operation. What the service does well: This home actively involved people living in the home to improve the service. An example of this was that they were included on the interview panel during staff recruitment. Assessments and care planning took into account people’s wishes and preferences and also their families’ knowledge. The home had a robust recruitment procedure. Staff training was monitored to ensure that all staff were trained and competent to do their jobs. Meadow View Nursing Home DS0000003083.V369550.R01.S.doc Version 5.2 Page 6 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 Nursing Home DS0000003083.V369550.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Meadow View Nursing Home DS0000003083.V369550.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 6 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People using this service had full assessments of their needs. EVIDENCE: People said that they received sufficient information about the home and that this home was chosen because the home “met her needs” and “came in for respite and didn’t want to go home”. Assessments were carried out and copies of the local authority assessments and the home’s own assessments were available on the three files that were checked. These provided detailed information of each person’s needs and wishes. This home does not provide intermediate care. Meadow View Nursing Home DS0000003083.V369550.R01.S.doc Version 5.2 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People were treated with respect. People’s needs were set out in individual plans of care but daily recordings were inconsistent and not met fully. EVIDENCE: People living in the home looked well cared for, clean and appropriately dressed. They said they were happy living in the home. Staff were observed treating people with respect and kindness, and interactions were good. People said that they received the care and support they needed and were treated with respect and dignity. Three care plans were checked in detail. They provided good details of the person’s needs and wishes and information of how the needs were to be met. However, the detail of information in the daily records depended on the person completing the record. Some entries in the files showed that efforts had been Meadow View Nursing Home DS0000003083.V369550.R01.S.doc Version 5.2 Page 10 made to provide a holistic view of the person whilst other entries were task orientated e.g. whether the person had eaten well or issues related to toileting, irrespective of whether these were relevant to the person’s care plan. Files contained good information of health needs and how these were being met. None of the files provided consistency of how each person had spent their day. The manager was aware of this and stated in the Annual Quality Assurance Assessment that this was an area for improvement. She had written “care notes …could reflect more what has taken place i.e. the time the care staff spent with the service user interacting. Staff do attend to these needs but dont always credit themselves by writing it in the care notes” There was information to verify that people living in the home or their families were involved in care planning to provide as much information as possible about the person and their life. People considered that the staff were good and treated people living in the home with respect and dignity. Comments received about people’s care were, “All the staff seem to care for my mother” “They always phone when they need to tell us anything” “Always been good to mum” Files contained risk assessments with details of the identified and associated risks and the action taken to minimise the risks. Bed rails were being phased out and profiling beds were being used where possible whenever there was a high risk of a person falling out of bed. Files contained inventories of people’s property but without detail to enable identity e.g. size, brand, model number of televisions, radios, etc. Accidents were recorded. The implementation of 72-hour monitoring charts was discussed. The use of these would provide a record of close monitoring of people who had had accidents or falls where there were no apparent injuries at the time of the incidents Nursing staff dealt with all medication. A medication round was observed. The correct procedure was followed. The trolley was clean and each person had his or her own prescribed medications. Medication audits were carried out monthly and records of these were seen during the inspection. Staff had regular refresher courses in medication. Meadow View Nursing Home DS0000003083.V369550.R01.S.doc Version 5.2 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15 People who use the service experience adequate quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People were generally satisfied with their lifestyles in the home. EVIDENCE: The home had two activity co-ordinators. There was a programme of activities displayed at various points throughout the home. This programme showed that as well as group activities; time had been allowed for individual sessions with people with dementia. The home also displayed posters of outside entertainers who were coming into the home. One person said that although their mother could not participate fully in activities, the staff tried to involve her with music and chatting to her. Another person commented, “There should be more choice of activities to help keep residents occupied”. Care plans contained information of people’s choices and preferences. Some people chose to spend their time in communal areas whilst others preferred to spend their time in their bedrooms, although two people considered that their relatives should be persuaded to take part in activities rather than spending Meadow View Nursing Home DS0000003083.V369550.R01.S.doc Version 5.2 Page 12 their time in their rooms watching televisions. This was discussed with the manager who said that staff attempted to get people to socialise and participate in activities but it was their choice whether they did so or not. Visitors were made welcome and visited throughout the day of this site visit. There was no information in the relevant section of the AQAA relating to meals and dining arrangements. Lunch was observed on the ground floor unit and improvements could be made to the whole dining experience. The dining room décor could improve. The manager said that some of the communal rooms were to be redecorated. Plastic beakers were being used for hot and cold drinks for everyone, there were no condiments on tables and the majority of people were wearing aprons of one design and colour. This looked institutional. The need to take account of people’s individuality was discussed with the manager. The menu board was a small blackboard and the writing was indistinct and difficult to read. On the dementia unit, there was no menu at all. People said that they usually liked the meals. The lunchtime meal provided no alternatives to the meal on offer on the menu and a member of staff confirmed this. The meal was corned beef hash with mashed potatoes and green beans. It was noticeable that quite a few people did not have green beans on their plates. One person who did have beans had left them. He said that because he had no teeth, he couldn’t eat them. Another person commented, “I would like a better choice of meals.” Areas for improvement were discussed with the manager. The manager had also commented about using the amenities budget to purchase fresh fruit for various people in the home. It was suggested that everyone be offered sliced fresh fruit with mid morning drinks. Meadow View Nursing Home DS0000003083.V369550.R01.S.doc Version 5.2 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People felt they were listened to and protected. EVIDENCE: The complaints procedure was displayed. People said that they knew how to complain and were confident that the service would respond appropriately. All staff had undertaken adult safeguarding training and were aware of their responsibilities. There were no allegations of abuse. Meadow View Nursing Home DS0000003083.V369550.R01.S.doc Version 5.2 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People lived in a clean and safe environment. EVIDENCE: The home was clean. Some parts e.g. some communal areas looked dull and the manager said that the home had a rolling programme of redecoration and that the areas noted were already prioritised for redecoration. Some bathrooms were untidy with towels and incontinence pads on shelves and windowsills. The provision of wall cupboards would alleviate this and was discussed with the manager. Liquid soap and paper towels were available to prevent cross contamination. Meadow View Nursing Home DS0000003083.V369550.R01.S.doc Version 5.2 Page 15 Bedrooms were attractive and had been personalised by their occupants. Aids and adaptations were fitted throughout the home to maintain people’s independence. Within the dementia unit, efforts had been made to help orientate people to their surroundings. Changes to the décor would enhance this and help maintain independence and this was discussed with the manager. Meadow View Nursing Home DS0000003083.V369550.R01.S.doc Version 5.2 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. People were cared for by a well trained and dedicated staff team. EVIDENCE: There were sufficient staff on duty at the time of this site visit. Some staff considered that they needed higher staffing ratios and that they sometimes worked under staffed. Comments received from people living in the home and visitors echoed this. “Sometimes could do with more staff as they are so busy and can’t always come for a while.” “Need more staff” and “They seem to be short staffed quite a lot, so this must have an effect on the elderly people in their care.” This was discussed with the manager who needs to monitor the situation to ensure that people’s needs are being met. Meadow View Nursing Home DS0000003083.V369550.R01.S.doc Version 5.2 Page 17 All new employees undertook induction training. Fifty eight percent of staff had achieved NVQ Level 2 in care and several had also achieved NVQ Level 3. A further four members of staff were currently undertaking this training. A high percentage of staff had undertaken Dementia Awareness, Equality & Diversity and Violence & Aggression. The recruitment files for three members of staff were checked. All contained the relevant checks and information. Criminal Record Bureau disclosures were discussed and advice given. Other correspondence was also available which showed that the system was robust. People living in the home were encouraged to participate in the interview process and there was evidence on staff members’ files that people’ living in the home had been included on the interview panel. This is good practice. Meadow View Nursing Home DS0000003083.V369550.R01.S.doc Version 5.2 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The manager promoted the welfare of people at the home, and it was run in their best interest. EVIDENCE: The registered manager had the relevant skills and experience. The home had a quality assurance system that included audits of systems and records within the home. Residents’ meetings were held regularly and people’s views were also sought via questionnaires. The registered manager informed the CSCI of any incidents that affected people living in the Meadow View Nursing Home DS0000003083.V369550.R01.S.doc Version 5.2 Page 19 home and a representative from the organisation carried out unannounced visits to the home and produced reports as required by regulation. Money held on behalf of people who lived at the home was stored safely. Individual records were kept of all transactions. A sample of these were checked during the site visit and money tallied with the records. Receipts were available for transactions made on behalf of people living in the home. The administrator was advised to number all receipts and keep a record of these in each person’s accounts for ease of reference. Records were kept of all staff training including mandatory health and safety training (i.e. moving and handling, basic food hygiene, emergency first aid, infection control and fire awareness). The staff training matrix showed dates when staff had undertaken training. Training was ongoing and updated at regular intervals, which is good practice. Records and certificates were available to verify that service and maintenance checks were carried out and a sample of these was checked during the site visit. Meadow View Nursing Home DS0000003083.V369550.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 Older People 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 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 1 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 2 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Meadow View Nursing Home DS0000003083.V369550.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? No 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. 1. Standard OP7 Regulation 12 Requirement Records of the care given must relate to each person’s individual care plan and consistent information of how they spent their day would demonstrate person centred care. Improve people’s dining experience by treating people as individuals. Staffing levels must be monitored to ensure that sufficient staff are on duty at all times to meet people’s needs. Timescale for action 06/10/08 2 3 OP15 OP27 12 18 06/10/08 06/10/08 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard OP7 OP8 Good Practice Recommendations People’s inventories should provide sufficient information to identify the property. Implementing 72-hour accident monitoring charts would help to highlight any injuries that were not apparent at the time of an accident or fall. DS0000003083.V369550.R01.S.doc Version 5.2 Page 22 Meadow View Nursing Home 3 4 5 6 OP15 OP15 OP19 OP35 Improve people’s dining experience by offering choices at all meals and providing information of meals in suitable and clear formats Consider providing sliced fresh fruit as a snack with morning drinks Wall cupboards in bathrooms would help to prevent untidiness. The numbering of receipts and entering the number against the transaction on people’s financial accounts would ensure ease of reference when auditing the personal allowances. Meadow View Nursing Home DS0000003083.V369550.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB 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. Extracts may not be used or reproduced without the express permission of CSCI Meadow View Nursing Home DS0000003083.V369550.R01.S.doc Version 5.2 Page 24 - 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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