Care Home: Meadowbrook Care Centre

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What the care home does well The service provides a high standard of nursing care in a friendly, professional caring environment. Staff are supported well by a new manager to achieve high standards expected of their role. If concerns are raised about aspects of the service, they are dealt with quickly and people have a variety of forums at which they can air their views. Records required by regulation for the protection of service users and for the efficient running of the business are maintained, stored securely, up to date and accurate. What has improved since the last inspection? The quality audit and monitoring of the service is more robust with outcomes being shared with residents. The company has employed a second social life co ordinator. Training programmes have been expanded to give staff the skills needed to provide an improved standard of specialist care. What the care home could do better: This service has more strengths than areas for improvement. There are no significant areas for improvement needed relating to the health and safety of people using the service or issues of management. We are confident that the management will address any areas for improvement identified by the service itself. The service has measures in place to recognise its own weaknesses as they emerge and manage them well. This is a good service with some excellent outcomes. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Meadowbrook Care Centre Twmpath Lane Gobowen Oswestry Shropshire SY10 7AH     The quality rating for this care home is:   two star good service 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 assessment of the service. We call this a ‘key’ inspection. Lead inspector: Pat Scott     Date: 2 8 1 1 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought 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 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 24 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 24 Information about the care home Name of care home: Address: Meadowbrook Care Centre Twmpath Lane Gobowen Oswestry Shropshire SY10 7AH 01691653000 01691662927 meadowbrook@fsch.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Four Seasons (DFK) Limited (wholly owned subsidiary of Four Seasons Health Care Limited) Name of registered manager (if applicable) Type of registration: Number of places registered: care home 79 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category physical disability Additional conditions: The home may accommodate a maximum of 24 Younger Adults with a Physical Disability in the specified unit. The home may accommodate a maximum of 55 Older Persons of whom up to 21 may have Dementia, in the specified unit for that category of service user. The home may accommodate a maximum of 79 service users. Date of last inspection 0 0 24 Over 65 21 34 0 Care Homes for Older People Page 4 of 24 Brief description of the care home Four Seasons Health Care is a nationwide provider of care. Meadowbrook is a purpose built care home providing nursing and personal care for older people who are physically frail and older people who have mental health needs such as Alzheimers disease. There is also a young physically disabled unit for service users to receive both continuing and short term care. Meadowbrook is situated on the edge of Gobowen village, just north of Oswestry, adjacent to an Orthopaedic hospital. It is within easy reach of shops, other amenities and public transport. Four Seasons Health Care make their services about Meadowbrook known to prospective service users in: The Statement of Purpose, Company Brochure and web site which also contain their contact e mail address. The inspection report is mentioned in the statement of purpose and is available in the home. Meadowbrooks rates are reviewed annually and service users are notified one month in advance. The additional charges to service users are clearly laid out in the admission agreement. Fees for Meadowbrook are £460-844 per person per week dependent on asessed need. Care Homes for Older People Page 5 of 24 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is *TWO star GOOD service. This means the people who use this service experience good quality outcomes. We, the commission, used a range of evidence to make judgements about this service. This includes: information from the manager in the annual quality assurance assessment (AQAA), staff records kept in the home, medication audits, survey results from people who use the service, discussion with the manager, tour of the premises, previous inspection reports, quality assurance processes, Fire Authority reports, Environmental Health Office reports, observation of care experienced by people using the service. Care Homes for Older People Page 6 of 24 Care Homes for Older People Page 7 of 24 What the care home does well: What has improved since the last inspection? 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 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 24 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 24 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service has a robust assessment process so that people wishing to be admitted to the home can be confident that their needs will be addressed. The manager reviews staff training so that the service has the capacity to meet individual needs. Evidence: Information is available about the home in a document called the statement of purpose which is up to date for 2008. The information reads with clarity so people who may wish to use the service can understand the facilities and care the home can provide. Another document called the service users guide is also available and provides clear information regarding the accommodation, staffing, fee structure and how to make a complaint to the service. Care Homes for Older People Page 10 of 24 Evidence: The service conducts a reviewed pre-admission assessment which document all comprehensive questions asked about the persons needs. The manager reviews staff training so that the home can be confident that the staff have updated skills, abilities and qualifications to meet the assessed needs of new people. For example, the manager has ensured that all staff working on the dementia care unit have received training on this topic. Care Homes for Older People Page 11 of 24 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples care needs and risk assessments are set out in their individual plans of care which ensures that all care needs have been addressed and will be fully met. The manager understands the need to comply with safe medication systems and staff practice ensures that the homes procedures are complied with and that residents health matters are safely addressed. The actions of staff and their approach to care ensures that people are treated with respect and their right to privacy is upheld. Evidence: Each resident at the home has a care plan. The practice of involving residents in the development and review of the plan is recorded where they are able. The plans are good in that they are person centred and reflect the actual care being delivered as they are updated on a monthly basis. The manager conducts a care plan audit on a six monthly basis. The record of this task shows that remedial action plans are in place to Care Homes for Older People Page 12 of 24 Evidence: address any omissions with the individual staff concerned. Risk assessments have been completed for the use of bed rails for individual people. These again are person centred by ascertaining agreement from all parties concerned in the decision making process to use them. The service surveys residents about their satisfaction with the personal and health care they are receiving. We spoke with a person who had been living at the home for some time and she said that she liked the staff and they cared for her very well. She felt that her health had improved since coming to live at Meadowbrook. Staff spoken to said that the care plans provide good information to assist them to care for people. Observation of care shows that staff hoist people with dignity and speak to them respectfully during the process. The manager conducts medication audits to ensure staff compliance with procedure. Care Homes for Older People Page 13 of 24 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff support people to keep in touch with family, friends and representatives so that they have appropriate relationships. People state they are as independent as they can be, and the service demonstrates that they lead their life in a chosen way so that they have the opportunity to make the most of their abilities and interests. The food in the home is of good quality so that the dietary needs of people are met. Evidence: Menus seen are nutritionally balanced and food and drinks are readily available. The residents we talked with praised the food. very nice and good meals were some of the comments. Some residents said they prefer to take meals in their rooms and they have chance to make comments about them in surveys or directly to staff. The service conducts audits on the hospitality service in the home and has achieved the platinum award in healthy eating. A survey comment stated My relative eats well and looks well. The policy which the home adopts is one of a person centred approach to activities, Care Homes for Older People Page 14 of 24 Evidence: where as well as providing structured, organised activities, they try and find out what the individuals need or would like to do and provide some of these things. A relatives meeting was held to go through the customer survey results. A recent activity survey has been done. Care Homes for Older People Page 15 of 24 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service has a complaints procedure that is up to date and accessible so that anyone associated with the service can complain or make suggestions for improvement. Evidence: People spoken to say they would go to the manager or one of the staff if they had a problem. All expressed confidence that issues would be dealt with. There is a good level of accessibility to the management at this home which ensures that concerns can be dealt with very quickly. The manager provides communication channels such as resident meetings, complaint, comments and compliment information, day to day contact and care plan reviews. Written booklets are available in the foyer to provide advice about the services of external agencies such as Shropshire County Council, Age Concern etc. Adult protection is covered after recruitment and discussed at supervision. Staff training records seen show that staff are provided with regular updates in adult protection. The management is clear about when incidents need external input and who to refer the incident to. Links with external agencies are satisfactory and include the Care Homes for Older People Page 16 of 24 Evidence: commission, police and adult protection teams. Outcomes of adult protection referrals during the year have resulted in changes in the service. E.g. the service has reviewed its admissions process. People who use the service and their supporters state within surveys that they are satisfied with the service provision, and feel safe and supported. Care Homes for Older People Page 17 of 24 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The physical design and layout of the home improves, through resident choice, so that they live in a safe, well maintained and comfortable environment, which encourages independence. Evidence: Residents tell us they like their environment and individual bedrooms. There is a programme of regular maintenance and of areas identified by the service as needing renewal. A wet room has been created and the physio room is fully in use. The home has a dedicated laundry service and staff are trained in infection control. The home reviews the premises, with input from residents so that people feel they live in a comfortable, clean home with modern furnishings and facilities which suit their individual needs and preferences. One relative commented I am sure I picked the right home for my relative who deserves it. Care Homes for Older People Page 18 of 24 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff get access to training, supervision and support they need from the manager so that people receive planned care. Staff in the home are trained and recognise the importance of care planning so that peoples changing needs are identified and acted upon Evidence: A review of staffing in the home has resulted in an improved skill mix within the units. Senior staff have more responsibility for the area of their expertise. There are NVQ, qualified and experienced staff employed to provide care to people at the home. Care staff without NVQ qualification have received all mandatory training and completed the common induction standards. The staff have good managerial support to develop their experience in the service they are delivering. People using the service tell us that staff working with them provide safe and appropriate support. A relative in a survey commented Very impressed with all staff. I chose Meadowbrook because of the continuity of staff. Care plans show that there is understanding of the person centred way of delivering care and support which is supported by training. Care Homes for Older People Page 19 of 24 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The management of the home is based on openness and respect. The service has quality assurance surveys in place so that people are assured that the overall conduct of the home is taking into account their views. Peoples opinions are more central to how the home develops and reviews its practice, and the service is developing appropriate ways of making sure they get things right. So, people have confidence in the care home because it is run and managed well. Evidence: The new manager has been in post for four months. She is about to commence the required qualifications and apply to be registered with the commission. Equality and diversity for residents is promoted throughout the home within the assessments, care plans and activities and training. Equality for staff is promoted through the opportunities for training at all levels. Quality assurance takes place throughout the Care Homes for Older People Page 20 of 24 Evidence: service in both a formal and informal manner. Meetings, surveys, audits, day to day contact all provide records to show that resident satisfaction is at the heart of the service. The manager and her deputy with administrative support implement plans for improvement. The provider produces a monthly report to the manager to demonstrate that the overall conduct of the service is being managed well. It covers areas such as; interviewing residents, relatives, staff, catering, complaints, health and safety. The home keeps records to show that the health and safety of service users is promoted and protected. The service conducts fire drills, has regular alarm tests and reviews its fire risk assessment. The home actively encourages people, where able, to manage their own money. Accurate records are kept and audited. Through discussions with the manager, she demonstrates that she is confident in her ability to lead a staff team whilst being fully aware of the individual needs of the people living at Meadowbrook. Care Homes for Older People Page 21 of 24 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, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 22 of 24 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, Care Homes 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 Care Homes for Older People Page 23 of 24 Helpline: 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 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. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 24 of 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!