Care Home: Meadowcroft

What the care home does well Service users` care needs are assessed before they use the service provided at Meadowcroft. Staff surveys returned to us indicated that on the whole they are given up to date information about the service users they support. Service users` health and personal care needs are met. One health care professional survey returned to us noted, `The staff provide a sound level of care for all service users and refer appropriately for any concerns. They demonstrate good care planning`. Another health care survey noted `The service shows great flexibility in accommodating individual`s wishes although account is always given to the risk of any individual and all other residents`. The relative of one service users spoken to during the visit said `The staff are fantastic and Meadowcroft is a beautiful place. I have absolutely no concerns to raise as the staff would do anything for you`. Staff have a clear understanding of how to ensure service users are treated with respect. One health care professional survey return to us noted `The staff at Meadowcroft take very good care of their clients. They are loved and looked after and treated with respect and kindness. The care is excellent`. Staff support service users with their medication. The complaint procedure is available so that service users` carers know what to do if they are unhappy with the care they receive. Service users are provided with a range of activities which gives them opportunity to meet with the other people staying at the unit and to prevent them from becoming bored. A varied and balanced diet is provided. Special diets based around service users` medical or religious needs can be catered for. Meadowcroft is well maintained and provides a comfortable, homely and safe environment. The premises are secure, bright and airy. Adaptations and special equipment is provided to maximise service users` independence and to minimise the risk of accidents happening. Staff are provided with a range of training to support them in their role and to keep them up to date with new ways of working. One health care professional survey returned to us noted `The staff demonstrate excellent skills within their remit (and beyond)`. All of the staff spoken to during the visit said they enjoy their work and are well supported in their role. They confirmed the manager is supportive and available for advice when necessary. Systems are in place to ensure the efficient and effective running of the unit and the ongoing improvements of the service. One health care professional survey returned to was noted `The staff are skilled and experienced and provide a calm and contentedatmosphere. They know the limit of their skills and know when to seek help`. A service user`s carer noted in the unit`s Comments Book `Many thanks for all your immense kindness and high standard of professional care. We are very much in your debt`. Another carer wrote `Our family are extremely happy with the carer and support are relative received during his stay. We cannot find fault with the staff at Meadowcroft and would like to thank all of them`. What has improved since the last inspection? Since the last visit staff have completed more training and the social activities have improved. This provides service users with a more stimulating environment and ensures the staff are kept up to date with new ways of working. What the care home could do better: Improvements need to be made to the assessment and care planning documentation to ensure staff have all the information they need on how to support the service users properly. Service users` care plans should be reviewed regularly to ensure the care provided accurately reflects their care needs. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Meadowcroft 304 Spital Road Bromborough Wirral CH62 2DE     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: Ingerbritt Moynihan     Date: 1 4 0 1 2 0 0 9 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 25 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) 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 25 Information about the care home Name of care home: Address: Meadowcroft 304 Spital Road Bromborough Wirral CH62 2DE 01513346325 01513342641 sheliahardie@wirral.gov.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Miss Sheila Hardie Type of registration: Number of places registered: Metropolitan Borough of Wirral care home 23 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia Additional conditions: The service should at all times employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. Date of last inspection Brief description of the care home Meadowcroft is a registered care home providing 24-hour personal care and accommodation for younger and older people who suffer from dementia. The home is owned and managed by Wirral Social Services which is a part of Wirral Borough Council. The home is located close to Bromborough town centre which has a selection of shops, pubs, a post office and other town amenities. There are public transport links close to the home which give access to Birkenhead and other parts of the Wirral. Meadowcroft is a single storey purpose built home. All bedrooms are single occupancy with en-suite facilities. The rooms are bright and spacious with emergency call points fitted. Specialist bathing facilities are provided in spacious bathrooms. There are two lounges as well as a separate lounge for service users who wish to smoke. There is 6 Over 65 17 Care Homes for Older People Page 4 of 25 Brief description of the care home also a large conservatory overlooking an inner courtyard. The home is well furnished throughout. Care Homes for Older People Page 5 of 25 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 staff refer to the people who stay at Meadowcroft as service users, therefore this term is used throughout the report. Information about the unit was obtained through discussion with the manager and five members of staff. We looked around the building and at a selection of service users case files and other supporting documentation. We also obtained information from the Annual Quality Assurance Assessment (AQAA). The AQAA is a self-assessment document that is filled in once a year by all providers. It is one of the ways that we get information from providers about how they are meeting outcomes for people using the service. Because the service users have dementia, they have limited capacity to express their views. In light of this we observed how staff interacted with them over Care Homes for Older People Page 6 of 25 the day. A part of the inspection process includes sending surveys to staff and health care professionals to obtain their views on the standard of the service. Twelve staff surveys and three health care professional surveys were returned to us. Comments made in these surveys are included in the report and contribute to the basis of any judgments made. A copy of this and previous inspection reports can be obtained from the manager at the unit. Fees 69.55 - 360.64 per week. What the care home does well: Service users care needs are assessed before they use the service provided at Meadowcroft. Staff surveys returned to us indicated that on the whole they are given up to date information about the service users they support. Service users health and personal care needs are met. One health care professional survey returned to us noted, The staff provide a sound level of care for all service users and refer appropriately for any concerns. They demonstrate good care planning. Another health care survey noted The service shows great flexibility in accommodating individuals wishes although account is always given to the risk of any individual and all other residents. The relative of one service users spoken to during the visit said The staff are fantastic and Meadowcroft is a beautiful place. I have absolutely no concerns to raise as the staff would do anything for you. Staff have a clear understanding of how to ensure service users are treated with respect. One health care professional survey return to us noted The staff at Meadowcroft take very good care of their clients. They are loved and looked after and treated with respect and kindness. The care is excellent. Staff support service users with their medication. The complaint procedure is available so that service users carers know what to do if they are unhappy with the care they receive. Service users are provided with a range of activities which gives them opportunity to meet with the other people staying at the unit and to prevent them from becoming bored. A varied and balanced diet is provided. Special diets based around service users medical or religious needs can be catered for. Meadowcroft is well maintained and provides a comfortable, homely and safe environment. The premises are secure, bright and airy. Adaptations and special equipment is provided to maximise service users independence and to minimise the risk of accidents happening. Staff are provided with a range of training to support them in their role and to keep them up to date with new ways of working. One health care professional survey returned to us noted The staff demonstrate excellent skills within their remit (and beyond). All of the staff spoken to during the visit said they enjoy their work and are well supported in their role. They confirmed the manager is supportive and available for advice when necessary. Systems are in place to ensure the efficient and effective running of the unit and the ongoing improvements of the service. One health care professional survey returned to was noted The staff are skilled and experienced and provide a calm and contented Care Homes for Older People Page 8 of 25 atmosphere. They know the limit of their skills and know when to seek help. A service users carer noted in the units Comments Book Many thanks for all your immense kindness and high standard of professional care. We are very much in your debt. Another carer wrote Our family are extremely happy with the carer and support are relative received during his stay. We cannot find fault with the staff at Meadowcroft and would like to thank all of them. 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 9 of 25 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 10 of 25 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. Service users care needs are assessed prior to a service being offered so they know they will receive the care and support they need. Evidence: Service users care needs are assessed before they use the service and a record of this information is held on file. Service users, their family and any relevant health care professionals can contribute to the assessment to ensure staff have all the information they need on how to provide the right level of care. Staff surveys returned to us indicated that on the whole they are given up to date information about the service users they support. However, one staff survey noted Occasionally we take emergencies from hospital or social workers and little information comes through. What does come through is occasionally inadequate and we struggled to meet the clients needs........... Another staff survey noted Emergency admissions can leave you with limited information While the manager said the admission procedure has Care Homes for Older People Page 11 of 25 Evidence: improved, she must ensure that all of the necessary information is gathered as quickly as possible after an emergency admission and before a respite stay. This will ensure service users receive the care they need. Care Homes for Older People Page 12 of 25 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. Service users personal care needs are met and they are treated with respect and valued as individuals. Evidence: A plan of the care provided to each service user is in place. One health care professional survey returned to us noted The staff provide a sound level of care for all service users and refer appropriately for any concerns. They demonstrate good care planning. Another health care professional survey noted The service shows great flexibility in accommodating individuals wishes, although account is always given to the risk to any individual and all other residents. This survey also noted There are very occasionally times when a service user will need more care than staff can practically provide, but they manage these situations extremely well while awaiting an alternative plan of care or transfer to another service. The relative of one service users spoken to during the visit said The staff are fantastic and Meadowcroft is a beautiful place. I have absolutely no concerns to raise as the staff would do anything for you. Care Homes for Older People Page 13 of 25 Evidence: Although there is clear evidence that service users are receiving a good standard of care, the manager acknowledged the supporting documentation needs to be improved as it did not always reflect service users specific care needs. Nor did the documentation demonstrate that service users care needs had been reviewed properly. One of the staff surveys noted I think the service could collect more personal details on each service user that stays for respite so we can have clear image of them. This will help us meet their needs a lot easier. The manager must ensure the staff are vigilant in recording information about the service users as it is only by doing this can they be sure the service users are receiving the care they need and they are not left vulnerable to the risk of harm. The manager acknowledged this issue needs to be addressed as quickly as possible and to ensure it was dealt with by the end of March 2009. Staff spoken to demonstrated a clear understanding of how they ensure service users are treated with respect and their right to privacy is upheld. One of the health care professional surveys returned to us noted The staff at Meadowcroft take very good care of their clients. They are loved and looked after and treated with respect and kindness. The care is excellent. Systems are in place for the administration of service users medication. Staff are trained in this area of care so they are aware of their responsibilities and know how to work safely. A medication policy and procedure is also available to support staff in their work. The medication administration records looked at were accurately maintained. The manager acknowledged that the system for auditing service users medication needs to be improved to ensure service users receive their medication as prescribed by their GP. Care Homes for Older People Page 14 of 25 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The units routines are flexible and service users are helped to exercise choice and control in their lives. Evidence: A range of social activities are provided to ensure service users have an opportunity to meet with the other people staying at the unit and to prevent them from becoming bored. The manager said this area of care has improved since the last visit and plans are being made to provide staff with further training. Service users friends and family can visit at any time and they can meet in private if they wish. The units routines are flexible and service users can go to bed and get up when they want. Mealtimes are flexible and a varied and balanced diet is provided. Special diets based around service users medical or religious needs can be catered for. The cook said the quality of the food is very good and service users are always provided with plenty to eat and drink. Staff are available to help service users with their meals if necessary. Care Homes for Older People Page 15 of 25 Care Homes for Older People Page 16 of 25 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. Systems are in place to ensure service users are protected from abuse. Evidence: A copy of the units complaint procedure is available to service users carers so they know what to do if they are unhappy with the standard of care provided and want to make complaint. The staff spoken to are aware of the action they must take in the event of them receiving a complaint. No complaints have been made about Meadowcroft either directly to the manager or to the Commission. Staff have completed training on how to ensure service users are protected from abuse, neglect and self harm and during discussion they demonstrated an understanding of the different types of abuse that can occur and what they should do if they know or suspect abuse is happening. None of the staff spoken to had any concerns about the safety and welfare of the service users or the care practices of their colleagues. The manager knows how to manage allegations of abuse correctly and a copy of the Wirral adult protection procedure is in place to support her with this. A whistle blowing procedure is available to staff so they can raise concerns anonymously. No allegations of abuse have been made at Meadowcroft. Care Homes for Older People Page 17 of 25 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 building is well maintained and provides a comfortable and homely environment for service users to stay. Evidence: Meadowcroft is well maintained and provides a comfortable, homely and safe environment for service users to stay. The premises are secure, bright and airy. There is a programme of routine maintenance and the grounds are kept safe, tidy and attractive. Adaptations and special equipment is provided around the unit to ensure service users independence and to minimise the risk of accidents happening. Systems are in place to prevent the spread of infection and staff are trained in this area of care so they are aware of their responsibilities and know how to work safely. Care Homes for Older People Page 18 of 25 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Recruitment and selection procedures ensure suitably qualified and competent staff are employed. Evidence: The manager and staff reported the staffing levels are good and additional staff are provided when necessary. The AQAA document indicated that most staff are qualified to the National Vocational Qualification level 2 or above in care, a recognised qualification for staff involved in the care profession. The staff surveys returned to us indicated they are given training which is relevant to their role and keeps them up to date with new ways of working. One of the health care professional survey returned to us noted The service staff demonstrate excellent skills within their remit (and beyond). The staff recruitment procedures are thorough and staff surveys returned to us confirmed that appropriate checks, such as a Criminal Records Bureau check and staff references, were completed before they started work. The recruitment procedures are based on equal opportunities and issues of equality and diversity are explicitly addressed. A number of new staff have recently been appointed to work at the unit. While they Care Homes for Older People Page 19 of 25 Evidence: were provided with induction training when first employed, a record of this information was not kept. To ensure staff are clear on their responsibilities and know what is expected of them, the manager must ensure an induction training programme is compiled and a record is kept when it was completed. Care Homes for Older People Page 20 of 25 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 systems ensure the unit is run efficiently and for the service users best interest. Evidence: The registered manager is qualified, competent and experienced to run the unit for its stated purpose. She has carried out training for her own personal development and the improvement of the service. There are clear lines of accountability within the unit. This means staff know who to speak to if they want to raise a concern and the issue will get resolved appropriately. One of the staff surveys noted The home is run very well by everyone to make sure the service users are happy while they are here. Systems are in place to ensure the efficient and effective running of the unit and the ongoing improvement of the service. While it is clear that service users are receiving a good standard of care, the manager acknowledged that some improvements need to be made to the administrative systems. She agreed to ensure this issue was addressed Care Homes for Older People Page 21 of 25 Evidence: by the end of March 2009. One health care professional survey returned to is commented The staff are skilled and experienced and provide a calm and contented atmosphere. They know the limits of their skills and know when to seek help. A service users carer noted in the units Comments Book Many thanks for all your immense kindness and high standard of professional care. We are very much in your debt. Another carer wrote Our family is extremely happy with the care and support our relative received during his stay. We cannot fault Meadowcroft and its staff and would like to thank all of them. The manager does not deal with service users fees, this is dealt with by the organisations head office. She will however help service users manage small amounts of money. The financial records looked at were accurately maintained. The staff spoken to during the visit said they enjoy their work and feel well supported in their role. They confirmed the manager is very supportive and available for advice when necessary. The staff surveys returned to us confirmed the manager meets with them regularly to give support and discuss how they are working. The health, safety and welfare of service users and staff is promoted through the provision of staff training and supporting policies and procedures. Regular health and safety checks are carried out around the building which is also regularly audited by the organisations health and safety department. A record of all health and safety checks is in place. Care Homes for Older People Page 22 of 25 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 23 of 25 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 1 7 15 Details about the way service users are looked after must be recorded in a clear plan of care. This plan of care must be reviewed regularly to reflect service users changing care needs. This will provide staff with the information they need on how to provide the right level of care and ensure service users are kept safe from the risk of harm. 31/03/2009 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 30 A record of the staff induction training should be in place so that staff are clear on their responsibilities and know what is expected of them. Care Homes for Older People Page 24 of 25 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. 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