Care Home: Meadows Court Care Home

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What the care home does well The service offers a comfortable homely environment. The home is well maintained. Staffing levels ensure that the needs of residents are met. Staff feel supported by the registered manager and proprietor. Resident stated staff are well trained and we feel that our individual needs are being met by the care home. What has improved since the last inspection? Care records have improved since the last inspection. A greater range of activities are provided. Staff training has been increased. What the care home could do better: The home can improve the care records by including a short life history for each resident and placing a picture of the resident within their care records. The registered manager should ensure that staff are kept up-to-date with current legistration including the Mental Capacity Act and the Deprivation of Liberty Act. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Meadows Court Care Home West End Hogsthorpe Lincs PE24 5PA     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: Ken Hague     Date: 1 1 0 2 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. that people have said are important to them: They reflect the things 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.cqc.org.uk Internet address Care Homes for Older People Page 3 of 25 Information about the care home Name of care home: Address: Meadows Court Care Home West End Hogsthorpe Lincs PE24 5PA 01754872302 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Mr Nilesh Shah care home 22 Number of places (if applicable): Under 65 Over 65 22 22 22 dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category Additional conditions: 0 0 0 The home is registered to provide personal care for service users of both sexes whose primary needs fall within the following categories:- DE(E) Dementia - over 65 years (22) MD(E) Mental Disorder, excluding learning disability or dementia over 65 years (22) OP - Old Age, not falling within any other category (22) The maximum number of service users to be accommodated is 22 Date of last inspection Brief description of the care home Meadows Court is a large detached house, which has been adapted and extended to provide the present accommodation. The home is registered to provide personal care for twenty-two residents in the categories of old age, dementia and mental health. Nursing care is not provided. Accommodation is provided on two floors. There are twenty single and one double bedrooms, twelve of these rooms are en-suite. The home has a stair lift to assist residents to reach the first floor. There are car parking spaces Care Homes for Older People Page 4 of 25 Brief description of the care home at the front of the building and an enclosed garden to the rear. The home is centrally situated in the village of Hogsthorpe, which has local facilities, including a shop, church, post office, craft centre and a public house. The home are able to provide transport for accessing facilities further a field and there is a bus stop within a short walking distance from the home for buses to and from Skegness. Mr N Shah owns the home. Meadows Court is a no smoking home. 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 inspection took place over 7 hours. The main method of inspection used was called case tracking which involved selecting three residents and tracking the care they receive through the checking of their records, discussion with them and the staff, and where more appropriate observation of interaction between staff and residents and related care practices. Two members of staff were interviewed and the opinions of three residents were sought. An (AQAA) Annual quality assurance assessment was completed by the care home. An expert by experience who is an independent individual who understands the needs of the residents staying in the care home took part in this inspection. Her comments and opinions are reflected within the report. Care Homes for Older People Page 6 of 25 Care Homes for Older People Page 7 of 25 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.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 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 9 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. Residents receive a comprehensive preadmission assessment which ensures the individual residents needs can be met by the care. Evidence: The care records for three residents were read as part of the case tracking process. Each file contained a completed assessment written prior to the resident admission to the home. The assessment contained information allowing the home to contact the extended family, the GP, consultants, and social workers of each resident. Medical history and current medication were recorded. The likes and dislikes of the residents including dietary needs were recorded. Risk assessments have been completed where any risk was identified the management of that risk was recorded.The information obtained at the initial assessment had been used to complete the initial person care plan. Care Homes for Older People Page 10 of 25 Care Homes for Older People Page 11 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. Residents have comprehensive individualise care plans that reflects their assessed needs. Care plans provide staff with guidance to ensure residents needs are met safely. The medication procedure the care home has been followed ensuring that medication is administered and stored safely. Evidence: Care plans were in place for all four residents who were being case tracked. Care plans set out the care and social needs of each residents and gave guidance to staff on how these need should be met. This included the equipment to be used and the numbers of carers required to provide personal care. Risk assessments have been completed, where a risk had been identified the management of that risk was included in the care plan. Risk assessments and care plans were being reviewed in accordance with national guidelines. Care plans were detailed they set out the likes and dislikes of the residents including social lifestyle and personal diet. Residents stated that they are involved in the reviewing of their own Care Homes for Older People Page 12 of 25 Evidence: personal care plan and had signed and dated care plans. Care plans identified current medication and any allergies. They were personalised and having read the care plans you can understand the needs of each individual. Care staff stated that care plans are used as working documents are helpful in ensuring safe care is provided. Residents were able to discuss their individual care plan with the Inspector. The input from community health care teams consultants and GPs were recorded in care records. Visits made by chiropodist opticians and visits to dentists were recorded. The home as an updated medication policy in place which ensures the safe administration of medication. Staff confirmed that they had been trained in the administration and storage of medication. Staff training records confirmed training have been provided. The registered manager stated that she was confident that staff giving out medication were competent to carry out this task. The pharmacy report provided further evidence that medication practice of the care home is satisfactory. No recommendations were made after the last pharmacy visit. Care Homes for Older People Page 13 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. A wide range of activities are offered which be the choice of the wishes of residents. The menu provides choice and meets a dietary needs of residents. Friends and other relatives are encouraged to maintain contact with residents. Evidence: A range of activities are offered by the home which meets the choices and wishes of residents.The homes menu was seen. It provided evidence that the home offers choices and meets the dietory needs of residents. Staff and residents stated that the home encourages relatives and friends to visit thus maintaining residents links with the community. Residents stated that they found the activities enjoyable. Residents stated that they go out into the community to attend social activities.A communion service is held at the home by a local minister once per month. Residents stated we are offered choice in respect of our diet. The likes and dislikes of resident are recorded on their individual care plans including Special dietary needs. Staff stated that the quality of food is excellent. A resident stated the food here is wonderful we are always happy with the menu. We are offered choices and it is well presented. on the day of the site visits residents were seen to be offered choices of Care Homes for Older People Page 14 of 25 Evidence: food during the lunch period. In addition residents were provided with a choice of drinks at meal times. The Expert by Experence comented in her report that food portions were observed to be very generous, special diets were being catered for residents. Care Homes for Older People Page 15 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. There are policies and procedures in place to protect residents and enable them to raise concerns. Staff ensure residents safety is maintained. Evidence: Staff have received training in protecting residents from any potential abusive situation. Training records provided evidence that this training had been provided. Staff confirmed that they had taken part in the training courses including one which advised them how to protect residents from any possible abuse. Residents stated that they are able to raise any concerns with the registered manager or any member of staff. There have been no complaints received by the home since the last key inspection. The Commission for Social Care Inspection has received no complaints since the last key inspection. No adult protection enquiries have been held since the last key inspection. Staff stated we feel confident in being able to raise any concerns we may have with the manager in relation to the care practice of care home. Staff interviewed confirmed that they would be confident and able to use the whistleblowing procedures of the care home. Residents stated in discussions that they felt the home was a safe place in which to live. Care Homes for Older People Page 16 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents live in a clean and comfortable home which meets their social and care needs. The health and safety and infection control procedure of the care home is being followed. Evidence: The home has an ongoing maintenance program. The proprietor has purchased additional equipment for the care home since the last key inspection. New windows have been fitted. Improvements have been made to several areas of the care home, ensuites have been fitted in all bedrooms. The home was found to be clean and smelt fresh. The Expert by Experence states in her report that The home was tidy and spotlessly clean.The rooms were so attractive,well furnished with good quality fittings. A new safe and secure garden area has been created to allow residents to sit outside in comfort while remaining safe. Areas of the home and been decorated and improvements made to ceilings with the removal of suspended ceilings. No health and safety or infection control problems have occurred in the home during the last year. The proprietor has an improvement plan in place for the next financial year. Care Homes for Older People Page 17 of 25 Evidence: Staff and residents stated the home is always clean, smells fresh. A resident stated the home is very nice it is always clean and smells nice. Staff take care of my bedroom and ensure it is always clean. Its a comfortable home, I like living here. 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. New staff are being recruited safely using the updated procedure of the care home. There are sufficient numbers of trained staff employed to ensure residents needs will be met . Evidence: Evidence was found that staff are receiving formal supervisions and a yearly appraisal. This evidence was found within supervision records and discussion with a staff and the registered manager. Staff stated that their individual training needs are identified through this process and that when skill training is identified appropriate training is provided. The home exceeded national guidelines in respect of NVQ training 70 of staff hold an NVQ two in care on an equivalent qualification. Staff training record provided evidence of core and specialised training been offered to staff. Staff stated that in their opinion staffing levels are sufficient to meet the needs of the residents. Resident stated staff come quickly if we ring the bell for help. We do not have to wait for care to be provided. One resident stated there are always enough staff around to help us. A second resident stated staff make sure that I am happy with the way they help with my personal care. They do not embarrass me or rush me they are very kind The expert by experence comented that in her opinion the staff take great pride in their work and practice. A member of staff told her that I would be Care Homes for Older People Page 19 of 25 Evidence: proud to recommend this home to anyone. A sample of recruitment records were examined this provided evidence that the homes recruitment procedure is being followed by the registered manager. All of the documentation set out in the Care Home Regulations had been obtained prior to employment being offered. This included a current enhanced CRB. a POVA (protection of vulnerable adults) check and two references. 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 team ensure that the needs of the residents are met safely.Longterm planning is taking place to improve the services provided by the home.staff benefit from the positive support provided by management. Evidence: The registered manager has improved the quality of individual care plans to a point where they now exceed the National Minimum Standards. The inspection of care records and discussions with staff provided evidence of good, professional leadership. Staff stated that they feel very supportive by the company and the acting manager who is very helpful and approachable. Observations during the inspection provided evidence of good teamwork and excellent communication between staff and residents. The conversations observed between staff and residents were managed in a professional manner. Staff were seen to listen carefully to residents then to answer them in a supportive and sensitive manner. Care Homes for Older People Page 21 of 25 Evidence: Notifications have been completed appropriately in the last year. No concerns have been raised about the safety of the residents. The registered manager and staff confirmed that no health and safety and infection control problems have been identified. A yearly plan was found to be in place to maintain the environment, provides staff training and recruitment. The registered manager produced records to demonstrate that quality assurance checks are made in addition to residents meetings and one-to-one discussions. All of these records contained only positive comments. The registered manager stated that there is a policy in place for the protections of the residents money. Staff confirmed that it requires the signatures of two staff members when giving residents back money held on their behalf by the care home. 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 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 24 of 25 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. 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. Care Homes for Older People Page 25 of 25 - 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!