Care Home: Meadows Sands Care Home

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What the care home does well `The home is in a quiet part of the seafront, in a cul-de-sac leading to a hotel, with a pleasure gardens and the beach opposite. There are sea views to some of the bedrooms. A visitor commented that a reason for choosing the home was its position. People are cared for in a clean and comfortable environment and the home is decorated to a good standard. All people spoken with made positive comments about the care they received; one said it was like being on holiday all the time and another said that he enjoyed sitting on the area at the front of the building in good weather and watching the world go by. The staff group is well trained and knowledgeable about the people living at the home and how they prefer to be cared for. The manager and providers work well as a team and there is a stable staff group, enabling good knowledge of the needs of people. People are encouraged to make choices about their daily lifestyles and individual likes and dislikes are catered for. The activities manager communicates very closely with people, their families and friends to ensure their wishes regarding their lifestyle are carried out. Comments from visitors were very positive and compared Meadow`s Sands very favourably with other homes in the area. Surveys we saw were very positive and comments included praise for the staff and the manager. What has improved since the last inspection? All contracts between the home and people or their families have been drawn up and signed. Pre-assessment paperwork has been reviewed and improved to enable staff to understand the needs of people better. Care plans have begun to be reviewed and will be made more concise. A review of leisure activities has been undertaken by the new activities manager. Staff have received safeguarding training and further information cascaded to staff at team meetings. A programme of renovation and improvements to the building has begun. A robust recruitment policy has been created. Staff training in basic food hygiene, dementia, safeguarding, mental capacity and deprivation of liberties has been carried out. The manager commenced in post three weeks ago and has already carried out initial supervisions sessions and meetings with staff. A review is under way to completely review and monitor the quality of care provided. The manager is awaiting contacts to arrange advocacy for the finances of people. What the care home could do better: Although some of the requirements made at the last inspection have not been addressed in full, the providers and manager have made a good start in raising care standards for the people living at Meadow`s Sands and no issues of any concern were found on the day of the visit. Key inspection report Care homes for older people Name: Address: Meadows Sands Care Home 98 South Parade Skegness Lincs PE25 3HR     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Julie Western     Date: 1 7 0 6 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. 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. Care Homes for Older People Page 2 of 24 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. 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 mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) © Care Quality Commission 2010 This publication may be reproduced in whole or in part in any format or medium for non-commercial purposes, provided that it is reproduced accurately and not used in a derogatory manner or in a misleading context. The source should be acknowledged, by showing the publication title and © Care Quality Commission 2010. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 24 Information about the care home Name of care home: Address: Meadows Sands Care Home 98 South Parade Skegness Lincs PE25 3HR 01754762712 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): care@meadowssands.co.uk Accredited Care Limited Name of registered manager (if applicable) Type of registration: Number of places registered: care home 26 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The home is registered to provide personal care for service users of both sexes whose primary needs fall within the following categories:- Old age, not falling within any other category (OP) (26) Dementia - over 65 years of age (DE[E]) (26) The maximum number of service users to be accommodated is 26. Date of last inspection Brief description of the care home Meadow Sands Care Home is situated on the sea front at the Southern end of Skegness. There are public car parking facilities to the front of the home and three car park spaces to the rear of the home for staff. The home has no garden but seating is available at the front of the building and there is a park across the road. The bedrooms are situated on three floors accessible by stairs or a passenger lift. There are communal lounges and dining facilities on the ground floor. Care Homes for Older People Page 4 of 24 Over 65 26 26 0 0 0 8 1 2 2 0 0 9 Brief description of the care home The current weekly fee is £310.00 - £446.00. Additional charges are made for chiropody, hairdressing, newspapers and personal toiletries. 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. This means the people who use this service experience good quality outcomes. This was an unannounced visit and it formed part of a key inspection, focusing on key standards, which have the potential to affect the health, safety and welfare of people who use the service. Throughout this report the terms we and us refer to The Care Quality Commission (CQC). The visit lasted approximately five hours and we took into account previous information held by us including the previous inspection report, their service history and records of any incidents that we had been notified of since the last inspection. Before we made our visit the provider had returned the Annual Quality Assurance Assessment (AQAA). This gave us information about their own assessment of how well they are meeting standards and their plans to improve aspects of the service. We sent Care Homes for Older People Page 6 of 24 out surveys to people before we visited the service; these will be recorded and used to form the next review. The main method of collecting information during this visit is called case tracking, which includes following the care of a sample of four people through their records and assessing their care. We spoke to three people who use the service and saw rooms of those people who said we could and to three staff members. The manager and both providers were present throughout the visit and the general outcomes of the visit were discussed with them. 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 on page 4. The report of this inspection is available from our website www.cqc.org.uk. Care Homes for Older People Page 8 of 24 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 9 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 10 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. People who use this service have good information about the home in order to make an informed decision about whether the service is right for them. Evidence: We saw the statement of purpose which was very comprehensive and contained terms and conditions and contracts. The service user guide we saw contained useful information for people. It was in large print. The manager said that she or a senior member of staff always visited prospective residents at home or in a care setting such as a hospital to undertake a thorough assessment of all their care needs. Records we saw confirmed this. We saw written admission records that were clear and gave staff all the information they needed to meet the needs of people. A resident we spoke with described how she had visited for the day before she was sure she wanted to move in permanently. A relative told us that this home had been Care Homes for Older People Page 11 of 24 Evidence: chosen because it was the best of the ones they saw. A staff member described the admission process and the importance of making new residents and their families welcomed. Care Homes for Older People Page 12 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. Care plans are in enough detail to ensure that the care needs of people can be met. Evidence: Care plans we saw contained information about the health and personal care needs of people. They included mental capacity assessments, risk assessments, weight charts, moving and handling assessments, medication records and daily logs. There was also a separate album for each person, entitled My Life Story, which included a life history, likes and dislikes, hobbies, photographs and last wishes. These were completed by people if they wished, assisted by families and staff. Care plans were reviewed regularly and signed where possible by people or their relatives or advocates. We saw a medication policy that was clear and comprehensive. The pharmacist visited regularly, the last visit being on 23rd May. No issues were identified and the pharmacist commented that medications were well ordered. People we spoke with received regular visits from district nurses, GPs, chiropodists and other agencies involved with their care. We saw staff carrying out their duties with kindness and sensitivity towards people, Care Homes for Older People Page 13 of 24 Evidence: especially when attending to their personal needs. Care Homes for Older People Page 14 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. Social activities are regular and are tailored to suit the individual needs of residents. People have a choice of meals from a balanced and varied menu. Evidence: We saw that each person has an assessment for activities in their care plans. We found that the home has an activities organiser, who provides a variety of activities for residents including entertainers, indoor games such as board and card games and trips to local pubs and shops. On the day of our visit digital TV was being installed in all rooms and people were sitting in the main lounge laughing and chatting with the activities organiser, who has a work station in the main lounge to maintain a constant presence. One person was accompanied to the pub by one of the providers. People we spoke with all said they had a choice of whether or not to take part in any events. The activities programme is displayed around the building, to ensure that all residents are kept informed. Future events included theatre trips, a summer fair and visits to the beach. A house magazine is published and distributed to local people as well as within the home. We saw people enjoying the mid-day meal and all said they enjoyed the meals served; one said the food was Marvellous and another that it was Lovely having meals cooked for you and with a good variety. The four-weekly menu offered alternative choices of Care Homes for Older People Page 15 of 24 Evidence: meals. The cook has the National Vocational Qualification in nutrition and food hygiene at Level 2. He was knowledgeable about the nutritional needs of service users and described cooking for people on various diets. The activities organiser often organises themed meals, the next one being a Wimbledon tea with strawberries and cream. Care Homes for Older People Page 16 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 procedures for addressing complaints and for protection from abuse are clear. People and their families are confident that their comments and concerns will be listened to. Evidence: People we spoke with said they did not wish to complain but knew how to make a complaint. The home had an up to date copy of the Local Authority adult protection procedures and staff members said they had read it. The training programme showed that there was a rolling training course for staff on POVA and safeguarding adults. Staff members we spoke with knew what to do in the event of a serious concern. The manager said that residents and their families were regularly asked for their views regarding the running of the home. A resident said If I had a complaint the manager would see to it and visitors spoken with said that they were given information on how to make complaints. 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. People live in a comfortable and pleasant environment with both private and communal space that is generally suitable for their needs. Evidence: Overall, the standard of decoration internally was good and residents said they were comfortable in their surroundings. Bedrooms were all clean and well personalised. Recent improvements have included a new wet room on the ground floor. The providers have embarked upon a scheme to totally redecorate most rooms and new carpets are due to be installed in the hallways and corridors on the upper floors. There are no gardens but there is space at the front of the building for people to sit out and watch the activities in the Pleasure Gardens and park across the road and the beach beyond. Staff described how any maintenance issues were addressed quickly by the providers who carried out most small maintenance repairs. There were safety notices around the building to prevent the spread of infection and COSHH regulations were observed throughout. Although the building has different levels and three floors, there is a lift to enable people to access the whole building and a ramp on the first floor. The building smelled clean and fresh throughout. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff numbers are adequate to meet the needs of the residents and staff have the necessary skills and knowledge to provide residents with appropriate care. Evidence: The staff rota we saw showed that there was one senior carer and one member of staff, plus the manager, two providers and the activities organiser, for 13 people. We saw training records for staff and these showed that 50 of staff have either achieved the National Vocational Qualification [a nationally recognised qualification] at Level 2 or are working towards it. We spoke with staff members who described how they had an interview, gave references and underwent CRB/POVA checks and had induction before starting work. Staff records we saw confirmed this. Training records we saw showed that the training required by law has been undertaken, with additional training in dementia, the role of the care worker and safeguarding of vulnerable adults. Future training included first aid and fire safety. We saw that, although the manager had only been in post for a few weeks, all staff members had received supervision and they confirmed this. There were also minutes of the first staff meeting. 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 home is well managed and the health, safety and welfare of people are promoted. Evidence: The manager, who is awaiting registration with the commission, has only been in post for three weeks. She has worked in the care profession for 14 years, seven of these with the Local Authority and 18 months in a managerial position. She is also working towards gaining the NVQ in management. She described various plans she and the providers had made in order to make improvements to the standard of care at Meadows Sands. The manager and providers work very much as a team and staff members spoken with said they were all very approachable and accessible. A visitor said They are all brilliant, they always make us welcome and will do anything they can to help. There is a quality assurance procedure, with separate questionnaires given to people, their relatives/visitors and staff. We saw returned survey forms from local GPs in the area and all had made positive comments about the care given. The findings of these surveys are discussed with the providers, who both visit two or three times a week, Care Homes for Older People Page 20 of 24 Evidence: and acted upon. The manager is presently reviewing how finances are being managed, but described how people are being encouraged to manage their own where possible. Health and safety policies are clear and demonstrate a commitment to ensuring the wellbeing of people. 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: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. 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