Care Home: Meteor Rest Home

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What the care home does well People living in the home are well cared for. Each persons health and personal care needs are assessed before they are offered a place in the home. Each person has a care plan which describes their individual needs and how staff are to support and care for them. Staff monitor residents health and ensure when a person becomes unwell that they see a doctor. Staff assess and monitor risks to residents health and safety and are rained to safeguard people from abuse. There is a complaints policy in place and concerns are taken seriously and investigated promptly. The home is clean, well maintained and furnished to suit the needs of residents. Staff are recruited thoroughly and supported to care for residents. The home is well managed and the views of residents and their families are obtained and used so as to improve the services provided. What has improved since the last inspection? Improvements have been made to the environment as part of the ongoing programme for refurbishments and redecoration of the home. What the care home could do better: More opportunities for activities and social stimulation could be provided for residents. All staff must attend planned training so that they have the skills and knowledge to be able to meet residents needs. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Meteor Rest Home 34/36 Meteor Road Westcliff On Sea Essex SS0 8DG     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: Carolyn Delaney     Date: 0 3 0 7 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 26 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 26 Information about the care home Name of care home: Address: Meteor Rest Home 34/36 Meteor Road Westcliff On Sea Essex SS0 8DG 01702340518 F/P01702340518 meteorresthome@gmail.com 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 Manilall Joysury,Mrs Sangeeta Joysury care home 15 Number of places (if applicable): Under 65 Over 65 0 15 dementia old age, not falling within any other category Additional conditions: 15 0 The maximum number of service users who can be accommodated is 15 The registered person may provide the following categories of service only: Care Home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category - Code OP Dementia - Code DE Date of last inspection Brief description of the care home Meteor Rest Home is a small private family run care home, Owned and managed by the registered providers. The home is a large house set in a residential area of Westcliff on Sea. It is not too far from the seafront and is close to local amenities including shops and Westcliff railway station. Meteor Rest Home provides care and accommodation for fifteen service users who may have dementia. The home has eleven single and two double bedrooms; there are two lounges and two Care Homes for Older People Page 4 of 26 Brief description of the care home dining areas, one of these is used for a quiet visitors room when not in use as a dining area. The home has a good-sized garden that is neat and tidy to the rear of the building. There are limited parking spaces at the front of the home; however, further parking is possible on Meteor Road. All prospective residents are provided with a Statement of Purpose and Service User Guide that supplies them with up to date information on the home. Previous inspection reports were noted to be available in the hall area of the home. Fees at the home range from £395.75 to £ 439.88 per week. There are additional charges for hairdressing, chiropodist, newspapers, toiletries and transport. Care Homes for Older People Page 5 of 26 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: This was a routine unannounced inspection, which included a visit made to the home between the hours of 10.45 and 17.30 on 7th July 2009. The last inspection was carried out on 8th August 2007. As part of the inspection process we reviewed information we had received about the service over the last twelve months including notifications sent to us by the manager of any event in the home, which affects residents such as injuries, deaths and any outbreak of infectious diseases. We also looked at the information the manager provided us with in the homes Annual Quality Assurance Assessment. This document is a self-assessment, which the registered provider or owner is required by law to complete and tell us what they do well, how they evidence this and the improvements Care Homes for Older People Page 6 of 26 made within the previous twelve months. We also looked at the improvement plan that we asked the manager to send us following the last inspection. This plan described how the manager was to address the issues as identified at the last inspection. We sent surveys each to the home to distribute to residents and staff and to complete and tell us what they think about the home. At the time of writing this report we had received surveys from six residents living in the home. We received six surveys from staff members. During the inspection we spoke with two residents, two members of staff, the manger and the homes owner. When we visited the home we looked at residents care plans and information available to staff to help them support residents. We looked at how staff were recruited to work in the home and how they were trained to support residents. We looked at how the home was managed and how residents were involved in this. We also observed how staff interacted with residents when supporting them with activities such as meals and providing recreation and stimulation. As a number of residents living in the home had communication problems due to their dementia we used an observation tool to help us assess the outcomes and experiences for these people. This observation is called a Short Observation Framework for Inspection (SOFI). We observed five people in sessions of five minutes over a two hour period. We looked peoples state of being (whether they were displaying a positive, neutral or negative state). We observed any interaction or engagement between these residents and other people in the room including staff. We made observations on how staff carried out tasks and their engagement with residents. We also observed the impact this had on residents and whether this was positive or negative. A brief tour of the premises was carried out and communal areas including lounge and bathrooms were viewed. Information obtained was triangulated and reviewed against the Commissions Key Lines for Regulatory Activity. This helps us to use the information to make judgements about outcomes for people who use social care services in a consistent and fair way. 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 26 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 26 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 move into the home can be assured that their assessed needs will be met. Evidence: The manager told us in the Annual Quality Assurance Assessment that before a person was admitted to the home that a detailed assessment of their needs was carried out either in their own home or in hospital and that people are given service users guide and statement of purpose with information to help them decide if the home will be suitable for them. Each of the six residents who completed surveys told us that they had received information about the terms and conditions of living there (a contract). They also told us that they had received enough information about the home to help them decide if it would be right for them. One person told us My niece had all of the information. Another person told us the home was recommended to them. Care Homes for Older People Page 10 of 26 Evidence: When we visited the home we looked at the information provided to people who were looking for a place in a care home. The homes statement of purpose and service users guide was detailed and provided information about the homes daily routines and information about laundry, meals, activities, care and medical treatment. There was information about who to speak to if a person was unhappy and how they might make a formal complaint. The manager told us that they were looking to develop the information given to residents into a format that they would more easily to understand. We looked at how a persons needs were assessed before they were offered a place in the home. We looked at the assessments carried out for two people who had moved into the home since the last inspection. The manager had visited both people and carried out a detailed assessment of their care, health and social needs. As part of the assessment the manager had looked at any special adaptations or mobility aids required, whether there was a risk of injury from falls etc. There was detailed information about how each person communicated and any aids needed to assist them. There was information about each persons health care needs and the assistance needed with daily activities of living such as washing and dressing, eating and drinking etc. Information about medical treatment, specialist diets etc was recorded and this information was used to determine whether the home would be suitable and whether staff would be able to meet the persons needs. Information was also recorded about any worries or anxieties a person may have about moving into the home. This information helped staff to make the move as stress free as possible. Care Homes for Older People Page 11 of 26 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. People living in the home are well cared for and their assessed needs are met. Evidence: The manager told us in the Annual Quality Assurance Assessment that they have a good care plan structure for all residents, which gave clear instructions to staff for the level of care to be given to each person. They told us that residents health care needs were recorded and delivered accordingly. They told us that medication policy and staff training in administrating medication was very good. They said that they always treated residents with dignity,respect and privacy. The manager said that medical advice was always sought at the earliest opportunity. Each of the six residents who completed surveys told us that they always received the care, support and medical attention they needed. One person told us said My (relative) has always enjoyed a fairly healthy life, but on the few occasions she has needed medical assistance they have received it. Another person told us that staff really care. Care Homes for Older People Page 12 of 26 Evidence: Staff who completed surveys told us that they ways in which information about residents needs was exchanged was effective and they told us that they were aware of the changing needs of people living in the home. When we visited the home we looked at how care for people was planned and delivered so as to ensure that residents needs were met. We looked at the care plans for three people living in the home. Each care plan contained good detail about the persons health and personal care needs. Information was clear and reviewed regularly so as to reflect any changes to the individual. There were clear assessments in place, which identified actual and potential risks to the health and safety of residents such as risks of falls, developing pressure sores, leaving the home undetected and poor diet and weight loss. We saw that each persons general health was monitored and residents were weighed regularly as part of this process. There was evidence that where needed medical advice was sought and acted upon and where a person became unwell that they had access to their doctor. We saw that staff were trained in the safe administration of medicines. We looked at medication administration records and saw that residents received medicines prescribed for them. Care Homes for Older People Page 13 of 26 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents do not always have opportunities to participate in suitable activities, which suit their needs. Evidence: The manager told us in the Annual Quality Assurance Assessment that residents experience a lifestyle that meets their needs. They told us that residents have as much choice and control over their lives as possible and that they were encouraged to maintain contact with family and friends and preserve their interests and hobbies as much as they possibly can. They told us that residents were given a choice of well balanced meals and were supported and helped with feedings. They said that regular residents meetings gave them opportunities to ask for changes or improvements. They said that there were regular daily living activities and that regular themed activities were provided. Of the six residents who completed surveys three told us that there were always activities, which they could participate in. Others told us that they did not always wish to or were unable to participate. When we visited the home we looked at the arrangements for providing opportunities for stimulation and occupation for people Care Homes for Older People Page 14 of 26 Evidence: living in the home. There was little evidence of planned activities or opportunities for occupation and stimulation suited to the needs of people who have dementia. The manager told us that it was difficult to provide activities as residents did not have much interest. They told us that the only planned activities were armchair exercises, which were facilitated by an external activities person one day each week. During the inspection we observed these activities. We saw that while some people clearly enjoyed activities with a ball that others did not but that they were made to participate despite protesting and indicating that they did not wish to. We looked at records for activities and saw that these were limited to music, chair exercises and watching television or DVDs. During the inspection we observed the lunchtime meal. Residents were offered an alternative if the did not like the planned meal on the menu. We saw that residents received meals which were well presented, looked appetising and were suited to the needs of individuals. We saw that staff were available to support residents who needed assistance and that the meal time was unrushed, allowing plenty of time for residents to enjoy their food. Of the six people who completed surveys, four told us that they always enjoyed the meals and two said that they usually did. Care Homes for Older People Page 15 of 26 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. People are treated well and know that their concerns will be taken seriously and dealt with. Evidence: The manager told us in the Annual Quality Assurance Assessment that there was a clear complaints procedure which informs residents and relatives of how they could make a complaint and which gave timescales for dealing with issues raised. They told us that they had a policy for dealing with safeguarding issues and that all staff had received training to help them identify signs of abuse and how to deal with this appropriately. Each of the six residents who completed surveys told us that they knew who to speak to if they were unhappy and how to make a formal complaint. One relative told us I know he (resident) will be well cared for. Another person told us My (relative) cannot speak but staff treat him with respect. People told us that they were happy with the care and service provided by the home. One person commented We have no concerns. Another person said We have had no concerns for the past four years. Each of the three members of staff who completed surveys told us that they knew how to act if residents or others raised any concerns. One member of staff told us I would inform the manager. Care Homes for Older People Page 16 of 26 Evidence: When we visited the home we saw that there were appropriate policies and procedures in place and that staff had received safeguarding training. We looked at how complaints had been received and responded to. We saw that since the last inspection two complaints had been received and both had been dealt with appropriately in line with the homes policy and procedure. We looked at accident records and saw that there had been no serious injuries to residents within the previous twelve months. Care Homes for Older People Page 17 of 26 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 home is clean, safe and comfortable and suits the needs of people who live there. Evidence: The manager told us in the Annual Quality Assurance Assessment that they always maintain a very safe environment for residents. They told us that they keep the home pleasant and clean, hygienic and free from odours. They told us that they endeavour to carry out repair works as soon as possible and that Tye carry out regular risk assessments to ensure that all areas are safe. Each of the six residents who completed surveys told us that the home was always fresh and clean. One person commented that the home was Clean everywhere because that is how they want it to be. When we visited the home we carried out a brief tour of the premises. All areas of the home were clean and communal areas were furnished comfortable. Resident were able to bring items of personal belongings such as furniture and ornaments to help make the space their own. We saw that regular checks were carried out so as to ensure that all of the systems and equipment necessary for the home was fit for purpose and the needs of residents. Care Homes for Older People Page 18 of 26 Care Homes for Older People Page 19 of 26 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. People living in the home are cared for by a team of staff who understand their needs and who treat them well. Evidence: The manager told us in the Annual Quality Assurance Assessment that there is ongoing training for staff provided throughout the year and that the majority of staff had completed National Vocation Qualification in Care to level two or three. They told us that there was a very good recruitment procedure and that all of the necessary checks including Criminal Records Bureau disclosures, PoVA First checks and references were obtained before a person started work in the home. Five of the six members of staff told us that there were always enough staff on duty to meet the individual needs of residents. One person said If a staff member is ill or requests for an unexpected off day there is always cover. Of the six residents who completed surveys five people told us that staff were always available when they needed them and one person said that staff were sometimes available. All staff who completed surveys told us that all of the appropriate checks had been carried out before they commenced work at the home. They told us that their induction covered everything that they needed to to do their job and that they Care Homes for Older People Page 20 of 26 Evidence: received training, which was relevant to their roles and helped them to understand the needs of the people they care for. When we visited the home we looked at the arrangements for recruiting, deploying and training staff in order to meet the needs of residents. The manager told us that four staff were employed during the day. During the night residents were supported by one waking staff and one person who slept and would be called upon if needed. We looked at staff rotas and saw that these staffing levels were maintained, that staff had appropriate time off duty and that the manager spent a good deal of time in the home ensuring that it was managed appropriately. We looked at how people were recruited to work in the home. We looked at the recruitment files for two people who had been employed since the last inspection. We saw that all of the checks including references from previous employers, Criminal Records Bureau disclosures and PoVA First checks were carried out before a person commenced work at the home. These checks helped to ensure that only people who were suited were employed. We looked at the training programme for staff. This included training in dementia awareness, challenging behaviour, emergency first aid, fire safety, safe moving and handling and health and safety. There was not evidence that all staff had undertaken some training. The manager told us that There is a training programme but some staff dont come. We advised him that this was unacceptable and that all staff must be trained to meet the needs of people living in the home. Care Homes for Older People Page 21 of 26 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 run in the interests of the people who live there. Evidence: The manager told us in the Annual Quality Assurance Assessment that they have over twenty years of experience of managing the care home. They told us that the home was run in the best interests of the residents. They told us that they safeguarded the interests and welfare of people who live in the home through implementation of policies and procedures, regular health and safety audits and engaging with residents and relatives. We looked at comments made by residents and their relatives about the service were very positive. We asked people in surveys what they thought the home did well. People told us that they were happy with the home. One person said They do all that is needed at all times. Another person said Meteor House care for my (relative) with kindness and consideration. The manager and staff do such a good job. One person Care Homes for Older People Page 22 of 26 Evidence: commented I cannot praise them highly enough for their dedication. None of the people who completed surveys identified any areas where they felt that improvements could be made. When we visited the home we looked at the arrangements for engaging with residents and other stakeholders to obtain their views as part of the process for monitoring and improving the quality of service provided. We saw that surveys had been given to residents, relatives and health care professionals to complete. People were asked to comment on things such as meals, activities, privacy and dignity, care planning and delivery. Responses and comments form all those people who had completed surveys were extremely positive. We did discuss the format of the surveys given to residents and suggested that it could be developed to suit the needs of people who have dementia. We looked at how the home was maintained so that it met the needs of the people living there. We saw that equipment such as heating and hot water systems, lifting hoists, gas, electrical and fire detection equipment was regularly checked and tested to ensure that it was in good working order. Care Homes for Older People Page 23 of 26 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 24 of 26 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 12 12 Activities appropriate to the needs of people who have dementia and which suit the wishes of people must be provided. This is so as to ensure that people living in the home are supported to remain active, occupied and stimulated for as long as possible, 25/09/2009 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 Care Homes for Older People Page 25 of 26 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 26 of 26 - 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!