Care Home: River Meadows

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What the care home does well People have their needs assessed before they move into the home. This should mean that staff have sufficient information to develop care plans and take action to support people`s needs and abilities when they move into the home. The service identifies challenging behaviours and takes action to minimise people`s anxiety and agitation. Strategies are developed and recorded in care plans for staff to monitor people`s behaviour. What the care home could do better: The service must keep us informed about events in the care home. This is to make sure we are aware of events as they occur and know the service takes appropriate action inresponse to incidents. Random inspection report Care homes for older people Name: Address: River Meadows Warwick Road Kineton Warwick Warwickshire CV35 0HN two star good service The quality rating for this care home is: The rating was made on: 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 review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Michelle McCarthy Date: 1 8 0 9 2 0 0 9 Information about the care home Name of care home: Address: River Meadows Warwick Road Kineton Warwick Warwickshire CV35 0HN 01926640827 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) : Prime Life Ltd care home 41 Number of places (if applicable): Under 65 Over 65 0 41 dementia old age, not falling within any other category Conditions of registration: 41 0 The maximum number of service users to be allocated is 41. The registered person may provide the following category 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 (OP) 41 Dementia (DE) 41 Date of last inspection Brief description of the care home River Meadows is a purpose built care home, situated in the village of Kineton. River Meadows can accommodate up to 41 older people including older people in the dementia care category. The home offers long and short-term accommodation. Care Homes for Older People Page 2 of 9 Brief description of the care home The accommodation is on three levels. Each floor has bedrooms, lounges and bathrooms. The dining area and kitchen are on the ground floor. The garden is secure and accessible. River Meadows is registered to provide personal care services only. The visiting district nurses treat residents needing nursing care. All placements at River Meadows are contracted through Warwickshire Social Services. Information about the home is available in a variety of formats. Care Homes for Older People Page 3 of 9 What we found: This was a random unannounced inspection undertaken in response to concerns shared with us through safeguarding investigations about the failure to notify us, social services or police about incidents of violence between people using the service. We visited the home on Friday 18th September 2009 between 1.45pm and 5.30pm. We did not tell the home we were visiting on that day. The deputy manager was on duty on our arrival. The registered manager was on leave but came to the home shortly after our arrival to assist us with the inspection. We focused on the way the service assesses peoples needs before they move into the home, the management of challenging behaviour among people using the service and the arrangements for reporting incidents to us. There were 33 people using the service on the day of our visit. The manager told us that 31 people had dementia care needs. We looked at the way the service assesses peoples needs before they move into the home. All placements are commissioned by Warwickshire social services, so all referrals for admission come from them. The manager told us that referrals are sent with a social workers assessment of needs. The manager or deputy visit people before they move into the home to undertake a further assessment. We looked at the care files of two people admitted to the service in the last six months. Both files contained evidence of a detailed assessment of peoples needs and abilities undertaken before they moved into the home. Both assessments included information about the behaviour people might use to express themselves, such as becoming verbally aggressive. There was evidence that the information gathered during assessment is used to develop care plans to meet peoples individual needs. People can visit the home before they move in, but in practice it is often their families or representatives that do this. We looked at the way the service supports people with challenging behaviour needs, to make sure people are safeguarded. We looked at the care files of two people with challenging behaviours. There was evidence that behaviours are monitored and recorded so that staff can anticipate any triggers for the behaviour. Care plans had been developed to give staff instructions about the actions they need to take to minimise the triggers and reduce the risk of harm to the person and to other people using the service. For example, one persons care plan recorded that staff should use a diversion of talking to the person about their place of birth and work history to alleviate inappropriate behaviour. There was evidence that care plans are kept under review and are updated when there is a change in need. There was evidence of referral to other health and social care Care Homes for Older People Page 4 of 9 professionals when peoples behaviour changed. We observed staff implementing the actions described in care plans. We spoke with one person identified as having a challenging behavioural need and we were able to use the information in the care plan to successfully minimise their anxiety during our conversation. Information shared with us raised concerns that the service was not reporting incidents about people using the service, as required under regulation 37. We looked at the homes admission register, which records the admission, transfer or discharge of people using the service. We found several incidents that should have been notified to us under regulation 37. For example, one person was transferred to hospital in May 2009 following a sudden deterioration in their health. We were not notified of their admission to hospital or their subsequent death. The manager told us that one person was recently admitted to hospital from the home because of a deterioration of a chronic health condition. We were not notified of this persons admission to hospital. We looked at the homes current accident book, recording accidents since June 2009. We have not consistently received notifications concerning injuries sustained by people involved in accidents, such as falls. For example, the accident book records one persons transfer to accident and emergency for x-ray following a fall in June 2009. We were not notified about this. Regulation 37 clearly states that we require a notification about serious illness at a care home at which nursing is not provided. It is reasonable to assume that a transfer to hospital indicates serious concern about the health of a person using the service. We discussed regulation 37 notifications with the manager. We gave the manager a copy of our guidance about reporting incidents and signposted to the information on our website. The manager was unable to provide copies of any notifications concerning the incidents included in this evidence, and confirmed that regulation 37 notifications had not been made. What the care home does well: What they could do better: The service must keep us informed about events in the care home. This is to make sure we are aware of events as they occur and know the service takes appropriate action in Care Homes for Older People Page 5 of 9 response to incidents. 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 2. Care Homes for Older People Page 6 of 9 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, Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 7 of 9 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, 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 37 37 Notifications must be made 15/10/2009 to us concerning events in the care home, in accordance with the specific requirements of Regulation 37 of the Care Home Regulations This is to make sure we are kept informed about events in the care home and the service can demonstrate they take appropriate 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 8 of 9 Reader Information Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. 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