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Inspection on 03/09/09 for Moorlands Nursing Home

Also see our care home review for Moorlands Nursing Home for more information

This is the latest available inspection report for this service, carried out on 3rd September 2009.

CQC has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CQC judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The home provides good systems and practices to care for the people accommodated. Recording systems were good and people had detailed admission assessments and care plans to reflect how their needs should be met. All of the people living at Moorlands said that they were well cared for and treated with dignity and respect. Comments about the social activities and food were mainly positive and all people spoken to said that the visiting arrangements at the home were good and that people were made welcome. The home has clear policies and procedures for managing any complaints or allegations. All staff receive regular training to support them in carrying out their roles effectively. Management systems are good and staff said that they felt well supported.

What has improved since the last inspection?

Care plans have been developed and they now reflect the support and care which each person requires. Activity assessments have been carried out on each individual The window in room 24 has been restricted to ensure the safety of any person using the room. The manager regularly reviews staffing numbers to ensure that they are sufficient to meet the assessed needs of the individuals living within Moorlands. The owners confirmed that the temperature of water within the building has been adjusted so that it is suitable to people living at the home. Moorlands Nursing Home DS0000055586.V377674.R01.S.doc Version 5.2

What the care home could do better:

Systems to ensure medication is disposed off within appropriate timescales must be reviewed as a number of eye drops had passed their shelf life. The temperature of the drugs fridge must also be monitored on a daily basis. The activity assessments should be used to plan and co-ordinate activities taking place at the home. The owner agreed to purchase a new carpet for the lounge and hallway as the existing one is badly marked. The owner also agreed to look at alternative storage arrangements for wheelchairs so that the conservatory could be better utilised by people living and visiting the home. Appropriate recruitment checks must be carried out and received prior to people starting work at the home, so that people are protected. A copy of an up to date gas safety certificate needs to be forwarded to CQC. The lift floor requires further attention to stop it from being a trip hazard and fire training records need to be better organised and reflect clearly the names of any staff who have taken part in any instruction or drill. This is to ensure the health, safety and well being of people living and working at the home.

Key inspection report CARE HOMES FOR OLDER PEOPLE Moorlands Nursing Home Northgate Guisborough TS14 6JU Lead Inspector Tanya Newton Key Unannounced Inspection 3rd September 2009 10:15 DS0000055586.V377674.R01.S.do c Version 5.3 Page 1 This report is a review of the 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. 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. Moorlands Nursing Home DS0000055586.V377674.R01.S.doc Version 5.2 Page 2 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Moorlands Nursing Home DS0000055586.V377674.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Moorlands Nursing Home Address Northgate Guisborough TS14 6JU Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01287 630777 01287 630374 moorland@btconnect.com Mr George Dixon Mrs Susan Olive Ellis, Mrs Angela Catherine Allick, Mr Michael Dixon Mrs Yvonne Elizabeth Southall Care Home 30 Category(ies) of Old age, not falling within any other category registration, with number (30) of places Moorlands Nursing Home DS0000055586.V377674.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only Care home with nursing - Code N 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 PC, maximum number of places 30 the maximum number of users who can be accommodated is 30 2. Date of last inspection 9th October 2007 Brief Description of the Service: Moorlands Nursing Home is registered to provide personal and nursing care to thirty older people. The home is a two-storey purpose built facility providing single accommodation. There is a passenger lift giving access to the upper floor. There is a large lounge, conservatory and a communal dining room on the ground floor of the home. Moorlands is situated close to local shops and amenities. Externally there is an open garden/patio area for residents to enjoy. There is a car park at the rear of the home. The cost of care at the time of the inspection visit ranged from £463.90 to £575.20 per week depending on the category of care required. Moorlands Nursing Home DS0000055586.V377674.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is a two star - good service. The inspection was unannounced and carried out over six hours. As well as carrying out a site visit to the service we looked at other sources of information. These include the homes annual quality assurance assessment (AQAA), surveys which were received from people living at the home, their relatives, staff and other health professionals. Information from these has been included within the body of the report. During the inspection time was spent talking to one of the owners, the nurse in charge, residential care manager, staff on duty and people living at and visiting the home. A number of records were looked at. These included care files which are written for every individual accommodated, medication records, staff recruitment and training files, health and safety records, accident records and quality assurance records. What the service does well: The home provides good systems and practices to care for the people accommodated. Recording systems were good and people had detailed admission assessments and care plans to reflect how their needs should be met. All of the people living at Moorlands said that they were well cared for and treated with dignity and respect. Comments about the social activities and food were mainly positive and all people spoken to said that the visiting arrangements at the home were good and that people were made welcome. The home has clear policies and procedures for managing any complaints or allegations. All staff receive regular training to support them in carrying out their roles effectively. Management systems are good and staff said that they felt well supported. What has improved since the last inspection? Care plans have been developed and they now reflect the support and care which each person requires. Activity assessments have been carried out on each individual The window in room 24 has been restricted to ensure the safety of any person using the room. The manager regularly reviews staffing numbers to ensure that they are sufficient to meet the assessed needs of the individuals living within Moorlands. The owners confirmed that the temperature of water within the building has been adjusted so that it is suitable to people living at the home. Moorlands Nursing Home DS0000055586.V377674.R01.S.doc Version 5.2 Page 6 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. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line – 0870 240 7535. Moorlands Nursing Home DS0000055586.V377674.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR 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) Scoring of Outcomes Statutory Requirements Identified During the Inspection Moorlands Nursing Home DS0000055586.V377674.R01.S.doc Version 5.3 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 3&6 People using the 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’s needs were assessed before moving into the home and they are assured those needs will be met. EVIDENCE: Three assessments were viewed. People who had been funded by the local authority had assessments which had been carried out by a care manager; these were then shared with the home. The manager then carries out a further assessment to determine whether or not the home is able to meet the person’s individual needs. Comments from people include, “I looked around before my wife moved in” and “I was able to visit the home first, it’s a lovely place”. Three health professional confirmed that people’s needs were always thoroughly assessed and all nine questionnaires received from people living at Moorlands Nursing Home DS0000055586.V377674.R01.S.doc Version 5.3 Page 9 the home said that they were given sufficient information about the home prior to them moving in and that they had been given a copy of the terms and conditions of residence. Moorlands Nursing Home DS0000055586.V377674.R01.S.doc Version 5.3 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 People using the 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 good standard of care is provided. Records in the main were well recorded, however, bed rail assessments must always be completed and medication systems need to be improved to ensure that medication is discarded within the prescribed timescale. EVIDENCE: Care plans were looked at. Care plans set out the way in which people’s individual health and personal care needs will be met by staff working at the home. Care plans were reviewed regularly to reflect any changes in need. Care plans included risk assessments to minimize risks to people living in the home. Two people recently admitted had no risk assessments in place for the safe use of bed rails. The staff were told that these must be completed with immediate effect. The home was also advised to seek the advice of an Moorlands Nursing Home DS0000055586.V377674.R01.S.doc Version 5.3 Page 11 occupational therapist to ensure that the beds and bed rails were suitable for the people using them. There was clear evidence in care plans that people’s health needs were being closely monitored with input being sought from other professionals where this was required. This included district nurses for residential clients, GPs and dieticians. Comments include, “the home provides good nursing care to all residents”, “I have found the care home to have resident’s needs uppermost in there care planning. They always respond promptly to suggestions and advice given. They have good collaboration with community services and are respectful for the care they deliver”, “I would recommend Moorlands nursing home to anyone, it is well run by very competent nurses and nurse managers”, “the care my relative gets is excellent”. Medication systems were looked at. The temperature of the drugs fridge was last recorded on the 28/08/09, six days prior to the inspection. These temperatures need to be recorded daily. The home uses the monitored dosage system (MDS) there were some queries regarding storage so a pharmacist inspector from CQC was asked to go and have a look at the arrangements. A separate letter of their findings will be sent following their visit to the home. A number of bottles of eye drops with a twenty eight day shelf life were found to be out of date. Although the home was recording the date that they were opened, there were no checks in place to ensure that they were disposed of at the end of the twenty eighth day. Bottles of fortified liquids also need to be dated on opening to ensure that their shelf life is followed. Staff were observed throughout the inspection to be respectful to people, they always knock on bedroom doors before entering the room and people are spoken to politely. The relationship between staff and people living at the home was very relaxed. Comments from people include, “the staff listen to what you say and are very helpful, not just to people living at the home but their families too”. Moorlands Nursing Home DS0000055586.V377674.R01.S.doc Version 5.3 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13 , 14 & 15 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. In the main people’s social, leisure and recreational needs are met by the home. Food is said to be enjoyable and nutritiously balanced. EVIDENCE: The home carries out a detailed ‘national association for the provider of activities’ (NAPA) assessment, which is a detailed activity of daily living file for each individual. This provides staff with detailed person centred information about each individual. The home should try to get staff to provide additional activities based on the information collected within the activites file. The home has an activities co-ordinator who visits the home for one day every other week and will provide either a group activity or something on a one to one basis with people. Additional activities include motivation and aromatherapy once a fortnight. Trips out to church or to the local shops are arranged as and when people want them. Trips to places such as Whitby have also been arranged and the home organises singers to come in and entertain people. Moorlands Nursing Home DS0000055586.V377674.R01.S.doc Version 5.3 Page 13 Visiting arrangements at the home were said to be good, comments include, “visitors are always made welcome” and “the staff are very helpful not just to resident’s but to relatives too”. The home’s menus were looked at. There is a variety of food on offer which includes a selection of freshly baked cakes which are available throughout the day. There is a main course at lunch then lighter options at tea. Alternatives are offered. Comments about the food include, “they provide good meals”, “I would like to see a more varied menu, i.e. do not offer the same dishes two days running”, “the food is good” and “everything is home made, people are asked what they would like”. Moorlands Nursing Home DS0000055586.V377674.R01.S.doc Version 5.3 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Any concerns or complaints are managed well by the home with policies, procedures and training in place to support staff. EVIDENCE: The home has a satisfactory complaints procedure. People spoken to during the inspection said that they had no concerns or complaints but felt confident in raising any issues if they arose. Comments include, “I could tell someone if any problem, I don’t think I have ever had any” and “I could say if any problem, yes”. The home has procedures in place to help protect people from abuse. Staff had received training in ‘safeguarding vulnerable adults’. Staff spoken too during the inspection said they knew what procedure needed to be followed if an allegation was made. They also confirmed that they would not hesitate to ‘whistle blow’ (tell someone) if they saw or heard anything inappropriate. Moorlands Nursing Home DS0000055586.V377674.R01.S.doc Version 5.3 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 People using the 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 and homely although would benefit from additional storage arrangements. EVIDENCE: Moorlands nursing home provides a comfortable homely environment for the people living there. It has undergone some refurbishment since the last inspection; this has included an extension of ten en-suite bedrooms making the home registered for 30 people all in single accommodation. The home also has a new entrance foyer and has been fitted with CCTV. In general communal areas are well maintained with appropriate furnishings throughout. The carpet in the lounge and hallways is quite badly stained and the owners agreed during the inspection to replace this. The home has a reasonable size Moorlands Nursing Home DS0000055586.V377674.R01.S.doc Version 5.3 Page 16 lounge and this leads out into a conservatory. The conservatory is nicely furnished but is being used predominantly as a storage area for wheelchairs. Again some discussion took place with the owner and an alternative storage solution is going to be looked at. One of the surveys received suggested a porch is built over the main entrance as a visitor had got soaked in a downpour whilst waiting for staff to let them in. Moorlands Nursing Home DS0000055586.V377674.R01.S.doc Version 5.3 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 People using the 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’s needs were met by the number and skill mix of staff that are trained and competent to care for people living at the home. In the main people were protected by the homes recruitment procedures. EVIDENCE: The staff rotas were looked at. There are five carers on duty on a morning and four on an afternoon and three throughout the night. There is one trained nurse on duty throughout the day and night. Comments from people include, “we are all very appreciate of the care and friendliness of all staff, they give the impression that they enjoy their jobs and nothing is a trouble for them, they are always jolly and friendly”, “staff are first class, always friendly and attentive”, “everything I need they help with, the staff make me feel at home” and “staff are extremely kind to patients, they provide good nursing care”. Staff recruitment files were looked at, of the six viewed, five contained an application form, two references, a CRB (police) check and an induction. One of the people employed in August 2008 had been employed with only one reference. It is important that two references are sought prior to being employed. Moorlands Nursing Home DS0000055586.V377674.R01.S.doc Version 5.3 Page 18 Training plans were looked at. Mandatory training includes fire, first aid, infection control, manual handling, food hygiene and health and safety. In addition training is provided in palliative care, dementia, medication and protection of vulnerable adults (POVA). Fourteen of the eighteen care staff also had an NVQ at level 2 or above. Comments from staff include, “extremely high standard of care delivered by all staff, good relationships and communication”, “we need to be more flexible with rotas to enable further outings and to increase staff when we support people in attending health appointments”, “everyone is friendly to each other and there is good teamwork” and “we get good training and we work well together”. Moorlands Nursing Home DS0000055586.V377674.R01.S.doc Version 5.3 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 & 38 People using the 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 service users. Health and safety systems in the main protect people living and working at the home. EVIDENCE: The manager is a registered nurse who has many years of experience of working with older people in a care home environment. Comments about the manager were positive and include, “the manager is approachable, and we get good support” and “there is an open door policy”. Moorlands Nursing Home DS0000055586.V377674.R01.S.doc Version 5.3 Page 20 Quality assurance systems were viewed. Surveys were about to be given out to people living the home, their relatives, other health professionals and to staff. The results of surveys are displayed in a graph and an action plan is developed from this. The provider visits the home on a regular basis; they also prepare a monthly report of their findings of the conduct of the care home. The manager carries out regular in house audits. Meetings are held for staff and for residents. Financial records were viewed. They were up to date and accurate. There is annual plan of maintenance for the home. Records viewed were in the main up to date. The gas safety certificate was dated October 2007, a copy of an up to date certificate must be forwarded to CQC. Fire safety records were viewed, although people confirmed that regular training and drills were taking place, records need to be clearer. In some cases ‘all staff’ was recorded. The name of each individual should be recorded and ideally there should be one file to record all of the information. The flooring in the lift has started to rise which is a trip hazard; although this has been fixed recently it needs attention again. Bed rail assessments must always be carried out prior to bed rails being fitted. Advice should be sought from an occupational therapist where the home has any concerns. Moorlands Nursing Home DS0000055586.V377674.R01.S.doc Version 5.3 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 4 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 2 Moorlands Nursing Home DS0000055586.V377674.R01.S.doc Version 5.3 Page 22 Are there any outstanding requirements from the last inspection? YES STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP9 Regulation 13(2) Requirement Timescale for action 30/09/09 2. OP29 19 3. OP38 23 The temperature of the drugs fridge must be recorded daily and items such as eye drops and Calogen must be disposed of within the prescribed timescale. The Registered Person must 30/09/09 ensure that appropriate employment checks are carried out and received prior to the commencement of employment to ensure safety of residents. Previous timescale of 15/10/07 unmet. An up to date gas safety 30/09/09 certificate must be gained and a copy sent to CQC. Bed rail assessments must be completed for all residents prior to them being used. Fire training and evacuation records must include the name of the staff member receiving training or evacuation. The lift floor requires attention to stop it from being a trip hazard. Moorlands Nursing Home DS0000055586.V377674.R01.S.doc Version 5.3 Page 23 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard OP12 OP19 Good Practice Recommendations The activities assessments which are undertaken by the home should be used to develop a programme of activities for the people living there. The Registered Person should give consideration to making the garden/seating area for residents secure to help to ensure privacy and safety. Moorlands Nursing Home DS0000055586.V377674.R01.S.doc Version 5.3 Page 24 Care Quality Commission North Eastern Region Citygate Gallowgate Newcastle Upon Tyne NE1 4PA National Enquiry Line: Telephone: 03000 616161 Email: enquiries.northeastern@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) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. 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