Inspection on 05/08/09 for Moot Lodge

This is the latest available inspection report for this service, carried out on 5th August 2009.

CQC found this care home to be providing an Good service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Moot Lodge 09/10/06

Moot Lodge 31/01/06

Moot Lodge 21/07/05

Moot Lodge 03/02/05

Moot Lodge 13/05/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 17/02/2010.

Key inspection report Care homes for older people Name: Address: Moot Lodge Market Place Brampton Cumbria CA8 1RW     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: Margaret Drury     Date: 0 5 0 8 2 0 0 9 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) 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 Care Homes for Older People Page 3 of 24 Information about the care home Name of care home: Address: Moot Lodge Market Place Brampton Cumbria CA8 1RW 0169772643 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: moot.lodge@cumbriacc.gov.uk www.cumbriacare.org.uk Cumbria Care care home 19 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The registered person may provide the following category/ies 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 (maximum number of places: 19) Dementia - Code DE (maximum number of places: 19) The maximum number of service users who can be accommodated is: 19 Date of last inspection Brief description of the care home Moot Lodge is a care home for older people operated by Cumbria Care, an internal business unit of Cumbria County Council. The home is situated in the market square of Brampton, a town some 9 miles from Carlisle, and is close to all the local amenities and services. The home has four floors with the accommodation for service users situated on three. There is a passenger lift between the floors, and level access to the garden from the rear of the home on the lower ground floor. The home is divided into two separate living areas. On the ground floor there are bedrooms, a bathroom, toilets Care Homes for Older People Page 4 of 24 Over 65 0 19 19 0 Brief description of the care home and a lounge. The dining room is on the lower ground floor together with a toilet, hairdressing room and the main kitchen. On the first floor there are bedrooms, a bathroom, toilets, a lounge/dining room with small kitchen area and a separate small, quiet lounge. There is a range of equipment in the home to assist people with a physical disability. There is a small sheltered patio area with seating accessed through the dining room on the lower ground floor, and a small parking area to the rear of the home Fees in this home are within a range set down by the local authority and can be discussed with the manager or social worker. There are extra charges for chiropody, hairdressing, newspapers, magazines, dry cleaning and private telephone calls. The home does not provide intermediate care. 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: This was the main or key inspection of this service with the visit to the home taking place over one day. We, The Care Quality Commission (CQC) were in the home for over 5 hours. We considered information gathered from different sources and used this as a basis for our assessment of this service. We received a completed Annual Quality Assurance Assessment (AQAA) from the manager within the timescale set by the Commission. It is a legal requirement that this document is completed annually by all regulated services as it outlines all the facilities on offer, gives information about any improvements over the past year and what the home hopes to achieve over the coming year. We sent and received back surveys from members of staff and people living in the home giving peoples views and experience of the service and care provided. We spoke to staff and residents, looked at a sample of care plans, residents records and staff files. We made a tour of the building to look at the environmental standards and looked at Care Homes for Older People Page 6 of 24 staff personnel and training records. 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. 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 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 9 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 have their needs assessed before moving in to Moot Lodge so they know their needs can be met in the manner they want and expect. Evidence: There are good systems within this service to ensure people wishing to move in are fully assessed prior to a place being offered. The assessment documentation looks at all aspects of daily living, social and healthcare needs, including medication and some personal history about the prospective resident. Part of the admission process includes a visit to look round the home and this is encouraged as it gives the opportunity to meet the staff and the other people living in Moot Lodge. Many of those admitted have already spent periods of respite care at Moot Lodge and this does make the move less traumatic. Care Homes for Older People Page 10 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. People living in this home are well supported and and cared for through an up to date and thorough care planning system. All healthcare needs are met. Evidence: Every resident has an individual plan of care based on the original assessment of needs and also the management assessment prepared by Social Services. We read a selection of care plans including those for specific people we had spoken to during our visit. We found all the plans up to date and written in a person-centred way. The home uses the Cumbria Care corporate format although each one is personal to the resident. Improvements have been made to the section All about me which now includes more in depth information and personal history. This has helped the staff learn more about the people they support and also to provide the right level of care needed to meet the individual needs. People living in the home are supported to make decisions about how to spend their time and, where possible, to say what leisure activities they would like. Information in the care plans includes, healthcare needs, medication, nutritional screening using a universal screening tool, dietary and fluid intake, social and religious preferences. Care Homes for Older People Page 11 of 24 Evidence: All the care plans are reviewed and updated at least monthly, more often if there is a change in circumstances or dependency levels. We spoke to care staff and they agreed that the current format gives much more information about the residents and that residents and families are now, where possible, involved in the care planning process. More emphasis is now placed residents personal preference and how they wish their care to be delivered. Healthcare needs are met and monitored by a close working relationship with the local G P surgery which is situated very close to the home. District nurses are on hand when required and are currently visiting 2 residents on a regular basis. We looked at the records for the receipt, administration and disposal of medication. These were well kept and up to date. We were able to observe part of the lunch time round and found this to be a relaxed and unhurried process. Weekly audits are completed by the supervisors to ensure there are no errors and although there are currently no controlled drugs prescribed there is a process in place for the recording of such medication. The care plans indicated that residents have regular visits from opticians and chiropodists with the visiting optician providing some in house training for the care staff. The home does struggle with dental care although they do have an emergency number they have used when necessary. We did observe staff interaction with the residents and found this to be warm and caring. It was obvious that the staff knew the residents well and were seen to be having a joke with some of them whilst still maintaining their dignity. All residents are asked how they wish to be addressed when they come to live at the home and their wishes are adhered to at all times. Care Homes for Older People Page 12 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Daily routines are flexible and allow those living in the home to enjoy the activities provided and home cooked food which they enjoy. Evidence: Since the last inspection the staff have worked hard to improve the activities programme at Moot Lodge and whilst there is no designated activities organiser the staff do provide some activities on a one to one basis or with small groups of residents. Residents do attend various social activities at the local community centre, which is situated very close to the home and some recently attended a concert given by the local schools. Outside entertainers come to the home every couple of months and a member of staff from one of the other Cumbria Care homes comes to do sing, smile and move which is very much enjoyed by all the residents. Lifestyle choices are now, as far as possible, included in the information documented in the care plans so staff are aware what interests are important to the residents. Residents meetings are held although it is sometimes difficult to persuade the residents to attend. As Moot Lodge is situated in the centre of Brampton there are always people popping in and chatting to those living in the home. One of the visitors brings in their dog every week that visits every resident. Families are very supportive and there is no restriction on visitors. Residents go out with their families to the local shops and cafes. Care Homes for Older People Page 13 of 24 Evidence: At present there is no church service held although this used to take place. We did recommend that the manager looks at this, as it was noted on one of the care plans that one resident always attended church in the past and would like to do so again. As far as the staff we spoke to knew a visitor from the Roman Catholic church came to visit and give Communion. A choice of meals is offered each day and we were able to observe lunch being served on the first floor. Meals can be served in residents rooms if they wish but the main dining room is on the lower ground floor. Residents we spoke to all confirmed that they enjoyed their food. Special diets are catered for. The catering staff do, however, only work part time and the evening meal is prepared by the care staff. Care Homes for Older People Page 14 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. Policies and procedures are in place, which help to ensure that people using this service are protected from harm or injury. Evidence: There are suitable policies and procedures in place for dealing with complaints and concerns and these are available for staff to read. All policies and procedures are discussed during staff supervision over a period of time and updates are provided by the organisation to ensure they are up to date with current legislation. There have been no complaints to record in the complaints log and we have not received any from Social Services. The staff we spoke to during our visit knew the procedure to follow should any resident voice any concern at all. There are clear procedures to follow with regards to the safeguarding of vulnerable adults and training in this subject has been completed by all the staff. This subject is discussed during staff supervision and staff meetings and all the staff are aware of the procedure to follow should this be necessary. There is currently one incident being investigated by Social Services and this was dealt with by the staff at the home in the correct manner. All staff have enhanced Criminal Records Bureau checks completed before they start work in order to protect the people they care for. There is also a copy of Cumbrias policy in the home for staff to refer to if they wish. Care Homes for Older People Page 15 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. Moot Lodge provides a safe and comfortable home that is reasonably well maintained, decorated and furnished to a good standard. Evidence: Moot Lodge is situated in the centre of Brampton with views overlooking the market square. Resident accomodation is over 3 floors, the 4th floor being offices, with a passenger lift serving all floors. There is a large lounge on the ground floor at the front of the building and the main dining room is in the lower ground floor giving access to the garden area. There is a lounge/diner on the first floor and a small lounge that is suitable for quiet times or private meetings. Bedrooms are on the small side but personal to residents with items brought in from home. The home is reasonably well maintained although some areas are now looking a little tired. Since the last inspection new domestic staff have been appointed and the home was extremely clean on the day of our visit. Over the past 12 months new bedroom curtains have been purchased, together with new garden furniture. There is an annual improvement plan in place that is discussed and approved by the organisations accomodation manager in an effort to ensure the environmental standards remain as high as possible. There are sufficient bathing and toilet facilities for the number of residents. These have recently been improved by the installation of a new rise and fall bath. Care Homes for Older People Page 16 of 24 Evidence: There are aids and adaptations in place to assist any resident who may have mobility problems with handrails throughout to assist with movement around the home. The kitchen area, which is next to the main dining room, was clean and well organised and there is a designated laundry area. Monthly health and safety checks are completed by the manager and there is suitable protective clothing available for staff to reduce the risk of cross infection. Care Homes for Older People Page 17 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. The staffing levels and skill mix ensure the care and support provided meets all the needs and expectations of those using this service. Evidence: Staffing levels were, on the whole, sufficient for the numbers and dependency of those currently living in Moot Lodge. There are some vacant night duty hours that are being covered by existing or relief staff. The manager told us that she does not use agency staff as this could disrupt the continuity of care. She has recently employed more domestic staff and has been given further hours to appoint another domestic assistant. She is compiling a report with regards to the staffing levels within the home to ensure there are sufficient to meet the assessed needs of all the residents. During our visit we observed the way in which staff provided care and found this to be warm and caring whilst still maintaining the dignity and privacy of those living in the home. The numbers and skill mix of the staff ensure the residents are supported, cared for and, wherever possible, kept safe at all times. Staff records were checked and evidenced that Cumbria Care has a robust and effective recruitment and selection policy. No member of staff starts work without all the required legal checks being completed and all staff have enhanced Criminal Records Bureau (CRB) and Protection of Vulnerable Adults (POVA) checks in place. The home has well over 50 of staff qualified to NVQ level 2 and others are just waiting for their certificates. Supervisory staff are now being given the opportunity of Care Homes for Older People Page 18 of 24 Evidence: progressing to level 3 if they wish. Staff training is ongoing although the manager confirmed that it is still sometimes difficult to obtain sufficient places for staff. Training has been completed in, adult protection, emergency action, end of life care, crossing the line, fire safety and food hygiene. Arrangements are in hand for some staff to commence a distance learning course in dementia care run in conjunction with Stirling University. The manager has been trained to train the staff using excellent material from the university. Training is currently being arranged with regards to The Mental Capacity Act and Deprivation Of Liberty. Comments on returned survey forms and those made during conversations with residents included, the staff always look after me, they all look after me well, the staff keep everywhere clean and I like all the staff,. 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. This home is suitably managed so that people who live in Moot Lodge are safe and well cared for. Evidence: The manager of this service has only recently moved from another home within Cumbria Care and has yet to be registered to manage Moot Lodge. She is currently in the process of completing her application. She has, however, several years experience as a registered manager within the group. She has completed the registered managers award and her NVQ in care at level 4. She told us that she was finding the management of a smaller home very different and was grateful for the support she was receiving from the supervisors and staff team. Staff we spoke to said the home was running well and all connected to the home were working well as a team. This was also confirmed through comments on survey forms that were returned to The Care Quality Commission(CQC). During our inspection we saw evidence that there were systems in place to measure Care Homes for Older People Page 20 of 24 Evidence: quality outcomes in all areas of the home, the annual survey being recently completed. The manager is currently preparing the quality audit report from the findings of the returned surveys sent to staff residents and family members. Comments on survey forms returned to CQC told us that residents were happy with the care and support received and that they could speak to Helen, the manager, at any time. We also received survey forms back from staff and comments on these were mixed. It was generally felt that the home ran well and that the residents were very well cared for but there was at times a shortage of flexible relief staff to cover staff vacancies, holidays or sickness. The manager did advise that she was preparing a report on staffing issues as she was well aware of the situation. One area that needs addressing is that of communication between the staff groups. There was a number of concerns raised that sometimes there was a lack of communication and this could compromise the level of care delivered. We did discuss this and felt that the manager was also aware of this and will address the problem. We checked on the money held on behalf of those who lived in Moot Lodge and found this to be well managed. There is a corporate system used throughout Cumbria Care that ensures regular audits are completed and documented. Staff training records are kept and the manager does her best to ensure staff are given every opportunity to undertake the training they wish to although one member of staff commented that she could do with more training. There is a health and safety audit completed annually and all risk assessments are completed and updated by the supervisors. A full fire risk assessment was undertaken by the previous manager and a fire drill was completed a couple of weeks ago. All manual handling is kept up to date by supervisors who are trained to train the staff. There is protective clothing available to keep cross infection to a minimum. Staff supervision is up to date with documentation on record as evidence. The manager has an understanding of her roles and responsibilities but we did recommend that her application for registration be completed as soon as possible. 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 1 2 12 31 The manager should try to organise for visiting ministers to attend and conduct a short service in the home. The manager should complete her application for registration with The Care Quality Commission as soon as possible. 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. 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. 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