Inspection on 08/01/09 for Moor House

This inspection was carried out on 8th January 2009.

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

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Moor House Vicarage Road Staines Middlesex TW18 4YG     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: Lesley Garrett     Date: 0 8 0 1 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. the things that people have said are important to them: They reflect 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.csci.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Moor House Vicarage Road Staines Middlesex TW18 4YG 01784453749 01784469188 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Ms Lyn Ann Spivack Type of registration: Number of places registered: Friends of the Elderly care home 25 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users to be accommodated is 25. The registered person may provide the following category/ies of service only: Care home only ? (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) Date of last inspection Brief description of the care home The home is situated in a residential area at the end of a private drive near to the centre of Staines. There is limited car parking space to the front of the building. The home has close circuit television covering the grounds of the home for security purposes. The building is purpose built and provides care and accomodation for twenty-five (25) older persons. Accomodation is provided in single bedrooms with ensuite facilities which is situated on the ground and first floors of the building. There is a 0 Over 65 25 Care Homes for Older People Page 4 of 26 Brief description of the care home passenger lift giving access to the first floor. In July 2008 the home was re-registered with the providers changing to Friends of The Elderly 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 inspection of the care home was an unannounced Key Inspection. Mrs Lesley Garrett, Regulation Inspector, carried out the inspection and the registered manager represented the service. The inspector arrived at the service at 10:00 and was in the home for five hours. It was a thorough look at how well the home is doing. It took into account information provided by the home and any information that CSCI has received about the service since the last inspection in December 2007.This was the first inspection since the home was registered in July 2008 and on this occasion all standards will be assessed. The home supplied CSCI with an AQAA (Annual Quality Assurance Assessment). This document was used to assist with the inspection. The inspector also spent time talking Care Homes for Older People Page 6 of 26 with some of the people using the service, the registered manager, the deputy manager and other staff members. The inspector looked at how well the service was meeting the key national minimum standards and complying with the regulations and has in this report made judgements about the standard of the service. Documents sampled during the inspection included the homes care plans, daily records and risk assessments, medication procedures, staff files, some training records, and the homes safeguarding and complaints policies and procedures. From the evidence seen by the inspector and comments received, the inspector considers that the home would be able to provide a service to meet the needs of individuals who have diverse religious, racial or cultural needs. 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.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.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 wish to use the service only move into the home following an assessment of their needs and are satisfied that their needs can be met. Evidence: The home has a new statement of purpose and service user guide. Every person who uses the service is supplied with these documents and they are updated when changes occur. The documents seen on the day of inspection were updated following the change of owner. During the inspection two care plans were sampled and all contained detailed preadmission assessments. These assessments were then filed in the administration folder. A discussion took place with the manager about them being kept with the care plans for each person using the service. Keeping this documentation together would allow staff to compare changes with the people using the service and care plans can Care Homes for Older People Page 10 of 26 Evidence: the be adjusted accordingly.Contracts for all people using the service were also kept in the administration folder and all sampled were in place. All people who wish to use the service are encouraged to visit the home prior to admission. People spoken to on the day confirmed that they had an opportunity to visit the home and that they were given information about the home before admission including the homes brochure. The manager stated that if any of the people using the service are admitted to hospital she will also do a visit prior to them returning and this ensures that their needs can still be met by the staff at the home. The manager confirmed that she will only admit new people if the staff have the skills necessary to care for them. Staff on the day confirmed that they have access to regular training and people using the service were very complimentary about the skills of the staff. One person said the staff are so good they just know what you need, they know us so well. The manager said that the home does not accept emergency admissions as it is not possible to arrange assessments. Trial visits are encouraged and people who wish to use the service are encouraged to stay for lunch or supper to meet other people in the home. 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. The health and personal care that people using the service receive is based on their individual needs. Evidence: Two care plans were sampled.They contained detailed information about the people who use the service which enabled care staff to deliver the care that is needed to each individual. All care plans sampled had been reviewed every month and there was evidence that the person using the service or their relative had been consulted. The plans were not person centred and, although they had been agreed, they did not reflect the opinions or wishes of the people using the service. The manager understood that more detail could be included to reflect how people like to be assisted with their personnel care, the name they preferred to be addressed by and if they have a preference for male or female care staff to assist them with personnel care. The care plans sampled contained detailed risk assessments which promoted choice and independence whilst ensuring the safety of the people using the service. The care Care Homes for Older People Page 12 of 26 Evidence: plans also demonstrated that staff respect the people who use the service choice and preferences when delivering personal care and allows for them to choose their clothes in the morning and the activity they would like to attend. Equipment that includes hoists and height adjustable beds are provided to encourage independence for the people using the service. There are specialist mattresses available for those people who are at risk from pressure sores. 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service are able to take part in social, cultural, religious and recreational activities and are able to exercise choice in their daily lives. Evidence: During the inspection we spoke with the activity organiser who works three hours a day. She stated that she can be flexible and if there is an activity at the weekend she will come in to do that. The activity organiser said that a range of activities are organised that would meet the needs of people using the service. The activities range from large group, small group and one to one activities. The AQAA stated that all activities are and what is available is discussed on admission. This then is documented in the care plans for peoples preferences. People using the service that spoke with us said that they enjoyed the activities on offer and were complimentary about the Christmas activities. The home has a mini bus so trips to a local garden centre, the theatre and shopping have all been organised. A Church of England service is held every week but other denominations can also be catered for if requested. The manager stated that family and friends are welcome at any time and during the inspection visitors were seen Care Homes for Older People Page 14 of 26 Evidence: coming and going. Visitors can also have a meal with their family member or friend if they wish. During the tour of the building lunch was being served in the dining room. Assistance was given by staff to those people using the service that needed support with their meals. The tables were laid with linen tablecloths and napkins. People who use the service that were spoken to said that generally the food was a good standard. The AQAA states that people using the service are offered several choices of meals for lunch and a variation of vegetables, fruit and desert.The manager stated that the manager and chef meet every week to assess the food that had been provided for that week. The people who use the service complete a comment sheet about the food they have eaten and these are also taken into account at the meeting. A certificate showed that the environmental health officer had visited in November and had awarded the home five stars and The young at Heart award that is given by Spelthorne Council in recognition of the quality of food provided and the standards of the kitchen. 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 who use the service can be confident that their complaints are listened to and that they are protected from abuse. Evidence: There is a clear complaints policy and procedure in place and this is displayed on the wall and available to all people who use the service. The manager stated that she had not received any complaints but that she has a log available to record any that she may receive in the future.In the hall there is also a complaints/comments book available for all visitors to the home to write in. People using the service still have the right to participate in local government and general elections. Postal votes are available for all people using the service when they have completed the application form that is sent to the home. All people using the service are supported by their relatives or friends but the manager said that she has details of independent advocates should this facility be requested. Since registration in July 2008 the home has referred one person using the service to the Surrey safeguarding adults team. This has now been resolved with no further investigation necessary. Records demonstrated that the staff had received training in safeguarding adults. Staff spoken to on the day were clear about the procedures to take in the event of witnessing or hearing about a case of abuse within the care Care Homes for Older People Page 16 of 26 Evidence: home.The home has the local authoritys safeguarding adult procedures and a whistle blowing policy and procedure, which is available to staff in order to safeguard people in their care. 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 enables people who use the service to live in a safe, well-maintained and comfortable environment. Evidence: The people who use the service are able to personalise their bedrooms and this was seen during a tour of the building. One person using the service was very keen that I should look at their room which had family photographs displayed and ornaments bought from his family home. The home also has a maintenance plan and this year there are plans to fit more fire dividing doors and door closures, to replace carpet to ground floor unit and more lockable units for the bedrooms of people using the service. The home is easily accessible for wheelchair users and there was plenty of equipment to enable the staff to care adequately for the people using the service. The home has purchased some more beds and mattresses and hoists are available on both floors. For those people that are wheelchair users or have a mobility problem there are accessible baths available.The bathrooms and toilet areas were noted as being clean and hygienic. The homes indoor and outdoor communal areas were well maintained and appropriate Care Homes for Older People Page 18 of 26 Evidence: access was available to all people in the home if they chose to visit the gardens. There is a small car park available at the front of the home but there are plans for this to be extended as many visitors have said that it is difficult to find somewhere to park their car. There is CCTV positioned on the outside of the building so that staff can see who is at the front door which is particularly useful for the staff on night duty. All people using the service wear a pendant so that wherever they are in home they can alert a member of staff if necessary. The manager stated that they also work if they are out in the garden or have walked down the drive. It was observed that liquid soap, hand gel and paper towels were all available for staff to aid infection control procedures. There is also a laundry room and the washing machines have a sluice programme. The home has a laundry assistant and at other times staff do the washing and the night staff do the ironing. Records confirmed that staff had received training in infection control procedures. 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. Staff in the home are trained and in sufficient numbers to support the people using the service. Recruitment practises at the home should be strengthened to protect the people living there. Evidence: The home had a relaxed atmosphere and staff were observed to undertake their tasks in a quiet and orderly manner. We observed staff interactions with people using the service all of which were professional and supportive. The staff in the home during the day were relaxed and calm with the people using the service. The staff rotas were seen and the manager said that she writes the rotas. There has been a stable staff team but the home still needs to use agency staff on occasions. The AQAA stated the plan for the next twelve months is to reduce the number of agency staff used. Dependency levels for all of the people who use the service are completed but these are not used to determine the amount of staff that are required. The manager stated that staffing levels are set by head office depending on the number of empty beds the home has. Comments received on the day of the inspection regarding the staff at the home were favourable. One person said we have wonderful staff theres no complaints there. Care Homes for Older People Page 20 of 26 Evidence: Three recruitment folders were sampled and they contained most of the information required to employ staff safely. On all three application forms sampled there was no full employment history and explanation for any gaps in employment and this will be a requirement at the end of the report. The manager said that staff continue with national vocational qualification (NVQ) training and eighty per cent of staff have obtained this qualification at level two. All other checks were in place. The staff induction and mandatory training records were sampled and evidenced that the home is committed to the ongoing training and development of staff. The manager said that all staff at the home are about to undertake dementia training at different times through the year. 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. Good management arrangements are in place and the home is run in the best interests of the people using the service. Evidence: The home has recently be re-registered but the staff team transferred into the new organisation including the manager and the deputy.The manger has been at the home since 2005 first as the deputy manager for eighteen months the as the registered manager. She has her registered managers award and attends regular training to ensure that her knowledge is current. The manager said that she has an open door policy. This was seen during the day as people who use the service, visitors to the home and staff all felt comfortable to come to the office for a chat with the manager and seek advice. During the inspection it was observed that the atmosphere was calm with staff Care Homes for Older People Page 22 of 26 Evidence: knowledgeable about the needs of the people using the service. Comments received during the day were complimentary about the staff and the care that people receive in the home. Regulation 26 visits takes place in the home every month and are carried out by the regional manager. These reports are available at the home. The home has yearly quality assurance audits carried out by the homes regional manager. The report is sent to the manager and then an action plan is developed for the year that identifies any shortfalls. Also every year the home seeks the views of the people who use the service and this was last done in February 2008. If these questionnaires identify any concerns an action plan for this is written so that the manager or staff can address the issues identified. There are meetings every six weeks for the people using the service and minutes are kept. The manager said that there are relative or friends meetings particularly at the time when the manager is looking at the budget for the coming financial year. the manager said that a discussion will then take place with them about ideas for what to buy for the home or what they think the home may need. The current insurance certificate is displayed in the home. The current business and financial plan is currently with the human resource director for checking following the registration of the home. this was not seen during this inspection as the manger said it was to be reviewed and updated where needed. People who use the service are able to keep small amounts of money with the home for safekeeping. This money is all kept in the safe transactions are recorded in each individual wallet and receipts are kept for the people who use the service and their relatives to examine at any time. The manager said that staff supervision takes place six times a year and records and staff confirmed this takes place. All relevant health and safety checks have taken place the manager stated and certificates are currently in date.This was confirmed in the AQAA and during the inspection. 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 29 19 All employees shall provide a full work history together with explanations for any gaps in employment. This ensures that all people who use the service are protected from abuse by the homes employment practises 08/02/2009 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: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.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!