Inspection on 15/02/06 for Moorfield House

This inspection was carried out on 15th February 2006.

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

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

Moorfield House 01/04/08

Moorfield House 03/04/07

Moorfield House 30/09/05

Moorfield House 18/02/05

Moorfield House 20/08/04

Moorfield House 10/03/04

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 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Moorfield House 132 Liverpool Road Irlam Gtr Manchester M44 6FF Lead Inspector Michelle Moss Unannounced Inspection 15th February 2006 12:00 X10015.doc Version 1.40 Page 1 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 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Moorfield House DS0000008336.V278602.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Moorfield House DS0000008336.V278602.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Moorfield House Address 132 Liverpool Road Irlam Gtr Manchester M44 6FF 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) 0161 775 3348 Mr Stephen Brown Mrs Mary Brown Mrs Mary Brown Care Home 20 Category(ies) of Old age, not falling within any other category registration, with number (20) of places Moorfield House DS0000008336.V278602.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 30th September 2005 Brief Description of the Service: Moorfield House is a large Victorian building providing personal care and accommodation for up to twenty (20) service users within the category of old age (OP), not falling within any other category. The home is registered in the name of Mr and Mrs Brown. Mrs Brown is also the registered manager of the home. The home is located in Irlam, on the corner of Moorfield Rd and Liverpool Rd. The home is close to local shops and the main Warrington to Manchester bus route. The home comprises of 16 single bedrooms and two double bedrooms. Twelve of the single bedrooms offer en-suite facilities and are located on the ground floor. Parking facilities are available to the rear of the property. A landscaped raised patio area and conservatory had been constructed to the front of the home since the last inspection. Moorfield House DS0000008336.V278602.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was the home’s second inspection of the year and was unannounced. It was carried out on 15th February 2006. A number of residents and relatives were met and spoken with about their experiences of the home. Time was spent with the assistant manager discussing welfare matters relating to the residents, the home supported and examining documentation in relation to the running of the home, staffing, care planning and the residents’ satisfaction. The term of address preferred by the users of the service was confirmed as “residents”. It was felt this best reflected the function and purpose of the service. The inspection only looked at a limited number of standards, so this report should be read together with the earlier report to get a full picture of how the home is meeting the needs of the residents living there. What the service does well: What has improved since the last inspection? The records for monitoring health of residents had been improved. The home had improved the safety of the patio area. The staff team were receiving supervision on regular basis from their line manager. Moorfield House DS0000008336.V278602.R01.S.doc Version 5.1 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Moorfield House DS0000008336.V278602.R01.S.doc Version 5.1 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 Moorfield House DS0000008336.V278602.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3&6 The process of admission resulted in the home being well informed about prospective residents’ needs. EVIDENCE: No residents were moving into the home without first having their needs assessed. This included the manager or assistant manager carrying out an initial assessment of needs by visiting the prospective resident. During the inspection a prospective resident was visiting the home. Time was given to the prospective resident and their relative by the staff team. This included having the opportunity to meet and talk with other residents, have a tour of the premises and have any questions answered. The home did not provide intermediate care. Moorfield House DS0000008336.V278602.R01.S.doc Version 5.1 Page 9 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8,9, The residents’ care and health needs were well documented by the home in a care planning system. However, some aspects of the care of medication and monitoring of health had the potential to compromise the well-being of residents. EVIDENCE: Two residents’ files were examined. Overall, these were found to be detailed records that set out the individualised plan of care for the specific resident. The care plan was supported by risk assessments where additional risks relating to the health and welfare of residents were identified. This included risk of falls, manual handling and dietary needs. These records were seen to inform the staff team about the level of support required and the safeguards that were necessary. However, on examining one specific risk assessment of a resident that had weight loss concerns, the strategies for managing the associated risks were not detailed. This was discussed with the assistant manager and addressed during the period of the inspection. Where a resident’s weight was of concern, the home was using specific monitoring charts to monitor the resident’s fluid and dietary intake. However, on examining a sample of these records, confusion emerged over the actual Moorfield House DS0000008336.V278602.R01.S.doc Version 5.1 Page 10 volume of food and drink being taken. For example, in some cases the staff team were only recording what was served and did not indicate how much was consumed by the resident. Furthermore, the total volume of fluid was not recorded and there were no measures in place that informed the staff team what they should do if the overall fluid/ dietary intake in a 24 hour period was below a specific level. In addition to these concerns, it was noted that despite the concern over the resident’s weight being raised back in October 2005 and investigation completed, no audit of the resident’s weight had been taken during the period until January 2006. Without this essential information it was difficult to determine the extent of weight loss. Added to this no admission weights of all residents were being obtained that provided a baseline of the residents weight. It was strongly recommended that this was obtained with the consent of the resident and there after monitored where their health needed ongoing monitoring. The interaction between staff and residents was seen to be respectful. Overall, medication practice was good. However, recording on the MAR sheets for medications that were prescribed to be administered at varying dosages were not sufficiently detailed to confirm the dosage given. For example, residents were prescribed Paracetamol 500mg tablets one or two. On the MAR sheets the staff were not indicating if they had administered one or two tablets. Furthermore, they were no supporting care plans for these various dosages that provided the staff team with the symptoms and triggers that indicated which dosage should be administered. This was particularly important for those residents that were not able to inform the staff of their symptoms. A requirement was made for a detailed audit trail to be maintained that states clearly the actual dosage that should be administered and that medication care plans should be written up that detail instructions on the circumstances when the medication should be administered and at what dosage. Moorfield House DS0000008336.V278602.R01.S.doc Version 5.1 Page 11 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13,14,15 An extensive range of meaningful activities were offered that reflected social, cultural and recreational interests and needs of residents. EVIDENCE: At the time of the visit, a number of residents were enjoying having their hair styled by the visiting hairdresser. They expressed the view that it was a highlight of their week. Other activities were detailed by the assistant manager and included having visits from a Physiotherapist who did movement / keep fit sessions and visits from an occupational therapist that did varied sessions from rumination sessions to arts and crafts. Other in house activities were planned, including Bingo evenings, celebrating birthdays and other special occasions. The residents were able to maintain their religious beliefs. This included having visits from the various religious bodies on a regular basis. The residents were able to confirm that they received a varied and balanced diet. The home maintained a record of meals served. On speaking with the cook, she confirmed that alternatives were offered where the main choice was Moorfield House DS0000008336.V278602.R01.S.doc Version 5.1 Page 12 not the resident’s favourite. A copy of the residents’ likes and dislikes was seen to be available to the cook on the kitchen wall. On examining the care plan of one resident, it was noted that they had included in their plan a nutritional screening plan which indicated that they were at risk of weight loss. As already highlighted, some aspects of the monitoring of the residents’ weight was insufficiently detailed. The relationship between the home and relatives was seen to be good. This was confirmed by speaking with 3 relatives, who in all cases made very positive comments about the home and the care of their family member. Moorfield House DS0000008336.V278602.R01.S.doc Version 5.1 Page 13 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 The complaints procedure in the home was good and staff were well informed about the protection of vulnerable adults. EVIDENCE: The home had a good complaints procedure in place. The home had continued to have no complaints made about the quality of care. Staff had been supported by the home to complete training on adult protection. This was covered both in induction and ongoing training provided by the home. Moorfield House DS0000008336.V278602.R01.S.doc Version 5.1 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,26 Overall, the standard of the environment within the home was good and provided residents with an attractive and homely place to live in. EVIDENCE: A tour of the premises was completed. Overall the home was found to be clean and in a good state of repair. However, some damaged floor vinyl did have the potential to cause a tripping hazard for both residents and staff. The assistant manager confirmed that planned work to replace these damaged areas was underway. Moorfield House DS0000008336.V278602.R01.S.doc Version 5.1 Page 15 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Overall, staff morale and training were good, which meant that the staff team were competent in their duties. EVIDENCE: The staffing levels on the day of the inspection were found to include the assistant manager, 2-care assistants, 1 senior carer, a cook and a housekeeper supporting 19 residents. The staff team were seen to have time to socialise with residents as well as meeting their care needs. The interaction between the residents and staff was found to be positive. The staff team were being supported to improve their competence through completing their NVQ awards. In addition, they were completing training in areas of Manual Handling, First Aid and Food Hygiene. However, the assistant manager was not able to confirm that all staff had received training in Infection Control. It was recommended that all staff received this important training. The home had not recruited any new staff for some time, which resulted in a low staff turnover. Moorfield House DS0000008336.V278602.R01.S.doc Version 5.1 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31 & 35 The residents benefited from a well ran home, where the management systems promoted the health, safety and welfare of residents. EVIDENCE: All appropriate financial systems were in place that safeguarded residents’ financial interests. The management systems in place meant that the home had a manager on duty or at least on call every day of the week. The management team were ensuring that all the appropriate practices of care and documentation were correctly managed to secure the health and welfare of residents. Moorfield House DS0000008336.V278602.R01.S.doc Version 5.1 Page 17 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 2 8 3 9 2 10 X 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 3 29 3 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X X X 3 X X X Moorfield House DS0000008336.V278602.R01.S.doc Version 5.1 Page 18 Are there any outstanding requirements from the last inspection? No 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 OP7 Regulation 15 Requirement Timescale for action 31/03/06 2. OP9 13 3 OP19 23 The monitoring records for dietary and fluid intakes must be sufficiently detailed to provide an actuate picture of what the resident’s daily consumption is. The home must ensure that the 31/03/06 care of medication records are sufficiently detailed to provide a clear audit trail concerning all medication administered, including the justification when administrating a varied dosage. The damaged flooring in the 30/04/06 kitchen and dining room must be repaired or replaced to secure the safety of both staff and residents. Moorfield House DS0000008336.V278602.R01.S.doc Version 5.1 Page 19 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 OP30 OP7 Good Practice Recommendations All staff should receive training in infection control. The home should, with consent of the individual resident, carry out baseline weight on all admissions and continue to monitor weight where the health of a resident requires monitoring. Moorfield House DS0000008336.V278602.R01.S.doc Version 5.1 Page 20 Commission for Social Care Inspection CSCI, Local office 9th Floor Oakland House Talbot Road Manchester M16 0PQ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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