Inspection on 19/12/05 for Moorfield House

This inspection was carried out on 19th December 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Poor. 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 found no outstanding requirements from the previous inspection report, but made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Moorfield House 05/10/07

Moorfield House 23/08/06

Moorfield House 29/09/04

Moorfield House 17/05/04

Moorfield House 17/03/04

Moorfield House 18/08/03

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOME ADULTS 18-65 Moorfield House Giddygate Lane Melling Liverpool Merseyside L31 1AQ Lead Inspector Ms Lorraine Farrar Unannounced Inspection 19th December 2005 12.30p Moorfield House DS0000043636.V266649.R01.S.doc Version 5.1 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 DS0000043636.V266649.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 Adults 18-65. 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 DS0000043636.V266649.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Moorfield House Address Giddygate Lane Melling Liverpool Merseyside L31 1AQ 0151 549 2100 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) moorfield.house@craegmoor.co.uk Park Care Homes (No 2) Ltd Ms Clare Reeves Care Home 31 Category(ies) of Learning disability (31), Physical disability (3) registration, with number of places Moorfield House DS0000043636.V266649.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Service users to include up to 31 LD, of whom 3 may also have PD. That the home do not in the future use bedroom 4 in cottage 3 as a bedroom. That the home ensure a flashing fire alarm is fitted to bedroom 7 in the main house, in the event that it is occupied by a person with hearing difficulties. That the home ensure that a ramp with an incline of no more than 1:2 is fitted to bedroom 7 in the main house in the event that a person with mobility difficulties occupies this room. Date of last inspection 7th July 05 Brief Description of the Service: Moorfield House is operated by Parkcare Home (no2) LTD, who are owned by Cragemoor Healthcare, an organisation who provide different services for people who require care, across the country. The home is in Melling, a rural area near to the local towns of Maghull and Kirby. Although on a country lane, there is public transport to local shops and leisure facilites within walking distance. The home is registered to provide support and accommodation for 31 adults who have a learning disability. Accommodation is provided over three main living areas, the main House and the Bungalow have staff 24 hours a day, the cottages have several hours of staff support during the day and support from house staff if needed, at other times. There is one double bedroom, all others are single and four of these are adapted so they can be used by people who have a physical disability. Each living area has its own staff team, living and dining areas, laundry, kitchen and bathrooms. The home has large grounds and also has a recreation hall although this is not used at present. Residents are supported to go to local colleges and centres and the home has its own transport. Moorfield House DS0000043636.V266649.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. During the inspection the inspector spoke with 5 members of staff and 11 residents, some of the records and files were read and parts of the building were looked at. An unannounced visit was made to the home in July 05 and information on many of the standards not looked at during this inspection can be found in the report of that visit. In October 05 an additional visit was made to the home by the CSCI and checks were carried out to see if the home had complied with the requirements given to the home following the July inspection. The home had complied with the requirements where the dates had passed. What the service does well: Residents spoken with were all positive about the home with comments including, “I’m happy here, I don’t want to leave” and “I’m happy with the way they (staff) help”. Throughout the inspection residents were seen to make full use of communal facilities including the kitchen and laundry areas in accordance with their skills and preferences. Staff were seen to spend time with residents chatting and engaging in activities other than those they need direct support with. The home have a three year plan (ending December 06) for refurbishment and redecorating, the areas that have been completed are to a high standard and provide a pleasant environment for the people living there. There is a good recruitment policy in place and all required checks are carried out prior to new staff being employed. Staff training is prioritised and the home have a firm plan in place to make sure they meet minimum standards for staff gaining a care qualification and most staff are up to date with their basic training courses. Staff have a good understanding of residents needs and are motivated to provide a good service. Residents are happy with the level of support they receive with their personal care, with one residents describing this as “really, really good”. Moorfield House DS0000043636.V266649.R01.S.doc Version 5.1 Page 6 What has improved since the last inspection? 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 DS0000043636.V266649.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Moorfield House DS0000043636.V266649.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These standards were not looked at during this inspection. EVIDENCE: Moorfield House DS0000043636.V266649.R01.S.doc Version 5.1 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 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 The home provides support to residents to make everyday decisions and residents are happy with this, stating that they make more decisions than in the past. However residents are not always supported to be fully involved in all decision making within the home such as choosing new furniture and in their care planning. EVIDENCE: Residents spoken with said that the home does support them to make decisions, with comments including, “we decide ourselves” “we have a meeting to decide who wants to go where” and “you get your money and spend it on what you want”. However through discussion with residents it became obvious that whilst they are supported to make decisions about what to spend money on and where to go they are not fully supported to make other decisions. The home has undergone extensive refurbishment and re-decoration in the past year and this is an on-going process. In some instances residents said they had been consulted about some choices for example the colour of their bedrooms, in other instances they explained that staff chose the lounge and bedroom furniture. Most residents went on to say they are satisfied with the choices made, however one resident explained that they actively disliked the picture in their lounge. Moorfield House DS0000043636.V266649.R01.S.doc Version 5.1 Page 10 The home has in the past tried to get a local advocacy group to talk to residents with little success. During the inspection one resident was upset about a recent incident and was asked if they had been offered an advocate, they were unaware of what an advocate was and when explained said, “I would like one of them”. The home should obtain information about local selfadvocacy groups, explain to residents what these are about and offer support for them to attend. Residents did say that they now make more choices than in the past and gave examples such as work experience, choosing holidays and going out more. Staff spoken with, were aware of the need to respect residents choices and able to give examples of how this is promoted in daily lives such as with choosing meals, shopping etc. Four residents were asked if they had a care plan and said that they did but did not see this, comments included, “I’ve not seen it” and “we don’t see care plans, they write it down”. One of the care plans read did contain a copy of a care review, which the resident had attended and all residents asked knew the name of their keyworker. During the compliance visit to the home in October 05 the manager was able to explain a new system of care planning she intended to introduce based on Person Centred Planning and an extended date of 1st February 06 was agreed for the home to fully implement this system. The home must make sure that their care planning system involves residents as much as possible. There is a system in place for supporting residents to manage their finances, the company provide a corporate appointee and residents have their own bank account. Staff provide the level of support needed to residents to manage their finances. Moorfield House DS0000043636.V266649.R01.S.doc Version 5.1 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 13,16 Residents are familiar with and part of the local community, staff provide support to access local facilities were needed and support to find local college placements and volunteer jobs. Many of the routines in the home are flexible and based around residents choices, however the home operates a daily routine file which is institutional and could prevent resident making real choices on a daily basis. EVIDENCE: Residents said that they are getting out more than in the past and on the day of the inspection several people were out shopping and others had a bowling trip planned for that evening, with one resident explaining “we try to get out because we have a driver on”, others explained that they are able to go out without staff or with each other. Many of the residents now attend a local college of further education and all those spoken with said they enjoyed this, others have work experience within the local community such as hospitals, a local care home and garden centre. Moorfield House DS0000043636.V266649.R01.S.doc Version 5.1 Page 12 The home provides transport, which is adapted for use by people with physical disabilities and there are adequate local public transport links. Residents spoken with are familiar with the local community and explained that they use local shops, leisure facilities, transport and the local church. Several residents were asked if staff knock on their bedroom or bathroom doors and all replied, “yes, with one resident explaining this is to “make sure we are safe”. Bedrooms doors are lockable and where possible residents hold a key for these, bathroom doors are also lockable and override devices are fitted. Throughout this and other inspections of the home residents and staff were seen to interact freely with each other, when asked about the staff team one resident explained “they talk to me” and went on to describe staff as “brilliant, no problems”. Residents were seen to use the communal facilities, including the kitchen and laundry areas as they choose and were able to explain the household tasks that they are responsible for and how these are decided. One member of staff explained that they like working in the home as “there are no set routines, it is their home”. However the home does have a ‘routines file’ which lists the people who should have a bath / shower each morning or evening. All staff asked said that if other residents wanted support with this then it would be provided and several residents spoken with either explained that they are able to do this themselves when they chose or are happy with the set routines. The practice of having a ‘bath list’ is institutional and could prevent residents from increasing their independence skills, the home should consider stopping this practice and using their new care planning system to support residents with their personal care choices. Moorfield House DS0000043636.V266649.R01.S.doc Version 5.1 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 The home provides appropriate support to residents in managing their personal care. EVIDENCE: The home provides several aids and adaptations to help people with their personal care, this includes, a walk in shower in the House and an adapted shower in the house suitable for people using a wheelchair and a Parker bath and walk in shower in the Bungalow again adapted for people with physical disabilities, there are grab rails in some bathrooms and hoists available in the Bungalow. Several residents asked about their personal care explained that they are able to manage this themselves. One resident explained that they have support from staff with personal care and described this as “really, really good, staff are good with the hoist, they help me have a wash and get ready”. When asked a resident said that “I decide when I want to get up, if staff can’t help right then, they explain why”. Residents and staff spoken with said that the residents decide when to get up or go to bed, although this depends on arranged day time activities such as college. All of the residents spoken with were well dressed and it was evident that where needed, they had received help with their personal care. Moorfield House DS0000043636.V266649.R01.S.doc Version 5.1 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These standards were not looked at during this inspection. EVIDENCE: Moorfield House DS0000043636.V266649.R01.S.doc Version 5.1 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These standards were not fully inspected during this inspection. EVIDENCE: The above standards were not fully inspected, however it was noted that several areas had been redecorated to a high standard. These included the lounge, dining room and hallways in the main house and new flooring in the cottages, as well as redecorating of several cottage and House bedrooms. Intercoms have been fitted to the cottages which one resident explained was “much better”. In addition requirements from the July 05 inspection relating to the building have been met, these included, locks on cottage bedroom doors, replacing a bedroom carpet in the House and following assessment fitting new fire doors throughout the House. Moorfield House DS0000043636.V266649.R01.S.doc Version 5.1 Page 16 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32.34.35 The home carries out appropriate checks before employing a new member of staff, however residents are not currently involved in this process. Staff training is a priority in the home with most staff attending basic training and the home having a firm plan in place for staff to meet the national standard for care qualifications. EVIDENCE: The home does not yet meet the national minimum standard of having over 50 of staff with a care qualification (NVQ). However all staff spoken with explained that many of staff are currently working towards this. One member of staff spoken with had achieved a care NVQ at levels 2 and 3 and was working towards a level 4. A Senior member of staff explained that he was working towards this and that the home aim to have met the standard within 6 months, a notice on the notice board was from an NVQ assessor advising that she planned to visit the home on 4/1/06. Two new members of staff were spoken with and they explained that they followed / are following a structured induction plan to the home. All members of staff spoken with had a good understanding of residents and of their support needs and residents spoken with said that they are satisfied with the staff team. Moorfield House DS0000043636.V266649.R01.S.doc Version 5.1 Page 17 The home manager and deputy manager were not working during this inspection and there was no access to staff files. However two members of staff were spoken with who were recruited fairly recently. Both were asked to describe the recruitment process they went through and explained this included, completing an application form, interview, 2 written references and a Criminal Records Bureau check (CRB). The newer member of staff also explained that she had a 3 moth probationary period. Although potential staff are invited to look around the home there is no evidence that residents are Involved in the recruitment process, the home should look at ways in which they can support residents with this. Staff have previously advised the CSCI that they have copies of their terms and conditions and codes of conduct. The home have invested a lot of time in staff training and have worked hard to make sure most staff have attended basic courses, the CSCI was provided with evidence of this in October 2005 and staff spoken with advised that they had attended a number of courses including, fire, manual handling, adult protection, health and safety, first aid and infection control. Moorfield House DS0000043636.V266649.R01.S.doc Version 5.1 Page 18 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 39 Full information regarding the homes quality assurance system was not available at this inspection. The home are meeting their development plan for the building and residents are given the time and privacy to talk with the CSCI. EVIDENCE: Neither the home manager of deputy manager were working on the day of the inspection and Senior staff were not able to provide information regarding the homes formal quality assurance system. The home are meeting their targets for development in terms of refurbishment and redecoration. The home work hard to meet CSCI requirements and where this is not possible they communicate openly and negotiate with the Inspector. Throughout this and other inspections of the home residents have been given the time to talk with the Inspector in private or with staff support as they chose. Standard 42 regarding safe working practices was not fully inspected, however it was noted that the radiator at the bottom of the stairs in cottage 3 was very hot and could cause a scald. The home must take action to prevent this. Moorfield House DS0000043636.V266649.R01.S.doc Version 5.1 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 X 2 X 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 X 23 X ENVIRONMENT Standard No Score 24 X 25 X 26 X 27 X 28 X 29 X 30 X STAFFING Standard No Score 31 X 32 3 33 X 34 2 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score X 2 X X X LIFESTYLES Standard No Score 11 X 12 X 13 3 14 X 15 X 16 2 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 X X x X X 1 X X X X Moorfield House DS0000043636.V266649.R01.S.doc Version 5.1 Page 20 Are there any outstanding requirements from the last inspection? 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 YA24 Regulation Requirement Timescale for action 31/12/06 23(2)(a)(b)(d) The home must ensure they meet the targets in their refurbishment and redecoration plan. This requirment is from a previous inspection, however the date for compliance has not passed and evidence was seen that the home are working towards meeting it. The home must work on care plans to make sure they meet the national minimum standards. This requirment is from a previous inspection, however the date for compliance has not passed The home must involve residents in their care planning process. The home must carry out a risk assessment of the heater at the bottom of the stairs, cottage 3 and act on any findings. 2 YA6 15 01/02/06 3 4 YA6 YA42 15(1) 13(4)(a) 01/03/06 21/01/06 Moorfield House DS0000043636.V266649.R01.S.doc Version 5.1 Page 21 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 3 4 Refer to Standard YA20 YA8 YA16 YA34 Good Practice Recommendations The home should provide small medicine cabinets in the cottages. (This is a previous inspection reccommendation) The home should provide residents with information on local self-advocacy groups and support to attend these. The home should consider stopping the use of their ‘routine’ list The home should look at ways of involving residents in their recruitment process. Moorfield House DS0000043636.V266649.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Knowsley Local Office 2nd Floor, South Wing Burlington House Crosby Road North Liverpool L22 0LG 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. Extracts may not be used or reproduced without the express permission of CSCI Moorfield House DS0000043636.V266649.R01.S.doc Version 5.1 Page 23 - 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!