Inspection on 05/10/07 for Moorfield House

This inspection was carried out on 5th October 2007.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Moorfield House 23/08/06

Moorfield House 19/12/05

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 Key Unannounced Inspection 5th October 2007 11.50 Moorfield House DS0000043636.V345658.R01.S.doc Version 5.2 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.V345658.R01.S.doc Version 5.2 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.V345658.R01.S.doc Version 5.2 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 Craegmore.co.uk Park Care Homes (No 2) Ltd Care Home 31 Category(ies) of Learning disability (31), Physical disability (3) registration, with number of places Moorfield House DS0000043636.V345658.R01.S.doc Version 5.2 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. 23rd August 2006 Date of last inspection Brief Description of the Service: Moorfield House is owned and run by Parkcare Home (no2) LTD, who are owned by an organisation called Craegmoor Healthcare. They are an organisation who provide different services for people who need support, across the country. The home is in Melling, a country area near to the local towns of Maghull and Kirby. Although on a country lane, there is public transport to local shops and leisure facilities, within walking distance. Moorfield House provides 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 that they can be used by people who also have a physical disability. Each living area has its own staff team, living and dining areas, laundry, kitchen and bathrooms. There are large grounds and also has a recreation hall although this is not used at present. The people living there are supported to go to local colleges or to work and the home provides some transport to help people get out and about. It costs between £318 and £1957.84 each week to live at Moorfield House. Moorfield House DS0000043636.V345658.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Information for this inspection was gathered in a number of different ways. Any information the CSCI has received since the last big inspection of Moorfield House is taken into account. An unannounced site visit took place on the 5th October 2007 where time was spent reading records and looking at the building. A system called ‘Case tracking’ was used as part of the visit. This involves looking at the support a person gets including their care plans, medication, money and bedroom, time is also spent meeting with people who live there and with staff about how they meet the persons needs and choices. Case tracking was used to look at life at Moorfield House for three of the people living there. Discussions took place with seven of the people who live there and four staff, including the manager. The manager contributed to the inspection by filling in a pre-inspection assessment. The people living there and their relatives had the opportunity to give their views by filling in comment cards before the inspection. Four relatives and four of the people living there completed comment cards and their views are incorporated into this report. An easy to understand summary of this report is available. If you would like to see a copy please ask the staff working at Moorfield House. What the service does well: Staff make sure that, before any new people come to live at Moorfield House they meet with staff who look at what their needs and choices are and make sure the home can meet these. They also invite the person and their relatives to visit several times so that they can decide whether they would like to live there. Support is provided to the people living at Moorfield House to make there own daily decisions and spend their time engaged in activities that they enjoy, including going on an annual holiday Staff have supported people to find out about different colleges and local community groups that they can join. Moorfield House DS0000043636.V345658.R01.S.doc Version 5.2 Page 6 The people living at Moorfield House are confident in the staff team who they say listen to them and explain things as well as offering the support that they need. Staff have a good knowledge of the people living there and were seen to take time to talk with people and support them to be as independent as possible as well as providing advice and support where needed. Mealtimes and arrangements are varied across the living areas in order to support people to be as independent as possible. Some people budget, plan and cook their meals, others plan meals with staff and help with the preparation. Several of the people living there said that they are being encouraged to eat more healthily and they think this is a good thing as they are losing weight. The people living at Moorfield House receive a good level of support to meet their health and personal care needs. Staff undertake training in basic care practices such as dealing with fire, moving and handling people and infection control. The people living at Moorfield House are confident that if they have any concerns they can talk to staff who will act on these. The manager is aware of adult protection procedures and has acted appropriately in referring these and co-operating with other authorities. What has improved since the last inspection? Staff have received training in supporting people with autism and in supporting people to manage the way that they behave. This training helps staff to have a better understanding of peoples support needs and the ability to support them more effectively Since the last random inspection of the service in March 2007 the organisation have appointed a new manager who is experienced in working within care services for adults with a learning disability. The people living at Moorfield House and their relatives have expressed confidence in her approach. Systems are now in place for assessing and checking the quality of the service offered. This includes a plan with timescales for ensuring everyone has a care plan in place that provides all of the information staff will need to support the person effectively. Moorfield House DS0000043636.V345658.R01.S.doc Version 5.2 Page 7 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. The summary of this inspection report can be made available in other formats on request. Moorfield House DS0000043636.V345658.R01.S.doc Version 5.2 Page 8 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.V345658.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2 & 4 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Sufficient information is obtained about and given to new people to help them decide if Moorfield House is the right place for them to live. However the format of the information may not always be easy for people to understand. EVIDENCE: The people living at Moorfield House said in their comment cards that before they moved in they were given enough information to help them decide if it was the right place for them to live. One person explained, “I liked the home that’s why I moved in” and another that “I came to look around first”. Since the last key inspection nobody new has moved into Moorfield House. However there are polices and procedures in place to ensure that sufficient information is obtained about the person, including an assessment of their needs, to ensure that Moorfield House can meet their choices and support needs. The last key inspection showed that staff followed this policy before anyone moved into the home. Moorfield House has a statement of purpose, which is displayed in the entrance hall. This gives information about the organisation, staff, the environment and the services that they provided. Moorfield House DS0000043636.V345658.R01.S.doc Version 5.2 Page 10 However it is not in an easy to understand format, with small print used and no pictures to help people understand the contents. Although it provides information about the age range of people it can cater for it does not provided information about the support needs of people that they can cater for. The format may mean that the people living at Moorfield House or others considering moving in, may not understand as much about the service as they could. Moorfield House DS0000043636.V345658.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7 & 9 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Peoples individual needs and choices are recognised within the service, however they are not always fully supported to learn everyday living skills and increase their independence. EVIDENCE: One of the people living at Moorfield House explained that his care plan had information about “everything” to do with him and that his keyworker asked questions which he answered so they did the plan together. This was confirmed in discussions with other people, all of whom knew they had a care plan and had contributed to and agreed with the information written down. The manager explained that they are in the process of altering the format of their plans to provide more detailed information about the person as well as their support needs. This was confirmed in discussion with one of the people living there who explained he had “a new style one, that covers everything”. Moorfield House DS0000043636.V345658.R01.S.doc Version 5.2 Page 12 There was evidence during the visit that work is being carried out on these more comprehensive plans, with staff sitting with the people living there and gathering information. In addition the manager has given written guidance as to the dates each plan must be completed and in use. However current care plans that were being used were not all up to date. The information in one had not been reviewed since September 2006 and another contained few guidelines for staff to follow to support the persons successfully. Risk assessments were in place in all plans however the review dates of these varied within one plan from May 2006 to May 2007. The lack of current information and reviewing of existing information may lead to staff not having the information they need to successfully support the person and quickly note and act upon any changes. Previously a weekly ‘catch up’ meeting was held between the person and their key worker to discuss how things had been in the past week and any changes they wanted to make. These meetings have now stopped, however one of the people living there explained that she liked the meetings and felt it was “a good idea” to hold them and would like them to be started again. The people living at Moorfield House said in their comment cards that they always or usually make their own decisions about the things they want to do. Records and discussions during the visit showed that people get up and go to bed when they choose and can spend their time at home engaged in activities that they enjoy. A recent ‘your voice’ meeting has been set up by Cragemoor for people who use their services. This is attended by a representative of Moorfield House who obtains the views of people living there via a meeting and them passes them on to the organisation. One of the people living there explained,” its where we get our voices heard” and records showed that issues affecting Moorfield House such as the slippery cobble stones and activities they would like to take part in, had been discussed. These meetings offer people the opportunity to become involved in the way the home is run and make suggestions for future improvements. However the date for the latest meeting had passed and no representative of Moorfield House had attended. The organisation manages most people’s money within separate bank accounts with details available on computer. If people want money then they can access it during the week by requesting it from the office and signing for it, or at weekends by pre-planning. Moorfield House DS0000043636.V345658.R01.S.doc Version 5.2 Page 13 Only two people manage their own account. One of the people living at Moorfield House explained,” its all in one account, I don’t’ know where that is” and others confirmed that they don’t go to the bank but have to request their monies. This practice does not support people to learn everyday living skills such as budgeting nor does it give them control or flexibility in planning their day. Moorfield House DS0000043636.V345658.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15, 16 & 17 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Peoples different lifestyle choices are identified and support generally provided for them to meet these. However a lack of staff availability sometimes means people cannot engage in activities they enjoy. EVIDENCE: The people living at Moorfield House said in their comment cards that they can always do the things they want to do, with one person explaining, “I go to work. I go to the shops at the weekend”. Relatives views were mixed with some feeling staff supported the people living there to stay in touch and informed relatives of important matters and others feeling that this is not consistent and people should get more support to stay in touch with their relatives. However the people living there said that they can have visitors when they want. During the site visit people were out and about engaged in a number of different activities. These ranged from paid and voluntary work to attending Moorfield House DS0000043636.V345658.R01.S.doc Version 5.2 Page 15 different colleges, resource centres and community classes such as drama and local history. People at home were spending their time engaged in hobbies, household tasks and chatting with each other and staff. One of the people living there said, “we can do what we want here” and another confirmed that she gets support to carry out small household tasks and to be more independent in looking after her appearance. The people living at Moorfield House said that at times they cannot take part in outside activities they enjoy, as there have not been enough staff to support them or sufficient staff who drive. Examples included, going to church on Sundays and going to a Monday club, one person explained, “its been called off quite a bit due to the driver situation”. Another person explained that they cannot always attend an exercise class their GP has recommended due to a lack of staff to support them. Everyone can go on an annual holiday if they choose. Recent holidays include a trip to Scotland and an activity centre that caters for people with physical disabilities with equipment to support them with rock climbing and using a zip wire amongst other things. People said that they have enjoyed these holidays and look forward to going again. Mealtimes through the different areas of the home are arranged differently depending on peoples support needs. One of the people living in the cottages explained they plan, shop for and prepare their own meals. He explained that meals are now “better, we get a balanced diet” as staff are encouraging them to eat healthier meals. In other areas of the home staff prepare meals with the people living there having input where they are able. Comments about the quality of meals were good with two people explaining, “We get nice dinners and teas”. Several people explained that they are now being encouraged to eat healthier meals and that they feel this is an improvement. Moorfield House DS0000043636.V345658.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Peoples health and personal care needs and choices are recognised and support is provided by staff to meet these. EVIDENCE: Relatives of the people living at Moorfield House said that their relative always or usually gets the care and support expected. One relative commented, “Not at first but now there is a definite improvement”. A GP confirmed in their comment card that the service seeks advice about people health appropriately and respects their privacy and dignity. Records showed and the people living there confirmed that they are supported to see health professionals such as the GP, Dentist and Optician and that staff will accompany them to appointments if needed. Records are kept of any on going health issues people have and any daily support they may need with this. This helps to ensure that the person is receiving the support they need to stay healthy and any changes can be quickly noted and acted upon. Moorfield House DS0000043636.V345658.R01.S.doc Version 5.2 Page 17 One of the people living there confirmed that she always receives support with her personal care as written in her care plan, explaining, “ I like a lie in and to get up at dinner time” and that staff support her with this. Medication across the site was stored and recorded correctly, with clear records of medication received and given or not given. This helps to reduce the risk of mistakes occurring and provides a clear audit trail to check people receive their medication correctly. One of the people living at Moorfield House was able to explain the information in his care plan about medication he takes ‘as required’ and said that staff give him “good support” to manage this. However not everyone had up to date guidelines in place for ‘as required’ medication. Some had guidance that was dated 2005 – 2006. The use of written guidance helps to ensure that everyone is aware of the reasons for the medication and supports staff and the person to judge when it may be needed. Moorfield House DS0000043636.V345658.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff listen and act upon any concerns that the people living at Moorfield House have. This helps to ensure the people living there are safe. EVIDENCE: The people living at Moorfield House said that they know who to talk to if they have any concerns or are unhappy, with one person explaining, “See one of the staff, if I am not happy” another person explained they would talk to their key worker as “she listens and explains”. Relatives said that they always or usually get an appropriate response if they raise any concerns. Information about how to raise concerns or complaints is readily available in all the living areas and has been provided in an easy to understand format so everyone can understand the process as much as possible. Staff have received training in recognising and reporting adult protection issues and since the last key inspection of the service there have been three referrals made for investigation under these procedures. Senior staff acted appropriately in making referrals, co operating with social services and the police and using internal staffing procedures to deal with the issues raised. Moorfield House DS0000043636.V345658.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 29 & 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Moorfield House provides a comfortable home for people to live but would benefit from further refurbishment. EVIDENCE: Moorfield House is situated on a country lane in Melling. However there is public transport nearby and shops and local facilities a short drive away. The home has extensive grounds, which provide space for several garden areas, a wild flower field and room for a recreation hall and small woodland area. Moorfield House DS0000043636.V345658.R01.S.doc Version 5.2 Page 20 The Main House has living and dining rooms, a large kitchen, which the people living there were seen to use and twelve single bedrooms. The remaining bedroom is shared by two people who are happy to share and have screens provided for privacy. Each Cottage has a living and dining area, single bedrooms, kitchen and bathroom and either there own laundry facilities or a small laundry shared between two of the Cottages. In the Bungalow there is a large lounge, two bathrooms, a dining area and separate garden along with a laundry and domestic kitchen. The people living at Moorfield House and their relatives said that the home is always fresh and clean, with one relative commenting, “They maintain a warm homely atmosphere”. Over the past couple of years many areas of the home have been decorated to a good standard, with the cottages and living areas in the house refurbished. However other areas are still in need of attention. During the site visit the bathroom in the main house had been replaced and new flooring and décor was scheduled. In the bungalow a new central heating system has recently been fitted, however no decoration has taken place. In one of the bedrooms paper was hanging down from the ceiling and there was a hole in the wall behind the door. In the hallway carpets were stained and paint work scratched. Although parts of the bungalow are adapted for use by people with physical disabilities, other parts are not. There are downstairs bedrooms and a bathroom with an adapted bath and shower provided. However the kitchen is a domestic kitchen and one of the people living there explained that the sink is to high for her to use. Doors throughout the bungalow do not have automatic fire closures fitted. Therefore they are closed at all times and restrict access for the people living there. One person explained that she tries to open the door or shout but “my voice is not that loud”. In the upstairs of the main house there are several steps leading down to the bathrooms and some bedrooms. This area is very dark which could lead to an accident occurring. Outside the front of the buildings are cobblestones. These are original and have become uneven and potentially slippery, a concern raised by the people that live there via their meetings. Moorfield House DS0000043636.V345658.R01.S.doc Version 5.2 Page 21 Each living area has its own laundry facilities these were clean and well organised with staff having access to disposable gloves and aprons if needed. All areas were clean and tidy and the majority felt warm. On one of the cottages the person living there explained it was “freezing” as the heating was not working, however the manager said that she would arrange to have this fixed as soon as possible. Moorfield House DS0000043636.V345658.R01.S.doc Version 5.2 Page 22 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34 & 35 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The people living at Moorfield House are confident in the support staff provide for them. Sometimes a lack of staffing can impact on their lifestyle and choices. EVIDENCE: The people who live at Moorfield House said in their comment cards that staff always treat them well and listen and act upon what they say. Their relatives said that they feel staff usually have the skills and experience to support people, with one relative commenting, “most of the carers show an interest in (my relative) and have a genuine concern for her day to day living. The staff are a great team and we are very thankful to them”. During the site visit the people living there highlighted several occasions when they had been unable to take part in activities they enjoy, which they felt was due to a lack of staffing or staff who can drive. Staff spoken with during the visit explained that they are in the process of recruiting more care staff and anticipate them starting work soon. At a random inspection of the service in March 2007 it was highlighted that some of the people living there are funded for 1- 1 support from staff. At this Moorfield House DS0000043636.V345658.R01.S.doc Version 5.2 Page 23 visit, as at the one in March 07, rotas did not reflect the 1-1 hours provided for people and staff confirmed that these were not formally identified, rather the person is supported by a mixture of the staff on shift. A rota for the bungalow showed that there had been only two carers working during the day over a period of six days. However staff believed that one of the people living there was funded for 1-1 care during the day and another person for 2-1 care at certain times in the day. This means that people may not be getting the full support they are assessed as needing. In the main house one person is assessed as needing 1-1 support. Staff advised that this occurs when the person goes out, however the rota showed that there were only two staff working in the house from 4pm until 8pm. This means that if 1- 1 support is provided there is only one member of staff to support the other twelve people living there, which may not be sufficient to meet their needs. A sample of files were looked at for staff who have different roles within the service. These showed that before any one commences work in the home a series of checks are carried out, such as obtaining references and a CRB (Criminal Records Bureau) check. These checks help to ensure that staff are safe and suitable to work with the people living there. During the site visit staff spoken with had a good understanding of the support needs of the people living there and were seen to take time to talk with people and treat them with respect. Some staff have obtained a care qualification (NVQ) and others state that they would like the opportunity to work towards obtaining this. A member of staff explained that the manager ensures “they are up to date with training” and records showed that staff have had recent training in basic care practices. This includes fire, moving and handling people and the protection of vulnerable adults. Staff have also had some training in more specialist areas such as supporting people with autism and primary and secondary intervention to support people to manage their behaviour. However training is not provided in other specialist areas that people need support in, such as the prevention of pressure sores or catheter care. This training would help to ensure staff are up to date with current good care practices and can support people safely. Moorfield House DS0000043636.V345658.R01.S.doc Version 5.2 Page 24 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Moorfield House is well managed for the benefit of the people living there. EVIDENCE: Since the last key inspection of Moorfield House the organisation have appointed a new manager and deputy manager, both of whom are experienced in managing services for adults with a learning disability. Some of the relatives who completed comment cards said that they felt the new management had introduced some positive changes with one explaining, “I have had real concerns in the past but am hopeful with the present new management Moorfield House will improve”. Moorfield House DS0000043636.V345658.R01.S.doc Version 5.2 Page 25 Mrs Judith Hacking is the appointed Manager of Moorfield House, she is a qualified nurse for people with learning disabilities and has experience in managing within care services. Mrs Hacking is aware of the need to apply to the commission for Social Care Inspection to become registered as the manager of the service and stated her intention to proceed with this as soon as possible. This registration helps to ensure that the manager is a suitably qualified and experienced person to manage the service and support the people living there. There are a number of systems in place at Moorfield House to check on the quality of the service offered and plan improvements. This includes regular visits and audits from the organisation who then provide a list of improvements to be made. In addition a senior manager from the organisation visits and carried out an audit of the service monthly, one of the people living there explained,“She asks questions, sees if we are all right”. The manager is organised, providing lists of work to be carried out and dates for staff to complete tasks. These checks and systems help to ensure that a good service is provided to the people living at Moorfield House and that any issues can be quickly noted and addressed. A relatives meeting was held in July 07 and the people living there are able to express their view at meetings within the home and at the organisations ‘your voice’ meetings. However there was little evidence that a formal response or follow up is made to people after these meetings to inform them of progress made or answer their queries. This information would help to keep people informed of changes being made and reassure them their views are taken into account. Records and certificates evidenced that the building and equipment used are checked regularly to ensure they are safe. This includes contractor’s checks of the fire system and hoists as well as in house checks on fire alarms and emergency lights. Moorfield House DS0000043636.V345658.R01.S.doc Version 5.2 Page 26 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 2 2 3 3 X 4 3 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 2 30 3 STAFFING Standard No Score 31 X 32 3 33 2 34 3 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 2 X 2 X LIFESTYLES Standard No Score 11 3 12 3 13 2 14 2 15 3 16 3 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 2 X X 3 X Moorfield House DS0000043636.V345658.R01.S.doc Version 5.2 Page 27 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA33 Regulation 18(1)(a) Requirement A record of the amount of 1-1 support each Service User is funded to receive must be retained in the home. A system for monitoring and recording when this support is provided must be in place. This will ensure that the people living there receive the support they are assessed as needing, at all times. 2. YA7 12(1)(b) The way in which money belonging to the people living at Moorfield House is managed must be reviewed. This will ensure that their rights are protected and they are supported to become as independent as possible. 3. YA24 13(4)(a) A risk assessment must be carried out on the short flight of stairs within the main house. 30/11/07 30/11/07 Timescale for action 30/11/07 Moorfield House DS0000043636.V345658.R01.S.doc Version 5.2 Page 28 Action should be taken if any risks are identified. This will help to ensure that the building is safe for the people living and working there. 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. Refer to Standard YA1 Good Practice Recommendations The statement of purpose should be reviewed to ensure it provides all required information. It should be provided in a format that is easy for the people living there to understand. This will ensure people can understand as much as possible about the service provided to them. 2. YA20 Up to date guidelines should be in place for medication people are prescribed ‘as required’. This will ensure that the person and staff team are clear about how and when to use it. 3. YA29 An assessment of the bungalow environment should be carried out taking into account the mobility needs of the people who live there and their rights to be as independent as possible. An action plan to address any findings should be compiled. Staffing levels should be formally reviewed to ensure people are able to receive the support they need to access leisure opportunities. A training plan should be compiled which looks at the individual supports needs of the people living at Moorfield House and ensures staff are equipped with the information to support them effectively. 4. YA33 5. YA35 Moorfield House DS0000043636.V345658.R01.S.doc Version 5.2 Page 29 6. YA39 A written response and dialogue should be maintained in response to issues raised at service user or relatives meetings. This will ensure that people are up to date and kept informed about how their views affect the service offered. Moorfield House DS0000043636.V345658.R01.S.doc Version 5.2 Page 30 Commission for Social Care Inspection Knowsley Local Office 2nd Floor, South Wing Burlington House Crosby Road North Liverpool L22 0LG National Enquiry Line: 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 © 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.V345658.R01.S.doc Version 5.2 Page 31 - 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. 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