Inspection on 19/03/09 for Moorfields Residential Care Home

This inspection was carried out on 19th March 2009.

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

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

Other inspections for this house

Moorfields Residential Care Home 05/03/07

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 09/07/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Moorfields Residential Care Home 388 Tottington Road Bury Lancs BL8 1TU     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Anthony Cliffe     Date: 1 9 0 3 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: Moorfields Residential Care Home 388 Tottington Road Bury Lancs BL8 1TU 01617644212 01617634618 canbra9@yahoo.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Moorfields Abby Limited care home 20 Number of places (if applicable): Under 65 Over 65 20 old age, not falling within any other category Additional conditions: 0 The home is registered for a maximum of 20 service users to include *up to 20 service users in the category of OP (Old age not falling within any other category). Date of last inspection Brief description of the care home Moorfields is registered to provide care for up to 20 Older People of either sex. Situated in the Tottington area of Bury, the home has easy access to the facilities of the town centre of Bury. Facilities within the home include three lounge areas, giving people that live there a good choice of where to sit, depending on whether they want a quiet room or to watch television and chat. There are 6 single bedrooms on the ground floor and 10 single and 2 double bedrooms on the floor that are easily accessible by passenger lift or staircase. All of the rooms are comfortably furnished, carpeted and decorated and have a nurse call alarm system to summon assistance as required. All residents? bedrooms are fitted with locks for additional privacy. There are five communal toilets, two assisted baths and an assisted shower room. Weekly fees are from four hundred pounds per week. Additional charges are made for private chiropody, hairdressing and newspapers or magazines. The provider makes Care Homes for Older People Page 4 of 28 Brief description of the care home information about the service available to people that use services or their relatives in the form of a Service User Guide and Statement of Purpose which is available from the home. Care Homes for Older People Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: References to we, our or us represent the Commission for Social Care Inspection This unannounced visit took place on the 18th March 2009 and lasted over eight hours. One inspector carried out the visit. This visit was just one part of the inspection. Other information received was also looked at. Some weeks before the visit the manager was asked to complete a questionnaire called an Annual Quality Assurance Assessment (AQAA) telling us what they thought they did well, what they needed to do better and what they had improved upon since the last visit, to provide us with up to date information about the services provided. This helps us to determine if the management of the home see the service Care Homes for Older People Page 6 of 28 they provide in the same way we do and if our judgements are consistent with home owners or managers. We provided questionnaires for people that use services, relatives, staff employed at the home and social and health care professionals involved in their care so they can tell us about their views about the service the home provides During the visit various records and the premises were looked at. People that uses services, relatives, staff and a visiting health professional were spoken with and gave their views about the service. We received questionnaires back from people using the service who said they received information that helped them to choose Moorfields as their home and they received health care when needed as well as having enough staff to provide care for them. In January 2008 we did an annual service review of the home which told us the home was maintaining the improvements we saw during out last visit and was also making further improvements. An annual service review is a summary of our knowledge about a service that has not had a visit in the last year. It is also how we decide if a service is still as good as we thought it was since the last visit or annual service review. What the care home does well: What has improved since the last inspection? What they could do better: The home needs to improve how decisions about daily living made by people that use services are reflected in their care plans so staff and others involved in their care understand how important peoples daily decisions about their lives and decisions about their future are to them so the agreements about how they make or are supported to make decisions are clearly understood. Care Homes for Older People Page 8 of 28 The variety of training staff receive should improve so they have training that helps them to understand the different needs of people and deal with difficult situations with more confidence. Quality assurance needs to improve so mistakes made by an outside organisation used by the home which led to the home being told that employment checks for staff had been completed when they were not completed properly are recognised by the manager or owners and not repeated. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 28 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are properly assessed before they are admitted to the home which gives an assurance to everybody that they are only admitted if the home can meet their needs Evidence: The information provided to people that use services called the statement of purpose and service user guide were made available to people that use services so they had information provided to help them decide if they wanted to live at the home. This included a copy of the contract that said what facilities and services were available at the home so they knew what the costs of their care covered. The information also included comments from people that lived at the home and relatives so they had information about the home from people that lived there. Information was available about the complaints procedure and included compliments from relatives and district nurses. Information was available for people on the Mental capacity Act and fees in care homes. Care Homes for Older People Page 11 of 28 Evidence: Before the visit people that use services sent us surveys and said they received information about Moorfields that helped them to decide they wanted to live there including a contract. A comment received was, They made me feel welcome. We could see that people that use services had individual information gathered about their needs before they moved into the home. We could see that people that use services were asked about their needs and the care records we looked at contained lots of information about them. Each individual has a person centred plan which contained information gathered from people that use services and involved gathering information from families and other professionals involved in their care so staff at the home had helpful information to help them provide the right support and care. The home use a person centred approach and person centred planning to care for and support people that use services so their care was based on their daily routines and preferences. The information we saw gathered about people before they moved into the home included details about their needs and we saw this covered information about their social interests and hobbies, medical information on their physical and mental health, how they communicated with people, maintaining their safety, managing finances, help with personal care, and their life histories so staff had information about the people they cared for and supported. We could see that in other records gathering information usually involved families and health and social care professionals and important information was obtained about people that use services from families and health and care professionals so staff had information about them before they moved into the home. We saw that a lot of information was gathered about the needs of people that use services so staff had information to provide support and care. The home uses person centred thinking and planing to provide care and support to people living at the home so their care is based around their needs. Person centred planning is a really good way for people that use services to take control of their lives. Person centred thinking helps staff that care and support people that use services to listen to them and then to get what they want. A person centred plan contains information on what is positive about people that use services for example what people like and admire about them and their gifts and talents. Information should be included about what and who is important to people that use services from their viewpoint, as well as what people want for their future. A person centred plan should have information about how people that use services want to be supported, so stay healthy, safe and well. This is called a support plan but may be called a care plan. This should be detailed enough to provide a living description of how people that use services want to be supported, how they Care Homes for Older People Page 12 of 28 Evidence: make decisions and says who will do what by when. We saw the home used a person centred care plan which included details on their life history and additional records were kept to record information about their health. Information about how staff could support people that use services to care for themselves and what skills they had in caring for or could be supported to care for themselves were recorded so staff knew how and when to support and care for them. The owner had introduced a care plan approach that asked staff to think about the care they provided and the experiences they had of caring for people that use services so they could provide more personalised care. This asked staff for example if they saw things that staff needed to know so they could improve the care they provided. This included information on whether people needed constant explanations about their care so they did not get anxious, what situations may cause people to become anxious or if people that use services could provide their own care so they improve their understanding of peoples needs. This also included what was working or not working when caring for and supporting people that use services so they were able to identify if additional support, training or a different approach to care was needed. Care Homes for Older People Page 13 of 28 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples physical, emotional and personal needs were looked after. They received their medicines safely so their health and welfare was cared for. Evidence: We looked at the care records of two people that use services. Care plans gave details as to the personal help and support needed by people using the service so staff knew when to provide help and support and what care people using the service could provide for themselves. Care plans contained information on how and when people using services wanted or needed help and support to remain healthy. We could see that people that use services had access to health professionals so they received the right health care. An example of this was that a person that had recently moved into the home had a review which her doctor attended and said she had improved in her health and was more mobile and able to care for herself. Before the visit people that use services returned surveys to us and said they always or usually received the health care they needed. A comment received was, When I feel poorly they get Care Homes for Older People Page 14 of 28 Evidence: someone to see me. Reviews of care showed that relatives and social and health care professionals were invited to reviews and contributed to care plans so important information was gathered and shared about people that use services. Mobility information and guidance on how to manage pressure sores were included so staff had information on what to do if medical attention was needed. A district nurse that was visiting at the time said, The staff always contact us for advice and are very good at that. This home has an excellent reputation locally, we never have problems. I am in here several times a week looking after a ladys leg ulcer and it is getting better as the staff encourage her to follow advice. The home demonstrated good relationships with the mental health services with the mental health of people being reviewed regularly so appropriate care could be provided. We saw the home was looking after the nutrition and mobility of people using the services and using records called risk assessments to make sure that staff understood if the weight or mobility of people needed to be watched more closely. The manager agreed that the risk assessments and plans in place to guide staff what to do could be clearer in what actions they needed to take if people lost weight or were falling over so staff would know who to contact. Medication policies were sufficiently detailed so staff had guidance on how to receive, store, administer, record and dispose of medicines safely. The home had a store cupboard for the storage of medicines.This contained the policies and procedures for medicine administration with specimen signatures for the staff responsible for the management and administration of medicines so staff were aware of their responsibility and accountability for managing and administering medicines. Storage included controlled drugs storage. The arrangements for the storage and administration of controlled drugs were looked at and found to be safe. Arrangements were in place for people that use services to manage their own medicines so that they could take them independently. Care Homes for Older People Page 15 of 28 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported to live a lifestyle of their choice but information held about them does not support that they are directly included in the decision making process, so are not always involved in everyday decisions. Evidence: We could see that people that use services had the opportunity to be involved in a variety of activities which included arts to hearts, an art and crafts group the home runs with a local school which involves local children visiting the home and joining in arts and crafts and getting to know people that use services. Activities also included beauty treatment, listening to music and enjoying a glass of sherry, armchair exercise, hairdressing and visiting entertainers, so we could see they had a varied lifestyle. Care plans detailed the level of contact with families so were able to maintain family relationships as well as contact with friends. The home did not employ an activities organiser and though care staff seemed to be busy the manager and owner were involved in activities. We saw the home provided information to people about the weekly activities taking place so they had information to help them decide if they wanted to join in. The home had a relative that enjoyed doing armchair exercise with people and had been a friend of the home for many years. The owner confirmed the Care Homes for Older People Page 16 of 28 Evidence: relative was not a volunteer so did not provide personal care or need to have employment checks carried out. We saw people living at the home enjoying daily word puzzles and crosswords they did together with the staff so staff had time to socialise with them. In the afternoon a visiting entertainer did a sing along which people also said they enjoyed. Before the visit people returned surveys to us and said activities were always or usually arranged so they could join in and a comment received was that the person could choose not to join in them if they wished. Information gathered about what was important in the lives of people living at the home and what was important for staff to know about them so staff provided care based on their wishes. This included information about their daily routines and how they wanted their care to be arranged. This was included in the information gathered about person centred care. We saw that staff treated people that use services with courtesy, dignity and respect and sought their views about how they wanted to be supported and saw staff help them make decisions. We did not see information about how people that use services made decisions or where they lacked capacity, experience or judgement to make them. So could not confirm why, when, where and how staff supported people that used services to make decisions or what decisions they made for them or them to make. The manager agreed to look at how the care and support that people that use services needed was recorded so records told staff how people were able to care for themselves and what they could do to support them and help them make decisions. The routines of the home were flexible and meals were seen to be varied and supported a balanced diet with advice sought from dietitians where necessary. We shared lunch with people that use services and they said they enjoyed their meals. Meals were described as home cooked and enjoyable. The menu had a choice of both main course and a sweet and the provider also made sure the menu contained fresh fruit and vegetables. An example of this was making fruit smoothies for people to try. The main meal of the day was at lunchtime and this was a social occasion with people talking to one another, staff and the cook. The tables were set with table cloths, fresh flowers and condiments so people that use services could help themselves. The cook served people at the table and confirmed with them what they had chosen for their lunch so they were offered a choice of meal. A person said about the meals, I love the meals they are all home cooked. I had roast pork and vegetables but could of had something else. I have chosen apple pie for sweet at its home made. The cook is lovely she comes and talks to us everyday about whats on the menu for lunch. She makes home made soup. I have lived here for many years and love it. The staff are friendly, helpful and I love them. Care Homes for Older People Page 17 of 28 Evidence: When people needed assistance staff were available to help and did not try to take over but helped people to eat and have a drink or encourage them where necessary. A person using the service said of living at the home, My daughter visits most days. I did not realise how much help I needed. I get help from staff when I need it. I call this my home I could not be in a better place. This is my home, I have friends so this is my home, my friends and my family. Care Homes for Older People Page 18 of 28 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are protected by the safeguarding procedures in place and are confident that the possible risk of harm to them is reduced. Evidence: During the visit we saw the complaints policy was available in the entrance and displayed for people using the service to see, so they had access to it. We had not received any complaints about the home since our last visit and the home had not received any either. Before the visit people that used services returned surveys to us and said they knew who to speak to if they were unhappy and how to use the complaints procedure. Policies and procedures were in place to protect vulnerable adults called the safeguarding adults procedures. The safeguarding adults procedure is how we, the local council, police and other agencies respond to and manage allegations or suspicions of abuse against vulnerable adults. Staff at Moorfields had received safeguarding training which helped them to respond to suspicions or allegations of abuse or neglect to make sure vulnerable adults were protected. Staff had received training from the manager who completed the Bury council safeguarding adults investigating officers training. Staff were also due to attend Bury Council safeguarding adults training but the owner provided evidence this Care Homes for Older People Page 19 of 28 Evidence: had been cancelled by the council. Staff spoken with said they received safeguarding adults training in house and were given information about this during their induction when the manager went through the homes policies and procedures. Staff spoken with during the visit knew what to do if they suspected someone was being neglected or abused and described the actions they would take so they could protect vulnerable people. Staff were also issued with the General Social Care Council code of practice a guide for social care staff on the standards expected of them so they were aware of their responsibilities and practice when providing care to people that use social care services. Staff also had access to the whistle blowing policy, which is a policy they could follow if they needed to tell members of the public or other organisations about things in the care home that concerned them and needed to be placed in the public interest. Care Homes for Older People Page 20 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a comfortable and safely maintained homelike atmosphere. Evidence: We looked around the buildings and saw that the home was well maintained and decorated, clean and odour free so people that use services lived in a comfortable well maintained home. Domestic staff were seen to be busy cleaning the building. We saw the bedrooms of people and they were nicely decorated and furnished to their tastes. Since the last visit, the homes office had been refurbished and more space provided with a built in desk. The owner said she was going to have the kitchen refurbished in 2009. The outside of the home was improved since the last visit with a patio built to the side of the home so people that use services had a safe area to sit. The owner said further improvements in the garden area were to be made with areas being landscaped. Care Homes for Older People Page 21 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Recruitment policies are in place but could be improved so people are better protected. Training is needed in safe systems of care and of the needs of individual people, so that they receive appropriate care. Evidence: We saw the staff numbers in place supported the needs of people that use services so they had sufficient help with their needs. There were three staff on duty as well as the manager. Additional staff were later on duty to assist with domestic and catering duties. The owners also visit the home daily and from their relationships with people that use services and staff, we could see the staff team was very well supported Staff we spoke with described training as good and varied and provided staff with the knowledge, skills and experience they needed to do their jobs so they were kept up to date with working practice. Staff had received training on a variety of subjects. Staff said they had the opportunity to complete NVQ level 3 qualifications which are a nationally recognised qualification in social care. The information returned to us before the visit by the manager said 3 staff had NVQ level 3 qualifications and nine had NVQ level 2 qualifications so all staff had a qualification in social care. We examined the recruitment records of two staff employed at the home. Recruitment Care Homes for Older People Page 22 of 28 Evidence: procedures were robust and included staff having to complete an application form, full employment history and two references sought about their suitability for employment. The recruitment of staff also included a Criminal Records Bureau (CRB) disclosure which is a check of staff to see they are suitable people to provide personal care and support to vulnerable adults. Staff were also issued with the General Social Care Council code of practice, a guide for social care staff on the standards expected of them so they were aware of their responsibilities and practice when providing care to people. During the visit the owner realised that the organisation that they used to provide a CRB check had not given them the correct information about two staff members employed and the agency they used confirmed the owner had been given the incorrect information so the staff had been employed without the necessary checks being in place so people that use services were not protected at all times. Staff were provided with a variety of training which included health and safety, food hygiene, moving and handling, safeguarding adults, medicine management and nutrition but staff training records were not all up to date so we could not confirm that all the necessary training had been completed. We talked to staff about their practice and they were confident about their skills and experience but said they had not had training in caring for people with memory problems such as dementia or how to deal with difficult behaviour and situations when people could become aggressive so were not always sure what to do. An example of this was what to do if someone hit staff while they were providing personal care when they were anxious and confused. Care Homes for Older People Page 23 of 28 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Quality assurance needs to improve so the welfare of people is promoted. Evidence: The registered manager is an established and confident manager who has managed the home for a number of years. The manager had not completed the nationally recognised registered managers award NVQ level 4 but said she was completing it. Another staff member had been promoted to develop skills in management and support the manager so people that use services had continuity of care. The quality assurance system in the home includes weekly health and safety checks of the building, fire safety, care records and medicine management so the welfare of people is promoted. The home used satisfaction surveys for families of people and the findings of these were made available for people to see so they knew what relatives thought of the quality of care offered. These were last completed in August 2008 and positive comments were received about the professionalism and friendliness of staff, Care Homes for Older People Page 24 of 28 Evidence: cleanliness of the home, and overall impression of living at Moorfeilds. Comments received were Excellent care and atmosphere, the management was seen as committed, caring, respectful and affectionate. The owner said the quality assurance system will be improved and had purchased the Mullberry House quality assurance system to be introduced so the home can improve and not repeat errors they had highlighted when two staff were employed without the necessary checks being completed. Mulberry House is a nationally recognised organisation that produces training and guidance for social care services. The home was also to be assessed for the Investors In People award it held, so that it could be renewed. The Investors In People award is a nationally recognised award for developing quality and investing in the development of organisations. Care Homes for Older People Page 25 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 26 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 7 The home needs to improve how decisions about daily living made by people that use services are reflected in their care plans so staff and others involved in their care understand how important peoples daily decisions about their lives and decisions about their future are to them so the agreements about how they make or are supported to make decisions are clearly understood. The variety of training staff receive should improve so they have training that helps them to understand the different needs of people and deal with difficult situations with more confidence. Quality assurance needs to improve so mistakes made by an outside organistaion which led to the home being told that employment checks for staff had been completed when they were not completed properly are recognised by the manager or owners and not repeated. 2 30 3 33 Care Homes for Older People Page 27 of 28 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. 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