Inspection on 05/03/07 for Moorfields Residential Care Home

This inspection was carried out on 5th March 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 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 19/03/09

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Moorfields Residential Care Home 388 Tottington Road Bury Lancs BL8 1TU Lead Inspector Rukhsana Yates Unannounced Inspection 5th March 2007 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Moorfields Residential Care Home DS0000067920.V317049.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 Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Moorfields Residential Care Home DS0000067920.V317049.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Moorfields Residential Care Home Address 388 Tottington Road Bury Lancs BL8 1TU Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 0161 764 4212 0161 763 4618 Moorfields Abby Limited Mrs Elizabeth Betsy Cross Walton Care Home 20 Category(ies) of Old age, not falling within any other category registration, with number (20) of places Moorfields Residential Care Home DS0000067920.V317049.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 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). Not Applicable Date of last inspection Brief Description of the Service: 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 residents 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 £341 to £365 as at March 2007. Additional charges are made for private chiropody, hairdressing and newspapers or magazines. The provider makes information about the service available to residents or their relatives in the form of a Service User Guide and Statement of Purpose. Moorfields Residential Care Home DS0000067920.V317049.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and carried out over the course of a day, with a total of 8 hours spent at the home. During the inspection, discussions took place with four residents on their own, a staff member, the manager, owner and a visiting District Nurse. Several people completed comment cards to give their views of the home. Comment cards were received from nine residents, nine relatives and three GPs. A meal was taken with the residents, and half of the inspection time was spent watching the way in which staff supported residents, and in talking with them on their own and in groups. Paperwork was looked at that related to the care and safety of everyone living or working at the home. The inspection covered all of the key standards. These standards cover moving in, the care provided, routines and social activities, complaints and protection, comfort, safety and cleanliness, how staff are employed and trained, and how the home is managed. What the service does well: Residents feel they are well looked after and that they are treated with respect, describing good care and support. One example of positive comments was “Staff are very helpful and I am very satisfied.” There is a satisfactory range of activities that residents appreciate and enjoy. Residents have choices about how they spend their time. As one resident said, “We can please ourselves what we do”. All the comments from residents showed that they enjoy their meals at the home and are always given choices at mealtimes. A typical comment was “the meals are lovely”, and a relative said “My father is well cared for, eats well and is calmer than he has been for years. I am very pleased with everything”. Residents and relatives have confidence in the manager to properly deal with any problems they may have. Residents are happy that the home is clean and comfortable and like the improvements taking place through redecoration. The staff enjoy working here because they get good support and training. The manager always carries out checks on staff before they can start working at the home. Residents like the fact many of the carers have worked there a long time and have got to know them. The home is well run and managed, and the owners and manager are keen to keep making improvements. Moorfields Residential Care Home DS0000067920.V317049.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. Moorfields Residential Care Home DS0000067920.V317049.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Moorfields Residential Care Home DS0000067920.V317049.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 3 was assessed. Standard 6 does not apply as the home does not provide intermediate care. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Each person considering moving to Moorfields has their needs assessed, and is given information about the home by the manager, before admission. The admission process ensures that those new to the home know what to expect of the service from the outset. EVIDENCE: The manager described the admission process, stating that she visits each prospective resident to assess their needs, either on her own or with the owner of the home. The manager considers the available information from the social worker, talks to the prospective resident and completes assessment documentation. If the prospective resident is privately funded, most of the information is gained through liaison with family members. The resident or their relatives can visit the home at any time to have a look around. Moorfields Residential Care Home DS0000067920.V317049.R01.S.doc Version 5.2 Page 9 Prospective residents are offered an introductory visit, may stay for a meal or come in for a full day to be assessed. Residents or their relatives are given a copy of Statement of Purpose and Service Users’ Guide. Records showed that a pre-admission assessment form is completed that covers areas such as medication, physical health, allergies, eyesight, hearing, continence and mental health. The file of a resident recently admitted to the home showed that the initial assessment was followed by formal review meetings to ensure that all parties agreed to continuation of the placement. A care plan had been developed from the initial assessment. Feedback from residents and relatives indicated that they were appropriately involved in the assessment and considered the home was able to meet their needs. A relative confirmed that she was satisfied with the admission process and said, “The manager was very helpful. She showed us around and explained everything to us.” Moorfields Residential Care Home DS0000067920.V317049.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 7, 8, 9 and 10 were assessed. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans reflect the needs of residents, and along with good communication systems ensure that those needs are met. Residents’ wellbeing is promoted through attention to physical and psychological health matters and safe medication arrangements. The ethos of the home results in residents feeling they are treated with respect and their right to privacy and dignity is upheld. EVIDENCE: Three care plans were examined for residents with differing needs. They contained a range of assessment information including personal and health care needs, falls and mobility assessments, dietary requirements and risk assessments in key areas. Care plans were reviewed monthly. The use of bedrails for some residents was not properly justified in the care planning records. The manager took immediate action to address this by removing bedrails and initiating multi-disciplinary reviews for the residents concerned. In addition to care plans the home maintains summaries containing key Moorfields Residential Care Home DS0000067920.V317049.R01.S.doc Version 5.2 Page 11 information, weight records and pressure risk management information. The owner is in the process of introducing a person centred care assessment format with a view to improving the existing care planning and review process. Staff work well together and pass information from one shift to the next verbally and via a communication book. It was clear from observations and discussions that the manager and staff have a good knowledge of the needs of residents and were able to respond to them in a caring and reassuring manner. Residents and relatives were positive about the staff and the quality of care. One said, “All of the carers are lovely. Nothing is too much trouble for them”. Another said, “I like them because I am not rushed. We can do what we please”. Inspection of the care files identified that residents have access to health care professionals, such as dentists, opticians, chiropodists and district nurses. All health care professionals’ visits are recorded, together with any action that needs to be taken. Residents feel their health care needs are well met, and said that doctors’ visits are arranged without delay if they or staff have concerns. The lunchtime medication round, carried out by the manager, was observed during the inspection. The Nomad medication system was in place and the correct procedures were followed. Records of medication were accurately completed and secure storage arrangements in place. The manager and senior staff are responsible for the administration of medication and all have received relevant certified training. A senior on duty on each shift ensures that a trained member of staff is always available should a resident need medication at any time. The aims and objectives of the home stress the importance of treating residents with respect and dignity. The ethos is promoted by the owner and manager and was in evidence throughout the day of the inspection. Residents were taken to the toilet without having to wait, toilet doors were closed and staff knocked on bedroom doors before entering. Relatives confirmed that they were satisfied with the staff’s manner and attitude towards the people they visited. One said “ I am very satisfied with the care that my father receives and all the staff are very friendly.” Many relatives are frequent visitors to the home and all reported a warm welcome and open atmosphere. It was evident that residents were abler to meet with their family and friends in the privacy of their own rooms. Moorfields Residential Care Home DS0000067920.V317049.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12, 13, 14 and 15 were assessed. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are encouraged and supported to exercise choice in their daily routines in relation to lifestyle, meals and activities. EVIDENCE: Residents confirmed that staff respect their choices in terms of daily routines, such as rising and retiring times, and where they wish to spend their time during the day, use of their room, what to wear and whether or not to take part in social activities. They also confirmed that staff take the time to chat with them individually, and that activities take place regularly, such as visiting entertainers, music and movement. A local pastor visits to address religious needs, and all residents consulted felt their religious needs were satisfactorily met. There are good links with a local school that facilitates art sessions with the residents in the home. One of these, called “Art to Heart”, was taking place on the day of the inspection and clearly being enjoyed by several residents. The home is also involved in sponsorship of a donkey sanctuary and residents talked fondly of a recent occasion when a donkey was brought into the home, and are looking forward to this unusual event being arranged again. Moorfields Residential Care Home DS0000067920.V317049.R01.S.doc Version 5.2 Page 13 Good use is made of community facilities. In addition to the link with the school, some residents enjoy going to the local pub on occasion. A high number of relatives, of residents past and present, frequently visit and partake in fundraising activities for the residents. The new owner of the home has organised an Easter Fair and is intending to use the day to introduce herself to as many relatives as possible and gain their views on the running of the home. In respect of meal provision, the menus are varies and nutritious. The owner and the cook have attended training on better nutrition, and were able to give good examples of ways they have introduced food that is appetising, well presented and better for residents’ health. Lunch was taken with residents and provided evidence of these aspects. For example, fresh fruit was pureed and served with meringue and ice cream. Residents clearly enjoyed their meals and spoke highly of the cook. One said, “She is brilliant and always aims to please”. The main meal is served at lunchtime and a buffet tea provided at teatime. This was seen to contain variety and was also well presented. Residents are regularly offered drinks throughout the day and have a supper of their choice if they wish. The dining room was clean, bright, nicely decorated and furnished with matching table linen and napkins. Those requiring assistance with their meals were provided with help and sensitive encouragement from staff. Moorfields Residential Care Home DS0000067920.V317049.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 16 and 18 were assessed. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents feel able to air their views and are confident that the manager and staff will listen and respond to their satisfaction. Written guidelines, and a positive approach to training, help to ensure the protection of residents from abuse. EVIDENCE: A complaints procedure is in place that is included in the service user guide and statement of purpose. The home has a complaints book that indicates no complaints have been received under the current ownership internally or by the Commission for Social Care Inspection. All the residents consulted said that if they had any complaints or concerns, they would feel able to speak to staff members or the manager, and that they would be listened to and taken seriously. Residents’ and relatives’ comment cards also indicated that they aware of the home’s complaints procedure. A procedure for responding to allegations of abuse was available in addition to the Bury Social Services Vulnerable Adult policy. Training records indicate that staff without training in this area have been nominated to attend courses, and the owner has discussed protection issues in staff meetings to ensure that all care staff have a good understanding of what constitutes abuse and the procedures to be followed in the event of allegations being made. Moorfields Residential Care Home DS0000067920.V317049.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 19 and 26 were assessed. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is clean, reasonably decorated and maintained, with significant ongoing improvements ensuring that the environment for residents is safe, comfortable and homely. EVIDENCE: The owner has made a number of significant environmental improvements within the home. Several bedrooms have been redecorated and fitted with new carpets. A comprehensive written improvement plan is in place, with a great deal of work having taken place over the past six months. Residents consulted were very pleased with the environment and several residents and relatives commented on the high standards of cleanliness in the home. A range of aids and adaptations are in place for residents who need them. The owner has carried out a fire risk assessment of the premises, and there was evidence of weekly fire safety and equipment checks taking place. Moorfields Residential Care Home DS0000067920.V317049.R01.S.doc Version 5.2 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 27, 28, 29 and 30 were assessed. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staffing levels ensure that the needs of residents are being met. Good staff training opportunities and recruitment procedures help to ensure that residents are protected and well cared for. EVIDENCE: One senior and two care assistants are on duty through the day and evening. In addition, the registered manager is supernumerary on most days. Two care staff are on duty through the night, and one of the seniors and the manager are “on call” should they be required. Residents and relatives commented that, although staff members are busy, they always have time to provide the assistance residents need, and make time to talk to them. As a result of low staff turnover, residents feel the staff members have come to know them. One said, “They know what I like and how I want things to be done. They are very good, every single one of them”. Observations were made during the inspection of staff treating residents with respect and being sensitive and responsive to their individual needs. Inspection of staff records, including those of a recently recruited carer, showed that safe recruitment and selection practices were followed in line with the home’s procedure. These included receipt of two satisfactory references, Moorfields Residential Care Home DS0000067920.V317049.R01.S.doc Version 5.2 Page 17 Protection of Vulnerable Adults (POVA) and Criminal Record Bureau (CRB) checks and completion of application forms. The manager stated that new employees do not commence employment until the CRB check is received. All staff members are provided with a contract and terms and conditions of employment. Induction records were seen to be in place and the manager agreed to review the way in which these are completed in order to better show the timescales in which induction topics are covered. Supervision records showed that the manager covers a range of areas in individual discussions with staff. These include training, performance, job satisfaction and other issues arising for the staff member concerned. The owner is committed to offering training opportunities to the staff, and is a Partner Member of the Bury Adult Care Training Partnership. As such, she is making arrangements to ensure that staff have the range of training they require, including NVQ qualifications, mandatory updates, and skills in caring for people with dementia. Moorfields Residential Care Home DS0000067920.V317049.R01.S.doc Version 5.2 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 31, 33, 35 and 38 were assessed. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed, ensuring that residents receive a good standard of care. A system for ensuring continuing improvement, based on the views of residents and others, needs to be developed. EVIDENCE: Although the ownership of the home has changed, the manager of the home has been in post for several years and continues to fulfil her role. The manager is experienced, competent, and fosters an open approach and commitment to good standards of care. She has completed mandatory training and is due to complete the Registered Managers’ Award within the next six months. Staff reported that the manager is easy to approach, works well with them, and listens to their views, individually and in staff meetings. Residents and Moorfields Residential Care Home DS0000067920.V317049.R01.S.doc Version 5.2 Page 19 relatives consulted spoke highly of the manager and the new owner. One resident said, “They care about you and you can talk to them”. At present there is a requirement to further develop the quality assurance system to produce a plan that reports on the views of residents, relatives, visitors and staff. Residents’ personal finances were checked. Only the senior staff have access to residents monies. A clear and simple record of credits, debits and balances is maintained. Health and safety matters are properly addressed, with current certificates seen in respect of electrical installations, portable appliances and the lift. A full gas safety check is scheduled, and satisfactory arrangements in place for the disposal of hazardous waste. Moorfields Residential Care Home DS0000067920.V317049.R01.S.doc Version 5.2 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 X X 3 Moorfields Residential Care Home DS0000067920.V317049.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? NA 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 OP33 Regulation 24 Requirement The views of people who use the service, and others who have an interest in the home, must be published in a quality assurance plan. Timescale for action 01/08/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Moorfields Residential Care Home DS0000067920.V317049.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Bolton, Bury, Rochdale and Wigan Office Turton Suite Paragon Business Park Chorley New Road Horwich, Bolton BL6 6HG 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 Moorfields Residential Care Home DS0000067920.V317049.R01.S.doc Version 5.2 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. 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