Inspection on 20/06/07 for Moorgate Croft Residential Home

This inspection was carried out on 20th June 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

Moorgate Croft Residential Home 24/02/06

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Snydale Care Home

Hawkhills

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Carentan House

Ravensworth Lodge

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

CARE HOMES FOR OLDER PEOPLE Moorgate Croft Residential Home Nightingale Close Moorgate Rotherham South Yorkshire S60 2AB Lead Inspector Sean Cassidy Key Unannounced Inspection 20th June 2007 08:45 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 Moorgate Croft Residential Home DS0000066113.V344215.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. Moorgate Croft Residential Home DS0000066113.V344215.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Moorgate Croft Residential Home Address Nightingale Close Moorgate Rotherham South Yorkshire S60 2AB 01709 838531 01709 835692 NONE 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) Park Lane Healthcare (Moorgate) Limited Carol White Care Home 28 Category(ies) of Old age, not falling within any other category registration, with number (28) of places Moorgate Croft Residential Home DS0000066113.V344215.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 24th February 2006 Brief Description of the Service: Moorgate Croft is a registered care home for up to 28 service users in the category of older people. The registered manager is Mrs C White who is responsible for the day to day running of the home. The home is situated in the Moorgate district of Rotherham and is accessible by public transport. The company have two other homes on the same site, Moorgate Hollow and Moorgate Lodge. The home is a three-storey purpose built dwelling providing accommodation for residents on the upper two floors. All bedrooms are single and have ensuite facilities and the communal areas are located on both floors. There is a centralised laundry and a large function room for use of the three homes. The weekly fees for the home are £358. Moorgate Croft Residential Home DS0000066113.V344215.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The accumulated evidence in this report has included: • • • A review of the information held on the home’s file since the last inspection. Information submitted by the registered provider in the pre inspection questionnaire. Information received from service users, relatives, staff and other professionals. An Unannounced visit to the home was conducted by one inspector and lasted one day. The majority of this time was spent speaking to residents, management, staff and relatives. The visit included a tour of the premises. A number of documents were examined which included care files, training files, recruitment files and health and safety details. What the service does well: What has improved since the last inspection? Moorgate Croft Residential Home DS0000066113.V344215.R01.S.doc Version 5.2 Page 6 There were no requirements or recommendations made at 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. Moorgate Croft Residential Home DS0000066113.V344215.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 Moorgate Croft Residential Home DS0000066113.V344215.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): 1 and 2. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People are provided with good information to assist them with making a choice about the home. EVIDENCE: The statement of Purpose and the Service User Guide were inspected and found to be informative. Both documents included all the necessary information needed to assist a person with making a decision to move in or not. The people spoken to who use the service said that they had received enough information to help them make their choice. The manager provided evidence to show a thorough assessment is carried out on each individual before they are offered a place in the home. The people that use the service and some relatives confirmed this did happen. They praised the home for enabling them to come and visit to get a feel for the service that was Moorgate Croft Residential Home DS0000066113.V344215.R01.S.doc Version 5.2 Page 9 being offered. Some comments made were, “ It was very helpful to come and have a look around before I made my decision.” “I was able to get an idea as to what type of home it was.” Moorgate Croft Residential Home DS0000066113.V344215.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): 7, 8, 9 and 10. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Not all the health and personal care needs of the people living in the home are being met. EVIDENCE: The care files for four people were inspected. Each person had a care plan and some risk assessments in place. Two care plans were written for people before they had arrived at the home. This is poor practice, as the person writing the plan of care does not have a true picture of the individual for which the care plan is being developed. The detail contained within the care plans was poor and did not provide the reader with enough information to enable them to provide the appropriate package of care. Examples of this were, a communication plan for a person who had clear identified dementia needs simply stated, “Communicates well.” Another care plan written for a person who had been identified as having a significant nutritional deficit stated, “Eats well.” One other person diagnosed Moorgate Croft Residential Home DS0000066113.V344215.R01.S.doc Version 5.2 Page 11 with Alzheimer’s disease did not have his specialist needs incorporated into his care plans, therefore, staff were not informed of how these needs should be met. This is poor practice. Care plans were overall poor and lacked a person centred care approach. One person had recently returned to the home after being admitted to hospital. The care needs of this person had changed from when she was first admitted, but the documentation had not been reviewed to reflect the changed care needs. The risk assessment of people in areas of nutrition, pressure area care, falls and continence was poor. No person had been nutritionally risk assessed even though there was a clear identified need to do so. Two people identified, as having lost significant amounts of weight had no evidence in their care plans that any action was taken to investigate the problem. At least two of the care files identified that there were continence problems but no assessment of this care need had been made. People identified as being at risk of falls did not have plans of care developed to ensure the carers were informed of what care they needed to provide to ensure the risk was minimised in this area. The manager did give assurances that immediate action would be taken to ensure these areas would receive priority attention. Nutritional assessments were obtained from another unit and the manager said they would be completed as soon as possible. The records showed that other professionals see each resident when the need arises. General practitioners, chiropodist and district nurses are regular visitors to the home. Those people spoken to said the staff are always responsive to their medical needs. This is good practice. Good feedback was received regarding the areas of privacy and dignity. Some comments made were, “They help me when I need it. They come very quickly when I ring my bell.” “They are very helpful and kind. They can’t do enough for me.” Staff were observed to be very helpful and polite when interacting with the people who lived in the home. They took time to listen to what was being said and responded well. They were also observed knocking on peoples doors and waiting before entering. The home has a medication policy and there is reference to self-medication. The manager said that no person self-medicates in the home. There are no risk assessments to enable people to self medicate and the system does not encourage independence in this area, even though the home does have the facilities to enable people to do so. Staff are well trained in the area of medication administration. The charts used to record administration of medication were correctly filled in. Moorgate Croft Residential Home DS0000066113.V344215.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): 12, 13, 14 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The people who live in the home are assisted and helped to keep active. The food provided does not meet everyone’s standards. EVIDENCE: The people that live in the service gave some positive feedback about the way they spend their time in the home on a day-to-day basis. Those spoken to could identify that there was an activities board that informed them what was planned for the week from an entertainment point of view. An exercise class was provided on the morning of the inspection, which was enjoyed by those spoken to. People were very clear that you were encouraged to attend the activities, however, if you did not wish to participate then this was reflected. The people living in the home were recently involved with the local election process. Two people said they were glad they were still able to vote. People said that their relatives took them out regularly to places of interest. The visiting times are very flexible and visiting is encouraged at all times. Moorgate Croft Residential Home DS0000066113.V344215.R01.S.doc Version 5.2 Page 13 The lunchtime meal was observed and was seen as a social occasion. The tables were well presented and had condiments for people to use if they wished. Staff were observed to be helpful and polite at all times. Specialist eating utensils were provided for those that needed them. Four people spoken to expressed disappointment in the quality of the food provided by the home. The manager has already identified this as a problem and is working with the kitchen to try and improve the situation. The comments received about the food served in the home were, “ The quality is not good. You get a lot of chicken dishes. “The meat is often tough and hard to chew.” “ The food is often very lukewarm.” Staff were observed reheating food in a microwave. They said that the food was not at a suitable temperature for people to enjoy. Although the staff were doing what they thought was the right thing they should refrain from reheating food as there could be a possibility of causing scalding as a result of this process. This was brought to the attention of the manager to deal with. The trolleys used to transport the food from the kitchen did not keep the food hot enough for peoples’ liking. Moorgate Croft Residential Home DS0000066113.V344215.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): 16 and 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The complaints and protection systems used by the home help protect the people who live there. EVIDENCE: The home has a robust complaints policy and it is displayed at various points around the home. People spoken to said they were very confident that any complaints they might have would be dealt with correctly. The manager keeps a record of all complaints that are made formally and also keeps a record of concerns raised, which she also investigates. This is good practice. The complaints records were seen and they showed that complaints are investigated according to the complaints procedure. This is good practice. The home has a thorough Safeguarding Adults policy and procedure, which is accessible to all. The staff receive training in this area at regular intervals. The staff spoken to during the site visit provided a very good understanding about what constituted abuse and how to deal with it if they identified it. People who live in the home and their friends and relatives spoke highly of the staff group and the way in which they assisted them with their care packages. “The staff are great. They help me as best they can. They are always helpful.” “They always give me enough time to do what I need to do. I’m not rushed.” Moorgate Croft Residential Home DS0000066113.V344215.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): 19 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The standard of the environment provided within the home meets the needs of the people who live there. EVIDENCE: The people spoken to during the site visit said the environment of the home was excellent. “It is home from home, in a way!” The environment was clean and tidy and was free from any odours. Many comments were made about the standard of cleanliness. Peoples’ rooms were well decorated and personalised. Many were enabled to bring in their own furnishings to make their rooms more homely. The rooms and corridors are very spacious and have handrails along the walls to assist people when needed. The toilets and shower facilities are also large Moorgate Croft Residential Home DS0000066113.V344215.R01.S.doc Version 5.2 Page 16 and there is suitable equipment in place to assist those residents with mobility problems. Three new rooms are being developed at present, which will increase the registration of the home to 31 beds. The manager has ensured the disruption caused by the building work has been kept to a minimum and people said they have been kept informed during the process. It was identified that the large lounge on the ground floor is used regularly as a training facility for staff from the service and the two surrounding services. This was discussed with the manager and she agreed that this would to be reviewed by the organisation. There was no evidence available to show the organisation-sought agreement with the people living in the home to use their lounge for staff training. Moorgate Croft Residential Home DS0000066113.V344215.R01.S.doc Version 5.2 Page 17 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): 27, 28, 29 and 30. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People receive care from a staff group that have been trained to a good standard. However, the recruitment procedure adopted by the manager does not properly protect the people living in the home. EVIDENCE: The organisation provides all new starters with a staff induction pack. Those staff spoken to said they did receive the induction when they started and evidence was seen in the staff files to support this. Staff said they felt well supported by this process. The manager has developed a staff rota which is well adhered to. The staffing levels have been set using the Staff Forum tool. The manager said the staffing levels are correct for the numbers of people needing care in the home. She did say that these would need to be reviewed if the four new rooms are added to the registration. Staff receive mandatory training in areas such as fire training and moving and handling. Other training provided to staff includes pressure area care, food hygiene and infection control. Moorgate Croft Residential Home DS0000066113.V344215.R01.S.doc Version 5.2 Page 18 Although the home is not registered for dementia there are a significant number of people living in the home that have this specialist care need. Staff do not receive training in dementia care. The care plans and activities provided showed evidence that the specialist dementia needs of the residents are not provided for in these areas. 50 of staff are trained to at least NVQ level 2 standard. The manager is very active in ensuring new staff are enrolled onto NVQ training. The recruitment files of two of the most recent employees were inspected. Not all the required information needed to employ a member of staff were obtained before that person commenced work. Two references were not obtained and the correct criminal records had not been properly checked. This is poor practice as it places people at potential risk. Moorgate Croft Residential Home DS0000066113.V344215.R01.S.doc Version 5.2 Page 19 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): 31, 33, 35 and 37. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. With the exception of a few areas, this home is generally well managed. EVIDENCE: The manager has many years experience in the care sector. She is well respected by the people who live in the home, their relatives and staff. She has developed systems that assist her with ensuring the home is managed to a good standard. The majority of systems used help maintain and improve care. But, the inspection did identify important areas such as care planning and recruitment as areas that are not well managed. Moorgate Croft Residential Home DS0000066113.V344215.R01.S.doc Version 5.2 Page 20 The manager has recently handed in her notice and will no longer be in the position when this report is published. Another senior person working within the organisation will manage the home when she leaves. The manager does monitor the quality of the care provided by the home through using a number of different tools such as the complaints procedure, monthly falls audit, questionnaires and meetings. The manager manages small amounts of money for some of the people who live in the home. A random sample of these monies was examined and was found to be correct. All transactions were properly recorded and receipts were kept. There are appropriate health and safety checks carried out within the home and appropriate documentation is recorded to provide evidence that these checks are regularly kept. Moorgate Croft Residential Home DS0000066113.V344215.R01.S.doc Version 5.2 Page 21 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 3 3 x x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 2 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 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 x 3 x x 3 x 3 Moorgate Croft Residential Home DS0000066113.V344215.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP7 Regulation 12(1) Requirement Where a person has an identified care need, a care plan must be developed to help care staff meet that need. Risk assessments in nutrition, continence and falls must be developed. This will assist carers to provide appropriate care needs and identify problems if they arise. Peoples care needs must be continually assessed so that appropriate care can be given. This refers to an individual that had recently returned from a stay in hospital with changed needs. No assessment had been carried out on return to the home. The food provided to the people who live in the home must be served at suitable temperatures. Appropriate food storage equipment must be provided to ensure this happens. Staff must cease reheating food in the microwave as this places people at risk of harm Residents must have access to DS0000066113.V344215.R01.S.doc Timescale for action 31/08/07 2 OP8 12(1) 30/08/07 3 OP8 15(2) 31/07/07 4 OP15 16(2)(g) 31/07/07 5 OP19 19(2)(e) 31/08/07 Page 23 Moorgate Croft Residential Home Version 5.2 6 OP29 19(1)(b) 7 OP29 18(1)(a) all the communal space provided. The organisation must not provide training in are which are allocated for residents. All the required information highlighted in Schedule 2 of the regulations must be obtained before an employee can work in the home. This will help reduce the potential risk of harm to the people living in the home. The staff working in the care home must receive training in the specialist area of dementia. This will assist them in their role of ensuring peoples’ care needs are appropriately met. 31/07/07 31/10/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP7 Good Practice Recommendations The care plans should be written when the person has moved into the care home. This will give the opportunity to assess the individual in their new environment and also provide the opportunity for consultation and agreement. The home should encourage people to self medicate whenever possible. A risk assessment should be developed to assist this process. The residents of the home should be consulted and involved with the development of the planned menu provided by the home. 2 3 OP9 OP15 Moorgate Croft Residential Home DS0000066113.V344215.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Ground Floor, Unit 3 Waterside Court Bold Street Sheffield S9 2LR 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 Moorgate Croft Residential Home DS0000066113.V344215.R01.S.doc Version 5.2 Page 25 - 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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