Inspection on 12/11/08 for Moorhaven

This inspection was carried out on 12th November 2008.

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

Moorhaven 14/11/06

Moorhaven 03/11/05

Moorhaven 28/07/05

Moorhaven 30/09/04

Moorhaven 20/05/04

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Extracts from inspection reports are licensed from CQC, this page was updated on 30/01/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Moorhaven Normandy Drive Taunton Somerset TA1 2JT     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: Jane Poole     Date: 1 2 1 1 2 0 0 8 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. the things that people have said are important to them: They reflect 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 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) 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.csci.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Moorhaven Normandy Drive Taunton Somerset TA1 2JT 01823331524 01823323529 diane.allen@somersetcare.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Somerset Care Limited care home 54 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: To accommodate two named service users (named on application dated 2/6/06) under the age of 65. Date of last inspection Brief description of the care home Moorhaven is a care home owned by Somerset Care Limited and is situated in a convenient residential area in Taunton, Somerset. The home is within walking distance of local amenities and not far from the town centre. It is registered to provide personal care for up to 54 residents over the age of 65 years. It is a purpose built unit on one level, apart from four rooms on the first floor for which there is a passenger lift for access. Moorhaven is well adapted for its purpose allowing easy access to all areas for wheelchair users. Private rooms are grouped together in several small units in the home. The home is owned by Somerset Care Ltd and the registered manager is Jo Fenn 0 Over 65 54 Care Homes for Older People Page 4 of 26 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: The quality rating for this service is 2 star. This means the people who use this service experience GOOD quality outcomes. The focus of this inspection visit was to inspect relevant key standards under the Commissions Inspecting for Better Lives 2 framework. This focuses on outcomes for service users and measures the quality of the service under four general headings. These are; excellent, good, adequate and poor. This inspection was carried out over a one day period, during this time the inspector was able to meet with people living and working at the home, was able to tour the building, observe care practices and view records requested. Care Homes for Older People Page 5 of 26 The inspector was given unrestricted access to all areas of the home and all records requested were made available. Prior to this inspection the manager completed an Annual Quality Assurance Assessment (AQAA) giving details of the home and their plans for ongoing improvement. 9 people living at the home, 7 members of staff and 6 health and social care professionals completed questionnaires prior to the inspection and some of their comments have been incorporated into this report. Fees at the home range from 390 to 500 pounds per week. The following is a brief summary of the inspection findings and should be read in conjunction with the whole of the report. What the care home does well: What has improved since the last inspection? What they could do better: People living at the home were very happy with the care that they received and could not think of anything that could be improved. More than one member of staff who completed a questionnaire said that they felt that people would benefit from more outings and a more varied activities programme. Care Homes for Older People Page 7 of 26 2 health and social care professionals said that they thought staff would benefit from additional training in the care of people with a dementia and how to best support people who presented behaviour that challenged staff. There is a computerised system for care plans and a sample was viewed. These need to be further expanded to ensure they fully reflect the wishes of people at the home and give clear guidelines for staff. 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.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 26 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 9 of 26 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 wishing to move to the home receive adequate information about the service and facilities offered. Before moving in everyone has their needs assessed by a senior member of staff to ensure that Moorhaven is the right place for them. Evidence: The home has an up to date Statement of Purpose which clearly reflects the services and facilities offered by the home. The statement of purpose is available in the entrance hall and everyone who moves in receives a service user guide which sets out what is included in the fee. Some people spoken with during the inspection said that they had been able to visit the home prior to deciding to move in. Other people had relied on family members to view the home. Care Homes for Older People Page 10 of 26 Evidence: People who completed questionnaires before the inspection felt that they had received adequate information to assist them to decide if Moorhaven was the right place for them. The manager, or a senior member of staff, sees and assesses everyone before a place is offered. Copies of pre admission assessments were seen in individual files. One person wrote on their questionnaire that before they moved in a supervisor had come to their house and explained everything in a very kind and sensitive manner. In addition to full residential care the home also offers day care and respite care which can be an opportunity for people to spend time at the home getting to know people living and working there. The homes contract states that there is an initial trail period when someone moves in, to ensure that the person is happy with the care and that the home is able to meet their needs. Care Homes for Older People Page 11 of 26 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. People living at the home have access to healthcare professionals in line with their individual needs. Care plans are personal to the individual but would benefit from being further developed to ensure that they give clear guidelines for staff to assist people in their chosen way. Privacy is respected. Evidence: The home uses a computerised system for care plans and paper summaries are available for people who wish to view their care plan in a more traditional way. The computer system is password protected and can only be accessed by authorised staff. A sample of care plans was viewed. These were personal to the individual but did not always give clear details to enable staff to assist people in their chosen manner. There were no clear instructions for staff to assist someone who at times refuses meals. Care Homes for Older People Page 12 of 26 Evidence: However care practices observed demonstrated that staff at the home have a good knowledge of individuals and assisted people in a person centred way. There was evidence that care plans were being regularly reviewed with input from the person living at the home. Assessments are also reviewed but the care plans were not always updated in line with the outcomes of these assessments. For example the review of one persons tissue viability assessment stated that the person should now be weighed weekly but the care plan still stated to weigh monthly. People living at the home were happy with the assistance that they received with healthcare needs. All 9 people who completed a questionnaire before the inspection answered ALWAYS to the question Do you receive the medical support you need?. Health and social care professionals said that staff communicate well regarding clients healthcare needs and that they always contact outside professionals for advice and support when needed. Everyone spoken with during the inspection felt that their privacy was respected and two people made particular reference to how sensitive staff were when assisting with intimate personal care. One person said staff are very kind and you never feel embarrassed when they help you. Health and social care professionals said that they were able to see clients in private. It was observed that people were able to spend time in their personal rooms or in communal areas. Staff were seen knocking on doors and waiting to be invited in before entering bedrooms. The home uses a Monitored Dosage System for medication and there are appropriate safe storage facilities, including facilities for controlled drugs and medicines that require refrigeration. One member of staff takes overall responsibility for medication and only staff who have received appropriate training administer medication. Risk assessments are in place for people who wish to self medicate and there was evidence that these are regularly reviewed. Medication Administration Records were viewed. These showed that medication is signed for when it comes into the home and when administered or refused, this gives a clear audit trail. A sample of controlled drugs were checked and stocks held correlated with records maintained. Internal audits of medication are regularly undertaken. Care Homes for Older People Page 13 of 26 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 living at the home are able to make choices about their day-to-day lives. Visitors are always welcome. There is a range of dining areas where people receive a choice of good quality food. Evidence: People living at the home stated that there were no strict routines and they were able to decide what time they got up, when they went to bed and how they spent their day. There is a programme of activities which people can join in with if they wish to. People said that there was no pressure to take part in organised activities and they could pick the ones that interested them. A timetable of organised activities is displayed around the home to enable people to choose what they would like to attend and to plan their day. Some people said that they enjoyed going out for short walks in the area and going out with friends and family. There is a gardening club which is well attended and also a choir. Volunteers run a weekly evening bingo session and there is a small shop run by people who live at the home. Clergy of different denominations visit the home Care Homes for Older People Page 14 of 26 Evidence: on a regular basis to enable people to continue to practice their faith. The home has recently replaced its minibus and some people said that they were hoping that there would be more trips out. Two staff members who completed questionnaires said that they would like to see more varied activities and more outings for the people who live at the home. Everyone asked said that they were able to have visitors at anytime and their visitors were always made welcome. The main dining room has been refurbished since the last inspection and is now a very pleasant, light and airy room. People are able to choose whether to eat in the dining room or in the smaller dining areas in each unit. Tables are laid with condiments at mealtimes and vegetable dishes are available on each table to allow people to choose what they eat and determine their own portion sizes. Mixed views were expressed about the food in the home but the majority of people were happy with the choice and quality of food. Everyone asked agreed that the quality of the meals had improved since the last inspection. Somerset Care Ltd have designed corporate menus which have been nutritionally balanced to meet the needs of older people. The manager explained that some meals on the menu were not well liked by people living at the home so some dishes had been altered to ensure that they were well received but remained nutritious. There is always a choice of food at each meal and one person said that the cooks were happy to make an alternative if they did not fancy anything on the menu. The inspector was invited to have lunch with people living at the home. It was a very sociable occasion. Food was well presented and tasty. Care Homes for Older People Page 15 of 26 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. The home has systems in place to minimise the risks of abuse to people living at the home. People living at the home feel comfortable to approach staff with any concerns or complaints. Evidence: The home has policies and procedures in respect of making a complaint, recognising and reporting abuse and whistle blowing. Since the last inspection 3 complaints have been received by the home. These are recorded in the complaints log and there is evidence to demonstrate that they have been resolved to the satisfaction of all parties. Some staff have received formal training in the protection of vulnerable adults and all have received in-house training during staff meetings. All staff have been issued with leaflets about recognising and reporting abuse. Staff spoken with were aware of the whistle blowing procedure and the ability to take serious concerns outside the home. The Annual Quality Assurance Assessment completed by the manager stated that within the next 12 months they will arrange training in the protection of Vulnerable adults for all staff. Care Homes for Older People Page 16 of 26 Evidence: Everyone who completed a questionnaire said that they knew how to make a complaint and all staff answered YES to the question Do you know what to do if a service user or advocate has concerns about the home?. Everyone spoken with during the inspection said that they would be comfortable to raise any worries or complaints with a member of staff and expressed confidence that action would be taken to address any issues raised. Evidence was seen that there is a robust recruitment procedure and all staff are checked against the Protection Of Vulnerable Adults (POVA) register and undergo an enhanced Criminal Records Bureau (CRB) check before they begin work. Care Homes for Older People Page 17 of 26 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. Moorhaven provides a comfortable, safe environment for the people who live there. Evidence: The home is located in a residential area of Taunton within walking distance of small shops. All areas are fitted with a fire detection and call bell system. To improve security a swipe key system has been fitted to the main doors. The home is divided into 7 small units and the majority of rooms are on the ground floor. Each unit has a communal area with a small kitchen where people can make drinks and snacks. In addition there is a large lounge and dining room which is accessible to all. Outside there are pleasant gardens which are well maintained. All bedrooms are used for single occupancy and people are able to personalise their bedrooms to reflect their particular tastes. A sample of bedrooms was viewed, all were pleasantly furnished and clean. There are adequate toilet and bathroom facilities. Bathrooms have been fitted with assisted bathing facilities, in line with the needs of the people who live at the home, but do not appear institutionalised. Care Homes for Older People Page 18 of 26 Evidence: There is a large laundry which is well equipped and appropriate to meet the needs of the home. To promote good infection control practices there are handwashing facilities throughout the home. All areas seen during the inspection were clean and fresh. In a recent environmental health inspection the home was awarded 5 stars for excellent practice. There is an ongoing programme of maintenance and refurbishment. Since the last inspection the dining room has been extended and completely refurbished, some areas have been redecorated and new carpets have been laid. Care Homes for Older People Page 19 of 26 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. People living at Moorhaven are supported by a well trained and competent staff team. There are adequate numbers of staff on duty to ensure that people do not wait excessive amounts of time for assistance. Evidence: The home employs 39 care staff and 20 ancillary staff. 24 members of the care staff team(62 ) have a National Vocational Qualification (NVQ) in care at level 2 or above. 10 members of staff are currently working towards NVQ awards. 2 recruitment files were viewed, these gave evidence of a robust recruitment procedure, which includes obtaining written references and undertaking appropriate checks before a person begins work. There is a comprehensive induction programme in place and there was evidence that all new staff worked through the induction programme. 7 members of staff completed questionnaires prior to this inspection all felt that they had received an adequate induction and were given ongoing training that was revelant to their role. Records seen in the home showed that all staff complete training in health and safety issues and other training appropriate to their role. A visiting Care Homes for Older People Page 20 of 26 Evidence: professional has recently facilitated a training session in caring for people who have a dementia and associated memory difficulties. Since the last inspection the staffing levels in the home have been increased in line with the changing needs of people living at the home. Staff spoken with felt that the staffing levels were adequate. People living at the home who completed questionnaires said that staff were ALWAYS or USUALLY available when they needed them. People spoken with said that staff came quickly if they called for assistance. During the inspection it was observed that call bells were answered promptly and no-one was left waiting for assistance for an excessive amount of time. People living at the home were very complimentary about the staff who supported them. One person said staff are all very nice and some are exceptional another person said staff are always kind and senior staff are excellent. One person wrote on their questionnaire that nothing was ever too much trouble for the staff and this was repeated many times throughout the inspection. Care Homes for Older People Page 21 of 26 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. The registered manager has appropriate experience and qualifications to manage the home. There are good quality assurance systems in place which demonstrate a commitment to ongoing improvement. Evidence: The registered manager at the home is Jo Fenn, she has many years experience of working with older people and holds a National Vocational Qualification in management at level 4. Before the inspection the manager completed an Annual Quality Assurance Assessment giving details of the home and plans for the future. The document was comprehensive and demonstrated a commitment to ongoing improvement. People living and working at the home said that the manager was open and approachable. Jo is very visible in the home and it was observed that staff and Care Homes for Older People Page 22 of 26 Evidence: residents appeared extremely comfortable in her presence. There is a clear staffing structure in the home with clear lines of responsibility. There are good quality assurance systems in place and evidence that changes in the home are made in line with the wishes of the people who live there. For example meal times have been changed in response to the expressed request of people at the home. There are regular meetings for people living and working in the home where people are able to share information and voice their opinions. Minutes of meetings showed that a variety of topics are discussed. Annual quality assurance surveys are sent out to all interested parties and results are collated. There is evidence that action is taken to address any issues raised. Returned surveys for this year demonstrated a high level of satisfaction with the services and care provided by the home. The home carries out regular audits to monitor the quality of care and to ensure ongoing improvement. There are systems in place to ensure the health and safety of people living and working at the home. Staff receive up to date training to promote safe working practices. All areas of the building are well maintained and equipment is regularly serviced and tested. All accidents and incidents are recorded and these records are audited to monitor individual well being and to look for patterns that may emerge. Records seen demonstrated that appropriate action is taken when accidents occur. People living at the home have lockable facilities in their rooms to store valuables if they wish to. The home also provides a facility for people to deposit small amounts of money for safe keeping. All monies coming in or going out are recorded for each individual using the facility. Records viewed during the inspection correlated with monies held. All transactions are accompanied by two signatures and receipts where appropriate. Up to date certificates of insurance and registration are displayed. Care Homes for Older People Page 23 of 26 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 24 of 26 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 manager should ensure that care plans give clear guidelines for staff to follow and reflect the person centred care provided by the home. All staff should receive formal training in the protection of vulnerable adults. 2 18 Care Homes for Older People Page 25 of 26 Helpline: 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 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 © (2008) 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. Care Homes for Older People Page 26 of 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!