Inspection on 14/11/06 for Moorhaven

This inspection was carried out on 14th November 2006.

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

Moorhaven 12/11/08

Moorhaven 03/11/05

Moorhaven 28/07/05

Moorhaven 30/09/04

Moorhaven 20/05/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

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

CARE HOMES FOR OLDER PEOPLE Moorhaven Normandy Drive Taunton Somerset TA1 2JT Lead Inspector Jane Poole Key Unannounced Inspection 14th November 2006 09:45 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 Moorhaven DS0000016063.V317592.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. Moorhaven DS0000016063.V317592.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Moorhaven Address Normandy Drive Taunton Somerset TA1 2JT 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) 01823 331524 01823 323529 diane.allen@somersetcare.co.uk Somerset Care Limited Diane Allen Care Home 54 Category(ies) of Old age, not falling within any other category registration, with number (54) of places Moorhaven DS0000016063.V317592.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. To accommodate two named service users (named on application dated 2/6/06) under the age of 65. 3rd November 2005 Date of last inspection Brief Description of the Service: 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 50 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. At the time of inspection the home was in the process of having a further 3 rooms registered for resident use with the Commission for Social Care Inspection. Moorhaven DS0000016063.V317592.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over a 7 hour period and was undertaken by two inspectors. At the time of the inspection there were 52 people living at the home, although 2 people were in hospital. During the day the inspectors were given unrestricted access to all areas of the home and were able to speak with staff, service users and visitors. The inspectors were also introduced to visiting healthcare professionals. Care practices were observed throughout the day. All records requested were made available and there were ample opportunities for discussion with the manager and other staff. What the service does well: Moorhaven has a warm and homely atmosphere with all visitors made to feel welcome. Prospective service users receive adequate information about the home and have opportunities to visit and spend time in the home before deciding to take up residence. There is a good range of activities and social events, which service users are able to join in with if they wish to. Service users appeared animated and content. The layout of the home means that there are many communal areas where service users can spend time socialising or pursuing their own interests. The home has good policies and procedures in respect of medication resulting in consistent good practice in this area. Service users were especially complimentary about the staff in the home. People felt that they could approach staff with any concerns and were confident that they would always be listened to. Staff interacted well with service users. It was observed that all requests for assistance were responded to promptly and people were helped in a pleasant unhurried manner. Moorhaven DS0000016063.V317592.R01.S.doc Version 5.2 Page 6 All areas of the home are well maintained and on the day of the inspection all areas seen were clean and fresh. 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 Moorhaven DS0000016063.V317592.R01.S.doc Version 5.2 Page 7 be made available in other formats on request. Moorhaven DS0000016063.V317592.R01.S.doc Version 5.2 Page 8 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 Moorhaven DS0000016063.V317592.R01.S.doc Version 5.2 Page 9 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, 2, 3, 4 & 5. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective service users receive adequate information about the home before deciding to move in on a permanent basis. All prospective service users have their needs fully assessed. Intermediate care is not provided. EVIDENCE: The home has an up to date statement of purpose, which clearly reflects the services and facilities offered by the home. Moorhaven DS0000016063.V317592.R01.S.doc Version 5.2 Page 10 All new service users receive a service user guide when they move to the home. Service users who are privately funding their stay receive a copy of their terms and conditions of residency and those being assisted with their fees have a financial agreement with the relevant local authority. Service users spoken to stated that they had had opportunities to visit the home prior to making a decision to move in. Moorhaven also offers day care and respite care facilities giving prospective service users a chance to spend extended amounts of time in the home to assist them to make a decision. All care plans viewed by the inspectors contained copies of assessments completed by professionals outside the home. In addition to this the manager also visits prospective service users. This is an opportunity for the manager to ensure that the home is able to meet a persons needs and offers the lifestyle that the service user is looking for. Moorhaven DS0000016063.V317592.R01.S.doc Version 5.2 Page 11 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 & 10. Quality in this outcome area is good). This judgement has been made using available evidence including a visit to this service. Service users are treated with respect and dignity at all times. The procedures in respect of medication ensure consistent good practice which safeguards service users. There is limited evidence to suggest that service users are fully involved in the care planning process. EVIDENCE: The inspectors viewed 5 care plans in detail. The care plans contain assessments in respect of nutrition, tissue viability, moving and handling and the risk of falls. Individual care needs are listed with instructions for staff as to the ways in which needs will be met. These are comprehensive and give clear directions for Moorhaven DS0000016063.V317592.R01.S.doc Version 5.2 Page 12 staff. However there was limited evidence that these had been drawn up with the full involvement of the service user and in some instances did not give details of the service users preferences or dislikes. The care needs in respect of one service user were not fully reflective of their up to date needs although all care plans showed evidence of monthly review. Daily records are kept and these gave comprehensive up to date information about the service user. From January 2007 the home will move to a computerized system of care planning. This was discussed with the manager who is currently looking at ways that service users can be involved in this process. All appointments with professionals are recorded in care plans and these give evidence that service users are accessing a range of health and social care professionals. Since the last inspection the home has added a treatment room where service users are able to see healthcare professionals in private. Service users spoken to felt that this was a positive addition to the home. Service users also stated that staff always assisted them to make and attend appointments. Service users stated that staff were especially helpful and kind if they were unwell. One service user said “they always go the extra mile if they know you’re not feeling your best.” The inspector observed that staff spoke respectfully to service users and respected their privacy by always knocking on bedroom doors before entering. Service users stated that all personal care in carried out in private and that staff were sensitive to their needs when assisting. Everyone asked stated that they felt comfortable with the staff who assisted them with intimate care. Service users are able to have keys to their personal rooms to further ensure privacy. Some people have private telephones in their rooms and there is a pay phone in a private cubicle for communal use. The home uses a Monitored Dosage System for medication and service users are enabled to take responsibility for their own medication if appropriate. Lockable storage is provided in bedrooms. Staff who administer medication receive specific training in this area. Medication Administration Records viewed by the inspectors were correctly signed when medication was received, administered or refused. Records of controlled drugs correlated with stocks held. Moorhaven DS0000016063.V317592.R01.S.doc Version 5.2 Page 13 The inspection of all documentation relating to medication gave evidence of consistent good practice. Moorhaven DS0000016063.V317592.R01.S.doc Version 5.2 Page 14 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 & 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users retain control over their day to day lives and continue to pursue their chosen lifestyles where able. Visitors are always made welcome and service users have opportunities to access the local community. EVIDENCE: All service users spoken to stated that they continued to be in control of their day to day lives and make personal choices. People said that there were no set times to get up or go to bed and they were able to decide how to spend their day. Visitors spoken to during the inspection stated that they were always made welcome at the home and staff always made time to speak with them. Moorhaven DS0000016063.V317592.R01.S.doc Version 5.2 Page 15 There are a variety of organised activities and social events. Service users stated that they are free to join in with whatever interested them but did not feel obliged to attend events that were not to their liking. During the morning of the inspection a quiz was being held which appeared to be enjoyed by those taking part and those observing. The home has a gardening club, which is well attended and has won local prizes for their displays and produce. The home has recently formed a choir who are currently rehearsing for their first performance. Service users gave other examples of activities that they had enjoyed, these included scrabble and board games, skittles, bingo and trips out. The home has a mini bus that is used to take people out, one person told the inspector of a trip to the sea where all service users had enjoyed a fish and chip meal. All organised activities and events are advertised on a large notice board. There is a regular church service in the home and service users can attend church outside the home. In order to better understand and respect the backgrounds of some service users, theme days have been arranged. The first planned day is a German day which service users were looking forward to. Other days have been planned throughout the year. Service users spoken to stated that there is always something going on. The home is divided into small units so service users can choose where they spend their time. Some service users stated that they enjoyed the company in the main lounge whilst others said they liked the relaxed quiet atmosphere of the smaller communal areas. The inspectors observed that some service users liked to go out for a short walk in the local area. Service users are also free to choose where they eat their meals. The majority of people stated that they liked to eat breakfast and supper in their rooms or the small unit lounges but went to the main dining area for lunch and tea. There is a four week menu which provides choices at every meal. Service users stated that they can always ask for an alternative if there is nothing on the menu that appeals to them. There were mixed feelings about the quality and choice of food in the home. Approximately half the people asked stated that the quality of food had gone down in the past months. Most of these people felt that the food continued to be adequate but was no longer of a good standard. Moorhaven DS0000016063.V317592.R01.S.doc Version 5.2 Page 16 These views were reflected in the homes own quality assurance questionnaires that were completed earlier in the year where only 54 of people felt that the choice of menu was good or excellent and 66 felt that the quality and choice of meals was good or excellent. Moorhaven DS0000016063.V317592.R01.S.doc Version 5.2 Page 17 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 & 18. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has taken reasonable steps to minimise the risk of abuse to service users. Staff and service users feel comfortable to discuss any concerns or worries. EVIDENCE: The home has policies and procedures in respect of recognising and reporting abuse, making a complaint and whistle blowing. In the last 12 months 3 complaints have been made and there is evidence that the home has fully investigated these in conjunction with the relevant parties. Service users spoken to stated that they would be comfortable to raise any concerns with a member of staff or the manager. All felt confident that any concerns would be listened to and action taken to address any issues. Staff spoken to stated that they were made aware of the whistle blowing policy when they began work at the home. All felt that there was an open culture in the home, which made it comfortable to discuss concerns. Moorhaven DS0000016063.V317592.R01.S.doc Version 5.2 Page 18 All staff are checked against the Protection Of Vulnerable Adults (POVA) register before commencing work and all undergo an enhanced Criminal Records Bureau (CRB) check. The inspectors observed that people moved freely around the home and had unrestricted access to their personal rooms and all communal areas including outside spaces. Moorhaven DS0000016063.V317592.R01.S.doc Version 5.2 Page 19 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, 20, 21, 22, 24 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Moorhaven provides service users with a comfortable homely environment with a range of communal areas. EVIDENCE: The home is located in a residential area of Taunton. All areas of the home are fitted with a fire detection and call bell system. There is an ongoing maintenance and refurbishment programme, at the time of the inspection the home was in the process of replacing all windows with double glazed units. Moorhaven DS0000016063.V317592.R01.S.doc Version 5.2 Page 20 All communal areas are located on the ground floor and offer a variety of settings for service users. The home is divided into 7 units, 6 of which have their own lounge and kitchen area. These small units are very homely and give service users the opportunity to spend time quietly away from the main areas of the home. All bedrooms are for single occupancy, 23 of the 54 have en-suite facilities, all have wash hand basins. Over 50 of personal rooms are below 10sq meters but have been pleasantly decorated and furnished. Service users spoken to were happy with their individual rooms. The inspectors viewed a sample of service users rooms and noted that all had been personalised to reflect the needs and tastes of their occupants. Various aids and adaptations have been put in place to enable service users to maintain independence. There are sufficient assisted bathing and toilet facilities with in the home. Although all bathrooms provide assisted bathing facilities the rooms themselves have been decorated in a domestic style making them pleasant and inviting. Since the last inspection the main laundry in the home has been extended and joined to the main building. The laundry was well organised with good infection control systems in place. On the day of the inspection all areas viewed were clean and fresh. Moorhaven DS0000016063.V317592.R01.S.doc Version 5.2 Page 21 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 & 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is a robust recruitment process in place that ensures the safety and wellbeing of service users. Appropriate training is available for all staff to ensure that they have the skills and knowledge to meet the needs of the service users. EVIDENCE: The home employs 21 care staff and 10 ancillary workers. 16 (66 ) of care staff have a National Vocational Qualification in care at level 2 or above. (Figures taken from pre inspection questionnaire) There is a clear staffing structure with all staff receiving training appropriate to their level of responsibility. There is always a senior member of the care staff team on duty who provides guidance and supervision to less experienced members of the team. Staffing levels in the home are kept under review and appeared adequate at the time of the inspection. Between 7.30am and 2.30pm there are 6 members of the care staff team on duty, in the afternoon there are 5 members of the Moorhaven DS0000016063.V317592.R01.S.doc Version 5.2 Page 22 team working and overnight it drops to 3. All management and ancillary hours are in addition to this. Generally staff and service users felt that there were adequate numbers of staff. The inspectors observed that staff answered requests for assistance promptly and assisted people in a relaxed unhurried manner. Service users asked stated that staff were ‘kind’ ‘excellent’ and ‘helpful.’ The inspectors observed that interaction between staff and service users was warm and friendly. More than one person stated that one of the best things about living at Moorhaven was that the staff were cheerful and ‘enjoy a good laugh.’ Staff spoken to were happy with the training provided and felt that their opinions and views were sought. The inspectors saw evidence that a wide range of training is available to all staff. The inspector viewed the recruitment files of the 3 most recently appointed members of staff. These gave evidence of a thorough and robust recruitment and induction process. Moorhaven DS0000016063.V317592.R01.S.doc Version 5.2 Page 23 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, 37 & 38. 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 taking into account the views of service users and other interested parties. EVIDENCE: The registered manager of the home is Diane Allen who has managed the home for three years. She has a many years of experience of working with older people and gives a clear sense of direction to the home. Moorhaven DS0000016063.V317592.R01.S.doc Version 5.2 Page 24 Diane regularly attends training courses to ensure that her practice is up to date and well informed. Last year she completed the Registered Manager’s Award (NVQ level 4.) The manager acts as a financial appointee for one service user. Financial records were seen and found to be clear and accurate. In addition to this the home also holds small amounts of money for some service users. Again records were checked and found to correlate with amounts held. The home regularly surveys the service users and their representatives to seek their views on the running of the home. There are staff and service user meetings, which are an opportunity for people to express their opinions and make suggestions. Minutes of the service user meetings show that these are not well attended and the home need to look at ways that these can be developed to ensure that they are more representative of the service user group. The company (Somerset Care) has recently introduced new quality assurance systems, which the home will begin working though shortly. Systems are in place to promote health and safety in the home. All accidents are recorded and audited monthly by the manager. A fire log is maintained that shows that fire detection equipment is regularly serviced by outside contractors and checked weekly by the home. All staff receive training in fire safety at least twice a year. Staff also receive training in manual handling, health and safety and health and hygiene. All areas of the home appeared well maintained and there was evidence that all equipment is regularly serviced. All records are appropriately stored, all seen by the inspectors were well maintained and up to date. Current certificates of registration and insurance are displayed in the home. Moorhaven DS0000016063.V317592.R01.S.doc Version 5.2 Page 25 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 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 4 4 3 x 3 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 3 x 3 x 3 3 Moorhaven DS0000016063.V317592.R01.S.doc Version 5.2 Page 26 Are there any outstanding requirements from the last inspection? 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. Standard Regulation Requirement Timescale for action 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 2 3 Refer to Standard OP7 OP15 OP33 Good Practice Recommendations Service users should be more fully involved in the care planning process and care plans should reflect individual wishes and aspirations. The manager should keep the menu and standard of food under review to ensure that it is reflective of service users choices and wishes. The home should look at ways of developing the service user meetings to appeal to a wider range of service users. Moorhaven DS0000016063.V317592.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Somerset Records Management Unit Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL 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 Moorhaven DS0000016063.V317592.R01.S.doc Version 5.2 Page 28 - 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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