Inspection on 17/11/06 for Moorhead

This inspection was carried out on 17th 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Moorhead 04/12/08

Moorhead 21/03/06

Moorhead 06/09/05

Moorhead 24/02/05

Moorhead 01/03/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Moorhead 309/315 Whalley Road Accrington Lancashire BB5 5DF Lead Inspector Mrs Lynn Mitton Unannounced Inspection 17th November 2006 10:00 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 Moorhead DS0000009447.V314563.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. Moorhead DS0000009447.V314563.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Moorhead Address 309/315 Whalley Road Accrington Lancashire BB5 5DF 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) 01254 232793 Mmr Care Limited Mrs Diane Hudson Care Home 15 Category(ies) of Old age, not falling within any other category registration, with number (15) of places Moorhead DS0000009447.V314563.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The home must at all times, employ a suitably qualified and experienced manager, who is registered with the Commission for Social Care Inspection The home is registered to provide personal care for service users who fall into the categories of Older People Date of last inspection Brief Description of the Service: Moorhead is a detached property within its own grounds, situated on a main road in Accrington. There is car parking to the front of the home. There are enclosed gardens accessible to service users. The home is registered to provide personal care and accommodation for up to 15 older people, over the age of 65. Communal accommodation comprises of two lounges and a separate dining room. Additional seating is also provided in the entrance hallway. The smaller lounge is a designated smoking area. Bedrooms are on three floors. There are 11 single and 2 double bedrooms, 8 of the single rooms and 1 of the double bedrooms have en-suite toilets. In addition, 4 of the single bedrooms have either have en-suite bath or shower. Various aids and adaptations are provided; including hand rails and grab rails. Fees per week range from £324.50 - £366.00. There was information available to potential residents advising them of the facilities and the care they could expect whilst living at Moorhead. Moorhead DS0000009447.V314563.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. A key unannounced inspection which included a visit to the home was conducted on 17th November 2006. The manager for the agency completed a pre inspection questionnaire. The inspector spoke to residents in receipt of a service, and interaction between the service users and staff members were observed. Care staff on duty at the time of the inspection were also spoken to. There were 14 service users accommodated at this time. A tour of the home took place. Throughout the report there are references to the “tracking process”, this is a method whereby the inspector focuses on a small representative group of service users. Records regarding these people were inspected. Policies and practices and safety documentation was also read. Seven service users and five service users relatives had completed the Commission’s comment card, and comments made about the service are included in this report. What the service does well: One service user said; I like it here I’d recommend it, the girls are great and they put me to bed last week when I wasn’t well and they kept popping in with lots of drinks and to see if I was OK. The foods very good and the girls treat me very well”. Another said; I could recommend it here – the food’s very good and the girls are great. I have settled in really well and feel much safer here”. The admission procedure for new residents ensured that information about their care needs was obtained and this enabled staff to have a clear understanding of how they needed to care for them. Safe administration, recording and disposal of resident’s medication was in place. Personal support was offered in accordance with resident’s wishes, and in a way that promoted privacy dignity and independence. Residents had opportunities to maintain family links, and they valued this. They were also given opportunities to exercise choice and control in their day to day living. A programme of planned activities ensured that residents had opportunities for their enjoyment, mental and physical stimulation. Moorhead DS0000009447.V314563.R01.S.doc Version 5.2 Page 6 Meals were varied and provided a social occasion on a daily basis. Many of the care staff had considerable experience in caring for older people, and were a well established team, ensuring continuity for residents. Staff spoken to were aware of the procedures to follow in order to protect the residents in their care. The home was clean, tidy, warm and free from offensive odours. Some training had been undertaken to ensure that care staff had the skills to care for the residents. 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. Moorhead DS0000009447.V314563.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 Moorhead DS0000009447.V314563.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): OP3 & OP6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The admission procedure for new residents ensured that information about their care needs was obtained before they arrived. This enabled staff to have a clear understanding of what they needed to do for them. EVIDENCE: Assessments of need were completed prior to new residents being admitted. The inspector saw these on resident’s files case tracked. A copy of the homes admission checklist was also seen on both care plans’ case tracked. Intermediate care is not offered at this home. Moorhead DS0000009447.V314563.R01.S.doc Version 5.2 Page 9 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): OP7 OP8 OP9 & OP10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Resident’s care and health needs were appropriately recorded, ensuring that care staff knew how each persons needs were to be met. Safe administration, recording and disposal of resident’s medication was in place. Personal support was offered in accordance with resident’s wishes, and in a way that promoted privacy dignity and independence. EVIDENCE: The inspector looked at two residents care plans. On them was some information identifying the resident’s care and health needs and how these should be met. These had been signed by the resident or their next of kin. A photograph of each resident must be on file. The inspector noted that the medication administration system was working satisfactorily. Some senior staff had undertaken administration of medication training. Moorhead DS0000009447.V314563.R01.S.doc Version 5.2 Page 10 Consent for staff to administrate medication was on care plans case tracked. The inspector observed some positive, caring and respectful interaction between residents and care staff. Care staff spoken to could give a clear indication about how she could promote residents privacy, for example, knocking on residents’ doors, offering personal care with doors closed and asking permission before giving help or support. Some residents told the inspector that some felt they were spoken to and treat with dignity and respect and gave examples of this. “You can get up when you want”, and “there’s nothing too much trouble for the girls – they are great”. One resident’s relative commented; “I would prefer that a little more care and time was taken when dressing my mother in the mornings”. Moorhead DS0000009447.V314563.R01.S.doc Version 5.2 Page 11 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): OP13, OP14, OP12 & OP15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents had opportunities to maintain family links, and they valued this. Residents were given opportunities to exercise choice and control in their day to day living. A programme of planned activities ensured that residents had opportunities for their enjoyment, mental and physical stimulation. Meals were varied and provided a social occasion on a daily basis. EVIDENCE: A large number of visitors were welcomed to the home on the day of the inspection. The visitors’ book was being completed. The inspector noted that privacy was afforded to service users when visitors were discussing private matters. The inspector observed resident’s exercising choice and control over day-today elements of their lives, for example, getting up at different times and having a choice of meals at lunchtimes. Care staff were seen to respect residents choices and opinions. Moorhead DS0000009447.V314563.R01.S.doc Version 5.2 Page 12 A weekly activity programme was in evidence. This included activities such as movement to music, dominoes, skittles, bingo movie afternoons, and aromatherapy. Residents spoken to told the inspector that they enjoyed participating in these activities. A Xmas raffle had been organised by one resident. The Xmas party was being organised and the entertainer booked. One resident went to a nearby day centre to play bingo during the inspection; this activity was accessed using the dial a ride bus. Resident’s religious needs were recorded on the care plan. A resident said; “I’m happy and comfortable here”. The inspector noted that choice of meals were offered to residents for all meals. There was record made of meals served, and each days menu was written on the wipe board. Residents with special needs, for example diabetic and soft diets were catered for. One resident was seen to be assisted in a sensitive and caring way. Specialised cutlery was available for those who needed it. One relative said; “The home cooked food is very good”. Moorhead DS0000009447.V314563.R01.S.doc Version 5.2 Page 13 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): OP16 & OP18 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The complaint procedure was robust, and the residents spoken to indicated that they knew how to and felt able to make a complaint. The written procedures for responding to an allegation of abuse were in place, and staff were aware of how to follow them. EVIDENCE: Of the 7 residents completed questionnaires sent back to the Commission, all said they knew who to speak to if they were unhappy and how to make a complaint. The complaints procedure was seen posted in the homes entrance foyer. There had been no complaints since the previous inspection. The “complaints and suggestions” book now included space to record how the complaint was resolved/what action was taken. The inspector spoke to two care staff who advised the inspector of what they would do if a complaint was made to them. They could also define the different types of abuse, and knew what to do if they had any concerns about resident’s wellbeing, and had an awareness of the whistle blowing policy. Documentation was in place for protecting residents from abuse of any kind, and included whistle blowing. This had been reviewed and updated in April 2006, and had been signed by the registered manager. Moorhead DS0000009447.V314563.R01.S.doc Version 5.2 Page 14 Only one staff member had completed prevention of abuse training, a further 7 staff member were due to have training in March 2007. The inspector advised that prevention of abuse training for all staff should be given high priority. Moorhead DS0000009447.V314563.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): OP19 & OP26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The general layout and décor of the home provided comfortable and clean surroundings, and was warm, tidy and clean, and mostly free from offensive odours. Adaptations and specialist equipment was in place to meet the needs of the residents. EVIDENCE: One service users relative said; “the home is very friendly and clean”. A tour of the home took place. Other than ongoing maintenance tasks, no refurbishment work had been undertaken since the last inspection. Domestic staff were employed for 22 hours each week. All residents’ rooms were personalised by the residents with small furnishings, pictures etc., and the home appeared well maintained. Moorhead DS0000009447.V314563.R01.S.doc Version 5.2 Page 16 Adaptations and specialist equipment was in place to meet the needs of the residents. Moorhead DS0000009447.V314563.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): OP27 OP28, OP29 & OP30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The number of staff on duty reflected the needs of the residents. Some training had been undertaken to ensure that care staff had the skills to care for the residents. EVIDENCE: The staffing rota was seen; this demonstrated that there were sufficient staff members on duty to care for the needs of the residents. There were at least 3 care staff on duty from 8 am until 8.30 pm. Many of the care staff team had considerable experience in caring for older people, and were well established at Moorhead. There were cooks, cleaners and a handy man also employed. The inspector was advised that ten out of the sixteen care staff had obtained NVQ2, and one had NVQ 3 training qualification. A further 3 were completing this training. One staff member was completing NVQ 4 training. In house Induction training was seen in place. Two care staff’s personnel files were examined and it was found that they had the information required to evidence that staff had been employed in accordance of that required by the Commission. The training matrix demonstrated that not all staff had completed health and safety training, for example, 1st Aid, food hygiene and infection control. The Moorhead DS0000009447.V314563.R01.S.doc Version 5.2 Page 18 inspector was advised that this training had been booked and was due to take place in the next few months. Moorhead DS0000009447.V314563.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): OP31, OP33, OP35 OP36, OP37 & OP38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The attitude of the staff and management is to run the home around the needs and choices of the residents. Residents and regular visitors to the home were consulted about the day-today running of the home. Risk assessments and a management framework must be completed to ensure the health and safety of residents and care staff. EVIDENCE: One residents relative said; “The manager is very enthusiastic and helpful”. Moorhead DS0000009447.V314563.R01.S.doc Version 5.2 Page 20 The registered manager was very experienced in managing a residential home and meeting the needs of older people. The inspector was advised that the manager is presently undertaking health and safety training, which includes risk assessment management. The inspector was advised that a residents’, visitors and visiting professionals survey had been undertaken by the home in April/May 2006 and the results published. The inspector was advised that residents meetings took place every three months but minutes of these meetings were not available. However, the inspector noted that from these meetings was evidence that the homes policies and procedures were being discussed with the care staff team, as staff were asked to read a policy before the meeting and then given a written test to ensure they had learnt the most important points about each policy. The inspector advised that this was excellent practice. The registered manager was not appointee for any resident, the inspector was advised that all other residents finances were dealt with by the residents themselves, their next of kin or families. There was no evidence to demonstrate that care staff received formal supervision this was discussed with the registered person at the time of the inspection. The inspector and registered manager discussed how this was especially important when new staff were still on their trial period. Staff meetings were held every three months, however minutes of these meetings were not available. Records seen by the inspector were now being reviewed and updated All staff had completed fire training in March 06. Safety certificates were seen for gas and electrical installations and appliances, the passenger lift and the PAT electrical test. New emergency lighting had been installed. The last fire evacuation drill had taken place in April 2006, and the last fire alarm tests on November 3rd 2006. The inspector advised that care must be taken to ensure that these are completed every week as some gaps were noted. Risk assessments were in evidence on care plans and these now demonstrated how, once the risk had been identified, the risk was to be managed and what action to be taken in order to minimise the risk. However the inspector and registered manager discussed the need to have risk assessments in place for the home – the registered manager was aware of this and advised that this would soon be remedied. Moorhead DS0000009447.V314563.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 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 2 3 2 Moorhead DS0000009447.V314563.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? Yes 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. 2 Standard OP7 OP18 Regulation Schedule 3 13(6) Requirement A photograph of each service user must be kept. The registered person must ensure that by staff training or other measures, to prevent residents from harm, abuse or being placed at risk or harm or abuse. The registered person shall ensure that the persons employed to work at the care home receive training appropriate to the work they are to perform. The registered person shall establish and maintain a system for reviewing and improving the quality of care provided at the home. The registered person shall ensure, that all parts of the home are so far as practicable, are free from hazards to health and safety, unnecessary risks are identified and eliminated. (Risk assessments) Timescale for action 31/03/07 31/03/07 3. OP30 18(1)(c) 31/03/07 4 OP33 24(1) (a&b) 31/03/07 5. OP38 13(4) 31/03/07 Moorhead DS0000009447.V314563.R01.S.doc Version 5.2 Page 23 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Moorhead DS0000009447.V314563.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection East Lancashire Area Office 1st Floor, Unit 4 Petre Road Clayton Business Park Accrington BB5 5JB National Enquiry Line: 0845 015 0120 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. 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