Inspecting for better lives Key inspection report
Care homes for older people
Name: Address: Moorhead 309/315 Whalley Road Accrington Lancashire BB5 5DF 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: Marie Dickinson
Date: 1 5 1 2 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 31 Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) 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 31 Information about the care home
Name of care home: Address: Moorhead 309/315 Whalley Road Accrington Lancashire BB5 5DF 01254232793 Telephone number: Fax number: Email address: Provider web address: ruby@bpsnorthwest.co.uk Name of registered provider(s): Name of registered manager (if applicable) Mrs Diane Hudson Type of registration: Number of places registered: Mmr Care Limited care home 27 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The registered person may provide the following category of service only: Care Home only - Code PC To Service Users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Old Age, not falling within any other category - Code OP The maximum number of Service Users who can be accommodated is: 27 Date of last inspection Brief description of the care home Moorhead is a detached property within its own grounds, situated on a main road in Accrington. There are car parking spaces to the front of the home. Entrance to the home is ramped for wheelchair access. There are attractive enclosed gardens accessible to service users. The home is registered to provide personal care and accommodation for up to 27 older people. Bedrooms are on three floors, the majority with with en suite facilities of shower, toilet and washbasin. Various aids and adaptations are provided; including hand rails and grab rails, and assistied bathing facilities. Staff are available, to provide assistance with personal care and support. Care Homes for Older People
Page 4 of 31 Over 65 27 0 Brief description of the care home Information about the service is available from the home. Weekly charges for personal care and accommodation are £412. Additional optional charges are hairdressing and toiletries. Care Homes for Older People Page 5 of 31 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. A key unannounced inspection was conducted in respect of Moorhead on the 4th and 15th December 2009. The inspection involved getting information from an Annual Quality Assurance Assessment completed by the manager, staff records, care records and policies and procedures. It also involved talking to residents, staff on duty, the manager and provider and visitors to the home. The premises were inspected as part of the process. Care Homes for Older People
Page 6 of 31 Areas that needed to improve identified in the last key inspection were looked at to assess progress made. The home was assessed against the National Minimum standards for Older People. An inspection of the premises had been made prior to this visit as part of registering new bedrooms. All work had been completed satisfactorily and the registration approved. An Annual Service Review had been completed in February 2008 and the findings were the home continues to provide good outcomes for residents living at the home. What the care home does well: Before being admitted to the home, people had their needs assessed. This was to establish if the service could provide the right care and support for them before a placement is offered. Records showed admissions were planned for and arranged properly. Residents living in the home were issued with a contract outlining the terms and conditions of staying in the home protecting their legal rights. The majority of residents who provided written comments indicated that they always receive the care and support they needed. Those interviewed during inspection made positive comments about the care and attention they receive at Moorhead. They considered they were Treated as individuals. And Staff are available when I need them and are very helpful. Residents living in the home benefited from the support of a named worker referred to as a key worker. Residents also benefited form additional specialist support where needed such as healthcare. Relatives and people visiting were happy with the standard of care given. They said they were involved in care reviews, and kept up to date with important issues regarding their relatives care. Care staff who provided written comments considered they were given enough information about residents to do their job well. We are talked through the care plan of a new person. People at risk of falls, pressure sores, poor nutrition and other risks had also been identified. This enabled staff to know what to look for and help prevent these happening. Residents thought very highly of the staff and how they cared for them. They considered their privacy and dignity was considered and staff are commended for their professionalism in ensuring this. Residents lifestyle was centred on them and they did not have to conform to any institutional practice such as set times for getting up or going to bed. Activities for residents were organised and offered a good variety. During inspection a resident celebrated her 100th birthday. Arrangements had been made for entertainers to perform at a birthday party arranged. All residents, staff and friends joined in. Visiting arrangements were very good and observations made of relatives visiting during inspection showed how staff were considerate to their needs and made them feel very welcome in the home. Meals provided met with residents tastes, needs and choice. Those residents spoken to during inspection said the food was excellent. They said they had choices all the time. Menus seen offered variety, choice and good nutrition. Staff were observed as courteous and attentive when assisting those residents requiring support. Residents and relatives, who were consulted, showed they knew who to talk to if they were not happy. People were confident to use the complaints procedure. Staff working Care Homes for Older People Page 8 of 31 at the home had been trained in adult protection and knew their responsibility in this area and confident they would report bad practice if ever the need arose. The home was well maintained, clean, and tidy, and provided a homely and pleasant environment for residents, visitors, and staff. Residents were delighted with the refurbishment of the home. They had watched the progress made and some of them were looking forward to moving into new rooms. Bedrooms were spacious and accommodated residents personal possessions. Bathing and toilet facilities were very good. The numbers of staff employed, training provided, and relatively safe recruitment practices, meant residents should be protected, and their needs effectively met. Staff working in the home were considered to be very good, and helpful. Visitors commented, there appears to be plenty of staff to cope Staff interviewed displayed a high degree of job satisfaction within a good team environment. Communication, was good and there was evidence of the provider and manager promoting equality of opportunity with training. Learning opportunities were very relevant to the homes purpose. All staff felt they were much appreciated for their work and were valued in the home. Staff interviewed had a good knowledge of understanding the needs of older people. The managers skills, and support from the provider, demonstrated changes made for improvement in service delivery, the environment, and staffing was successful. Quality Assurance was carried out and residents, relatives and professional people who gave their view on the service provided. The home was well managed and run in the best interests of the people living and working there. What has improved since the last inspection? What they could do better: It should be clear in the service user guide the home is a non smoking home. This will help to avoid any misunderstanding with this issue and prevent any unnecessary measure taken to accommodate this ruling. To improve the assessment of people requesting to live in the home, all information received during the assessment process and any observations made should be recorded. This will help provide a more accurate assessment and prevent essential Care Homes for Older People Page 9 of 31 information being missed. When writing needs assistance, more detail is needed to ensure residents benefit the right level of support. Care plans could also be improved by recording more detail of personal wishes of residents for staff to know about and make their care plan more person centred. More detail should be recorded for supporting someone with confusion. This will help staff to know and deal with issues raised for every day living and what support to give to help them. Any medication received in the home should be signed on each residents medication record. This will help to ensure accuracy. Medication given as when necessary also needs more detail as to when this would be given. This will help when it involves administering medication to residents unable to verbally tell someone if they were not well. Not all residents would be able to communicate their needs independently and staff need to be aware of how to monitor this. To fully safeguard residents, contractual arrangements for new staff should commence on appointment to cover the probationary period. This will provide a formal agreement for staff to comply with the homes policies and procedures on for example the ruling on non-acceptance of gifts, or being involved in wills or bequests. Where any restriction is put in place on residents doing what they liked that may cause themselves or other people problems, for example smoking, this measure needs to be risk assessed and the outcome agreed by all parties involved. More care is required with checking application forms are completed properly, and consideration given to improving their format. This will make them more user friendly and help to make sure all gaps in employment are recorded prior to interview. Interview notes must also be taken to show that the home operates as an equal opportunity employer. When handling information received from references, referring to suitability such as character or health, this should be recorded to support the decision made to employ that person. This will help to decide if any measures for example, moving and handling training update are to be taken to make sure that the new staff, the provider, residents, and staff are fully protected. 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 10 of 31 Care Homes for Older People Page 11 of 31 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 12 of 31 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. Assessment of peoples needs completed prior to admission, helped decide if the home had the right facilities and staff resources to support people with every day living. Contracts issued, informed people of the terms and conditions of living at the home, and protected their legal rights. Evidence: Information about the home in the service user guide was made available for people. This gave them an opportunity to read about the home and what they could expect if they chose to stay there. Whilst the information was very good, there was no information regarding the home being a non smoking home. People have a right to know about this before they decide to stay and avoid any misunderstanding. The non smoking ruling is in the contract. All residents had a contract, and those funded by a local authority were issued with a
Care Homes for Older People Page 13 of 31 Evidence: financial contract. This was to agree to the funding arrangements made on their behalf, and people knew how much they would have to pay. All contracts seen on resident files were signed by the resident agreeing to the terms and conditions of residence. Records showed that prior to any service being provided peoples needs had been assessed to help make sure they would receive the right care and support they needed. This meant a record was made of what people wanted and what was important to them when receiving care. Records kept of the most recent admission showed how planned admissions were managed. An assessment had been completed by social services and this information made available to the home. The manager had visited the resident in hospital and carried out a further assessment of needs, that included for example health and personal care, mobility, and nutrition. The assessment record supported the decision to offer a place at the home, and admission was agreed with all concerned. Information received at the Commission for this inspection informed us, If in hospital we talk to the staff about the person concerned and get their input. There was no evidence of this. More care is required to ensure information received from any discussion with professional people and or relatives involved in the assessment is recorded, as essential information can be missed. Consideration should be given to make sure the assessment is a more person centered approach that has taken into account what people want and what they say. As part of the assessment, individual risk assessments had been completed to help staff to know what they need to do and be aware of, to care for individuals safely. Care Homes for Older People Page 14 of 31 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. Residents had care plans, risk assessments, and a named key worker, which supported them to ensure their health and personal care needs being met in a consistent way. Medication was managed safely. Evidence: The majority of residents surveys, indicated that they always receive the care and support they needed. Residents who were spoken to made positive comments about the care and attention they receive at Moorhead. For example they said, Treated as individuals. And The staff look after us very well, and we are looked after. Staff are available when I need them and are very helpful. Staff worked to a key worker system, having responsibility to make sure care needs were personalised for residents. Information seen on care plans included a brief record of peoples past history. This helped staff to understand people as individuals. Needs identified such as personal care, mobility, communication, personal safety, medication, medical, and social were listed. How identified needs are to be supported was mainly
Care Homes for Older People Page 15 of 31 Evidence: clear, showing how peoples needs was generally considered. For example, the support they required with getting dressed and when having a bath. When writing needs assistance, it was not always clear what the assistance to be given was. This could be improved by recording more detail of personal wishes of residents for staff to know about and make the plan more person centred. Relatives and people visiting were happy with the standard of care given. They said they were involved in care reviews, and kept up to date with important issues regarding their relatives care. Care plans seen had been reviewed and updated. Care staff who provided written comments considered they were given enough information about residents to do their job well. We are talked through the care plan of a new person. Resident’s benefited additional specialist support where needed. This included healthcare. All residents were registered with a GP and accessed local services either in the community, or were supported by visits to the home by health care professionals. This included visits from the district nursing team for nursing intervention required such as applying dressings. Pressure care was promoted and pressure-relieving aids were used on medical advice. Risk assessments had been completed for moving and handling and were used as guidance for staff to help care for residents safely. People at risk of falls, pressure sores, poor nutrition and other risks had also been identified. This enabled staff to know what to look for and help prevent these happening. Observations were made of wheelchairs being used safely. More detail should be recorded for supporting someone with confusion. For example identify how the confusion impacts on a persons everyday life and what support should be in place to help them. The rights of residents to be treated with dignity and respect was included in staff training. Staff are commended for their efforts in achieving this, as residents spoke very highly of the staff. There was never any question of their privacy being compromised. Observations showed staff respectful, and personal care provided in privacy such as toilet doors shut and residents spoken to discreetly re these needs. Complimentary remarks about the staff were made, such as very good, and helpful. Visitors commented, there appears to be plenty of staff to cope. The home operated a monitored dosage system for the administration of medication. Information received at the Commission showed a number of staff had been trained in medication procedures. Residents had the opportunity to say how they would like their medication managed. Consent to medication had been recorded, and one resident currently managed their own. An appropriate recording system was in place to record the receipt, administration and disposal of medication. However when medication is
Care Homes for Older People Page 16 of 31 Evidence: received in the home this should be signed on each residents medication record. Medication given as when necessary also requires more detail as to when this would be given, particularly where it involves administering medication to residents unable to verbally tell someone if they were not well. Not all residents would be able to communicate their needs independently and staff need to be aware of how to monitor this. Care Homes for Older People Page 17 of 31 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. The homes routines were flexible and provided an environment where individual social, cultural, and recreational needs could be met. Evidence: The residents preferences in respect of social activities had been recorded as part of their assessment. Activities for residents were organised and offered a good variety. Comments from residents returned to the Commission as part of the inspection show everyone thought there was activities arranged by the home they could join in. They said, At the present moment with the work that is going on at the home, we dont have an artist coming in but we play dominoes, bingo and do movement to music. During inspection a resident celebrated her 100th birthday. Arrangements had been made for entertainers to perform at a birthday party arranged. All residents, staff and friends joined in. Plans were also being made for Christmas Although care plans did not include a daily living plan with preferred routines recorded to support residents personalise their day, observations showed residents appeared to have freedom of choice over their lives within their capability. For example several
Care Homes for Older People Page 18 of 31 Evidence: residents said they got up when they wanted and went to bed when it suited them. The residents were able to receive visitors at any time and were able to entertain their guests in private. There was evidence seen in care records that relatives regularly visited the home and observations of relatives visiting showed how staff were considerate to their needs and made them feel very welcome. Residents were also supported to continue with their chosen religion. This was recorded in residents assessment. Residents bedrooms were personalised. They were able to bring in personal belongings and arrange their rooms how they wished. Residents could choose where to eat their meals. Those residents spoken to during inspection said the food was excellent. They said they had choices all the time and supper was good too. They could have toast, cake, biscuits, milky drinks or tea. Menus seen were planned over a four week period to alternate meals provided, and ensure variety, choice and good nutrition. Residents who provided written comments for this inspection said, Theres always a choice. And the meals are lovely. The meals are always nice and presented well. Care Homes for Older People Page 19 of 31 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 complaints procedure was available and used properly, which helped residents and other people have confidence to raise any concern they may have. There were policies and procedures, and appropriate training for staff in professional conduct and adult protection issues. This meant residents rights, safety, and welfare was promoted. Evidence: The complaints procedure was given to residents when they were admitted to the home. A complaints recording system was in place. The procedure gave clear directions on whom to make a complaint to and the timescales for the process. Any issue raised was quickly dealt with by the manager who said people are very open and would say if they had any concern. Residents and relatives, who were consulted, showed they knew who to talk to if they were not happy. People were confident to use the complaints procedure. Written comments included Staff look to all my needs and any concerns I have. I know the staff will help me. Residents were encouraged to say what they wanted and were asked regularly if everything was all right. Staff working at the home said they were trained in adult protection and were aware of the written abuse policies and procedures, which included whistle blowing. They knew their responsibility in this area and were confident they would report bad practice if ever the need arose. In addition to this staff training was provided regularly to ensure new staff understand procedures. To fully safeguard residents, contractual
Care Homes for Older People Page 20 of 31 Evidence: arrangements for new staff should commence on appointment to cover the probationary period. This will ensure a formal agreement is made for staff to comply with the homes policies and procedures for example the ruling on non-acceptance of gifts, or being involved in wills or bequests. Where any restriction is put in place on residents doing what they liked that may cause themselves or other people problems, for example smoking, this measure needs to be risk assessed and the outcome agreed by all parties involved. Care Homes for Older People Page 21 of 31 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home was very well maintained, clean, and tidy, and provided a homely and pleasant environment for residents, visitors, and staff. Evidence: The home is a detached property in a residential area in Accrington. It has recently had several new bedrooms registered with the Commission, increasing the numbers available to 27. A three floor extension has been built to accommodate the additional bedrooms, all of which are en suite with shower, toilet and washbasin. The upper floors can be accessed via a passenger lift. Outdoor areas were pleasant with decking and seating areas in the garden for residents use during good weather. Pathways were ramped to accommodate wheelchairs. The home was furnished and fitted to a very good standard. Residents were delighted with the refurbishment of the home. They had watched the progress made and some of them were looking forward to moving into new rooms. Bedrooms were spacious and accommodated residents personal possessions. Bathing and toilet facilities were very good. A new assisted bath had been installed. Care Homes for Older People Page 22 of 31 Evidence: The home was found to very clean during inspection, and policies and procedures for health and safety were in place for staff to follow. To help prevent the spread of infection, staff were provided with disposable gloves and aprons. Care Homes for Older People Page 23 of 31 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. The numbers of staff employed, training provided, and relatively safe recruitment practices, meant residents should be protected and their needs effectively met. Evidence: Rotas completed showed the compliment of staff was sufficient to cover all essential duties in providing care, and maintaining essential standards in the home such as hygiene and catering, and senior staff were on duty at all times. Staff files showed recruitment checks to be complete and met with legislative requirements for Criminal Record Bureau (CRB) and Protection of Vulnerable Adults (POVA) register check being applied for, prior to employment. However more care is required with checking application forms are completed properly. Consideration should be given to improving their format to make them more user friendly and help to make sure information such as all gaps in employment being recorded prior to interview. Interview notes must also be taken to show that the home operates as an equal opportunity employer. When handling information received from references, referring to applicants suitability such as character or health. This should be recorded to support the decision made to employ that person. This will also help to decide if any measures for example
Care Homes for Older People Page 24 of 31 Evidence: additional training is required to make sure the applicant, the provider, residents, and staff working in the home are fully protected. On appointment members of staff were not issued with a contract of terms and conditions of employment that covered their probationary period of three months. The manager said this would be put in place immediately. Staff who provided written comments for the inspection said they had received induction training, and training relevant to their role as carer. Records showed the induction-training programme carried out, covered essential training in basic principles of care, and safe working practice issues, such as moving and handling residents and health and safety. A high percentage of care staff hold a National Vocational Qualification in care level 2 or above. Staff interviewed displayed a high degree of job satisfaction within a good team environment. Communication, both formal and informal was seen as being good, open, and honest. There was evidence of the provider and management encouraged staff to maximise their potential. Equality of opportunity was demonstrated with training. Learning opportunities were very relevant to the homes purpose. All staff felt they were much appreciated for their work and were valued in the home. Care Homes for Older People Page 25 of 31 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 home is well managed and run in the best interests of the people living there. Evidence: Information received at the Commission for this inspection informed us the registered manager had completed City & Guilds Advance Management in Care. She had recently finished the Registered Managers Award, and had kept up to date with all new information and ideas on all aspects of the care of the elderly. She has been the manager at Moorhead since 2003. The management structure of the home included support from the providers to ensure the welfare of the residents and staff, and commitment for training, health and safety, was managed properly. To ensure sufficient staff are employed to meet the needs of the residents, recruitment was ongoing. Quality assurance had also been carried out in the home and relatives, and residents, were given the opportunity to have their say. Information received at the Commission
Care Homes for Older People Page 26 of 31 Evidence: from the home informed us what they had done to ensure the views of people using their services was promoted. Since the last key inspection they had carried out a review of the service, and provided staff with specialist training, for example dementia care and Protection Of Vulnerable Adults. All the records required for the efficient running of the home were available to look at. They were stored securely, readily available for this inspection, and organised. Information received at the Commission informed us Residents personal finances are not handled by Moorhead, but there is a safe available in the locked office for residents to keep monies or valuables if necessary. A record of this is kept in the care plan. Records showed staff supervision was given, providing staff with an opportunity to individually express themselves, their concerns, and their plans for the future or to receive feedback on their performance. Staff received appraisals. Staff meetings were usually held at regular intervals during which staff received information on polices and procedures and had an opportunity to voice their opinion and share information. Observations made during the inspection showed staff worked as a team, and were well thought of by the residents. Information received at the Commission showed regular auditing of fire, water temperatures; wheelchairs and hoists etc. had been carried out. Fire risk assessment for the building had been completed recently as part of the complete refurbishment of the home. General risk assessments were completed and taken into account in planning the care and routines of the home. The home had access to professional business, legal, and financial advice and had all the necessary insurance cover in place to enable it to fulfill any loss or legal liabilities. Care Homes for Older People Page 27 of 31 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 28 of 31 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 1 18 17 A record must be made of any limitations agreed with residents. This will prevent any misunderstanding occurring when staff are caring for residents. 30/01/2009 2 29 7 It is essential that any information received at the home regarding the fitness of an applicant is risk assessed to support the decision to employ that person. This will ensure the right measures are in place to protect the provider, residents,other staff and support the new mployee. 30/01/2009 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 Care Homes for Older People Page 29 of 31 1 1 Although people are given information about the smoking policy of the home, they should be given a chance to read whether the home is non smoking in the service user guide to help them make a decision about staying at the home. Assessments of peoples needs should include their view of the placement offered and what they personally would like from the service. When writing needs assistance, this should provide more detail of the staff support to be given. More detail should be recorded in the management of issues identified with mental health needs. All medication received in the home should be signed for when checked for accuracy. Medication given as when necessary requires more detail as to when this would be given, particularly where it involves administering medication to residents unable to verbally tell someone if they were not well. Residents would benefit from having a daily living plan in place with preferred routines recorded. To make sure residents are fully protected staff should have a formal agreement signed as part of their contractual arrangements for working at the home when they are employed. Interview notes should be taken to support the decision made to employ and demonstrate equal opportunities. The application form should be revised to make it more user friendly and reduce the possibility of important information being missed. 2 3 3 4 5 7 8 9 6 7 14 18 8 9 29 29 Care Homes for Older People Page 30 of 31 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 © (2009) 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 31 of 31 - 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!
