CARE HOMES FOR OLDER PEOPLE
Moorhouse Farm Moorhouse Lane Ashington Northumberland NE63 9LJ Lead Inspector
Jackie Burke Announced Inspection 29th November 2005 09:30 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 Moorhouse Farm DS0000040473.V256210.R02.S.doc Version 5.0 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. Moorhouse Farm DS0000040473.V256210.R02.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Moorhouse Farm Address Moorhouse Lane Ashington Northumberland NE63 9LJ 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) 01670 857727 01670 857733 moorhousefarm@highfield-care.com Southern Cross Home Properties Limited Care Home 24 Category(ies) of Old age, not falling within any other category registration, with number (24) of places Moorhouse Farm DS0000040473.V256210.R02.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 14th June 2005 Brief Description of the Service: Moorhouse Farm is a converted single storey farm building made of stone with an apex roof to the front where the staff room and administrative offices are located. Outside the building retains its traditional character; inside the accommodation has been modified to provide access throughout the building. The home is in a residential area of town and shares its grounds with a separate care home, Ashington Grange. Both homes are owned by Southern Cross and retain close links and some shared facilities. There is a small kitchen at Moorhouse Farm where breakfasts, teas and suppers are provided; main meals are cooked in Ashington Grange. Car parking is located to the front and side of the building. There is level access to the building on both sides of the home. Ashington town centre is approximately one and a half miles away and there is a local school and park nearby. Moorhouse Farm provides a large lounge and conservatory and a separate dining room and a quiet lounge. The home provides two bathrooms with assisted bathing facilities and an adapted shower room. There are six communal toilets in the home and all rooms are single occupancy. Commodes are used overnight. Residential care is provided at Moorhouse Farm and the home is registered for up to 24 older people. Nursing care is not provided. Moorhouse Farm DS0000040473.V256210.R02.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This is a report of an announced inspection, which took place on 29 November 2005. The inspection took 5.5 hours and during the inspection and subsequent visit I spoke with 10 service users, 2 family members, a care manager and 3 staff on duty in the home. A tour of the building took place. Comments cards were circulated and returned by 7 service users and 9 relatives/visitors. What the service does well:
Moorhouse Farm provides a homely welcome atmosphere and on the day of inspection the home was decorated for Christmas and seasonal music was playing in the foyer. Moorhouse farm provides a holistic approach to the needs of individual service users and staff demonstrate a flexible, positive attitude toward people who live in the home The mini bus was available this week and a series of outings were planned to the metro centre and to the coast for fish and chips. Activities and events include a charity beard shave for “Children in Need” two weeks ago and in house activities organised as and when staff have time The manager is well motivated and enthusiastic and keen to develop herself and her team. Service users and relatives speak highly of Moorhouse Farm One service user said “They are fantastic here, I can’t praise them enough” Another person said “The staff are very helpful and caring” One relative said that she had every confidence in the home and that the staff spend as much time as they can with the residents but they are very busy. Moorhouse Farm DS0000040473.V256210.R02.S.doc Version 5.0 Page 6 Comments Cards “Very impressed with the care, assistance and kindness received by my mother and all the other residents from all members of staff.” What has improved since the last inspection? What they could do better:
Filing has improved since the last inspection however staff files were disorganised and it was difficult to find key documents. The administrative systems within the home could be improved as an administrative error led to a temporary variation form being filed instead of completed and sent. The standard of care provided in this case has been good and all stakeholders expressed satisfaction in the way that the service users needs have been dealt with; a retrospective variation in registration has been processed. One resident said “The food is a bit bland and the menu never seems to change” Main meals are provided by Ashington Grange and consideration should be given to providing meals in house to improve choice and standards of vegetables. One person said that he would like to have fresh fruit available and that he got visitors to bring in grapes and tomatoes. Activities are limited, as many people do not want to participate. Further work should be done with service users to develop a greater range of activities. Comments cards “I do not feel the accommodation and food are to the standard provided by other homes in the area.”
Moorhouse Farm DS0000040473.V256210.R02.S.doc Version 5.0 Page 7 “There are not sufficient members of staff on duty” “There usually seems to be plenty of staff on duty but it would be good to have a “floater” to spend a few minutes of “quality time with each individual clientto hold her hand and have a chat. The staff are busy with their duties and haven’t time for the personal one to one approach I would like to see more of.” “ Home cosy and friendly but there’s a noticeable lack of activities which could be due to staffing levels and/or funds” 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. Moorhouse Farm DS0000040473.V256210.R02.S.doc Version 5.0 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 Moorhouse Farm DS0000040473.V256210.R02.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Service users moving into the home have had their needs assessed and are assured that these will be met. EVIDENCE: People considering moving to Moorhouse Farm have their needs assessed by a care manager and the manager before admission. One service user admitted on a temporary basis has had a full needs assessment and additional outreach support has been provided to ensure that his needs are met. The service user commented positively on his stay in Moor House Farm and said that he was well looked after and that everyone was very kind to him. His Care Manager is very happy with the care provided and said that she felt the placement had proved successful in meeting his needs. Care files examined during the inspection contained satisfactory assessment information linked to risk assessment and care planning. Moorhouse Farm DS0000040473.V256210.R02.S.doc Version 5.0 Page 10 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7-10 Each service user has a care file, which contains information relating to health, personal & social care needs. The health care needs of residents are met fully. Moorhouse Farm has a satisfactory policy for dealing with medication. Residents are treated with respect and privacy is safeguarded. EVIDENCE: Four care files were examined which contained assessment information, care plans and risk assessments in addition to review documents which indicate that the needs of residents are recorded and that their health care needs are being met. Care file recording and organisation has improved since the last inspection and new documentation has been introduced following the change of provider to Southern Cross.
Moorhouse Farm DS0000040473.V256210.R02.S.doc Version 5.0 Page 11 There is a medication policy at Moorhouse Farm and medication is stored appropriately and administered safely by staff who are trained to do so. Controlled drugs are stored and recorded accurately, however failure to return medication no longer required was discussed with the manager and she agreed to amend this oversight. There is a system in place whereby people may take responsibility for their own medication. Observation on the day indicates that staff treat service users with respect and dignity and this was confirmed by conversations with service users and relatives. Moorhouse Farm DS0000040473.V256210.R02.S.doc Version 5.0 Page 12 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12-15 Needs are identified during assessment and activities and routines are developed accordingly. Moorhouse Farm provides a good standard and variety of activities. Links with families, friends and the community are encouraged. People are enabled to exercise choice in some areas of their lives. People are provided with a balanced diet and meal routines are provided flexibly wherever possible, however choice is limited at weekends. EVIDENCE: Comments cards returned indicated that 6 service users felt that activities provided in the home were sometimes suitable. 7 service users said they liked the food. One service user spoken to said that the food was bland and that there were not enough activities available. One relative said that she would like more quality time to be spent with residents and that it was important that people felt valued by those working with them.
Moorhouse Farm DS0000040473.V256210.R02.S.doc Version 5.0 Page 13 One person said that the staff spent as much time with people as their duties would allow but it would be nice to have some flexibility available. There is an activities programme in place at Moorhouse Farm however only 9hrs per week are allocated to the activities coordinator who also works in the home as a care assistant. Activities offered are relatively sedate and do not appear to actively engage all service users. There was a good range of activities offered during the week of inspection as this coincided with the mini bus being available. There is a rota within the company to make use of a minibus to enable trips and outings to take place. The bus is available this week and activities planned include a shopping trip to the metro centre, which took place on the day of inspection; a trip to Sunderland to see the illuminations and an outing to the coast for fish & chips. In the run up to Christmas there is a make up party planned, a Christmas raffle ongoing and an entertainer is booked for the week before Christmas. Day to day activities require further input to ensure that service users are consulted and engaged in meaningful activities. Visitors are welcome in Moorhouse Farm and links are maintained with the local community via church and the local school. Some service users said that the food in the home was bland and repetitive and that they would like to see more variety and fresh fruit and vegetables. Moorhouse Farm DS0000040473.V256210.R02.S.doc Version 5.0 Page 14 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Service users and their relatives are confident that their complaints will be dealt with appropriately. Service users are protected from abuse. EVIDENCE: There is a complaints policy in place at Moorhouse Farm and copies are made available to all service users. Complaints records examined confirm that the complaints procedure has been followed. Service users were aware of their right to complain and said they would speak to Cheryl if they had a complaint. The manager demonstrated an awareness of abuse and whistle blowing and confirmed that the home has policies and procedures in relation to abuse and whistle blowing and that POVA training has been accessed. The recruitment procedures within the home protect service users from abuse and files examined confirmed that Criminal Record Bureau checks are undertaken and references are followed up. Moorhouse Farm DS0000040473.V256210.R02.S.doc Version 5.0 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): 19 & 26 Service users live in a safe well- maintained environment The home is clean, pleasant and hygienic. EVIDENCE: I made a tour of the building and found that all areas free from odour; the building is well maintained and clean with a maintenance worker who operates an ongoing maintenance and repair programme and a decoration programme. Portable appliance testing is undertaken regularly and maintenance records are appropriately kept. Fire checks are undertaken regularly and records appropriately kept. Moorhouse Farm DS0000040473.V256210.R02.S.doc Version 5.0 Page 16 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): 27-30 The needs of service users are met by the numbers and skills of staff. Service users are in safe hands at all times. Service users are supported and protected by recruitment policies. Staff are trained and competent to do their jobs. EVIDENCE: There are 17 care staff and 5 ancillary staff employed at Moorhouse Farm. The manager’s hours are supernumerary however she will help out when short staffed, senior staff are on call out of hours. Vacancies created by staff movement in the summer have been filled and new staff provided with induction and mandatory training. Criminal Record Bureau checks are being processed for two newly appointed staff and in the meantime they are working under supervision at all times and appropriate POVA checks have been made. Moorhouse Farm DS0000040473.V256210.R02.S.doc Version 5.0 Page 17 Shifts are covered as follows. 8-3pm 1 senior care officer 2 care staff 3-10pm 1 senior 2 care staff 10-8am 2 care staff There is a commitment toward training and development at Moorhouse farm. 11 staff are qualified to NVQ level 2. The manager and deputy manager have begun to work toward NVQ level 4 and the manager is due to commence her Registered Managers Award in January 2006. Moorhouse Farm DS0000040473.V256210.R02.S.doc Version 5.0 Page 18 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): 31,33,35 & 38 Service users live in a home which is run & managed by a person who is fit to be in charge, is of good character and who discharges her responsibilities fully. The home is run in the best interests of service users. Service users financial interests are safeguarded in line with current practice. The health, safety and welfare of service users and staff is protected. EVIDENCE: The manager has worked hard since her appointment to develop the morale and skills of her team and to safeguard the interests of service users during a time of change. The manager is committed to ensuring that the home runs in the best interests of the residents. Moorhouse Farm DS0000040473.V256210.R02.S.doc Version 5.0 Page 19 Filing procedures have improved since the last inspection however further work is required to reorganise staff files and to ensure that administrative systems are accurately maintained. This was discussed with the manager during the inspection and will be addressed as a priority. The manager is aware that she has overall responsibility for managing the home and that compliance is required in order for Moorhouse Farm to provide a good service to people who live there. Separate bank accounts have not yet been set up for residents however individual accounts are maintained within the home and monies belonging to residents are kept securely in the safe. Records were available and confirmed that mandatory training is provided and that safe working practices are adhered to in relation to fire safety, moving and handling, first aid, food hygiene and infection control. Moorhouse Farm DS0000040473.V256210.R02.S.doc Version 5.0 Page 20 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 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Moorhouse Farm DS0000040473.V256210.R02.S.doc Version 5.0 Page 21 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP12 Regulation 16(2)(m) (n) Requirement Routines of daily living and activities should be flexible and varied to suit service users expectations, preferences and capacities Timescale for action 28/02/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP15 Good Practice Recommendations Fresh fruit & drinks should be made available in the dining room for service users to access as they wish Consideration should be given to Moorhouse Farm operating an autonomous kitchen for main meals to ensure quality and freshness of food. Separate bank accounts should be developed for each resident. Record keeping and administrative systems are to be audited to ensure that the rights and best interests of service user are fully safeguarded. 2 3 OP35 OP37 Moorhouse Farm DS0000040473.V256210.R02.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Cramlington Area Office Northumbria House Manor Walks Cramlington Northumberland NE23 6UR National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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