Inspection on 11/10/05 for The Moorings

This inspection was carried out on 11th October 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

The Moorings 18/08/09

The Moorings 29/08/07

The Moorings 05/06/06

The Moorings 04/05/05

The Moorings 24/11/04

The Moorings 20/05/04

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

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

CARE HOMES FOR OLDER PEOPLE The Moorings Egypt Hill Cowes Isle Of Wight PO31 8BP Lead Inspector Annie Kentfield Unannounced Inspection 11th October 2005 12:20 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 The Moorings DS0000012512.V250827.R01.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. The Moorings DS0000012512.V250827.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service The Moorings Address Egypt Hill Cowes Isle Of Wight PO31 8BP 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) 01983 297129 01983 293386 Mrs Janet Holmes Miss Dawn Amanda Richards Care Home 25 Category(ies) of Dementia - over 65 years of age (2), Old age, registration, with number not falling within any other category (25), of places Physical disability over 65 years of age (3) The Moorings DS0000012512.V250827.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 4th May 2005 Brief Description of the Service: The Moorings is an attractive period house set in its own grounds, and close to Cowes sea front with good views of the Solent from some of the first floor windows. The home is registered to admit up to 25 older people including 3 people with a physical disability and 2 people with dementia. The accommodation is arranged over three floors with the sitting and dining rooms on the first floor. There is a passenger lift between the floors and one part of the building that requires access via a short flight of steps; these five bedrooms would not be suitable for anyone who is not fully mobile. There is a large conservatory on the ground floor that provides an additional sitting room for residents to enjoy a view of the garden and Egypt Hill. The Moorings DS0000012512.V250827.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the second unannounced inspection of the home in the current inspection year, and took place on a Tuesday afternoon. At the time of the inspection the passenger lift was not working and this meant that the usual routines in the home were temporarily changed to ensure that residents either had their meals in the ground floor conservatory/sitting room, or in their rooms on the second floor. Residents on the first floor were not affected. Since the inspection, the manager has confirmed that the lift has been repaired and is now working again. The inspection included a tour of the premises, discussion with some of the residents, and inspection of some of the home’s records with the manager and the owner of the home. At the time of the inspection there were 23 residents in the home with 2 carers and the manager on duty. In addition, there was a cook, housekeeper and maintenance person in the home. What the service does well: The residents that the inspector spoke to were happy living in the home. Although it was not possible to engage in discussion with all of the residents, the home environment appears to be warm, comfortable and friendly for those residents who need care due to the frailty of old age. The bedrooms vary in size but residents expressed satisfaction with the bedroom of their choice. The home is well managed and run by an experienced and qualified registered manager who has worked in the home for a number of years and demonstrates a good knowledge of the conditions associated with old age. Although there have been some staff changes since the last inspection, more than 50 of the care staff have already achieved the NVQ level 2 in care or above. Residents were aware of the problems with the lift being out of order and some of the residents told the inspector that they knew this would be a temporary situation that was being addressed by the home, and did not mind too much. The Moorings DS0000012512.V250827.R01.S.doc Version 5.0 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The Moorings DS0000012512.V250827.R01.S.doc Version 5.0 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 The Moorings DS0000012512.V250827.R01.S.doc Version 5.0 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): 3 Residents only move into the home having first had a comprehensive assessment of their individual care needs. The home does not provide intermediate care although it does offer respite care if a room is available and also offers day care to some local residents. EVIDENCE: The manager confirmed that all residents are admitted within the home’s categories of registration. Records show that all prospective residents have an assessment of their care needs before moving into the home and the registered manager usually does this. The home uses a number of printed assessment forms to gather this information and the assessment is continued and subject to review when the resident first moves into the home. The information for the assessment includes all relevant information from other people involved in the care of residents such as family and/or care managers and forms the basis of the individual care plan. The manager also develops a social “pen portrait” of each resident after they move into the home that is written in discussion and agreement with each resident. The Moorings DS0000012512.V250827.R01.S.doc Version 5.0 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): 7, 8, 9 & 10 Every resident who moves into the home has an individual plan of care and this is reviewed weekly and monthly. The health care needs of the residents are monitored and met and appropriately trained staff dispenses medication. Residents said that care staff are kind and caring and respect residents’ privacy and dignity. EVIDENCE: The inspection looked at 3 care plans for residents who had recently moved into the home. The care plans contained relevant information to guide care staff on the care to be provided and all care given was recorded and reviewed regularly. The home undertakes a general risk assessment for each resident and where a specific risk is identified this is separately recorded with a risk management plan. Care plans contain a record of any health care interventions or appointments with GPs, District Nurses etc. The manager explained that they are working towards making sure that all care plans and risk assessments are discussed with residents and agreed and signed by the residents wherever possible. This is seen as good practice in the National Minimum Care Standards and will be reviewed at the next inspection. The Moorings DS0000012512.V250827.R01.S.doc Version 5.0 Page 10 The manager has reviewed the medication procedures and ensures that all medication is regularly reviewed by the prescribing GP. All medication is stored in a locked cupboard and dispensed into individual pots. The manager ensures that staff that dispense and administer medication have received the appropriate training. If residents choose to self-medicate, they can, subject to a risk assessment and signed agreement. In discussion with some of the residents, it was evident that residents find the care staff kind and caring and efficient. Although one resident commented that they don’t like changes in care staff and would prefer to see the same carers all the time, they “couldn’t fault” the care that is provided. One resident said that staff are always very busy and would like staff to have more time “to chat”. New care staff receive a copy of the home’s code of conduct and it is evident that the philosophy of the home promotes the residents’ rights to privacy and dignity at all times. Care staff were seen to knock on doors before entering bedrooms and bathrooms. The Moorings DS0000012512.V250827.R01.S.doc Version 5.0 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): 14 This inspection looked at standard 14 and the other standards were assessed at the last inspection. Residents are supported to maintain choice and control over their lives as much as possible. EVIDENCE: Residents are encouraged to manage their own financial affairs and where assistance is needed, this is provided by either family or independent advocates. The manager looks after small amounts of residents’ personal allowances and records are kept and checked by the manager. Residents are encouraged to bring personal items with them when they move into the home and to personalise their own rooms. The home offers residents a number of services such as hairdresser and chiropodist and residents pay for these services as they use them. Social activities are arranged regularly as well as three-monthly residents’ meetings and the manager said that a member of staff was currently producing an information leaflet for residents that sets out all of the services and activities available in the home. It was evident that residents are encouraged to exercise choice over their daily living activities as much as possible within their individual ability. The Moorings DS0000012512.V250827.R01.S.doc Version 5.0 Page 12 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 The home has a complaints procedure and residents’ complaints are taken seriously and acted upon. The home is required to ensure that the recruitment procedure is more thorough and meets current regulations to ensure that residents are protected from possible abuse. EVIDENCE: There have been no formal complaints since the last inspection. There is a residents’ meeting held every three months and records show that feedback from residents at these meetings is listened to and taken seriously by the manager who takes action to address any problems or complaints that arise. The manager ensures that staff in the home are made aware of the policies and procedures for reporting any suspected abuse and ensures that staff training is regularly updated. There is evidence that checks are carried out on new staff who start work in the home, however, in discussion with the manager, it was agreed that the recruitment procedures need to be more thorough and robust and that procedures need to be reviewed to meet the requirements of the current and amended Care Homes Regulations. Further details are discussed under Standard 29. The Moorings DS0000012512.V250827.R01.S.doc Version 5.0 Page 13 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 The home has had a lot of refurbishment since the last inspection and this has greatly improved the general environment and facilities for the residents. EVIDENCE: Requirements from the last inspection have been met and in the last few months the worn carpet in the main communal areas of the home has been replaced and has greatly improved both the safety and the attractiveness of the home environment. A programme of fitting doors with self-closing mechanisms to ensure fire safety has been completed. The first floor bathroom has been refurbished with a new bath, new flooring and shelves fitted to store residents’ toiletries etc. The shower room on the first floor has also been refurbished. All of the residents have their own bedroom, these vary in size and most have en-suite facilities and one bedroom has its own shower. Although there is only one bathroom with a hoist for the use of residents, it has previously been agreed that this meets the needs of residents who require assistance with The Moorings DS0000012512.V250827.R01.S.doc Version 5.0 Page 14 bathing. The ground floor bathroom is used as a hairdressing room and additional storage. There is in addition, a toilet for residents’ use close to the dining and sitting rooms, and on the ground floor close to the conservatory sitting room. The first floor bathroom toilet is not accessible for wheelchairs but the ground and first floor toilets are accessible although the space is limited. With the lift being out of order at the time of the inspection, it was clear that residents rely on the lift to be able to access the different floors in the home. However, temporary arrangements were in place to deal with this problem and it was evident that the owner of the home and the person responsible for maintenance were doing everything they could to have the lift repaired and working again as soon as possible. Residents spoken to were aware of the problem and it was evident that care staff were very busy as meals had to be taken to residents on all floors of the home while the lift is not working. Grab rails are installed in all areas of the home to assist residents with mobility and access, however there are areas of the home where access to other parts of the building is limited for residents who need assistance with mobility. At the time of the inspection, the laundry room was being refurbished and a new boiler room being created. The central heating system has also been renovated. There are no separate sluicing facilities. The person in charge of maintenance in the home was there during the inspection and confirmed that the storage and temperature of hot water in the home meets the regulatory requirements and there are thermostatic valves fitted to the bath and plans to fit these to all washbasins that are used by the residents. The home was clean and tidy and warmly heated throughout. The inspector spoke to some residents who were in their own rooms and residents expressed satisfaction with their room and confirmed that they have access to a call alarm and that staff always respond if it is used. One resident who is not able to access the sitting and dining room because of the location and access to their room, said that they had been offered another bedroom, but preferred to stay in that room and enjoyed the fine views that the room offered. There is a good range of communal space for the residents; the large conservatory on the ground floor and a large dining room and large sitting room on the first floor. All of these rooms are comfortably furnished in a homely way and there are plans to also renew the carpeting in the conservatory as part of the ongoing maintenance of the home. All of the communal rooms offer fine views for residents to enjoy and are light and sunny rooms. The first floor sitting room is arranged in a way that offers smaller and more private areas within the larger space for residents to feel comfortable and at home. Residents can sit outside in the warmer weather if they want to. The garden area is planted with trees, shrubs and lawns and provides an attractive view for residents to enjoy on several sides of the house. The Moorings DS0000012512.V250827.R01.S.doc Version 5.0 Page 15 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 staff rota shows that there are sufficient staff on duty to meet the needs of the residents and there is an ongoing programme of staff training and development to ensure that staff have the skills and training required to provide the level of care needed. The recruitment procedures need to be reviewed to meet the current regulatory requirements. EVIDENCE: The staff rota showed that there is usually 4 care staff, including the manager on duty in the mornings and 3 care staff, including the manager in the afternoons. There is usually 2 or 3 staff on duty in the evenings and 2 carers at night. The manager includes herself on the rota and regularly works some evenings and weekends to ensure that she is able to supervise staff on all shifts, and comes in at different times to see night carers on a regular basis. The home also employs a cook, housekeeper and maintenance person. The manager is very aware of the changing needs of the residents and explained that she regularly reviews the staff rota to ensure that there always sufficient numbers of staff to meet the needs of the residents. The staff-training plan showed that there is ongoing training and development opportunity for staff to achieve NVQ qualifications in care and to ensure that staff have regular training in all areas of safe working practice in the home. The Moorings DS0000012512.V250827.R01.S.doc Version 5.0 Page 16 The home currently has more than 50 of the care staff with a qualification in NVQ level 2 in care and some with NVQ level 3. Inspection of some of the staff recruitment files showed that there are some shortfalls in the recruitment procedures. The Care Homes Regulations were amended in 2004 and there are additional responsibilities for care homes to undertake thorough checks on all new staff to ensure the safety and protection of vulnerable residents. The requirements are set out in a separate letter to the registered manager and were also discussed during the inspection. The manager agreed to review the recruitment procedures for all new staff starting employment in the home and a further inspection visit will be arranged. The Moorings DS0000012512.V250827.R01.S.doc Version 5.0 Page 17 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 - 38 The home is well run by an experienced and qualified manager and there is evidence that the home is run in the best interests of the residents. EVIDENCE: The registered manager has many years of experience in care and has the necessary qualifications in care and care management, as well as being an accredited NVQ assessor. The manager likes to have a ‘hands on’ approach to managing the home and works alongside the staff in the home and it is evident that the manager is always available for both residents and staff and is committed to providing a home that is run in the best interests of the residents. The manager demonstrates a good knowledge and awareness of the individual needs of the residents and maintains an overview at all times of any changes in the residents’ care needs. The Moorings DS0000012512.V250827.R01.S.doc Version 5.0 Page 18 There are arrangements in place for regular staff supervision including a yearly staff appraisal. The manager confirmed that all staff have recently updated their fire safety training and fire practice drills are done on an irregular basis with a record kept of staff and residents who took part. The Food Safety Officer from the Environmental Health Department recently inspected the home and the inspection was satisfactory with no recommendations or requirements. Since the last inspection health and safety assessments for all areas of practice in the home have been reviewed and new risks assessments recorded and these records were available during the inspection to support this. On the whole, records kept by the home are accurate and up to date and securely stored. The only exceptions have already been discussed in other parts of this report with regard to recruitment procedures. It is also recommended that residents have greater opportunity to help maintain their personal and individual care plans and that these are discussed and agreed with residents wherever possible. It is also recommended that advice be sought from the Health and Safety Executive about the system for recording incidents and accidents in the home and whether the home’s current recording system meets current requirements. The Moorings DS0000012512.V250827.R01.S.doc Version 5.0 Page 19 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 N/A DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 N/A 13 N/A 14 3 15 N/A COMPLAINTS AND PROTECTION Standard No Score 16 3 17 N/A 18 2 3 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 N/A 3 3 2 3 The Moorings DS0000012512.V250827.R01.S.doc Version 5.0 Page 20 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 OP18OP29 Regulation 19 and Schedule 2 Requirement Recruitment procedures used by the home must be thorough and include all of the checks required by regulation. New staff must not start employment in the home until sufficient information and checks are satisfactory and the safety of the residents is assured. Timescale for action 11/10/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard OP37 OP37 Good Practice Recommendations It is recommended that the manager seek advice from the Health and Safety Executive on the approved system for recording accidents and incidents in the home. Where appropriate and practical, individual care plans and risk assessments should be discussed, agreed, and signed by residents and/or the nominated representative. The Moorings DS0000012512.V250827.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Southampton, Portsmouth and Isle of Wight Ground Floor Mill Court Furrlongs Newport, IOW PO30 2AA 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. Extracts may not be used or reproduced without the express permission of CSCI The Moorings DS0000012512.V250827.R01.S.doc Version 5.0 Page 22 - 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!