CARE HOMES FOR OLDER PEOPLE
Moorland House Station Road Hathersage Hopevalley Derbyshire S32 1DD Lead Inspector
Stuart Hannay Unannounced Inspection 21st November 2005 09:45 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Moorland House DS0000020057.V265263.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. Moorland House DS0000020057.V265263.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Moorland House Address Station Road Hathersage Hopevalley Derbyshire S32 1DD (01433) 650582 (01433) 650795 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) Methodist Homes for the Aged Florence Efua Nyarko Doku Care Home 33 Category(ies) of Old age, not falling within any other category registration, with number (33) of places Moorland House DS0000020057.V265263.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. Plus One (1) Day Care Place Date of last inspection 10th August 2005 Brief Description of the Service: The home is a large Victorian building, which has been extended and is situated close to the facilities of Hathersage village. There are two floors, which have several levels. The home is registered for up to 33 residential beds for older people. All bedrooms are single. Support services are available locally, including GP and other health services. The home is lookinging to change its present registration to a care home for up to 48 older people, including nursing residents. New extensions are in the process of being built, and the current home will be upgraded and refurbished as part of the same process. Because of ongoing building works the home is currently providing a service to 27 residents. Moorland House DS0000020057.V265263.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. Four service users were spoken with on the day of the inspection about the service provided at the home. A brief tour of the building was made – the home is in the process of being extended and the environment is being separately monitored. Fire training records were checked, along with staff rotas and staff supervision records. This report should be read in conjunction with the report of 10th August 2005. What the service does well: What has improved since the last inspection? What they could do better:
Some service users felt that the temporary heating measures provided in the older part of the home were not sufficient. There were problems with the
Moorland House DS0000020057.V265263.R01.S.doc Version 5.0 Page 6 temporary additional electrical circuit set up to cope with the additional fan heaters, causing the power to cut out on a frequent basis in parts of the home. The manager was working to address this on the day. Redecoration had not taken place in the kitchen as identified in the previous report. 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. Moorland House DS0000020057.V265263.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 Moorland House DS0000020057.V265263.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 A full assessment is made of potential service users prior to them coming into the home in order to ensure that their needs can be met. EVIDENCE: Pre admission assessments were checked in two care plans. They had been fully completed by the manager and included assessment of a wide range of needs. Service users spoken with said that they were able to visit the home prior to moving in. Moorland House DS0000020057.V265263.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 10 Each service user has a care plan that is regularly updated and reviewed. Wherever possible service users are involved in creating and reviewing the plan. Service users said they were treated with dignity and respect. EVIDENCE: Three care plans were checked in order to monitor requirements made in the previous inspection. All the plans had been fully completed in each section of the pre-printed documents. The home had introduced a monitoring system to ensure that all parts of the plan are completed and updated as required. This is checked monthly and an action plan is created to ensure that gaps are filled in. All the service users spoken with were positive about the attitude of the staff, conversations between the service users and staff were noted to be friendly and mutually respectful. Moorland House DS0000020057.V265263.R01.S.doc Version 5.0 Page 10 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 13 14 The home provides proactive activities programmes in line with the wishes of the service users. They are involved in decisions about their care and are encouraged to maintain relations with their friends and families. EVIDENCE: There was a detailed programme of activities provided at the home. The service users spoken with praised the commitment of the activities coordinator and said that they felt that there were enough things to do. One service user said that she would like to have more time to talk to staff – she said that the home had ensured that a volunteer spent time talking with her. Care plans identified that service users’ spiritual needs are identified and steps are taken to ensure that people attend services, both in the home, and at external places of worship. All those spoken with said that they could have visitors whenever they wanted and were encouraged to keep in touch with friends and relations. Service users are consulted about events in the home. The service users spoken with had been kept up-to-date about progress on the building work and the manager had largely managed to pre-empt concerns about this. A number of service users had had to temporarily change rooms whilst the work was being done and, whilst they expressed a certain exasperation with extended timescales, they acknowledged that they had been kept informed quickly about progress and delays.
Moorland House DS0000020057.V265263.R01.S.doc Version 5.0 Page 11 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 The home has a formal complaints system of which service users were generally aware. Service users felt complaints would be taken seriously. EVIDENCE: The home had a complaints procedure which had timescales for resolution. It contains the current address of the Commission for Social Care Inspection and informs the complainants that they are able to contact the Commission at any stage of the complaint if they wished to do so. Service users interviewed said that they would have no hesitation in putting any concerns to the staff or the owners and felt that they would be taken seriously. Moorland House DS0000020057.V265263.R01.S.doc Version 5.0 Page 12 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 25 The home needs to take steps that the temporary heating provided during the building work is adequate for service users. EVIDENCE: Progress with the building work is being monitored separately. However, a number of service users in the older part of the building said that they felt cold at times. Temporary heating is in place but this has caused the electrical circuits to cut out due the overloading caused by a large number of fan heaters working at once. The manager was trying to address this on the day and has agreed to monitor and record the temperatures in the bedrooms and to consult service users about this. The kitchen had not been repainted as identified in previous reports. Moorland House DS0000020057.V265263.R01.S.doc Version 5.0 Page 13 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 Staff and service users generally felt that staffing levels were sufficient for the current numbers of service users and these must be reviewed when full occupancy is achieved. EVIDENCE: Three weeks rotas were checked in detail. Staff work 12 hour shifts. From 8.a.m to 8. p.m. there is 1 senior staff member and 2 carers for 25 service users. From 8.p.m. to 8.a.m there are 2 carers, one of whom is trained in the administration of medication. Service users felt that these numbers were sufficient for the current reduced number of service users. The manager and the activities co-ordinator are supernumerary for five days over the 7 day period and there are separate domestic and kitchen staff. Moorland House DS0000020057.V265263.R01.S.doc Version 5.0 Page 14 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 32 36 38 There is a suitably qualified and experienced manager at the home who fosters an open atmosphere at the home. Fire training records checked were of a good standard. Professional staff supervision is in place. EVIDENCE: The home’s manager is suitably qualified and experienced to run the home. Service users felt that she was very approachable and this was evident on the day of the inspection. She was keen to promote the rights of the service users and demonstrated an excellent understanding of the National Standards and her responsibilities in meeting them. The home has a well-established system of staff supervision and appraisal, which includes monitoring of staff progress, comportment and training needs. Fire training and alarm testing records were of a good standard. Moorland House DS0000020057.V265263.R01.S.doc Version 5.0 Page 15 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 X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 X 9 X 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 X 2 X X X X X 2 X STAFFING Standard No Score 27 3 28 X 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 X X X 4 X 3 Moorland House DS0000020057.V265263.R01.S.doc Version 5.0 Page 16 Are there any outstanding requirements from the last inspection? YES STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 2 Standard OP25 OP25 Regulation 23 (2) (p) 23 (2) (p) Requirement Timescale for action 07/12/05 3 4 OP19 OP19 23 23 The home must ensure that the temporary heating is adequate to keep service users warm. The home must monitor and 07/12/05 record the temperatures in the bedrooms in the older part of the home. The recommendations of the 30/01/06 Environmental Health Officer must be acted on. The kitchen must be repainted 30/01/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Moorland House DS0000020057.V265263.R01.S.doc Version 5.0 Page 17 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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