Inspection on 09/08/06 for Moorland House

This inspection was carried out on 9th August 2006.

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

The inspector 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

Moorland House 21/11/05

Moorland House 10/08/05

Moorland House 15/12/04

Moorland House 15/04/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

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

CARE HOMES FOR OLDER PEOPLE Moorland House Station Road Hathersage Hopevalley Derbyshire S32 1DD Lead Inspector Ray Coonan Unannounced Inspection 9th August 2006 10:20 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 Moorland House DS0000020057.V302688.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Moorland House DS0000020057.V302688.R01.S.doc Version 5.2 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) home.fxg@mha.org.uk Methodist Homes for the Aged Florence Efua Nyarko Doku Care Home 48 Category(ies) of Old age, not falling within any other category registration, with number (48) of places Moorland House DS0000020057.V302688.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 21st November 2005 Brief Description of the Service: Moorland House is a large extended Victorian building situated close to the facilities of Hathersage village. During the past year there has been substantial construction work at the Home in order to extend the Home further, through the addition of two new wings, and also upgrade the existing accommodation. The Home is on two floors throughout. The Home was registered for up to 33 residential beds for older people, but this has now increased to 48 beds since the beginning of May 2006, with one wing specifically designated for nursing care. The Home also offers one day care place. All bedrooms are single with en suite facilities and there are several lounge and communal areas including an extended dining area. There remains accessible sitting and garden areas at the rear of the Home. Support services are available locally, including GP and other health services and the Home has an active group of volunteers. At the time of this inspection visit the Home’s scale of charges was from £430 to £616 per week. Moorland House DS0000020057.V302688.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over a period of six and a half hours on the 9th August. The manager of the Home, Florence Doku, was on holiday at the time and the deputy manager was not on duty. However, one of the Home’s assistant managers, Natalie Shepherd, was present throughout the visit. There was the opportunity to meet with several of the staff on duty and talk to many of the residents, together with visiting relatives in some instances. Most parts of the premises were viewed including the newly built wings, and a variety of documentation was examined, such as several individual care plans, staffing records, relevant policies and procedures and health and safety records. What the service does well: What has improved since the last inspection? The most obvious and significant improvement is the completion of the substantial building programme at the Home, which has markedly improved and upgraded the facilities throughout the Home, including lounge areas, bathroom resources and individual bedrooms. Moorland House DS0000020057.V302688.R01.S.doc Version 5.2 Page 6 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. Moorland House DS0000020057.V302688.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Moorland House DS0000020057.V302688.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Appropriate assessments were undertaken with potential residents in order to ensure their needs can be met. EVIDENCE: There was evidence on care plans that pre admission assessments are undertaken on prospective residents with relevant nursing or community assessment information obtained from agencies, such as hospital or social services departments. One resident who had been at the Home for several years was moving from residential to nursing care and relevant professional assessments had been obtained covering identified special needs. There was also evidence that residents were involved in this process. Moorland House DS0000020057.V302688.R01.S.doc Version 5.2 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Each resident had their general needs suitably assessed and their care plans were kept under review, though there was room for more consistency in the development of these plans. The health needs of residents were well promoted and monitored. EVIDENCE: A sample of four individual resident care files was examined in detail, including two care plans that involved nursing care. Overall the plans were well organised, up to date and monitored on a regular basis. A full range of assessment material was evident, including such areas as mobility, skin integrity and nutrition. These were also kept under review though it was noticed that in two instances, with bed rails in use, there was no record of resident consent on file. There were forms for the resident to sign regarding assessment consultation though these were not always completed. Moorland House DS0000020057.V302688.R01.S.doc Version 5.2 Page 10 The actual care plans contained relevant detail and guidance to meet identified needs. Health and personal care needs were monitored closely and it was clear that relevant professional community health advice was obtained on a regular basis with records of contact from G.P. practices, community nurses, speech therapy, chiropodist, dental and optician on file. There was also space to monitor and record specific health issues such as wound management and pain relief management. However, information on residents’ social needs was not always complete with variable amounts of detail regarding leisure interests and social background and no records of participation in specific activities. Residents and relatives spoken to were very positive about the practice and attitudes of care staff, who were observed interacting with residents in a warm and appropriate manner. However, several residents mentioned that they thought staff were very stretched since the full building had come into use and occupancy had increased. It was noted that several bedroom doors were kept open whether residents were in them or not and there were no records or policy evident regarding this practice and the implication for resident privacy. The Home has a specific room for the storage of medicines and these were securely stored and managed appropriately with clear records and processes in place for their administration and disposal. Medicines are administered by the qualified nursing staff and the assistant managers. Regular audits of these arrangements were undertaken through the pharmacist. Moorland House DS0000020057.V302688.R01.S.doc Version 5.2 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ views on the running of the Home are actively encouraged. The Home’s activity programmes were not consistently organised. Residents enjoyed a satisfactory standard of catering that was in line with their expressed needs and preferences. EVIDENCE: There were mixed messages from the resident survey forms regarding the provision of activities at the Home with several comments indicating that they thought this could be better organised and more stimulating. One comment described the provision as ‘sporadic’ since the Home’s activities coordinator left last January. The Home has been unsuccessful in appointing another coordinator and several different staff have been covering the role. Some trips have taken place during this time and an open day was held recently. Several activities have continued within the Home such as some craftwork, small group meetings and the use of percussion instruments, though staff commented that this area “had fallen off a bit” and was not as consistent as before. There was an established volunteer group in contact with the Home who assisted residents to access local facilities. Moorland House DS0000020057.V302688.R01.S.doc Version 5.2 Page 12 There were no residents with any specific cultural needs. There were regular religious services available for residents and involvement from local churches, though there was no pressure to maintain observance if residents were not interested. Residents were observed using different parts of the building as they wished and from their comments it was clear that there was no undue emphasis on routines at the Home. There were several relatives visiting on the day of the inspection and those spoken to said that they were made welcome and that the Home maintained good communication. Regular resident meetings were held and detailed minutes were available. These showed that resident views were encouraged and were frequently expressed on a range of issues such as health and safety matters, building work, activities and catering. Since the last inspection the kitchen area has been upgraded and new furniture provided in the extended dining area. Established menus are in place with alternatives available and any special dietary requirements met. The cook has regular contact with residents to discuss menu planning and there were many positive comments from residents regarding the standards of meals at the Home. Moorland House DS0000020057.V302688.R01.S.doc Version 5.2 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The views of residents and/or their representatives are taken seriously at the Home and protection from abuse satisfactorily promoted. EVIDENCE: The Home has a comprehensive complaints procedure, which is accessible to residents and visitors. The formal complaints records were not immediately available as they were said to be with the manager who was not on duty. The Commission has received one complaint since the last inspection, which was principally concerned with the disruption for a resident during transition arrangements to facilitate building work. This was investigated separately, substantiated and responded to appropriately at the Home. As indicated earlier in the report the Home has a positive culture of listening to residents’ views and residents meetings have a regular slot for discussing any complaints or concerns. The minutes demonstrated that several issues have come up such as the functioning of the resident call system and access to the front of the building as well as compliments regarding staff support. The Home also has a comment and suggestions book available to visitors. The Home maintains relevant policies and procedures regarding abuse and protection and has had experience of liaising with local agencies on these Moorland House DS0000020057.V302688.R01.S.doc Version 5.2 Page 14 issues. Discussions with staff showed that they had a suitable awareness of these matters and had received relevant training. Moorland House DS0000020057.V302688.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22, 23, 24, 25 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents enjoy a pleasant and comfortable environment, which has been upgraded to a good standard. However, problems with the Home’s resident alarm call system detract from the overall safety of the environment. EVIDENCE: The upgrading of the Home has now been completed and the overall environment is for the most part light, spacious, clean and hygienic with a good range of facilities for residents. Décor, fixtures and fittings and general furnishing of the Home have been renewed throughout. Bedrooms are of a good size and residents have settled in well and personalised their accommodation. There are several comfortable lounge areas available throughout the building though many residents are still mostly using the main lounge on the ground floor at the moment. However, a visiting family and a Moorland House DS0000020057.V302688.R01.S.doc Version 5.2 Page 16 resident were in one of the new wing lounges on the day of the inspection and making full use of the kitchenette facilities available there. In addition to the en suite toilet and shower facilities the Home has accessible bathrooms available on each floor. Bathrooms have a range of aids and adaptations to assist residents with mobility difficulties and these areas were well – maintained and clean. The Home has adequate sluice facilities and its own laundry facility, which also has been upgraded, and is well - equipped and organised with its own separate staffing arrangements. There remain some aspects of the environment in need of attention. There are two rooms on the North Wing that have been damaged by radiator leaks though the rooms are currently unoccupied. There have been ongoing problems with the resident alarm call system, which on occasions activates unnecessarily but more worryingly sometimes, when activated by a resident, does not register with staff. It is understood that the system has had to be reset on several occasions. There have also been associated problems with the front door, which is linked to the alarm call system and there have been instances when visitors have not been able to get access to the Home because the door is locked for security reasons but the bell is not functioning. Finally though the Home has accessible garden and sitting areas, there are some areas that require tidying up and weeding, particularly at the front. Moorland House DS0000020057.V302688.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 29 and 30. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The Home has yet to fully adapt to matching some staffing levels to the new care environment and staff training arrangements would benefit from a further review in order that services better meet residents’ needs. Residents benefit from a structured approach to the recruitment and monitoring of staff. EVIDENCE: As mentioned earlier in the report there were several comments from residents that they thought staffing levels for care staff were not satisfactory and discussions with staff indicated that they were of the same view and felt more stretched with the increased occupancy and the fact that the size and lay out of the premises had significantly expanded. The assistant manager stated that this had been raised with the management and that authorisation had just been given to increase the number of care staff on duty in the morning. The Home also now has a qualified nurse on each shift. There is a current 29 hour nurse vacancy and the Home have an established group of nursing ‘bank’ staff to cover this post. It was noted that because of staffing shortages and sickness in May and June the manager had covered a lot of the nurse shifts. Moorland House DS0000020057.V302688.R01.S.doc Version 5.2 Page 18 The Home has a structured approach to staff training and records are maintained for each member of staff. Basic mandatory care courses, such as safe handling, food hygiene and health and safety are arranged on a regular basis. It was noted that for some staff fire safety training was now overdue. Input had also been provided on dementia awareness though some staff felt this was not in sufficient depth. It was also noted from the pre-inspection information supplied that there had not been any training provision during the current year. A sample of staff files were examined and these were in good order demonstrating that the Home takes up written references, criminal record checks and keep suitable interview records. Induction training records are also maintained and there were also appraisal and supervision notes. Moorland House DS0000020057.V302688.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from a generally systematic approach to the running of the Home, which is responsive to their views and interests. EVIDENCE: The Home’s manager is suitably qualified and experienced and both service users and staff felt she was approachable and responsive to any issues that were raised. It was not possible to fully evaluate the Home’s quality assurance processes in the absence of the manager, however, from discussions with residents and from the minutes of resident meetings it was clear that the Home actively looks for feedback on the quality of services at the Home. It was Moorland House DS0000020057.V302688.R01.S.doc Version 5.2 Page 20 also noted that the administrator conducts regular audits in this respect and with the help of staff interviews each resident. The Home has a secure and systematic process for the handling of residents’ personal monies though some residents look after their financial affairs with the help of relatives or legal representatives. Individual account sheets are kept for each resident and any financial transactions are recorded, as are any transfers to individual bank accounts. The provider’s central office also conducts a regular audit of this process. The Home’s health and safety arrangements and checks on utilities and equipment were satisfactory at the time of the site visit/inspection in April 2006 when the Home’s new registration was agreed. On this occasion fire safety records were examined and were in good order with checks and testing of equipment up to date. Moorland House DS0000020057.V302688.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 2 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 2 3 3 3 3 3 3 3 STAFFING Standard No Score 27 2 28 X 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Moorland House DS0000020057.V302688.R01.S.doc Version 5.2 Page 22 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) (n) Requirement The Home must ensure that a more focussed and coordinated approach to the provision of leisure activities is developed. The residents’ alarm call system must be in good working order and associated problems with the front door access must be resolved. Timescale for action 31/10/06 2. OP19 23 (2) (c) 15/09/06 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. 2. 3. 4. Refer to Standard OP7 OP10 OP27 OP30 Good Practice Recommendations Care plans should be more consistently maintained. Resident’s consent regarding their bedroom doors being left open throughout the day should be noted on care plans. Staffing levels should be kept under review. A further staff skills and training analysis should be developed. Moorland House DS0000020057.V302688.R01.S.doc Version 5.2 Page 23 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 © 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 Moorland House DS0000020057.V302688.R01.S.doc Version 5.2 Page 24 - 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!