Inspection on 27/04/07 for Moorlands Grange

This inspection was carried out on 27th April 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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

Moorlands Grange 05/10/06

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

CARE HOMES FOR OLDER PEOPLE Moorlands Grange Spruce Drive Netherton Huddersfield HD4 7WA Lead Inspector Karen Summers Key Unannounced Inspection 09:00 27 & 28th April 2007 th 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 Moorlands Grange DS0000067432.V329131.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. Moorlands Grange DS0000067432.V329131.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Moorlands Grange Address Spruce Drive Netherton Huddersfield HD4 7WA 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) 01484 222351 01484 222352 www.kirklees.gov.uk Kirklees MC Acting Manager - Mrs Mary Frances McCullagh Care Home 40 Category(ies) of Old age, not falling within any other category registration, with number (20), Physical disability (20), Physical disability of places over 65 years of age (20) Moorlands Grange DS0000067432.V329131.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Can accommodate a maximum of 20 service users within PD/PD(E) category over 55 years of age 5th October 2006 Date of last inspection Brief Description of the Service: Moorlands Grange was built in 2006. It is a two-storey care home that is owned by Kirklees Adult Services Council and is registered to provide accommodation and care for a total of forty people; twenty people who are experiencing issues related to the ageing process, twenty places for people with a physical disability. Out of the total of forty, twenty places are for people who require intermediate care. The intermediate care services are on the first floor in The Oakmoor Suite and are run by a partnership between Kirklees Adult Services and Health Services. The aim is to make sure that people who would otherwise be admitted to hospital remain as independent as possible and regain or adapt their day-today living skills. The maximum stay on this unit is 6 weeks. The long-term services are on the ground floor in The Hawthorne Suite where long-term care is provided for people who are unable to live safely and independently at home. All bedrooms are for single occupancy and are equipped with en-suite facilities. Communal areas are spacious and comfortable and are decorated and furnished to a high standard. The establishment is situated in a residential area of Netherton and the main road through the centre of the village has a good bus route to Huddersfield Town and the village of Meltham. Long-term peoples’ fees are £514.09 per week. People who use the service do not pay for intermediate care. Items not covered by fees include hairdressing, newspapers, toiletries, WRVS sweet trolley, phone calls, postage of personal mail, private chiropody, optician and the dentist. Information about the home and the services provided are available from the home in the statement of purpose and service user’s guide. Moorlands Grange DS0000067432.V329131.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report refers to a key inspection, which included an unannounced site visit on the 27th and 30th April 2007, and the length of the inspection was 11.25 hours. Mrs Frances McCullagh proposed manager was present throughout the inspection. During this visit the inspector spoke to 6 people who live in the home, and a number of staff. Following the visit 2 relatives were also contacted at their request. The inspector read care records, audited a sample of medication, staff training records, and staff supervision records and also had a tour of the home and garden. There were 31 people living in the home on the day of this visit. To reflect the views of those who use the service, satisfaction surveys were sent to: 10 people living at the home, 8 were returned; and 10 relatives/ advocate/ friends, 6 were returned. When the inspector wrote this report no responses had been received from GPs. Other information used in the inspection process included notifications from the provider to the Commission for Social Care Inspection about incidents at the home. The inspectors would like to thank those who contributed to the inspection, and also thank Mrs McCullagh, the group managers, the staff and people who use the service, for their time and hospitality on the days of visits. What the service does well: What has improved since the last inspection? Moorlands Grange DS0000067432.V329131.R01.S.doc Version 5.2 Page 6 The care documentation has improved. The policies and procedures for medicines are followed. The manager has an NVQ level 4 in management and care. Staff has up to date training in movement and handling and fire. The smoking room floor covering has been replaced with one that is easy to keep clean. What they could do better: It is recommended that a more varied programme of activities be provided taking into account the interests of the people living in the home. One of the relatives commented in the survey that the home could improve by providing more activities and social occasions. The person also said that her relative had said that she feels she has nothing to do to fill her time. A second person commented that their relatives’ physical needs are addressed, but they believe that staff have insufficient time to address their social needs. A third person said that the home could improve by having entertainment from outside of the home. Out of the 8 surveys received from people who live at the home, 6 said that there are usually activities arranged by the home that they can take part in. 1 said always, and 1 said sometimes. Feedback should be carried out with all people who use the service and the results made available to them. The supervision of staff should take place six times a year. The fire alarms should be tested every seven days and recorded. Please contact the provider for advice of actions taken in response to this Moorlands Grange DS0000067432.V329131.R01.S.doc Version 5.2 Page 7 inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Moorlands Grange DS0000067432.V329131.R01.S.doc Version 5.2 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 Moorlands Grange DS0000067432.V329131.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3–6 People who use the service experience good quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to the service. Prospective people to use the service are assessed prior to moving into the home and are able to visit the home to establish whether or not it is the right place for them. People who are assessed and referred for intermediate care are helped to increase their independence and return home. EVIDENCE: A number of people living at the home had transferred from existing Local Authority homes that have since closed down and two of the people spoken with confirmed that they liked their new home, but would have preferred not to have moved from their previous home. People who were living at the home said that they came to look round, some with their relatives, and some said that their relative came to look for them, before they decided to move in. Some people also said that staff visited them Moorlands Grange DS0000067432.V329131.R01.S.doc Version 5.2 Page 10 before they came to the home. One of the relatives spoken with said that they had made their own arrangements to visit the home prior to their relative’s admission and spoke with the staff. Without exception all people living at the home said that they had received a contract. Four people said that they had been given enough information about the home before they moved in, and four people said that they had not. Prior to admission of a person who would like long-term care, a senior member of staff visit them in their place of residence and carries out an assessment of their needs. A community care assessment is also obtained, and once staff are satisfied that the persons needs can be met then they are sent a letter offering them a place at the home. When a person who is to be admitted requires intermediate care, the staff obtain a community care assessment and contact health care professionals to ensure that they have up to date information about the persons. Once the staff are confident that they can meet the persons needs, then that person is offered a place. Each person had a plan of care based on his or her pre admission assessment. Whilst the home welcomes people from differing cultural backgrounds, at the moment no one from an ethnic minority uses the service. There was a welcome pack in each of the bedrooms, which included a Service User Guide, and statement of aims and objectives. The documentation, which was written in large print, was of a good standard. Moorlands Grange DS0000067432.V329131.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 People who use the service experience good quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to the service. The level of care people need, which includes their health, personal and social cares needs are clearly recorded within their care plan. Medication systems are generally good. People are treated with respect. EVIDENCE: The intermediate care plans were generally of a good standard and the multidisciplinary team continued to be involved in writing the plans and contributing to the care delivered. One of the people who were receiving intermediate care commented on how she had been well looked after, and how she had enjoyed her stay. The long term people’s care records had improved since the last inspection, however the daily records examined were variable in the detail recorded. There needs to be more consistency and detail in all the daily records. Mrs Frances McCullagh acting manager said that new documentation was to be introduced, and that it would be written in greater detail and show the care that had been identified and given to the person using the service. Moorlands Grange DS0000067432.V329131.R01.S.doc Version 5.2 Page 12 The people living at the home on the day of this visit, looked well kempt, comfortable and relaxed. People responded well to the staff and it was evident from observing staff interaction with people living in the home that they knew each individual likes, dislikes and needs. Two people who live at the home said in the survey that they receive the care and support they need. Three said usually and three said sometimes. Seven out of eight said that they receive the medical support they need. The healthcare needs of people are met, evidence was seen of involvement from GPs, optician, dentist and other healthcare professionals where needed. The medication of three people was checked and all were found to tally with the records held. Records were clear and accurate, and medication was stored correctly. Systems are in place to ensure safe administration of medication. A staff signatory list is in place. During this visit staff were observed to maintain the privacy and dignity of people. Staff approached and spoke to people in an appropriate manner. Moorlands Grange DS0000067432.V329131.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12 – 15 People who use the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. People living in the home have choice over their lives and some social activities are provided. They are encouraged to maintain contact with their family and friends. People receive a varied diet and in pleasant surroundings. EVIDENCE: People’s social interests were recorded in their care plan and included information about their past hobbies and interests. When people attended an event/ activities a combined list of names are recorded. The information should be recorded in more detail to show the person enjoyment of the event and the information should be evaluation to ensure that the activities meet the people’s needs. A list of activities was displayed on a notice board in the dining area of the home, and included; quiz’s, Crown Green Bowling, dice games, board or hand games, music, ball dartboard, skittles, and throwing rings onto a board. The WRVS shop comes to the home each Tuesday. A person living at the home said that Church services take place monthly, and it can include communion for those people who wish to participate. The person also said that the hairdresser visit everyone who wishes to have her, weekly, and that Moorlands Grange DS0000067432.V329131.R01.S.doc Version 5.2 Page 14 she was very happy with her hair cut. Out of the 8 surveys received from people who live at the home, 6 said that there are usually activities arranged by the home that they can take part in. 1 said always, and 1 said sometimes. One of the relatives commented in the survey that the home could improve by providing more activities and social occasions. The person also said that her relative had said that she feels she has nothing to do to fill her time. One person commented that their relatives’ physical needs are addressed, but they believe that staff have insufficient time to address their emotional and social needs. Another person said that the home could improve by having entertainment from outside of the home e.g. singers, magicians, bingo, “Pat a dog”, and talks about the older days. And one person said that the recreational services at the home in no way compare to what was on offer at their previous Local Authority home. “No one seems to have time to organise any activities of any note.” “On most of my visits the residents just seem to sit around in the lounge with not much to do.” There is also a League of Friends of Moorlands Grange that have worked successfully in helping to enhance the quality of life for residents at the home. People said that they could see their visitors in private and that they were always made welcome. The menus offered a variety of food and took account of individual peoples’ food preferences; specialised diets and cultural needs. People who were spoken with on the day said that staff asked everyone what they would like for their meal, and that the food was good. One person said that she wished that she had chosen the alternative meal to what she had chosen that day. Out of the 8 surveys received from people who live at the home, 2 said that they always like the meals at the home, 4 said usually and 2 said sometimes. Moorlands Grange DS0000067432.V329131.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 People who use the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to the service. Service users and their relatives and friends are confident that their complaints will be listened to and taken seriously. Service users are protected from abuse. EVIDENCE: The complaints procedure is located in the Service User Guide. From August 2006 until April 2007, the home received 1 complaint and the records show that it was properly investigated. The surveys indicated that 5 out of 8 people who use the service knew how to make a complaint, and 3 out of 5 relatives also knew how to make a complaint. The comments from the people who use the service were generally, that they would speak with staff if they had any concerns. Compliments from relatives included, “Thank you for the care and compassion shown to my mother whilst been in moorlands Grange.” “Thank you to all the staff for making my grandmas 100th birthday party, and all the hard work.” “Thank you for my mothers care, love and affection that she received from all the staff. There is also a whistle blowing procedure and staff have received abuse awareness training and further update training dates have been arranged. Staff were also aware of the procedure to following if they suspected that an incident of abuse had occurred. Moorlands Grange DS0000067432.V329131.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 People who use the service experience good quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to the service. The home is in a good state of repair and decorative condition and peoples’ individual needs are met in a comfortable and modern setting. The premises are clean and systems are in place to control the spread of infection. EVIDENCE: The home continues to be in a good state of repair and decorative condition. At the time of the inspection the home was expecting an admission from another Kirklees home, and their room had been personalised with their pictures, photographs, memorabilia & flowers. The premises were clean and systems are in place to control the spread of infection. Four of the surveys received from people who use the service said that the home was always fresh and clean and four people said that the home Moorlands Grange DS0000067432.V329131.R01.S.doc Version 5.2 Page 17 is usually fresh and clean. One relative said that she cannot find fault with anything, and another said that the physical environment is impressive, however the building takes too much of the carers time. One relative commented that she was aware that the residents have there own rooms but she said that something was lacking, and that she would say “too minimalist!” Moorlands Grange DS0000067432.V329131.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27 - 30 People who use the service experience good quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to the service. The staffing levels and skill mix were sufficient to meet the number and needs of service users. Service users are supported and protected by the home’s recruitment practices. EVIDENCE: There was a sufficient number and skill mix of staff on duty to care for the number of people living in the home. Out of the surveys received from people who use the service 3 people said that there was always staff available when they need them 4 said usually and 2 said sometimes. Relatives were asked in their survey “Do the care staff have the right skills and experience to look after people properly? One relative commented that they were not aware of the qualifications of the staff; another said that they only visited once a week, and so they could not comment. Two said usually and one said, that they believe that the carers who work with their relative, are generally very skilled within the expectations of the role. 52 of care staff has an NVQ 2 or equivalent. Not all staff has had supervision 6 times a year, and the manager is in the process of setting this up. Moorlands Grange DS0000067432.V329131.R01.S.doc Version 5.2 Page 19 In relation to recruitment, the staff files contained the relevant information and documentation. Moorlands Grange DS0000067432.V329131.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31,33,35 & 38 People who use the service experience good quality outcomes in this area. We have made this judgment using a range of evidence, including a visit to the service. The registered manager is of good character and competent to manage the home, and so far as is practicable she ensures that the health, safety and welfare of service users and staff are protected. The financial interests of the people living in the home are safeguarded. EVIDENCE: In relation to quality assurance, the Group Manager visits monthly and provides a written report on the conduct of the home. In addition to this, when the people who have received intermediate care are discharged home, they are asked if they would complete a survey about how the home can improve on the service. The questionnaires are then discussed at the staff Moorlands Grange DS0000067432.V329131.R01.S.doc Version 5.2 Page 21 meeting and improvements made as appropriate. The manager said that she is in the process of arranging regular relatives and people who use the service, combined meetings. The results of the meetings and any feedback from surveys she plans to send copies to all interested parties and also display the information on the notice board. When audits of care have been done previously the information has been discussed at the relatives meetings and minutes have been recorded. Feedback should be actively sought from service users about the services provided, and the results of the surveys should be published and made available to current and prospective service users. Individual reviews of people who live at the home, which includes information about whether the home is meeting the persons needs, are done approximately 6 monthly, and all interested parties are invited to the meetings. Satisfactory records are maintained for accident reporting Staff have had fire lectures and drills, and movement and handling training. Fire alarms should be tested weekly and recorded, as presently they are tested between 4 – 16 days, and not tested when the person who checks them is on holiday. Moorlands Grange DS0000067432.V329131.R01.S.doc Version 5.2 Page 22 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 3 3 3 HEALTH AND PERSONAL CARE Standard No Score 7 2 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 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 2 X 2 Moorlands Grange DS0000067432.V329131.R01.S.doc Version 5.2 Page 23 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. Standard Regulation Requirement Timescale for action 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 OP7 OP12 Good Practice Recommendations There needs to be consistency and detail in all the daily records. The individual activities that people take part in, and their enjoyment of the activity should be recorded and evaluated to ensure that the activities meet the people’s needs. Feedback should be actively sought from people who use the service, and the results of the surveys should be published. Staff should have supervision 6 times a year. Fire alarms should be tested every 7 days and recorded, and when the person who tests the alarms is on holiday someone else should be asked to carryout the checks. Emergency lighting checks/ tests should also be recorded. 3. 4. 5. OP33 OP36 OP38 Moorlands Grange DS0000067432.V329131.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Brighouse Area Team First Floor St Pauls House 23 Park Square Leeds LS1 2ND National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © 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 Moorlands Grange DS0000067432.V329131.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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