Inspection on 05/10/06 for Moorlands Grange

This inspection was carried out on 5th October 2006.

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 27/04/07

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 5th October 2006 08:40 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.V304280.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.V304280.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 01484 222351 01484 222352 www.kirklees.gov.uk Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration Kirklees MC Mrs Karen Knapik Care Home Moorlands Grange DS0000067432.V304280.R01.S.doc Version 5.2 Page 4 No. of places registered (if applicable) 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.V304280.R01.S.doc Version 5.2 Page 5 SERVICE INFORMATION Conditions of registration: 1. Can accommodate a maximum of 20 service users within PD/PD(E) category over 55 years of age New Service – Registered in March 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 twenty service users over the age of 65 years, 20 service users with a physical disability, and 20 service users who require intermediate care and are over 55 years of age. Not exceeding twenty service users in each category, and a total of 40 service users at any one time. 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 service users’ fees at the home are £498.25 per week. Items not covered by fees include hairdressing, newspapers, toiletries, WRVS sweet trolley, phone calls, postage of personal mail, private chiropody, optician and dentist. Moorlands Grange DS0000067432.V304280.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. This report refers to a key inspection which included unannounced visits on the 5th & 12th October 2006; the duration of the visits was 10.75 hours. Mrs Karen Knapik, manager, and Mr Paul Cunningham, group manager, were present at the second day of the inspection. The following areas were looked at and have been used in the production of this report; a sample of records, care plans, medication, individual discussion with six service users and 2 members of staff, tour of the premises and document reading. Other information used in the inspection process included notifications from the provider to the Commission for Social Care Inspection about deaths, illnesses, accidents and incidents at the home and a pre inspection questionnaire completed by the manager. To reflect the views of those who use the service, satisfaction questionnaires were sent to 10 service users, three were returned; 10 relatives/advocate/ friend, none were returned; GPs and district nurses, none were returned. The inspector would like to thank those who contributed to the inspection process, and also thank Mr Cunningham, Mrs Knapik, her staff and service users, for their time and hospitality on the day of inspection. What the service does well: What has improved since the last inspection? This is the first inspection since the home was registered in March 2006. Moorlands Grange DS0000067432.V304280.R01.S.doc Version 5.2 Page 7 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. Moorlands Grange DS0000067432.V304280.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.V304280.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1-6 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. No service user moves into the home without having had his/her needs assessed and been assured that those needs will be met. 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 who are assessed and referred for intermediate care are helped to maximise their independence and return home. EVIDENCE: A number of service users had transferred from existing Local Authority homes that have since closed down and one of the service users spoken with confirmed that they liked their new home and the move had not been too traumatic. Prospective service users and their relatives are encouraged to have a look around the home and spend some time there before deciding to Moorlands Grange DS0000067432.V304280.R01.S.doc Version 5.2 Page 10 move in. A service user spoken with confirmed that they had visited the home before moving there. Prior to admission of a long-term service user, a senior member of staff visits them in their place of residence and carries out an assessment of their needs. A community care assessment is also obtained and staff ensure that they can meet the service users’ needs prior to offering them a place at the home. When an intermediate service user is to be admitted, the staff at the home obtain a community care assessment and contact health care professionals to ensure that they have up to date information about the service user’s needs. Once the staff are confident that they can meet the service user’s needs, then they are offered a place. Each service user has a plan of care based on their pre admission assessment. There is a welcome pack in each of the bedrooms which included a Service User Guide and statement of aims and objectives. The documentation, which is written in large print, was of a good standard. Moorlands Grange DS0000067432.V304280.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7 - 10 Quality in this outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this service. Without detailed care documentation, there is no evidence to suggest that the needs of the service user have been identified or met. Staff must maintain the correct procedures for the administration of medication in order to protect service users. Service users are treated with respect. EVIDENCE: The intermediate care plans were generally of a good standard and the multidisciplinary team is involved in writing the plans and contributing to the care delivered. The long term care plans need to be written in greater detail and the daily record should show the outcome of the care that has been identified in the care plan. Staff who administer medication have had training and records are kept of all medicines received, administered and leaving the home. One of the audits Moorlands Grange DS0000067432.V304280.R01.S.doc Version 5.2 Page 12 carried out were incorrect in relation to the amount of medication recorded on the drug chart and what should have been left in the bottle. In relation to intermediate care, staff had taken the medication from the bottles and put them into a dosette box ready for another member of staff to give to the service user. This is secondary dispensing and Paul Cunningham, Group Manager, confirmed that the practice would not continue. Staff were seen to respond to service users by name and in a kind and dignified manner. Moorlands Grange DS0000067432.V304280.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12 - 15 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. Service users find the lifestyle experienced in the home matches their expectations and preferences. Service users are encouraged to maintain contact with family and friends, and they visit on a regular basis. A variety of meals is offered that take into account the likes and dislikes of the service users. EVIDENCE: An activities coordinator is employed Monday - Thursday between 2/2.30pm – 4pm and, as the service is developing, activities are also being developed. In addition to this, service users are offered weekly manicures and the WRVS shop comes to the home each Tuesday and a church service is held monthly. Apart from the in house activities, outings are also arranged to places of interest including local garden centres. 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. Up to date information about Moorlands Grange DS0000067432.V304280.R01.S.doc Version 5.2 Page 14 activities is displayed on a notice board in the breakfast area of the home and also distributed to individual service users. Service users confirmed that they can see their visitors in private and that they are always made welcome. The menus offered a variety of food and took account of individual service users’ food preferences; specialised diets and cultural needs had also been taken into consideration when planning the menus. Service users spoken with on the day said that staff asked everyone what they would like for their meal, and that the food was good. Moorlands Grange DS0000067432.V304280.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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon in a timely manner. Service users are protected from abuse. EVIDENCE: There is a complaints procedure located in the Service User Guide which specifies how complaints may be made, and with an assurance that they will be responded to within a maximum of 28 days. 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.V304280.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. The home is in a good state of repair and decorative condition and service users’ individual needs are met in a comfortable and homely setting. The premises are clean and systems are in place to control the spread of infection. EVIDENCE: The home is new and the decorative condition of the home was of a very good standard. On the day of the inspection, the gardeners were in the process of planting bulbs ready for spring. The premises were clean and systems are in place to control the spread of infection. One service user said how lovely the home was, and that she also had a lovely bedroom. Moorlands Grange DS0000067432.V304280.R01.S.doc Version 5.2 Page 17 There is a designated smoking room on the ground floor of the building. However, even though the home has only been open a few months, the floor covering was burnt and heavily stained. Staff are looking to replace the floor covering with a more serviceable type. Moorlands Grange DS0000067432.V304280.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27 - 30 Quality in this outcome area is adequate. This judgement has been made from evidence gathered both during and before the visit to this 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 service users in the home. There was a domestic vacancy of 16 hours per week that was being covered by existing staff. On occasions, agency staff are been used to cover care staff duties, holidays and sickness and, where this is the case, the same staff are used to ensure the continuity of care. 52 of care staff have an NVQ 2 or equivalent. In relation to recruitment, the staff files contained the relevant information and documentation. Moorlands Grange DS0000067432.V304280.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 & 38 Quality in this outcome area is poor. This judgement has been made from evidence gathered both during and before the visit to this service. The registered manager is of good character and competent to manage the home. Service users are safeguarded by the accounting and financial procedures of the home. Without up to date training in fire safety and movement and handling, and complying with relevant health and safety legislation, service users and staff health and safety are potentially not protected. Moorlands Grange DS0000067432.V304280.R01.S.doc Version 5.2 Page 20 EVIDENCE: Mrs Knapik, the manager, is of good character and has many years’ experience in the care of older people. Two service users’ financial records were examined and satisfactory records were being maintained. 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 intermediate service users are discharged home, they are offered a questionnaire about how the home can improve on the service. The questionnaires are then discussed at the staff meeting and improvements made as appropriate. As the service has recently been established, the manager is looking at offering a questionnaire to the long stay service users as presently they are asked on a regular basis about the services provided but this has not yet been made available in writing. 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. Satisfactory records are maintained for accident reporting Emergency lighting has been tested monthly. Fire alarms have been tested weekly, however the person checking the fire alarms should ensure that all the 18 fire alarm zones are tested within a 13-week period. Fire lectures - 39 out of 51 staff received a fire lecture prior to the home opening in March 2006 and the manager is aware that more lectures need to be arranged. Fire drills were carried out in August and October and a number of staff did attend. The provider must ensure that all staff have fire drills and practices. Mr Cunningham confirmed that he would ensure that all staff receive the training and drills. Movement and Handling – Not all staff had had movement and handling training and one member of staff last had training in 1999. All staff must have up to date movement and handling training. Following the inspection, Mr Cunningham confirmed in writing that movement and handling training had been arranged for November 2006. The cupboard where the substances hazardous to health (COSHH) were being stored was unlocked and they were in an unlocked sluice room. Mr Moorlands Grange DS0000067432.V304280.R01.S.doc Version 5.2 Page 21 Cunningham was made aware of the situation and locked the sluice room. The sluice room and the COSHH cupboard must be kept locked. Moorlands Grange DS0000067432.V304280.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 3 3 3 3 3 3 HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 X 3 X X 1 Moorlands Grange DS0000067432.V304280.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? N/A 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 OP9 Regulation 13.- (2) Timescale for action The registered person shall make 13/10/06 arrangements for the recording, handling, safekeeping, safe administration and disposal of medicines received into the care home. Secondary dispensing must not take plane. Following the inspection Mr Cunningham, Group Manager confirmed in writing that secondary dispensing had stopped. (13/10/06) Persons working at the care home must receive suitable training in fire prevention; and take part in fire drills and practices at suitable intervals. Requirement 2. OP38 23.-(4) (d)(e) 17/11/06 3. OP38 13.- (5) Please confirm in writing by 17/11/06 the action you have taken. The registered person shall make 30/11/06 suitable arrangements to provide a safe system for moving and handling service users. All staff to have up to date training. Mr Cunningham confirmed that the training would take place in Moorlands Grange DS0000067432.V304280.R01.S.doc Version 5.2 Page 24 5. OP38 13.(1)(4)(c) November 2006. Unnecessary risk to the health or 12/10/06 safety of service users is identified and so far as possible eliminated. - The cupboard where the Substances Hazardous to Health are stored (COSHH) must be kept locked, and also the sluice room. Mr Cunningham locked the sluice rooms during the inspection. 12/10/06. 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. Refer to Standard OP7 OP8 OP9 Good Practice Recommendations Care plans should be written in greater detail. Daily record should show the outcome of the care that has been identified in the care plan. The home should continue to keep running totals of medicines administered and regular audits of the medication. (The group manager confirmed in writing on 19/10/06 that a medication audit was underway, and that the results would be sent to the Commission.) The smoking room floor covering should be replaced with a more serviceable type. The Manager should have an NVQ in management and care. Feedback should be actively sought from service users, and the results of service user surveys should be published and made available to current and prospective service users and other interested parties. Fire alarms – all zones should be tested within a 13-week period. Fire drill – all staff should have two drills a year. Fire lecture – all staff should have two lectures a year. 4. 5. 6. OP19 OP31 OP33 7. OP38 Moorlands Grange DS0000067432.V304280.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Brighouse Area Office Park View House Woodvale Office Park Woodvale Road Brighouse HD6 4AB 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 Moorlands Grange DS0000067432.V304280.R01.S.doc Version 5.2 Page 26 - 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. 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