Inspection on 11/03/08 for Moorlands Nursing Home

This inspection was carried out on 11th March 2008.

CSCI found this care home to be providing an Adequate service.

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 Nursing Home 11/11/08

Moorlands Nursing Home 10/10/06

Moorlands Nursing Home 31/01/06

Moorlands Nursing Home 07/07/05

Moorlands Nursing Home 14/12/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

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

CARE HOMES FOR OLDER PEOPLE Moorlands Nursing Home Macdonald Road Lightwater Surrey GU18 5US Lead Inspector Mavis Clahar Unannounced Inspection 11th March 2008 09:00 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 Nursing Home DS0000061257.V359602.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 Nursing Home DS0000061257.V359602.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Moorlands Nursing Home Address Macdonald Road Lightwater Surrey GU18 5US 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) 01276 473 140 01206 828 291 moorlands@caringhomes.org Moorlands (Lightwater) Ltd Ms Kathleen Henrietta Buckley Care Home 41 Category(ies) of Dementia - over 65 years of age (8), Old age, registration, with number not falling within any other category (41), of places Physical disability (1) Moorlands Nursing Home DS0000061257.V359602.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. One named service user to be accommodated within category Physical Disability (PD) Eight service users to be accommodated within category DE(E) Date of last inspection 10th October 2006 Brief Description of the Service: Moorlands is an attractive house built in the early 1900s. The home is set in its own grounds, situated 1 mile from Lightwater village centre, 2 miles from Camberley town centre and within reach of the major towns in North West Surrey. The home provides nursing care and accommodation on two floors for 41 older people. Twenty-five of the bedrooms have en-suite facilities. The home has a lift and stair access to the upper floor. The home is tastefully decorated and furnished, with lounges and quiet areas overlooking well-kept gardens. The home is staffed by Registered Nurses and health care assistants, and is supported by the Primary Health Care Team and specialist’s nurses. The range of fees for the rooms is from £570 - £785.and includes physiotherapy assessment. There is an additional cost for hairdressing, chiropody service and any personal toiletries, newspapers and magazines. Moorlands Nursing Home DS0000061257.V359602.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. This unannounced site visit, which forms part of the key inspection to be undertaken by the Commission for Social Care Inspection, (CSCI) was undertaken by Mrs Mavis Clahar on the 11th March 2008 and lasted for eight and a half hours; commencing at 09:00 hours and concluding at 17:30 hours. The CSCI Inspecting for Better Lives (IBL) involves an Annual Quality Assurance Assessment (AQAA) to be completed by the service. This document, which includes information from a variety of sources, was received in good time. This initially helps us to prioritise the order of the inspection and identify areas that require more attention during the inspection process. This document is referred to throughout the report. The registered manager of the home was on annual leave on the day of the visit. The deputy manager and the Responsible Individual were in attendance throughout the visit. The majority of the service users spoken to were able to express their thoughts and feelings about the care they receive. The information contained in this report was gathered mainly from observation by the inspector, speaking with a number of service users, and with care staff. Further information was gathered from records kept at the home. The deputy manager and staff are aware of the Laws regarding equality and diversity and this was reflected in the staff mix. All service users in this home are Caucasian and reflect the population of the area in which the home is situated. All records sampled were mostly up to date with care plans being signed by the service users or by relatives. A number of requirements and recommendations of good practice were issued on this visit Please see Environment outcomes, Staffing Outcomes and Management and Administration outcomes for full disclosure. The final part of the inspection was spent giving feedback to the deputy manager and Responsible Individual about the findings of this visit. The inspector would like to thank all the service users and care staff that made the visit so productive and pleasant on the day. In this document the pronouns “we and us” are used to represent Commission for Social care inspection. Moorlands Nursing Home DS0000061257.V359602.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? What they could do better: The manager needs to analyse the homes admission policy and procedure and ensure there are sufficient staff employed to meet the needs of the service users in the home over any twenty-four hour period. Ensure that all staff employed at the home must be able to speak and understand the English language. The registered manager must ensure that repairs and redecoration and refurbishment of the home is on a planned basis rather than reactive. A number of requirements were made on this site visit, and these can be found in the body of the report under Staffing, Environment and management and administration of the home. Moorlands Nursing Home DS0000061257.V359602.R01.S.doc Version 5.2 Page 7 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Moorlands Nursing Home DS0000061257.V359602.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 Nursing Home DS0000061257.V359602.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 People who use the service experience good quality outcomes in this area. This judgement has been made using a range of evidence including a visit to this service. Prospective service users and their relatives have the information needed to choose a home, which will meet their needs and service users are being assessed to ensure the home is capable to meet the needs of the service users prior to being admitted into the home. EVIDENCE: Review of service users documents and identified policies demonstrated the home has a policy and procedure on admission and discharge of service users. Within the admission policy all service users must have an assessment prior to being admitted into the home. The Manager, and in her absence, the deputy manager who are trained in the principles of assessment of service users’ needs based on the care the home says it will provide carries out all pre Moorlands Nursing Home DS0000061257.V359602.R01.S.doc Version 5.2 Page 10 admission assessments of service users prior to them being admitted into the home. Review of a random sample of service user’s files including one recently admitted service user, demonstrated that pre admission assessments are being carried out and relatives were being involved in the assessment process. We observed that pre admission assessment were signed but not dated by the manager. A recommendation of good practice was made on this standard. The pre assessment records of service users reviewed were very brief, and there was no documented evidence that further assessment had taken place. However, care plans were completed for each service user. In discussion with the deputy manager and Responsible Individual we were told that the documentation used by caring homes did not allow for in-depth assessment. A requirement was made to ensure all service users are fully assessed to ascertain their health deficit and this must be documented. Standard 6 does not apply to this home Moorlands Nursing Home DS0000061257.V359602.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. This judgement has been using a range of evidence including a visit to this service. The home has a good and clear care plan in place for service users and this includes appropriate risks assessments. Which forms the basis for care based on the agreed care needs of the service users and demonstrated that trained staff met service users’ health and personal care needs. The home’s medication policy on receiving, storing and administering of medication was in place and being adhered to thereby ensuring the safety and protection of the service users. Care workers treated service users with respect and maintain their dignity and privacy when delivering personal care. EVIDENCE: Moorlands Nursing Home DS0000061257.V359602.R01.S.doc Version 5.2 Page 12 The randomly selected care plans were clear and easy to read with actual risks to service users identified and documented with supporting evidence detailing how these risks would be managed. The daily work sheet along with discussion with service users and care workers demonstrated that service users care needs met. The service user or relative signed the care plans to indicate their involvement in deciding what care they received. It was evidenced that development and review of the care plans was not consistent and further work needs to be done in this area to ensure evaluation of care is documented in a meaningful and understandable way. We observed that care plans reviewed were signed and dated by staff. In discussions with service users/relatives on the day of the visit they confirmed they were involved in the planning of their daily care. Information contained in the home’s Annual Quality Assurance Assessment (AQAA) states “All residents are treated with dignity and respect in a caring and home-like atmosphere”. Random review of selected service users files indicated service users are registered with a local General Practitioner (GP) of their choice and visits are recorded, with access to specialist healthcare professionals through their GP practice as required such as sight and hearing tests which are carried out on a regular basis; and these visits are also recorded in the service user’s folder. The home employs a part time physiotherapist who told us she assess all newly admitted service users to determine their degree of care. She then develops a programme of need e.g. stretching exercises or gentle workouts with them and instructs the activities co-ordinator to ensure these activities are carried out. Service users are offered access to chiropody service and weekly hairdressing facilities are available at a cost to the service users. We were told on the day of the visit that no service user at present was risked assess as capable to self medicate. However, the home had a policy on selfmedication should it becomes necessary. The AQAA gave no information regarding management of medication. We were told qualified nursing staff who have all received training in the receipt, recording, storage handling and administration and disposal of medicines administered all medication. We observed all medicines were administered from a lockable drugs trolley. We were told the home kept controlled drugs register and evidenced this as correct during a tour of the home, when medication was checked and found to be correct according to the homes records. All service users have a recent photograph included in their personal folder and medication record, to reduce the risk of mistakes happening during medication administration. We observed that care workers wore name badges to enable visitors and service users with memory impairment to be sure of whom they are speaking with; and we also observed Service users being treated in a friendly but respectful manner by care workers. Moorlands Nursing Home DS0000061257.V359602.R01.S.doc Version 5.2 Page 13 In discussion with service users who were able to understand the questions, they told us that they are treated with respect and dignity, and that they are able to make their own choice. Moorlands Nursing Home DS0000061257.V359602.R01.S.doc Version 5.2 Page 14 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 13 14 15 People who use the service experience good quality outcomes in this area. This judgement has been made using a range of evidence including a visit to this service. Service users lifestyles matched their needs and preferences and where possible they are able to maintain contact with family, friends and the local community. Service users are able to make choices in accordance with their abilities and were provided with a balanced diet in pleasant surroundings and in an unhurried way. EVIDENCE: The home employs a full time activity-co-ordinator who provides a range of activities based on the individual assessed and agreed needs, including their preferences, cultural beliefs and customs. We were told that wherever possible relatives are encouraged to participate in the planning and carrying out of service users’ activities. The AQAA states “In the past year the new Moorlands Nursing Home DS0000061257.V359602.R01.S.doc Version 5.2 Page 15 activities co-ordinator has been very successful in planning activities and developing her role as the residents’ needs require. She helps together with the manager to establish links with outside agencies such as local schools and churches”. We observed the activities programme on display, and in discussion with the activities co-ordinator we reviewed individual service users’ activity programme planned with the service user to meet their identified needs. We were told visiting is open, and service users can entertain their guests in their bedrooms in private or in the communal areas of the home. The C/E Vicar visits on a regular basis. Three of the service users spoken to said they had choice in their clothing. Sometimes they receive help from their key worker. On the day of inspection all service users were dressed appropriately for the winter weather. Service users spoken to say the food was very good and plentiful and they can have more if they wish. The Chef operates from a four-week menu with the winter menu being in use now. There is always a choice of two hot meals per day at mid-day, or salad at mid-day or the service user can choose their own food e.g. omelette etc. On the day of inspection service users had a choice of two main dishes, followed by dessert. Moorlands Nursing Home DS0000061257.V359602.R01.S.doc Version 5.2 Page 16 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. This judgement has been made using a range of evidence including a visit to this service. The home has a satisfactory complaints policy and procedure and training in place that evidenced that service users and relatives concerns are listened to and acted upon. Robust Safeguarding adults’ policies are in place to protect the service users from abuse. EVIDENCE: CSCI Maidstone received no complaints about the home. However a relative raised one concern and this is currently being investigated under Surrey Safeguarding Adults Team. One complaint was logged at the home, and this was dealt with satisfactorily according to the home’s records and, within the home’s time scale for dealing with complaints. The deputy manager told us that both her and the manager are in touch with service users on a daily basis and issues raised are dealt with immediately; this reduces the incidents of formal complaints. Service users spoken to say they do not complain, but when things go wrong their relatives complain on their behalf. The home has a complaints procedure and policy, which is available along with the homes’ statement of purpose in the reception area of the home. Moorlands Nursing Home DS0000061257.V359602.R01.S.doc Version 5.2 Page 17 The care workers were aware of the homes’ policy and procedure on Safeguarding Adults and a random sample of care workers training record demonstrated that care workers are being trained to undertake the duties of meeting the service users assessed needs, thereby protecting them from abuse. Moorlands Nursing Home DS0000061257.V359602.R01.S.doc Version 5.2 Page 18 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 adequate quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home provides a physical environment that meets the specific needs of the people who live there. The home has a programme to improve the decoration, fixtures and fittings. Occasionally there is slippage of timescales and maintenance tends to be reactive rather than proactive. EVIDENCE: We were told the management and staff encourages service users to see the home as their own. It presents as an attractive building in which the interior needs refurbishment. The home has specialist adaptations, needed to meet the service users needs. It was noted that call bells were left in their base outside the reach of each service users who were sitting in armchairs, and Moorlands Nursing Home DS0000061257.V359602.R01.S.doc Version 5.2 Page 19 service users said the bells are not usually answered promptly. We observed that service users were on their own in the lounges and no call bell was visible or within the reach of service users. Requirement was made on this standard. We observed that the nurses’ office situated on the first floor is in need of complete refurbishment. A requirement was made on this standard. On the first floor, the carpet along the passage way and on the landing and especially on the top tread of the stairs must be replaced as soon as possible. We were told that the home had only yesterday chooses the replacement carpet and the order has been forwarded to head office. A recommendation was made to hurry this order as high priority. Along the corridor leading from the nurses’ station on the first floor towards the admin office, there is a huge rent in the wall and ceiling. A requirement was made to investigate the cause and rectify We observed that many of the wheelchairs being used by service users were in need of cleaning. The armchairs in both lounges should be replaced as soon as possible. Requirements were made on this standard. In discussion with the laundry person it was evident she had a good of how to deal with different types of laundry. She told us she has had training in infection control, manual handling and first aide. This was supported in documentation in the personal training records. Generally, the home presents as clean and tidy and free from offensive odours. Random review of care workers training record demonstrated they have had training in infection control and this was evident in the storage of waste. Moorlands Nursing Home DS0000061257.V359602.R01.S.doc Version 5.2 Page 20 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 28 29 30 People who use the service experience poor quality outcomes in this area. This judgement has been made using a range of evidence including a visit to this service. There is not enough qualified, competent and experienced staff to meet the health and welfare needs of people using the service. Staffing rotas demonstrate that current staff are working extremely long hours, which could result in service users health and welfare being adversely affected. EVIDENCE: Review of the staff rota demonstrated the number and grade of staff on duty to provide care and attention to service users for any twenty-four period was suitable to meet the assessed care needs of the service users. Review of staff rota from last week in January 2008 to week ending 16th March 2008 revealed serious shortage of staff, with staff working regular fifty-four and fifty nine hours per week to cover the shifts thereby ensuring the correct numbers of staff on duty. On one occasion it was noted a member of staff did twelve hours night duty finishing at 08:00 hours, and later returned at 16:00 hours to work continuously until 08:00 hours the next day. In discussion with the Responsible Individual and acting manager we were told “the home had gone through a period of loss of staffing but is now in the good position of having secured staff from Eastern Europe to ensure the home has the correct Moorlands Nursing Home DS0000061257.V359602.R01.S.doc Version 5.2 Page 21 numbers of staff to meet the needs of the service users”. A requirement was made on this standard. We were told the home has a programme of planned training in place and all members of staff have an individual training record. The randomly selected staff files reviewed all had a completed induction programme and records of training undertaken. The AQAA states, “The new training programme now includes phlebotomy, sub-cutaneous infusions, syringe drivers and male catheterisation which should help reduce hospital admissions”. In discussions with staff they were able to support this statement. The home ensures that staff undertakes the mandatory training with yearly updates as necessary to maintain their competency to fulfil their duties. This was evidenced through discussion with the acting manager and care workers and from review of care workers training records. Review of the home’s training matrix did not reveal any training available in English language to foreign non English speaking carers, and this was borne out when on seeking admission to the home the carer who opened the door to us was unable to understand basic English and could not speak English in its basic form to be understood by us. This incident was discussed with both the deputy manager and the Responsible individual. A requirement was made on this standard. A review of the staff rota from Sunday 6th January 2008 to Sunday 16th March 2008 revealed the home is consistently relying on their current staff to undertake extremely long hours of duty, which could result in people who use the service receiving care that is rushed, inconsistent and impersonal from over tired staff. It was also observed that care staff at the home was unable to understand English and was not able to communicate with us in English. This was very worrying to us as we expect service users to be in safe hands at all times. In discussion with the acting manager and responsible individual we were told that they were aware that this identified person’s English was not so good. Requirement was made on this standard to ensure all carers employed at the home are able to speak and understand the English language. It was noted that staff turnover at the home is high. In discussion with the acting manager and responsible person we were told that staff from Eastern Europe comes to England with their partners and usually a group of them share a house. When their partners find work else where in the country then the wives move with them, and the remaining couple is unable to manage the rent on their own so they in turn leave. All care workers files reviewed contained evidence that Criminal Records Bureau (CRB) and Protection of Vulnerable Adults (POVA) checks were carried out prior to commencing employment, and they are in receipt of terms and conditions of employment as evidenced in their randomly selected files. We were told that supervision records were up to date and this was verified during random sampling of care workers files. Moorlands Nursing Home DS0000061257.V359602.R01.S.doc Version 5.2 Page 22 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 37 38 People who use the service experience adequate quality outcomes in this area. This judgement has been made using a range of evidence including a visit to this service. The returned AQAA was brief and gives very little information about the service. There is minimal evidence to support much of the claims made within it. There is a lack of understanding of the purpose of the AQAA. Checks shows that records are generally up to date although service users personal files were not kept secure. EVIDENCE: The registered manager of the home was on annual leave on the day of the visit. The acting manager told us she had not seen the AQAA document and Moorlands Nursing Home DS0000061257.V359602.R01.S.doc Version 5.2 Page 23 was not fully able to answer questions about this document. The AQAA was received by within the agreed time scale. All sections of the AQAA were completed but the information gave limited picture of the current situation within the service. The evidence made to support the statements is sketchy. During discussion with the deputy manager it was evident she was knowledgeable about the care needs of the service users and the training needs of the care workers to meet these identified needs. There are clear lines of accountability within the home, each member of staff spoken to on the day of inspection aware of their role and responsibilities. We observed that the registered manager has failed to ensure staff appointed in the home is fully able to fulfil their role. A requirement was made on this standard. We were told regular residents meetings are arranged and minutes of the meetings, which are passed to the owners, were available for review. The home does not become involved in service users finance except for service users spending money, which the home oversees. Receipts are kept and logged for all transaction carried out on behalf of service users. Review of documented records demonstrated that health and safety checks are routinely carried out at the home. All equipment examined on the day was properly maintained. Records indicated that fire drills, fire alarm, water temperature fridge and freezer recordings were routinely carried out. Records of Regulation 26 visits by the Responsible individual were on file and available for review. Service users’ records and other records for regulation for the protection of service users and for the effective and efficient running of the home are maintained and up to date. We observed that service users notes are not kept securely in looked cabinet. A requirement was made on this standard. We observed that the registered manager fail to ensure as far as reasonably practicable the health, safety and welfare of service users and staff, by allowing staff to work extremely long hours of duty on a regular basis according to the duty rota reviewed, thereby contravening the Health and Safety at Work Act 1974. A requirement was made on this standard Moorlands Nursing Home DS0000061257.V359602.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 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 2 STAFFING Standard No Score 27 1 28 1 29 1 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 3 X 2 2 Moorlands Nursing Home DS0000061257.V359602.R01.S.doc Version 5.2 Page 25 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 OP19 Regulation 16 (2) (c) Requirement Plan and implement some form of enabling service users to contact nursing staff whilst sitting in the lounges on their own. Place call bells in the reach of service users whilst they are sitting out of bed. Investigate and repair the rent in the wall and ceiling of the upstairs passageway leading from nurses’ office to the admin office. Replace the old floor covering in the nurse’ office Ensure service users’ wheelchairs are kept clean and in good working order. Replace the worn armchairs in the downstairs lounges. Ensure the home employs sufficient numbers of staff to meet the assessed needs of the service users. Ensure service users are in safe hands at all times by providing training in English language for non-English speaking as first language carers. DS0000061257.V359602.R01.S.doc Timescale for action 11/04/08 2 3 OP19 OP19 16 (2) (c) 23 (2) (b) 11/03/08 11/05/08 4 5 6 7 OP19 OP19 OP19 OP27 23 (2) (b) 16 (2) (c) 16 (2) (c) 12 (1) (a) 11/05/08 11/04/08 11/06/08 11/05/08 8 OP28 13 (6) 11/04/08 Moorlands Nursing Home Version 5.2 Page 26 9 OP29 18 (1) (c) (i) 10 OP31 18 (1) (a) 11 12 OP37 OP38 17 (1) (b) 18(1) (a) 12(1) (a) Ensure that carers employed by the home are able to speak and understand the English language in order to uphold the aims and philosophy of the home in giving a high standard of care to people using this service. The registered manager must ensure at all times suitable staff are appointed in the home, through a thorough and vigorous use of their employment policies and procedures. The personal files of the service users must be kept safely n a locked cupboard The registered manager must ensure the health and safety of the service users and staff are not compromised by employing sufficient staff to meet the needs of the service users. 11/05/08 11/05/08 11/04/08 11/06/08 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 OP19 OP3 Good Practice Recommendations Give high Priority to the ordering and fitting of the carpets to the hallway, stairs and landing. Ensure pre assessments form are signed and dated. Moorlands Nursing Home DS0000061257.V359602.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 Nursing Home DS0000061257.V359602.R01.S.doc Version 5.2 Page 28 - 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!