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Inspection on 09/10/07 for Moorlands Nursing Home

Also see our care home review for Moorlands Nursing Home for more information

This inspection was carried out on 9th October 2007.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Moorlands Nursing Home provides residents with a warm, pleasant and friendly environment. Resident`s needs are generally well met by staff who have the appropriate level of knowledge and are well trained. The relationship between staff and residents was seen to be very relaxed and it was obvious that staff enjoyed their work. Residents and relative comments made included, "Everyone is very friendly and organise events to try and bring us all together in a family atmosphere" "I have found the staff willing to listen" "Staff are always helpful and cheerful" The home has been accredited by City and guilds and as such has its own training centre to provide NVQ level 2, 3 and 4 to staff. The home employs three staff as in house assessors and two staff as verifiers. Following completion of the qualification the Manager said that an external verifier from City and Guilds visits the home to audit completed course work. 75% of care staff working at the home have achieved an NVQ level 2 in care with some also achieving a level 3. Food provided is both appetizing and varied. One resident said, "The food is good and all freshly cooked. If you don`t like something you can have something different"

What has improved since the last inspection?

Since last inspection the lounge and downstairs corridor carpets have been replaced. The dining room and a number of resident bedrooms have also benefited from re-decoration. Externally a lovely sensory garden/seating area has been created for residents to enjoy. Numerous scented plants, shrubs, trees and flowers have been planted which will grow over the months to come. Residents spoken to during the inspection spoke of the benefits of having a pleasant external environment to enjoy.

What the care home could do better:

Some care plans need to be developed/updated to include individual needs/problems of the resident this should include what the resident can do for themselves and help that they need from staff. Staff at the home must take particular care to ensure that care plans are updated to reflect current treatment that is prescribed. Systems need to be put into place to prevent over ordering of medication, which results in wastage. Although activities and outings are planned some residents did not feel that there was enough activities provided in the home on a day-to-day basis. Some residents and relatives said that they did not always feel that there was enough staff on duty to meet resident`s needs. The Manager needs to look at dependency of residents and assess this. Water temperature checks need to be carried out more regularly. The Manager must take action to address the shower and bath water temperatures that are too cool. Action should be taken to ensure that night staff are involved in fire drill taking place in the home. Consideration should be given to making the sensory garden/seating area into a more secure area to help to ensure safety of residents.

CARE HOMES FOR OLDER PEOPLE Moorlands Nursing Home Northgate Guisborough TS14 6JU Lead Inspector Katherine Acheson Key Unannounced Inspection 9th October 2007 09:45 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Moorlands Nursing Home DS0000055586.V351965.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 DS0000055586.V351965.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Moorlands Nursing Home Address Northgate Guisborough TS14 6JU 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) 01287 630777 01287 630374 moorland@btconnect.com Mr George Dixon Mrs Susan Olive Ellis, Mrs Angela Catherine Allick, Mr Michael Dixon Mrs Yvonne Elizabeth Southall Care Home 29 Category(ies) of Old age, not falling within any other category registration, with number (29) of places Moorlands Nursing Home DS0000055586.V351965.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Five individuals who are under the age of 65 are allowed to reside in the home. 16th October 2006 Date of last inspection Brief Description of the Service: Moorlands Nursing Home is registered to provide personal and nursing care to twenty-nine older people. The home is a two-storey purpose built facility providing both single and shared accommodation. There are 21 single bedrooms and 4 double bedrooms. The single bedrooms are a minimum of 10 sq.m and the double bedrooms are a minimum of 16 sq.m. There is a passenger lift giving access to the upper floor. There is a large lounge, conservatory and a communal dining room on the ground floor of the home. Moorlands is situated close to local shops and amenities. Externally there is an open garden/patio area for residents to enjoy. There is a car park at the rear of the home. The cost of care at the time of the inspection visit ranged from £405 to £505 per week depending on the category of care required. Moorlands Nursing Home DS0000055586.V351965.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection of the home was carried out over two days the 9th and 15th October 2007. On the first day of the inspection the Inspector arrived unannounced. The Manager of the home was aware of the second day of the inspection. On the 9th October 2007 the Inspector arrived at 09:45am and left at 2:15pm. On the 15th October 2007 the Inspector arrived at 1:45pm and left at 5:50pm. The reason for the inspection was to see how good a job the home does in meeting the National Minimum Standards set by the government for Care Homes. Five residents, two relatives, the Residential Care Manager, Deputy Manager, Cook and Laundry Assistant were spoken to during the inspection. A lengthy discussion also took place with the Manager. Numerous records including care plans, menus, quality assurance, complaints and staff recruitment and training records were examined. The Inspector walked around the home. Before the inspection ten surveys for residents and ten surveys for relatives were sent to the home for the Manager to distribute accordingly. Surveys requested feedback on the service and staff provided. Two resident and five relative surveys were returned to the Commission for Social Care Inspection. Comments received can be read within the report. The manager had completed an Annual Quality Assurance Assessment (AQAA) before to the inspection. The AQAA is the Registered Persons own selfassessment of the service and care that is provided. Information contained within the AQAA is reflected within the report and is also used to support the judgements. The findings from the inspection were that the home provides a good service with most of the National Minimum Standards being met. The details of any issues identified at this inspection requiring action are to be found at the back of this report. Moorlands Nursing Home DS0000055586.V351965.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? Since last inspection the lounge and downstairs corridor carpets have been replaced. The dining room and a number of resident bedrooms have also benefited from re-decoration. Externally a lovely sensory garden/seating area has been created for residents to enjoy. Numerous scented plants, shrubs, trees and flowers have been planted which will grow over the months to come. Residents spoken to during the inspection spoke of the benefits of having a pleasant external environment to enjoy. Moorlands Nursing Home DS0000055586.V351965.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. The summary of this inspection report can be made available in other formats on request. Moorlands Nursing Home DS0000055586.V351965.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 DS0000055586.V351965.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): Standards assessed 3 and 6 People who use this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Assessments of prospective residents are carried out to ensure that the home can meet their needs. EVIDENCE: Before going into Moorlands Nursing Home, residents are assessed by a Social Worker or Nurse. A copy of this assessment is forwarded to the home for the management to look at. The Manager said that staff at the home then carry out their own preadmission assessment either visiting the person in their own home or at hospital to ensure that the needs of the resident can be met. Moorlands Nursing Home DS0000055586.V351965.R01.S.doc Version 5.2 Page 10 The Annual Quality Assurance Assessment states that prospective residents and relatives are encouraged to visit the home to have a look round and spend some time. Prospective residents will be given a statement of purpose and service user guide, which gives important information about the home. The service users guide is also available in large print and on audiotape. Two residents files were looked at during the visit, both of which contained an assessment of needs and evidence of personal choice. Moorlands Nursing Home does not provide intermediate care so standard 6 is not applicable. Moorlands Nursing Home DS0000055586.V351965.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): Standards assessed 7, 8, 9 and 10 People who use this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides a good standard of care, residents living at the home are happy. Some improvement is needed in respect of medication ordering to ensure that medication ordered does not exceed amount required to avoid wastage EVIDENCE: Two plans of care were looked at during the visit. One was that of a resident receiving nursing care the other was that of a resident receiving personal care. The care plans of the resident receiving nursing care were in general found to be fairly detailed and included action that staff should take to help to meet the needs of the person. It was noted that one plan of care in respect of an acute medical problem had not been updated to reflect treatment prescribed by the hospital Doctor, the Manager said that she would take action to address the situation. The plan of care belonging to the resident receiving personal care Moorlands Nursing Home DS0000055586.V351965.R01.S.doc Version 5.2 Page 12 contained limited information. An example of this was that within the plan of care it was documented that the resident needed help with washing and dressing, however, did not describe what the resident could do for themselves or highlight help that they needed from care staff working at the home. Care plans were updated/evaluated collectively on a monthly basis within the resident’s daily report. A discussion took place with the Manager about evaluating each problem individually so that any deteriorations or improvements made from month to month could be seen at a glance. On return to the home for the second day of the inspection staff at the home had started to evaluate care plans individually. Resident’s files included healthcare visits and appointments. The records showed the regularity of visits for treatment from: doctors and district nurses, opticians, dentists and other healthcare specialists. One resident raised concerns that the home seem to be “struggling to get a chiropodist to visit” The home had equipment, to assist staff when they were moving residents. Residents spoken to confirmed that their dignity and privacy was respected. Residents and relatives spoken to during the inspection and comment cards received stated, “The care is good and the staff are respectful” “We are well looked after and nothing is a trouble” “I’ve made one or two friends and the staff are good” “It’s very nice, I am quite happy” “Mum is very happy and content” “I feel that carers try to be bright and pleasant with residents. They try to create a safe, warm and pleasant atmosphere” During the inspection arrangements for receiving, storing, administering, recording and disposing of resident’s medication were observed and examined. The home has a medication policy, however this was not looked at during the visit. The Manager said that in general it is nurses that administer medication to residents, however on occasions the Manager of those residents receiving personal care, although not a nurse has received appropriate training and does administer medication to residents receiving personal care. Moorlands Nursing Home DS0000055586.V351965.R01.S.doc Version 5.2 Page 13 During the visit a medication audit of one of the residents files sampled during the inspection was carried out. Medication administration charts had been completed correctly and the stock balance of medication belonging to the residents was correct, matching up with medication ordered, received, administered and remaining in the home. Appropriate codes were being used when medication was not being given for a particular reason. Examination of records and a count of medication identified some over ordering of prescribed medication; this was pointed out to staff at the home. Moorlands Nursing Home DS0000055586.V351965.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): Standards assessed 12, 13 14 and 15 People who use this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Appropriate and enjoyable activities do take place at the home, however not as often as some residents would like. Residents are able to exercise choice and visitors are made to feel welcome. Food provided is varied, appetizing and appealing and provides residents with a wholesome balanced diet. EVIDENCE: The Manager said that one care assistant working at the home gets designated time to plan and take part in activities with residents. At other times care staff organize activities. Activities taking part include bingo, jigsaws and skittles. Twice monthly motivational afternoons are planned with residents taking part in a number of activities one of which includes a quiz. The Manager said that entertainers come into the home on a regular basis to sing to residents and that there are regular clothes parties. Moorlands Nursing Home DS0000055586.V351965.R01.S.doc Version 5.2 Page 15 Although activities are provided for residents it appears that those daily activities are not quite as often as some residents would like. Residents spoken to during the inspection and comment cards received in respect of activities stated, “The activities could be improved there is a lack of resources” “I have just started to knit again a relative of another resident brought me in some needles and wool” “We have had some lovely trips out this summer to Saltburn and Danby” “I get a bit bored” “For the first time today we played dominoes”. During the inspection one resident was observed to be playing dominoes with two staff members. A discussion took place with the Manager regarding better planning and involving more residents. The home supports residents to practice their religion. The Manager said that a representative from the Roman Catholic Church visits the home on a Sunday to give communion to those residents who want it. She said that currently there are not any residents expressing a wish to attend church, however if this was the case arrangements could be made. One comment card received stated, “Various religious groups have been into the home at different times. I am aware of one person receiving communion from the church. My church have been into the home at Christmas”. Visits from relatives and friends are welcome at any time. One relative stated, “I am made to feel welcome and offered a cup of tea” another said, “Visiting is very flexible which is appreciated and comforting. On one occasion when I was unable to visit I telephoned and I was able to speak to my mother on the phone”. Residents interviewed spoke of flexibility in routine and freedom of choice. On the first inspection day the Inspector arrived at 09:45am. Some residents were observed to be enjoying a leisurely breakfast. Food provided by the home is enjoyed by residents. There is a four-week menu plan in which residents are offered choice. The dining room is pleasant. A work surface that is accessible to residents had lots of home baked scones, jam tarts and biscuits on it. The cook said that soups were homemade and that she regularly baked cakes, scones and puddings. Residents spoken to during the inspection and comment cards received stated, Moorlands Nursing Home DS0000055586.V351965.R01.S.doc Version 5.2 Page 16 “The food is quite good” “The food provided is of a good standard, well prepared and attractive home cooking” “The cooks provide excellent meals and a very caring service” “Meals are always hot and look appetizing” Moorlands Nursing Home DS0000055586.V351965.R01.S.doc Version 5.2 Page 17 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): Standards assessed 16 and 18 People who use this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents and relatives are able to express their concerns. Staff are aware of procedures to follow if abuse is suspected which helps to protect residents. EVIDENCE: The home has a complaint procedure, which informs residents/relatives of their right to complain to any commissioning authorities such as the Primary Care Trust or Social Services. The home keeps a record of complaints. There have been three complaints made to the home in the last twelve months. The first day of the inspection identified that records of complaints were recorded in a book and did not ensure confidentiality. On return to the home for the second day of the inspection that Manager had developed a system in which to ensure that complaints were recorded separately to ensure data protection and confidentiality. Residents, relatives and comment cards received stated that they were able to approach the staff to raise any concern that they may have. The Manager said that the home has an adult protection policy that details action that staff should take if abuse is suspected. She said that she and the Moorlands Nursing Home DS0000055586.V351965.R01.S.doc Version 5.2 Page 18 Residential Care Manager had attended adult protection training, which they are to deliver to other staff working at the home. Staff spoken to during the inspection were able to inform of procedures to follow if abuse is suspected. Moorlands Nursing Home DS0000055586.V351965.R01.S.doc Version 5.2 Page 19 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): Standards assessed 19 and 26 People who use this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The standard of the environment within this home is good providing the people who live there with and attractive, homely and comfortable place to live. Consideration should be given to securing the garden area for residents to help to ensure privacy and safety. EVIDENCE: The Inspector walked around the home. In general communal areas are well maintained with appropriate furnishings throughout. Moorlands Nursing Home provides a comfortable homely environment for residents. On the ground floor of the home there is a large lounge area that leads onto a conservatory. There is also a pleasant dining room. Since last inspection carpets in the lounge and Moorlands Nursing Home DS0000055586.V351965.R01.S.doc Version 5.2 Page 20 downstairs corridors have been replaced. The dining room and upstairs corridor have benefited from re-decoration. On walking round the home it was noted that the window in room 24 on the first floor of the home was not restricted to ensure safety of residents. The Inspector was advised that immediate action would be taken to ensure safety. Bedrooms visited on the day of the inspection were personalized and contained appropriate furnishings. The Manager said that there is an ongoing programme for re-decoration of resident’s bedrooms. To the rear of the home a pleasant sensory garden/seating are has been created. Lots of lovely scented shrubs/flowers have been planted for residents to enjoy. The garden/seating area is not enclosed to ensure privacy and security. One comment card received stated, “ The garden area at the rear of the home is not a secure area” On both inspection days the home was observed to be clean and dour free. Appropriate laundry facilities are in place. A discussion took place with the Laundry Assistant during the walk round who was able to demonstrate knowledge in respect of hygiene requirements and procedures to follow to prevent the spread of inspection. Moorlands Nursing Home DS0000055586.V351965.R01.S.doc Version 5.2 Page 21 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): Standards assessed 27, 28, 29 and 30 People who use this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff at the home are trained to meet the needs of people living at the home, however inadequate pre employment checks do not help to ensure safety of residents. EVIDENCE: At the time of the inspection there were twenty-nine residents living at the home. The homes duty rota showed that there were four or five care assistants on duty on a morning four on an afternoon and three on an evening until 8:00pm and two care assistants on duty at night. There is one trained nurse on during the day and night. The Manager of the home, who is also nurse, works thirty-two hours a week usually over four days. One day of the four is supernumerary and as such works in addition to the staff numbers above. The Residential Care Manager also works one supernumerary day a week. Moorlands Nursing Home DS0000055586.V351965.R01.S.doc Version 5.2 Page 22 In general residents, relatives and comment cards received in spoke highly of the Manager and staff team, however a number said that they did not feel that there were sufficient staff on duty at all times. Comments made included, “Sometimes there isn’t enough staff on duty. It’s obvious how busy the staff are and they never complain but they can’t do two jobs at once” “More staff are needed at busy times” “The staff are good, everything is free and easy” “The staff are very nice and helpful”. Moorlands Nursing Home has been accredited by City and guilds and as such has its own training centre to provide NVQ level 2, 3 and 4 to staff. The home employs three staff as in house assessors and two staff as verifiers. Following completion of the qualification the Manager said that an external verifier from City and Guilds visits the home to audit completed course work. The Manager said that 75 of care staff working at the home have achieved a minimum qualification of NVQ level 2 in Care with many also achieving level 3 Two staff files were examined during the inspection. Files contained the required documents including, a photograph, proof of identity, two references one being from the last employer. Of the two staff files examined, one contained evidence that the Registered Person had received a satisfactory Criminal Record Bureau Check before the staff member started work, the other did not. The Manager was informed that this was not acceptable and that appropriate checks must be received prior to start of work. Evidence of induction training was available on both staff files looked at during the visit. The Manager said that this meets with the required standards as set by Skills for Care. Certificates were available on staff files looked at to confirm that they had received recent training in fire and moving and handling. The Manager said that she is a qualified moving and handling trainer and as such delivers theoretical training to staff and that an external company delivers the practical. The Manager said that the Fire Authority delivers fire training to staff on an annual basis and that she does regular updates in between. Moorlands Nursing Home DS0000055586.V351965.R01.S.doc Version 5.2 Page 23 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): Standards assessed 31, 33, 35 and 38 People who use this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Quality assurance systems are in place to ensure that the home is run in the best interest of residents. In general the home is well run with the health and safety of residents being promoted, however, failure to follow Health and safety guidelines to carry out weekly water temperatures could put residents at risk. EVIDENCE: The Manager is a Registered Nurse who has achieved a management qualification. The Manager has many years of experience of working with older people in a care home environment. Moorlands Nursing Home DS0000055586.V351965.R01.S.doc Version 5.2 Page 24 The Manager advised that she has attended lots of training during the last twelve months. Training mentioned included, adult protection, managing medication, Mental Capacity Act Training and training on the use of syringe drivers and naso gastric tubes. The Manager said that quality assurance and quality monitoring practices are in place. Surveys are sent out to residents on a yearly basis to see if they are happy with the home and care that is provided. The results are published and displayed on a notice board. The Manager advised that the home is a little later than usual in sending out the questionnaires this year. Resident and relative meetings are held within the home. Records were evidenced to confirm that the last meeting took place in August 2007. The Manager said that her door is always open if residents or relatives wanted to speak to her. Residents and relatives spoken to during the visit confirmed that this was the case. The home looks after small amounts of money belonging to some residents. Appropriate records of transactions are kept. A sample of health and safety records were examined and most were found to be in order. Records were examined to confirm that the Gas boilers and fire extinguishers had been serviced within the last year. Water temperatures in resident areas are taken and recorded on a monthly basis it is suggested that the Registered Person give consideration to the Health and Safety Guidelines to monitor bath and shower water temperatures weekly. Records examined highlighted a number of bath and shower water temperatures that were too cool; this was pointed out at the time of the inspection. Tests of the fire alarm system are also carried out on average weekly. The Manager said that weekly fire tests are used as training and as fire drills. Records examined identified that tests were carried out mostly during the day and such did not involve night staff. A discussion took place with the Manager in respect of this. Moorlands Nursing Home DS0000055586.V351965.R01.S.doc Version 5.2 Page 25 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 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 2 X X X X X X 3 STAFFING Standard No Score 27 2 28 4 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 2 Moorlands Nursing Home DS0000055586.V351965.R01.S.doc Version 5.2 Page 26 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 OP7 Regulation 13, 14, 15 • Requirement Care plans must be developed further to ensure that they are specific to the resident and reflect current treatment. This will help to ensure that the resident gets the help that they need and receive care/treatment prescribed Timescale for action 15/02/08 2 OP12 16 3 OP19 13 4 OP27 18 5 OP29 13 The Registered Person must consult with residents and plan suitable and regular activities for residents to enjoy. The window in room 24 on the first floor of the home must be restricted to ensure safety of residents. The Registered Person must carry out an assessment of residents to determine if there are sufficient staff on duty The Registered Person must ensure that appropriate employment checks are carried out and received prior to the commencement of employment to ensure safety of residents. DS0000055586.V351965.R01.S.doc 30/12/07 15/10/07 30/11/07 15/10/07 Moorlands Nursing Home Version 5.2 Page 27 6 OP38 23 The Registered Person must address the problem of shower and bath water temperatures that are too cold to ensure resident comfort and safety 15/10/07 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 Refer to Standard OP7 Good Practice Recommendations The Registered Person should give consideration to evaluating/updating each plan of care individually so that deteriorations or improvements made can be identified quickly. The Registered Person should review the homes system for ordering medication to ensure that medication ordered does not exceed amount required to avoid wastage. The Registered Person should give consideration to making the garden/seating area for residents secure to help to ensure privacy and safety. The Registered Person should give consideration to the Health and Safety Executive Guidelines to monitor bath and shower water temperatures weekly. The Manager should ensure that both day and night staff take part in fire drills to ensure that all staff are appropriately trained. 2 3 4 5 OP9 OP19 OP38 OP38 Moorlands Nursing Home DS0000055586.V351965.R01.S.doc Version 5.2 Page 28 Commission for Social Care Inspection North Eastern No1, Hopetown Studios Brinkburn Road Darlington DL3 6DS 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 DS0000055586.V351965.R01.S.doc Version 5.2 Page 29 - 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. 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