Inspection on 19/01/06 for Moorlands Residential Care Home

This inspection was carried out on 19th January 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Moorlands Residential Care Home 24/08/07

Moorlands Residential Care Home 31/01/07

Moorlands Residential Care Home 23/05/06

Moorlands Residential Care Home 13/07/05

Moorlands Residential Care Home 16/03/05

Moorlands Residential Care Home 18/06/04

Moorlands Residential Care Home 17/03/04

Similar services:

Turret Villa Retirement Home

Moor House

Mendip House

Beaconsfield Court Care Home

Little Sisters Of The Poor

Manor House

Middleton Hall Ltd

Middlesbrough Intermediate Care Centre

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

CARE HOMES FOR OLDER PEOPLE Moorlands Residential Care Home Moorlands 57/61 Stanhope Road Darlington Durham DL3 7AP Lead Inspector Rachel Dean Unannounced Inspection 11:30 19 & 23 January 2006 th rd 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 Residential Care Home DS0000000811.V279185.R01.S.doc Version 5.1 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 Residential Care Home DS0000000811.V279185.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Moorlands Residential Care Home Address Moorlands 57/61 Stanhope Road Darlington Durham DL3 7AP 01325 487413 01325 487413 moorlands911@aol.com 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) Mr David Hodgson Smith Mrs Michelle Smith Mrs Michelle Smith Care Home 19 Category(ies) of Learning disability (1), Mental disorder, registration, with number excluding learning disability or dementia (1), Old of places age, not falling within any other category (17) Moorlands Residential Care Home DS0000000811.V279185.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. Rooms 18 & 19 Are to be occupied at all times by independently mobile service users 13th July 2005 Date of last inspection Brief Description of the Service: Moorlands Residential Care Home is registered as a care home for older people, providing care and accommodation for up to nineteen service users. The homes premises are located on two main stories, with a lower ground floor dining room and kitchen. A passenger lift providing access to all floors. Bedrooms are located throughout the building. However, two of these bedrooms are only accessible by way of stairs and a condition of registration has been made requiring that these rooms are only used to accommodate service users who are independently mobile. Communal space includes two lounges, a dining room and there is a patio and garden area to the rear of the property. Communal toilet and bathroom facilities are located through out the home. The home is pleasantly situated, overlooking park land and within walking distance of Darlington town centre and its many amenities. Moorlands Residential Care Home DS0000000811.V279185.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection of Moorlands Residential Care Home took place over two days, on Thursday 19th and Monday 23rd January 2006. During the inspection six service users and two members of care staff were spoken to about the care provided. Discussions were also held with the owners of the home, Mr and Mrs Smith. In addition to these discussions a selection of the home’s records were inspected. This inspection focused on issues that were identified during the last inspection, activities and lifestyle in the home, the meals that are provided, the way complaints are handled by the home, how the home is staffed and how staff are recruited and trained, and how the home is managed and makes sure that it is providing a good service. What the service does well: What has improved since the last inspection? Since the last inspection the home’s owners have distributed information about the home to all of the people living here. This information is called a Service User’s Guide and each service user has now been given a copy to keep in their room. The home’s has also developed policies and procedures for referring appropriate staff for inclusion on the Protection of Vulnerable Adults (POVA) List. This is a list of staff who are not considered suitable to work with vulnerable adults and which is checked when new staff are recruited to work in care homes. A sample care plan document has also been developed to help improve the home’s care planning and record keeping. However, this is not yet being used by the home. In addition to the above the home’s dining room and lounge have been redecorated and refurbished to a comfortable and pleasant standard, described by service users as ‘very smart’, ‘lovely’ and ‘very nice’. Moorlands Residential Care Home DS0000000811.V279185.R01.S.doc Version 5.1 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Moorlands Residential Care Home DS0000000811.V279185.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Moorlands Residential Care Home DS0000000811.V279185.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These key standards were not fully assessed during this inspection. The key standards were assessed during the last inspection and only outstanding issues were followed up during this inspection. EVIDENCE: A Statement of Purpose and Service User’s Guide have been developed and since the last inspection these documents have now been made available to service users. Moorlands Residential Care Home DS0000000811.V279185.R01.S.doc Version 5.1 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): The key standards were not fully assessed during this inspection. The key standards were assessed during the last inspection and only outstanding issues were followed up during this inspection. EVIDENCE: During the last inspection four care plans and care records were inspected and showed that all service users have a basic care plan and record of their care needs in place. These records were not all up to date and needed to be developed to ensure that they contained up to date and detailed information about each person’s care needs. However, little progress had been made in the development of care planning at the home since the last inspection. An example care plan has been developed, containing the documentation that is to be used, but at the time of this inspection this documentation had not been put into practice. As a result the same recommendations and requirements have been made in this inspection report as in the last two inspection reports (see requirements and recommendations section, page 21). The home’s owners must take prompt action to make sure that these requirements and recommendations are addressed within reasonable timescales. Moorlands Residential Care Home DS0000000811.V279185.R01.S.doc Version 5.1 Page 10 A selection of medication records were inspected and the stock balances in the home were checked against the records available. There remain some parts of the medication audit trail that are unclear, particularly around medication that is not prescribed in the monitored dosage system. There must be a clear and auditable record of all medication entering the home, being administered, being stored and leaving the home. Parts of the medication trolley were found to be disorganised, sticky and in need of being cleaned out. For example, there was some medication being stored in the trolley that was not in the packaging that it had been prescribed in, with the MAR sheet directing that it be given ‘as directed’, so no prescribing instruction were readily available. The metal cabinet used to stored medication, including the controlled drugs cabinet, needs to be secured to the wall. The home’s owners have purchased a new larger medication trolley and a small medication fridge. However, despite these items of equipment being purchased some time ago they were still not in use during this inspection. These pieces of equipment must be put into use as soon as possible and a regular audit of the medication records, stock and storage must take place to ensure that medication is being managed safely. Moorlands Residential Care Home DS0000000811.V279185.R01.S.doc Version 5.1 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Service users expressed mixed satisfaction at the level of activities provided in the home, with some wanting more outings and craft, while others were satisfied with what was on offer. The home has an open visiting policy, with people being able to visit the home at times convenient to them and their relative or friend. The home provides a nutritious and balance diet for its service users. Service user’s had mixed views about choice, with more choice felt to be available in some areas than others and depending on how able you were to ask for things. EVIDENCE: During this inspection daily life and activities were discussed with service users living in the home and staff working in the home. The home does not employ a specific, designated activities coordinator, but one of the care staff helps to coordinate activities in the home. Activities include bingo, film afternoons and evenings, a weekly visit from a manicurist, exercise classes and occasional entertainers. The home has access to a min bus, but this has off the road while being repaired and staff confirmed that it can be difficult to organise outings for all of the residents or to get staff involved in their free time. Moorlands Residential Care Home DS0000000811.V279185.R01.S.doc Version 5.1 Page 12 Service users had mixed views about the activities provided in the home, with some people feeling that they would like more activities, including more trips out and more opportunities to do craft. Other service users were happy with the activities provided. The home has an open visiting policy, with people being able to visit the home at times convenient to them and their relative or friend. Service users spoken to during this inspection confirmed that their visitors could come and go as they want and that there were no unnecessary restrictions on visiting times. Service users had mixed views about the choice available to them at Moorlands. The home’s routines around getting up and going to bed were thought to be flexible, as were the arrangements for having visitors. However, a number of service users felt that the choices available about food could be improved a little. For example, you had to be able to ask for an alternative at lunchtime and some staff were described as ‘more helpful and understanding than others’ in this respect. During this inspection a lunchtime meal was observed, the home’s menus were looked at and service users were spoken to about the meals provided at Moorlands. The menus show that a nutritious and traditional range of food and snacks was provided, with a main cooked dinner and pudding provided at lunchtime and choice of a lighter cooked meal or sandwiches provided at teatime. Although there was no alternative lunchtime meals on the menu, the staff and owners of the home indicated that alternatives were provided if people asked for them. Service users were generally satisfied with the food provided in the home. However, although some felt that alternatives to the main meal were not actively made available, rather that the staff would see what they could do if you asked. One service users commented that ‘we used to get more choice, but we also had a much more experienced cook. Moorlands Residential Care Home DS0000000811.V279185.R01.S.doc Version 5.1 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 A complaints policy and procedure is in place and records suggested that complaints were being handled appropriately by the home. Further amendments are needed to the home’s adult protection procedures, to ensure that all suspicions and allegations of possible abuse are reported appropriately. EVIDENCE: The home has in place a complaints policy and procedure and a complaints records was available and was inspected. There have been no recent complaints made directly to CSCI about Moorlands or made to the owners themselves. Since the last inspection the home’s owners have put into place policies and procedures for referring appropriate staff for inclusion on the Protection of Vulnerable Adults (POVA) list. However, although their adult protection procedure has been reviewed it would benefit from being clearer about how and when adult protection referrals should be made. Moorlands Residential Care Home DS0000000811.V279185.R01.S.doc Version 5.1 Page 14 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 Moorlands provides a comfortable and homely environment for people to live in, although a more formal maintenance plan would be beneficial to make sure that redecoration and maintenance takes place as soon as it is needed. The home is kept clean, tidy and service users were happy with the domestic arrangements that were in place. EVIDENCE: Since the last inspection the home’s owners have finished decorating and refurbishing the home’s dining room and the downstairs lounge. Both of these rooms now have new carpets, are nicely decorated and have new furniture in them. The service user’s consulted during the inspection were very complimentary about these rooms saying they were ‘very smart’, ‘lovely’ and ‘very nice’. In addition to the redecoration the home’s owners have acquired a new industrial carpet cleaner, which has made a noticeable improvement to the appearance of the home’s carpets. However, there remain areas of the home that would benefit from redecoration, such as the upstairs lounge and some of the corridors. Due to this and the length of time it has taken for Moorlands Residential Care Home DS0000000811.V279185.R01.S.doc Version 5.1 Page 15 maintenance work to be completed in the past, it is recommended that a maintenance audit and plan be completed to identify what tasks need doing and how and when these will be completed. Service users rooms were seen to be homely and contained personal possessions and pieces of furniture that people had wanted to bring with them when they came to live at the home. The home was also observed to be clean and tidy and service users were complimentary about the cleaning standards achieved by the home’s new cleaner. For example, ‘the new cleaner is good at keeping things clean’ and ‘she gets things done’. During the last inspection a number of doors in the home were propped open using wooden chocks or furniture and it is required that the home sought advice from the Fire Authority about safely propping open doors. Since then a number of self-closing door guards have been purchased by the provider. However, only some of these have been fitted and it is required that these are fitted to any door where they are considered necessary for the protection of service users in the event of a fire. Moorlands Residential Care Home DS0000000811.V279185.R01.S.doc Version 5.1 Page 16 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, 28, 29 & 30 Staffing levels are being maintained at appropriate levels, to meet the needs of service users in the home. A high number of staff who work in the home have achieved NVQ qualification in care. The records kept of staff recruitment need to be improved, to ensure that all the required checks are carried out on new staff and that service users are protected. Some areas of core training need to be updated to make sure staff are up to date with good practice. EVIDENCE: The staff who were consulted during this inspection had no concerns about staffing levels in the home and commented that they were now fully staffed and having to cover much fewer shifts than they had in the past. Service users were generally happy with staffing levels, but comments were made about staff being busy and not having time to sit and talk to service users in any depth. Staff rotas were inspected and showed that staffing levels were being maintained at required levels. The recruitment records for three members of staff who had been recruited in the last year were inspected. Although the records showed evidence of Criminal Record Bureau (CRB) disclosures being completed for the staff, none Moorlands Residential Care Home DS0000000811.V279185.R01.S.doc Version 5.1 Page 17 of the records inspected contained two written references. Discussions with the home’s owners highlighted that they sometimes experienced problems getting references returned. However, the law requires that two written references are obtained before new staff start work and the home needs to develop better ways of recording verbal references, recording what they do to chase overdue references and seeking alternative references when necessary. Other paperwork was also missing, such as copies of each staff member’s terms and conditions of employment, copies of the written offer of employment and records of the date staff commenced employment. The training files for three staff were inspected and staff were asked about the training provided at Moorlands. Staff were positive about the training provided and confirmed that National Vocational (NVQ) training was given high priority at the home. At the time of this inspection approximately 90 of care staff had achieved an NVQ in care. Staff had recently commenced an in depth dementia care course, two staff were due to complete fire training and all staff responsible for handling medication had completed a safe handling of medication course. However, some staff need to have update training in core areas like manual handling and first aid, to make sure that they are up to date with safe practice. As highlighted in previous inspections, specialist training in ‘learning difficulties’ would be beneficial, given the needs of some of the service users accommodated in the home. Moorlands Residential Care Home DS0000000811.V279185.R01.S.doc Version 5.1 Page 18 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 The home has a suitably qualified and experience manager. However, there are concerns that this person is currently unable to discharge their responsibilities fully, due to them also having management responsibilities for a domiciliary care agency. Improvements in the home’s own quality assurance systems are still needed, to ensure that prompt action is taken to address shortfalls in the service provided and to ensure that ongoing improvements are made. Safe systems are in place to help service users manage their personal monies, where this assistance is needed. Although some health and safety checks and systems are in place, improvements are needed to ensure the ongoing safety of service users. Moorlands Residential Care Home DS0000000811.V279185.R01.S.doc Version 5.1 Page 19 EVIDENCE: The home has a registered manager who has completed the Registered Managers Award and has many years experience of running the care home. However, the manager is also currently registered as the manager of a domiciliary care agency and there is concern that this additional role is impacting on the managers ability to effectively manage the care home. These concerns have been raised by the large number of requirements and recommendations that continue to be outstanding and the lack of progress being made in resolving these issues. As a result it is recommended that an alternative manager is registered for the domiciliary care agency, so that the registered manager of Moorlands can concentrate on fulfilling their management responsibilities for the care home. Improvements are needed in the home’s quality assurance systems. It is concerning that very little progress has been made since the last inspection and that a large number of requirements and recommendations have not been addressed. The Commission for Social Care Inspection has agreed to work closely with the owners of Moorlands to ensure that the required improvements are now made within appropriate timescales. However, if progress is not made further action will have to be considered. There are systems in place to help service users who cannot manager their own personal money. All money belonging to service users is stored individually and in a safe and secure place. During this inspection the financial records of three service users were inspected and found to be up to date, with regular checks being made to make sure that the records were accurate. During this inspection a selection of maintenance records were inspected. Although systems were in place for the majority of the needed safety checks and routine maintenance in the home, a number of recommendations and requirements have been made as a result of this inspection. Although tests of the emergency lighting system and fire alarm in the home do take place, these are not currently as regular as they should be. It is recommended that the fire alarm is tested every week and that the emergency lighting is tested every month to ensure that these systems are working correctly. Fire drills need to take place more regularly, with day staff having two drills each year and night staff having three drills each year, to ensure that all staff take appropriate action if there is a fire. It is also recommended, in line with the Environmental Health Officers recommendation, that regular portable appliance testing (PAT) is arranged to ensure that the electrical appliances used in the home are safe. The home’s electrical installation certificate was due for renewal in 2005 and had not been done at the time of this inspection. Similarly, the servicing of the fire alarm had been started, but not completed at the time of this inspection. As a result it has been required that this work be completed as a matter of urgency. Moorlands Residential Care Home DS0000000811.V279185.R01.S.doc Version 5.1 Page 20 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 X X X X HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 X 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 2 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 1 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 1 X 3 X X 1 Moorlands Residential Care Home DS0000000811.V279185.R01.S.doc Version 5.1 Page 21 Are there any outstanding requirements from the last inspection? Yes 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(4) Requirement Timescale for action 30/06/06 2. OP7 15(1) 3. OP7 15(2) 4. OP8 12(1)& 13(4) Risk assessments must be developed in more detail and linked to the care plans that relate to each area of risk (for example, a moving and handling or falls risk assessment should be located with the resulting care plan for mobility or manual handling and the care plan should include any action identified as necessary by the risk assessments). This is outstanding from previous inspections. Care plans must be developed to 30/06/06 include more detailed information about the care needs of each individual. This is outstanding from previous inspections. Care plans must be reviewed 30/06/06 monthly or more often if required by the changing needs of each service user, to ensure that each plan of care is kept up to date. This is outstanding from previous inspections. Care plans must be reviewed 30/06/06 monthly or more often if DS0000000811.V279185.R01.S.doc Version 5.1 Moorlands Residential Care Home Page 22 5. OP8 12(1)& 15(1) 6. OP9 13(2) 7. OP9 13(2) 8. OP9 13(2) 9. OP18 13(2) 10. OP19&OP3 8 13(4) & 23(4) required by the changing needs of each service user, to ensure that each plan of care is kept up to date. This was a recommendation in the last inspection report, but has not been addressed by the providers. Care plans must be developed to include more detailed information about the health care needs of each individual (for example, care plans for maintaining continence should include the type of pads a service user needs, details of any toileting programme and the input of other professionals, such as continence adviser or catheter care by district nurses). This is outstanding from the previous inspection. Medication records need to be reviewed to ensure that there is a clear and auditable record of all medication entering the home, being administered and leaving the home. This is outstanding from the previous inspection. The metal cabinet used to stored medication, including the controlled drugs cabinet, needs to be connected to the wall. A regular audit of the medication records, stock and storage must take place to ensure that medication is being managed safely. Some amendments are still required to the homes adult protection procedures. This requirement is outstanding from three previous inspections. It is required that self closing door guards are provided where these are considered necessary. This Requirement remains DS0000000811.V279185.R01.S.doc 30/06/06 30/04/06 30/04/06 30/04/06 30/04/06 30/04/06 Moorlands Residential Care Home Version 5.1 Page 23 11. 12. OP29 OP30 19(1) & Schedule 2 18(1)(a) & 19(5)(b) 24 13. OP33 14. 15. OP38 OP38 13(4) 13(4) & 23(4) outstanding from the previous inspection. Two written references must be obtained for all staff, before they start work in the home. Update training in core areas, such as manual handling and first aid, must be provided to make sure that staff are up to date with safe practice. Effective quality assurance and quality monitoring systems must be put in place and should include consultation with service users and their representatives. This Requirement remains outstanding from previous inspections. It is required that the home’s electrical installation certificate is renewed (it was due in 2005). It is required that the fire alarm service is completed. 28/02/06 30/06/06 31/08/06 31/03/06 31/03/06 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. Refer to Standard OP8 Good Practice Recommendations Care plans must be structured in an easier and more user friendly way (for example, using an index and subject dividers). This recommendation is outstanding from the previous inspection. Given that the home has to store insulin and other medication that requires refrigeration for a number of service users, it is recommended that a small medications fridge is provided. This recommendation is outstanding from the previous two inspections. It is recommended that a maintenance audit of the premises is carried out to identify maintenance tasks that need to be done (for example, clearing out the guttering, identifying areas that need redecoration) and a DS0000000811.V279185.R01.S.doc Version 5.1 Page 24 2. OP7 3. OP19 Moorlands Residential Care Home 4. OP26 5. OP29 6. 7. OP30 OP31 8. 9. 10. OP38 OP38 OP38 maintenance plan drawn up covering how and when these tasks will be completed. The current vista point policy and procedure for the Control of Infection in the care home should be individualised to reflect the homes circumstances and practices. This recommendation is outstanding from previous inspections. The home needs to develop better ways of recording its recruitment process including verbal references, recording what they do to chase overdue references, seeking alternative references when necessary, copies of staff terms and conditions, offers of employment and recording the date staff commenced employment. Training in the area of Learning Disabilities is recommended. This recommendation is outstanding from previous inspections. It is recommended that an alternative manager is registered for the domiciliary care agency, so that the registered manager of Moorlands can concentrate on fulfilling their management responsibilities for the care home. It is recommended that the fire alarm is tested every week and that the emergency lighting is tested every month to ensure that these systems are working correctly. It is recommended that day staff receive two fire drills each year and that night staff receive three fire drills each year. It is recommended, in line with the Environmental Health Officer’s recommendation, that regular portable appliance testing (PAT) is arranged to ensure that the electrical appliances used in the home are safe. Moorlands Residential Care Home DS0000000811.V279185.R01.S.doc Version 5.1 Page 25 Commission for Social Care Inspection Darlington Area Office No. 1 Hopetown Studios Brinkburn Road Darlington DL3 6DS 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 Residential Care Home DS0000000811.V279185.R01.S.doc Version 5.1 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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