Inspection on 24/08/07 for Moorlands Residential Care Home

This inspection was carried out on 24th August 2007.

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

The inspector 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 31/01/07

Moorlands Residential Care Home 23/05/06

Moorlands Residential Care Home 19/01/06

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 Paul Emmerson Unannounced Inspection 24th August 2007 9:45 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 Residential Care Home DS0000000811.V349052.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 Residential Care Home DS0000000811.V349052.R01.S.doc Version 5.2 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.V349052.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Rooms 18 & 19 Are to be occupied at all times by independently mobile service users 31st January 2007 Date of last inspection Brief Description of the Service: Moorlands Residential Care Home provides personal care and accommodation for up to 19 older people – in 17 single bedrooms and 1 double bedroom. 8 bedrooms have en-suite facilities. Moorlands was originally 3 large (now converted) terraced town houses. It is pleasantly situated, overlooking a park and within walking distance of Darlington town centre. Bedrooms and communal spaces are arranged over 4 floors, with a passenger lift providing access to most areas. However, 2 bedrooms are only accessible by stairs so are only suitable for people who are more independently mobile. Communal space in the home includes 2 lounges, a dining room and a patio / garden area to the rear of the property. Communal toilets, two bathrooms and a shower room are located throughout the home. At the time of this inspection it costs between £345 and £355 per week to live at Moorlands. Additional charges are made for things like hairdressing. Moorlands Residential Care Home DS0000000811.V349052.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection of Moorlands Residential Care Home included an unannounced site visit, which took place over 7 hours, on the morning and afternoon of Friday 24th August 2007. In line with current CSCI policy on ‘Proportionality’ the inspection focused upon a number of key standard outcomes for the people who use the service. The inspector looked around the building and a number of records were examined. 7 people who use the service, the home’s owners and 6 members of staff were spoken to. 3 people who use the service and 2 members of staff returned CSCI’s ‘Have your Say About / Inspection Comment Cards’ about the service. CSCI is trying to improve the way we engage with people who use services so we gain a real understanding of their views and experiences of social care services. We are now using a method of working where ‘experts by experience’ are an important part of the inspection team and help inspectors get a picture of what it is like to live in or use a social care service. The term ‘experts by experience’ used in this report describes people whose knowledge about social care services comes directly from using them. For part of the inspection an ‘expert by experience’ visited Moorlands. Her comments have been used in writing this report. What the service does well: People spoken to during this inspection are happy living there. The staff are friendly and do their best to meet people’s needs and wishes. Moorlands has a homely feel. The staff know the people who live there well. A person spoken to said, “The staff have been kind to me, natural. I’ve been made to feel welcome. My room’s a bit small, but it’s nice”. Another person said, “It’s like one big happy family”. In a CSCI ‘Have your Say About / Inspection Comment Card’ about the service, a person who lives at Moorlands wrote, “This house is wonderful and I am well looked after, especially at night, when I have to call quite regularly for assistance. I am very happy and settled here”. The ‘expert by experience’ who visited Moorlands wrote, “I was happy with what I saw and would have no difficulty in allowing one of my family to reside there.” Moorlands Residential Care Home DS0000000811.V349052.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? 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 Residential Care Home DS0000000811.V349052.R01.S.doc Version 5.2 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.V349052.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2 & 3. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Admissions to the home are well managed; needs are assessed prior to admission. However, people could be better informed about the home, its facilities, the services provided and fees payable. EVIDENCE: Some of the people spoken to during the inspection had moved in to Moorlands quite recently. They spoke positively about the home. One person said, “The staff have been kind to me, natural. I’ve been made to feel welcome. My room’s a bit small, but it’s nice”. Another person said, “It’s like one big happy family”. A recently admitted person’s care plan documents were examined. These showed a pre-admission assessment had been carried out, which was being developed to inform the delivery of the person’s care. Assessment / care plan information was also obtained from the local authority social services department. Moorlands Residential Care Home DS0000000811.V349052.R01.S.doc Version 5.2 Page 9 People who are thinking about moving into Moorlands are welcome to visit with relatives, have a meal and stay overnight if necessary. In this way people can get to know the home. Moorlands is now providing written confirmation that it can meet the needs of any person being admitted there. Any move into the home is on a six-week trial basis. At the six-week stage a formal review meeting is held to consider permanency. Moorlands has: ‘Statement of Purpose’; ‘Service Users Guide’; and ‘Contract’ documents to provide people with information about the home. However, although available on request, ‘Service Users Guides’ have not been given to those people who have recently moved into the home. Further, as highlighted in the previous inspection report, the home’s current terms and conditions / contract documents need to be reviewed in light of The Office of Fair Trading’s report on ‘Fair Terms for Care’. In particular to ensure fees charged and any other costs payable are more explicitly stated. Everybody living at Moorlands should receive a copy of the home’s terms and conditions, or contract if privately funded. This is important so that people are better informed and have clear and fair written agreements about the service they should receive. The home should keep a signed copy of each person’s terms and conditions or contract for its own records. Moorlands Residential Care Home DS0000000811.V349052.R01.S.doc Version 5.2 Page 10 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. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Personal and healthcare needs are met. Although some risk assessments need to be reviewed, appropriate care plans are prepared. Medicines are dealt with correctly. EVIDENCE: The inspector spoke to, and spent time in the company of, the people who live at Moorlands. They are well cared for and comfortable in their home. Management and staff ensure any healthcare needs are met. Where specialist intervention is required it is sought. Records confirm that contact with GPs and other health professionals is maintained. A person who lives at Moorlands said, “I see my own dentist, one of the carers took me in her car”. Another person spoken to said, “I’m well looked after here. Nothing’s too much trouble to the girls”. The ‘expert by experience’ who visited Moorlands wrote, “There are plenty of toilets and bathrooms and the staff are trained to help the residents with bathing. There were plenty of towels and soap but if the residents wanted “smellies” they provide their own. There is a weekly visit from a manicurist.” Moorlands Residential Care Home DS0000000811.V349052.R01.S.doc Version 5.2 Page 11 The inspector looked at 4 care plans, which were all generated from initial assessments. Care plans are clear about people’s physical and emotional needs and describe the care required and being provided to meet such needs. Although nutritional needs should be developed, care plans are good records of care. Care plans consider a range of needs, including equality and diversity matters, mental health and mobility. However, some risk assessments and related risk management arrangements need to be reviewed. In particular, risks associated with stairs and bedrails (where fitted). Where it is decided to use bed-rails as the most suitable form of bed management, the assessment, which concludes this, must be recorded; alternative options must first have been explored. Further, a suitable and sufficient assessment of the risks associated with the use of bed-rails must be completed, the significant findings recorded and ongoing monitoring / reviews conducted and safety checks undertaken. The inspector observed, through their actions and responses, that staff respect the privacy and dignity of the people who live at Moorlands. For example, staff were seen to knock before entering people’s bedrooms. People spoken to expressed their satisfaction with the manner and attitude of staff. The home uses a monitored dosage system to administer medicines. Policies, procedures and systems in place relating to the receipt, recording, storage, handling, administration and disposal of medicines are satisfactory. Moorlands Residential Care Home DS0000000811.V349052.R01.S.doc Version 5.2 Page 12 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. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Social needs are recognised and activities are being provided by the home. There are open visiting arrangements. The rights of people who use the service are respected and choice is provided. Meals are of a good standard. EVIDENCE: An activities co-ordinator (a relative of the home’s owners) is now employed for 20 hours per week. Outside entertainment is also arranged. For example, on special occasions such as birthdays being celebrated in the home. Care staff also provide activities wherever possible, and staff were seen to engage with the people who live at Moorlands in social interaction. The ‘expert by experience’ who visited Moorlands wrote, “There are two social lounges where entertainment takes place. The activities co-ordinator arranges games, e.g. dominoes, cards, bingo, musical entertainment, chair exercises, etc. If there is a birthday then a party is arranged. One resident is a member of the Salvation Army and some members of the band come to play on her birthday and at Christmas. If residents don’t want to participate then they are taken to the other lounge or their room. All residents I spoke to liked the entertainment. One or two wished they could have more outings. On the day of the visit the activities co-ordinator had arranged to set up an ice cream Moorlands Residential Care Home DS0000000811.V349052.R01.S.doc Version 5.2 Page 13 shop; it was a hot day and he thought they would like it. This brought a talking point again – memories of Iannereli with his cart outside of the Grammar school every day at 4 pm. Then in the winter no ice cream but hot jacket potatoes. We did have a laugh!” Moorlands shares a mini-bus lease / hire arrangement with another care home. Although some people said they would like to get out and about more, people spoke about trips out. For example, to Paddock Farm Nursery and Water Gardens last week. People also spoke about the benefits of being close to the town centre and other amenities such as the nearby Arts Centre. A person who lives at Moorlands said, “The staff are nice and cheerful, they’re good company and keep things going”. Another person said, “We went to a garden centre last week to look at things for the garden. It’s nice to get out”. Moorlands has open visiting arrangements. A person who lives at Moorlands said, “It’s sometimes noisy downstairs, but there’s a lounge upstairs where it’s quieter”. People spoken to said they were satisfied with the food provided. Food served was seen to be of a good standard. A person who lives at Moorlands said, “The meals are good, I can ask for an alternative if I wish. I usually enjoy what’s on offer but if there’s liver I’ll ask for, and will get, an alternative”. Another person said, “The food’s fine, I’ve no complaints”. Although no formal main meal alternative is provided, alternatives are available if required. To ensure that meals served meet people’s preferences, kitchen-staff said that they speak to the people who live at Moorlands on a regular basis to obtain their meal preferences / alternatives. The ‘expert by experience’ who visited Moorlands wrote, “Meals can be taken in the residents’ rooms but they are encouraged to go to the dining room. They place the order at the previous meal. It was Friday so it was fish and chips, peas, corn, followed by a trifle. All who had it seemed to enjoy it, it was well cooked and staff asked about portion size. There was an alternative for those who did not want fish and there was one diabetic meal. We followed this with a cup of tea. The staff came at the end of take orders for the evening meal.” Moorlands Residential Care Home DS0000000811.V349052.R01.S.doc Version 5.2 Page 14 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. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has systems in place to respond to complaints and safeguard people who use the service. EVIDENCE: Information about complaints, how and who to make them to, is made available through information in the home’s ‘Service Users Guide’. Any complaints or concerns are appropriately dealt with. People’s views are obtained through ‘Residents Meetings’, regular contact and an ‘open door policy’. A person who lives at Moorlands said, “We have Residents Meetings where we can air our views”. Another person said, “If there’s a problem I can talk to any of the staff”. Policies and procedures for referring appropriate staff for inclusion on the Protection of Vulnerable Adults (POVA) list and for handling adult protection allegations are in place. These procedures safeguard from abuse, the people who use the service and also protect people’s financial affairs. Although some staff have received ‘No Secrets / Protection of Vulnerable Adults’ training, it is recommended that additional training in this area should be provided. This is important so that staff have a better understanding of these issues and know what to do if an allegation of abuse is made. Moorlands Residential Care Home DS0000000811.V349052.R01.S.doc Version 5.2 Page 15 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. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Moorlands is homely, but parts of the home are in need of refurbishment. Some aspects of hygiene and infection control also need to be improved. EVIDENCE: Moorlands provides personal care and accommodation for up to 19 older people – in 17 single bedrooms and 1 double bedroom. 8 bedrooms have ensuite facilities. The property was originally 3 large (now converted) terraced town houses. It is pleasantly situated, overlooking a park and within walking distance of Darlington town centre. Bedrooms and communal spaces are arranged over 4 floors, with a passenger lift providing access to most areas. However, 2 bedrooms are only accessible by stairs and are occupied only by people who are more independently mobile. Moorlands Residential Care Home DS0000000811.V349052.R01.S.doc Version 5.2 Page 16 Communal space in the home includes 2 lounges, a dining room and a patio / garden area to the rear of the property. Communal toilets, two bathrooms and a shower room are located throughout the home. The ‘expert by experience’ who visited Moorlands wrote, “As soon as I entered the building I was made to feel welcome… I was shown all the rooms. Some were large with big bay windows and a wonderful view across the park. Others were smaller but were still attractive. Some residents had pieces of their own furniture in. All rooms had a TV. Residents could remain in their rooms as much as they wished but were encourage to go to one of the lounges and mix. Some rooms had recently been decorated and some were in the process of redecoration. If a resident wanted a larger room and one became vacant then they would be told of it and families would be invited to inspect it before any decision would be made.” Some areas of the home have been redecorated and refurnished over the last couple of years and provide pleasant and homely accommodation. A bedroom and the home’s bathrooms are being redecorated. However, other areas also need to be redecorated and refurnished. Since the last inspection, the home has applied for and successfully secured a ‘Capital Improvement Grant’ from the local authority. This is to be used to upgrade the bathrooms and improve the home’s garden / patio area. However, as highlighted in previous inspection reports, the home’s management should produce a realistic maintenance system and plan, linked to a recognisable quality assurance system, that helps to identify and prioritise maintenance jobs. This is important so that the home is well maintained and provides a safe and pleasant place for people to live. The inspector looked around the building. On the day of the inspection, the home was seen to be tidy, safe and free from odour. However, as highlighted in the previous inspection report, some infection control issues need to be improved, to make sure that staff and people living in the home are not put at risk of infection. For example, the hand soaking of soiled laundry should stop and the sluicing programme on the washing machine should be used instead. The home should provide specialist laundry bags that dissolve in the wash, to reduce the handling of soiled laundry. Paper towels and soap dispensers should replace the use of bar soaps and hand towels in communal bathrooms, as these are more hygienic and will reduce the risk of spreading infection. Moorlands Residential Care Home DS0000000811.V349052.R01.S.doc Version 5.2 Page 17 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. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Sufficient staff are employed. The home has a settled and well-trained staff team. EVIDENCE: From discussions with management and staff, and from an examination of duty rosters, sufficient staff are employed within the home. There is a settled staff team. Staff know the people who live there well. A member of staff interviewed said, “I believe in the small home. I know we’re not luxury standards, but we’re homely and don’t stand by ceremony. With only 19 residents we know everybody, and their families, well”. The ‘expert by experience’ who visited Moorlands wrote, “The attitude of the staff was excellent. Before I went into the room the resident was asked if I could go into have a look and speak with them. Then I was introduced and had a talk. This was in private. All spoke highly of the staff. I could see that their attitude was excellent, they were caring and nothing was too much trouble. There was laughing and joking on both side and privacy and dignity were respected. These were comments from the residents: “She is funny she makes you laugh;” “She’ll do anything for you;” “She took me to the shops to get some new clothes”. Moorlands Residential Care Home DS0000000811.V349052.R01.S.doc Version 5.2 Page 18 Agreed staffing levels for Moorlands are (in addition to the owner / manager, deputy manager and ancillary staff): 2 care assistants throughout the day and night - with extra staff working 8am to 1pm & 3pm to 6 pm shifts. These staffing levels are considered to be appropriate to meet the needs of the people currently accommodated. However, they should be reviewed if people’s needs, and associated dependency levels, change. Recruitment procedures within the home are safe. CRB (Criminal Records Bureau) disclosure checks are carried out. Applicants for employment complete an application form and 2 references are requested. A reference from the last employer is requested, plus another; any gaps in employment are explored. Each member of staff receives a contract of employment and a job description. Staff training is provided. Most care staff either have, are undertaking, or are about to undertake NVQ (National Vocational Qualification) training at level 2 or above. Core training such as First Aid and Moving & Handling is arranged. However, as highlighted in previous inspection reports staff training in the area of learning disabilities should be provided. In a CSCI ‘Have your Say About / Inspection Comment Card’ about the service a member of staff wrote, “I have had a lot of training, including some different types such as dementia and a grief and bereavement seminar, which was very interesting”. Moorlands Residential Care Home DS0000000811.V349052.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 36 & 38. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home has experienced owners. However, they need to bring about sustained improvements in order to demonstrate their capacity to better manage the home. Improvements in the home’s quality assurance systems are still required. EVIDENCE: Moorlands is run by Mr. and Mrs. Smith, who have run a care home for many years. Mrs. Smith is registered as the manager. She has the ‘Registered Managers Award’ (RMA) and other appropriate care qualifications. People who use the service were very complimentary about the owners’ caring nature and approachability. One person spoken to said, “I like Mr. & Mrs. Smith and their family. It’s like one big happy family”. Moorlands Residential Care Home DS0000000811.V349052.R01.S.doc Version 5.2 Page 20 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 her ability to effectively manage the care home as well and bring about improvements to the running of the home. As a result of this it is required 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. For example, the home’s formal ‘Quality Assurance System’ is not fully implemented and this needs to be developed. It is recognised that some elements of ‘Quality Assurance’ are already in place. These include ‘Residents Meetings’ that are held approximately every three months. However, there are still some concerns about the provider’s ability to independently identify and address problems within appropriate timescales. Systems for staff supervision are in place. However, formal supervision of staff is infrequent. Staff should received formal supervision once every two months. This is especially important for new staff, to make sure they are doing a good job and understand their new responsibilities. The home’s electrical installations certificate and other maintenance certificates (such as the ‘landlord’s gas safety certificate’ and the servicing of lifting equipment) are up to date. A fire risk assessment has been written. However, as highlighted in the previous inspection report, adequate fire training must be provided to staff. Day staff should complete refresher fire training/drills every six months and night staff should complete refresher training/drills every three months. As also highlighted in the previous inspection report, Portable Appliance Testing should also be carried out as soon as possible. Further, as highlighted earlier in this report, some risk assessments and risk management arrangements need to be reviewed. In particular, risks associated with stairs and bedrails (where fitted). Where it is decided to use bed-rails as the most suitable form of bed management, the assessment, which concludes this, must be recorded; alternative options must first have been explored. Further, a suitable and sufficient assessment of the risks associated with the use of bed-rails must be completed, the significant findings recorded and ongoing monitoring / reviews conducted and safety checks undertaken. Moorlands Residential Care Home DS0000000811.V349052.R01.S.doc Version 5.2 Page 21 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 2 2 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 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 2 X 3 2 X 2 Moorlands Residential Care Home DS0000000811.V349052.R01.S.doc Version 5.2 Page 22 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 OP1 Regulation 5 Requirement A copy of the home’s Service User Guide must be given to each person who uses the service. This is to ensure that people who live at Moorlands are better informed about the home, its facilities, the services provided and fees payable. The terms and conditions / contracts used by the home must be reviewed in line with The Office of Fair Trading’s report ‘Fair Terms for Care’. This is important so that people are better informed and have clear and fair written agreements about the service they should receive from the home. Everybody living at Moorlands should receive a copy of the home’s terms and conditions, or contract if privately funded. This requirement remains outstanding from the previous inspection - timescale of 30/04/07 not met. The manager must be able to discharge their management responsibilities fully. The registration of an alternative DS0000000811.V349052.R01.S.doc Timescale for action 30/11/07 2. OP2 5 30/11/07 3. OP31 8 & 10 30/11/07 Moorlands Residential Care Home Version 5.2 Page 23 4. OP33 24 5. OP38 23(4)(e) 6. OP38 13 manager for the domiciliary care agency must be sought. This requirement remains outstanding from previous inspections - timescales of 31/10/06 and 31/03/07 not met. Effective quality assurance and 30/11/07 quality monitoring systems must be put in place and should include consultation with the people who use the service and their representatives. This requirement remains outstanding from previous inspections - timescales of 31/08/06 and 30/06/07 not met. To make sure people who live at 30/10/07 Moorlands are safe, adequate fire training must be provided to staff. Day staff should complete refresher fire training/drills every six months and night staff should complete refresher training/drills every three months. This requirement remains outstanding from the previous inspection - timescale of 28/02/07 not met. To make sure people who live at 30/10/07 Moorlands are safe, risk assessments associated with stairs and bedrails (where fitted) must be reviewed. Where it is decided to use bedrails as the most suitable form of bed management, the assessment, which concludes this, must be recorded; alternative options must first have been explored. Further, a suitable and sufficient assessment of the risks associated with the use of bedrails must be completed, the significant findings recorded and ongoing monitoring / reviews conducted and safety checks undertaken. DS0000000811.V349052.R01.S.doc Version 5.2 Page 24 Moorlands Residential Care Home 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 OP8 OP18 Good Practice Recommendations Care plans should be developed to consider nutritional needs in more detail. This is important to ensure that appropriate action is taken to meet such needs. Staff should receive additional training about ‘Safeguarding’ and the ‘Protection of Vulnerable Adults’. This is important so staff have a better understanding of these issues and know what to do if an allegation of abuse is made. As highlighted in the previous inspection report, the home’s management should produce a realistic maintenance system and plan, linked to a recognisable quality assurance system, that helps to identify and prioritises maintenance jobs. This is important so that the home is well maintained and provides a safe and pleasant place for people to live. As highlighted in the previous inspection report: The hand soaking of soiled laundry should stop and the sluicing programme on the washing machine should be used instead. The use of bar soaps and hand towels in communal bathrooms should be replace by paper towels and soap dispensers, as these are more hygienic in communal facilities. These are important to minimise the risk of infection spreading in the home. As highlighted in previous inspection reports, staff training in the area of learning disabilities should be provided. This is important so that staff better understand the needs of people living in the home. As highlighted in the previous inspection report, staff supervision sessions should take place on a two monthly basis. This is important so that staff are better supervised and supported in their work. As highlighted in the previous inspection report, regular portable appliance testing (PAT) should be arranged. This is important to ensure electrical items in the home are safe to use. 3. OP19 4. OP26 5. OP30 6. OP36 7. OP38 Moorlands Residential Care Home DS0000000811.V349052.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Darlington Area Office No. 1 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 Residential Care Home DS0000000811.V349052.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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