Inspection on 23/02/07 for Moorlands Rest Home

This inspection was carried out on 23rd February 2007.

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

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

Other inspections for this house

Moorlands Rest Home 24/01/09

Moorlands Rest Home 07/02/06

Moorlands Rest Home 13/09/05

Moorlands Rest Home 22/02/05

Moorlands Rest Home 25/05/04

Similar services:

St Vincents

The Cotswold Home

Newbeech House

Winton House

Rush Court

Hillyfield Rest Home

The Maypole Nursing Centre

The Briars

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

CARE HOMES FOR OLDER PEOPLE Moorlands Rest Home 987 Oxford Road Tilehurst Reading Berkshire RG31 6TN Lead Inspector Kate Harrison Unannounced Inspection 23rd February 2007 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Moorlands Rest Home DS0000011120.V328568.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 Rest Home DS0000011120.V328568.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Moorlands Rest Home Address 987 Oxford Road Tilehurst Reading Berkshire RG31 6TN 0118 942 7522 0118 9427522 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 Sundith Ramdany Mrs Koomari Nanda Ramdany Mrs Koomari Nanda Ramdany Care Home 12 Category(ies) of Old age, not falling within any other category registration, with number (12), Physical disability (1) of places Moorlands Rest Home DS0000011120.V328568.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. That provision is made for one service user aged under 65 years, identified in the application form dated 20.04.03, to be resident in the home. 7th February 2006 Date of last inspection Brief Description of the Service: Moorlands Rest Home is a care home providing personal care and accommodation for twelve older people with low to middle dependency needs. The home is located approximately two miles from Reading city centre and privately owned by Mr. and Mrs. S. Ramdany. Mrs K. Ramdany, who is a qualified Registered General Nurse and Registered Mental Nurse, manages the home. Service users are currently accommodated in two double and eight single bedrooms. Moorlands Rest Home is equipped with a four-passenger lift and bathing aids to assist the more dependent service users. The aim of the home is to provide a homely and comfortable atmosphere; a lifestyle that satisfies their social, cultural, religious and recreational interests and needs; promote and maintain service users’ health; and to ensure the independence and individuality of the service users is respected. Fees range from £307 to £380 per week. Moorlands Rest Home DS0000011120.V328568.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Commission has, since the 1st April 2006, developed the way it undertakes its inspection of care services. This inspection of the service was an unannounced ‘Key Inspection’. The inspector arrived at the service at 11.30 hours and was in the service for 4 hours. This inspection was a thorough look at how well the service is doing. It took into account detailed information provided by the service, and any information that CSCI has received about the home since the last inspection. The inspector saw all areas of the home and looked at records and documents relating to the care of the residents. The registered manager was available on the day and was able to help the inspector gain a full understanding of the service provided at Moorlands. The inspector asked the views of the people who use the services or who responded to questionnaires (comment cards) that the Commission had sent out. Three health care professionals replied to the comment cards and seven residents replied to the questionaires. The inspector spoke to several residents at the home during the day, but no visitors were available at the time. All the comments about the care at the home were very positive. From the evidence seen and comments received, the inspector considers that this home would be able to provide a service to meet the needs of individuals of differing religious, racial, physical or cultural needs. This is because the home has a strong focus on the needs of the individual, and the manager knows how to access training and advice for staff members as needed. What the service does well: What has improved since the last inspection? A ramp has been acquired to help residents easily get into the garden from the conservatory, and this enhances the quality of life for several of the residents. Moorlands Rest Home DS0000011120.V328568.R01.S.doc Version 5.2 Page 6 Sessions to help residents remember particular topics about their earlier lives have started, and residents and staff have benefited. More staff training about dementia has been provided. 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 Rest Home DS0000011120.V328568.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 Rest Home DS0000011120.V328568.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): 3. The home does not provide intermediate care. Quality in this outcome area is good. The manager assesses the needs of individuals before admission to the home, and makes a decision that the home can meet the needs of the individual before individuals are admitted to the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: All the residents who replied to the Commission’s questionnaire said that they received enough information about the home before they moved in. The inspector tracked the admission process for two residents to access the pre-admission procedures. Both individuals’ needs were assessed before a decision was made regarding admission, and the individuals told the inspector that they were happy with their choice of home. The manager usually collects available information and then goes to see the individual. She completes the home’s pre-admission assessment form to record all the personal, social, medical, emotional and family information of relevance. All the documentation regarding the two individuals was available, including the information available from one individual’s social worker, and another’s key worker at a day centre. Moorlands Rest Home DS0000011120.V328568.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10. Quality in this outcome area is good. The residents’ health and welfare needs are met through careful planning and recording, and staff act respectfully towards the residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The inspector tracked the care process for two individuals at the home. Care plans were developed from the pre-admission assessment, and a more detailed assessment was carried out soon after admission for both the individuals. The risk assessments and care plans covered all the needs of the individuals, including social and emotional needs, and gave detailed instructions to staff members on how to provide the care. The individuals signed the care plans, signifying their agreement with the care plans and reviews were carried out regularly. All of the residents who replied to the Commission’s questionnaire said that they ‘always’ or ‘usually’ received the care and support they need. Moorlands Rest Home DS0000011120.V328568.R01.S.doc Version 5.2 Page 10 All the residents are registered with a local General Practitioner (GP), and the three health care professionals who replied to the Commission’s comment cards said that they were satisfied with the overall care at the home. To improve the quality of the home’s nutritional risk assessments, the inspector recommends that the Malnutrition Universal Screening Tool (MUST) be used, with advice from the district nurse, as this is the present best practice tool. Medication is ordered from a local pharmacy and is securely stored. The records seen by the inspector for two individuals were well kept. Appropriate medicines are stored in the fridge and the inspector recommends that for preparations with an expiry date after opening, that these are dated on opening, so that the expiry date of the medication is known. A major pharmaceutical company and a local college provide staff training regarding medication, and the registered manager provides some update training as necessary. Staff members were noted to be very respectful towards residents, and residents said in the questionnaires that staff members ‘always’ listen and act on what they say. Moorlands Rest Home DS0000011120.V328568.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 and 15. Quality in this outcome area is good. Residents have choice and control over their lifestyles as far as possible. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Residents are encouraged to make choices about how they want to spend their day. Some take meals in their rooms, while others like the atmosphere of the day room or conservatory. Residents can arrange to see the hairdresser who comes regularly. All the residents who replied to the Commission’s questionnaire said that activities were arranged that they could take part in. Activities include memory games, gentle exercises, ball games, visits outside the home and church services. A dance company provides mobility sessions from time to time. Relatives are encouraged to visit, and usually help residents to manage financial and other matters. Moorlands Rest Home DS0000011120.V328568.R01.S.doc Version 5.2 Page 12 The home has a menu showing a variety of home cooked food for lunch and tea. Residents said that they ‘usually’ or ‘always’ liked the food, and one said that a choice was always available if she did not like the main dish offered. The manager usually prepares lunch in the home’s domestic kitchen, and has good knowledge of the residents’ food preferences. The dining room is well presented and several residents took lunch at the dining room tables. Staff members helped other residents with their food in an unhurried professional way. Moorlands Rest Home DS0000011120.V328568.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18. Quality in this outcome area is excellent. Residents are safeguarded from harm and the residents and other stakeholders know that any complaints they make will be taken seriously. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home’s complaint procedure meets regulation and is displayed at eye level in the home so that residents and visitors know how to make a complaint. All the residents who replied to the Commission’s questionnaire said that they whom to complain to if they had any concerns. A record is kept of all the complaints received and of the action taken to address the issue. The inspector noted that new residents have the opportunity to discuss the complaints procedure with the manager. This is good practice and makes sure that residents know their rights regarding making their concerns and complaints known to the home’s manager. No complainant has contacted the Commission with information about the service since the last inspection. The home has a policy and procedure to safeguard vulnerable adults, and staff members attended update training in 2006. Moorlands Rest Home DS0000011120.V328568.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26. Quality in this outcome area is adequate. The home is clean and well maintained, though some issues need to be addressed to improve safety. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home is a two storey building situated in a residential road, with steps leading to the front entrance but with easy access at the back of the house. There are gardens to the back that are accessible for residents. A new resident had requested that her bedroom door remain open during the day, and a doorstopper was used to keep it open. The inspector recommends that the registered manager seek advice from the fire service about the matter, so that residents’ safety is not compromised. Not all the radiators at the home are protected, and the inspector recommends that a risk assessment be carried out regarding the unprotected radiators, so that any risks are identified. The registered manager should to act on the results of the assessment. Moorlands Rest Home DS0000011120.V328568.R01.S.doc Version 5.2 Page 15 The home has an annual development plan and plans maintenance according to need at the home. The home’s laundry room is located off a ground floor bathroom, and the walls and floor should be covered in a wash-proof finishing, to help the control of infection. All the residents who replied to the Commission’s questionnaire said that the home was ‘always’ clean and fresh. Moorlands Rest Home DS0000011120.V328568.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. Quality in this outcome area is adequate. The home has suitable and sufficient numbers of carers and is working to improve staff training. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home has a staff rota showing who is on duty at all times, and on the day of the inspection visit there were two staff members on duty plus the registered manager, for the 11 residents. The majority of the residents who replied to the Commission’s questionnaire said that the staff members were ‘always’ available when they needed them, and staff numbers on the day of the inspection visit were sufficient to meet the needs of the residents. To support the lone carer on night duty, the inspector recommends that the rota show who is on call and can be contacted in case of an emergency during the night. Three members of the care team have (NVQ) in Care, and the home is working towards meeting the national minimum standard of 50 trained staff by supporting more carers to start the training. The inspector checked two staff members’ individual recruitment files, and found that all the necessary information was available about them. The inspector recommends that the home’s staff members’ application form be amended to include the referees’ details, so that the recruitment procedure fully protects the residents. Moorlands Rest Home DS0000011120.V328568.R01.S.doc Version 5.2 Page 17 The registered manager is working towards bringing the home’s induction programme up to the Skills for Care standard. Mandatory training such as fire safety, food hygiene and moving and lifting residents is organised for staff members and other relevant training is provided, such as dementia awareness, medication and pressure area care. Moorlands Rest Home DS0000011120.V328568.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38. Quality in this outcome area is good. The health and safety of residents is protected by the home’s policies and through the professionalism of the registered manager. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The registered manager has several years experience at the home, has the NVQ Level 4 management qualification and several residents praised her qualities as a manager. The home carried out a quality review of the service in June 2006 with questionnaires to health care professionals, residents and relatives. The inspector saw several complimentary cards regarding the high quality of the service that were received during the year. The home does not manage any residents’ financial affairs. Moorlands Rest Home DS0000011120.V328568.R01.S.doc Version 5.2 Page 19 The home has a policy statement on health and safety regarding the safety of staff and residents, and maintains appropriate checks on the appliances in the home. The home has carried out a fire safety risk assessment and an emergency evacuation plan is in place in case of fire. Moorlands Rest Home DS0000011120.V328568.R01.S.doc Version 5.2 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 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 4 17 X 18 3 2 X X X X X X 2 STAFFING Standard No Score 27 3 28 2 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X X Moorlands Rest Home DS0000011120.V328568.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard OP8 OP9 OP19 OP38 OP26 Good Practice Recommendations 1 2 3 4 5 6 The inspector recommends that the Malnutrition Universal Screening Tool (MUST) be used to assess the nutritional state of residents. The starting date of those medications with an expiry date after opening should be recorded on the medication. The inspector recommends that the registered manager seek advice from the fire service about appropriate means to keep bedroom doors open. A risk assessment be carried out to highlight risks to residents and to act on the results of the assessment The walls and floor should be covered in a wash-proof finishing, to help the control of infection. The home’s staff members application form be amended to include the referees details, so that the recruitment procedure fully protects the residents. DS0000011120.V328568.R01.S.doc Version 5.2 Page 22 OP29 Moorlands Rest Home 7 OP27 The inspector recommends that the rota shows who is on call in case of an emergency Moorlands Rest Home DS0000011120.V328568.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Oxford Office Burgner House 4630 Kingsgate Oxford Business Park South Cowley, Oxford OX4 2SU 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. 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