Inspection on 24/02/09 for Moorleigh Nursing Home

This inspection was carried out on 24th February 2009.

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

The inspector found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Moorleigh Nursing Home 27/02/07

Moorleigh Nursing Home 17/11/05

Moorleigh Nursing Home 08/06/05

Moorleigh Nursing Home 25/11/04

Moorleigh Nursing Home 20/05/04

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Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Moorleigh Nursing Home 278 Gibson Lane Kippax Leeds Yorkshire LS25 7JN     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Sean Cassidy     Date: 2 4 0 2 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 25 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 25 Information about the care home Name of care home: Address: Moorleigh Nursing Home 278 Gibson Lane Kippax Leeds Yorkshire LS25 7JN 01132863247 01132872989 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Brampton Meadow Limited Name of registered manager (if applicable) Mrs Rosemarie Holt Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The place for DE(E) is for the use of the service user named in the variation application V17005 only Date of last inspection Brief description of the care home Moorleigh is a detached property situated in the village of Kippax. It is next door to the Health Centre and within a short walking distance of local shops and amenities. The village has bus routes linking it with Leeds, Castleford and Wakefield. Moorleigh is registered as a Care Home with Nursing, offering care to a maximum of 36 people over the age of 65. The home offers care to both male and female service users. Accommodation is provided in 32 single and 2 double rooms, 18 rooms have en-suite facilities. The home has extensive well-maintained gardens, which are accessible to Care Homes for Older People Page 4 of 25 care home 36 Over 65 1 36 0 0 Brief description of the care home service users. Disabled access to the home is provided by means of a ramp. Car parking is provided at the front of the building. Care Homes for Older People Page 5 of 25 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The accumulated evidence used in this report has included: A review of the information held on the homes file since its last inspection. Information submitted by the registered provider in the AQAA (Annual Quality Assurance Assessment) Surveys received from people who use the service, relatives and staff. An unannounced visit to the home, which lasted eight hours. This included a partial tour of the premises. Care Homes for Older People Page 6 of 25 Evidence gained by direct observation, talking with people who use the service and management. Inspection of records including care plans risk assessments, medication administration records,and the homes policies and procedures. What the care home does well: What has improved since the last inspection? What they could do better: The care plans should be reviewed to ensure they show clearly that consent to receiving care has been obtained. The staff working in the home must receive relevant training that supports them in their role of providing care. A more robust system must be in place for monitoring the quality of care provided in the home. This will help ensure care is assessed and improved where necessary. The provider must ensure Regulation 26 visits are performed monthly. This will ensure care is regularly monitored. Care Homes for Older People Page 8 of 25 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 25 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 25 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are provided with good opportunities to visit the home before choosing a place. A preassessment is carried out before admission. This helps ensure each persons needs can be met. Evidence: Three people spoken to said they were provided with the oportunity to visit and look around the home before they took a place. Only one said she actually took the opportunity to visit and said she found this really useful. The documentation belonging to three people showed that each person was preassessed before being admitted to the home. this is good practice as it helps ensure each individuals needs can be met in the home. Care Homes for Older People Page 11 of 25 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home receive a good standard of health and personal care. Evidence: The care files for three people were inspected. All showed evidence that an assessment had taken place and care plans had been written to direct staff when providing care. The care plans were well written and provided staff with good instructions as to how each individuals needs were to be met. They were reviewed monthly. There was however an inconsistent approach to gaining consent from those who were receiving the care or from their representative. Good risk assessments were in place and there was clear evidence seen that staff were quick to respond to any identified changes in a persons condition. Examples of this were, when nutritional risk assessments highlighted a negative change then the relevant health professional was contacted. The staff involved the tissue viability nurse for two people when it was clear her input was needed. All risk assessments inspected were reviewed monthly. Care Homes for Older People Page 12 of 25 Evidence: Staff were observed interacting well with people over the course of the day. They were polite and helpful. people told us, Staff are really kind and loving when they help me. Staff cant do enough for me. Mum is really well liked after her. The staff go the extra mile. Medication administration and recording was observed. The medication charts showed evidence that the administration and recording of medicines in the home is of a good standard. Care Homes for Older People Page 13 of 25 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home receive and activities programme that meets their needs. Evidence: The care documentation showed people likes and dislikes in relation to their social interests were discussed and recorded. The daily records showed good evidence recorded that showed people were involved with different activities provided by the home. Two people told me they get the papers regularly. they also said they were able to vote in the elections but they chose not to get involved. Evidence was seen around the home that informed people of activities that were on offer. Three people said they enjoyed what was offered by the home in the way of activities and they said that it suited their needs. Two people said they are not pushed to join in but that it is left up to them whether they involve themselves or not. Local entertainment is also brought in regularly. People provided positive feedback about the food that is provided within the Its good home cooked food her. They are very good when it comes to getting something thats not on the menu. Mum really enjoys the food. Shes started to put back on Care Homes for Older People Page 14 of 25 Evidence: some weight since she moved in. Staff were observed going around the home and asking people what they would like to eat at lunch time. Staff assisted those people who needed help and support with their meals and this was carried out in a dignified manner. The lunchtime meal was observed in the dining area on the first floor. People were provided with appropriate assistance to eat their meals. Care Homes for Older People Page 15 of 25 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are good systems in place that help protect people from harm. Evidence: The home has developed a complaints procedure that is displayed around the building and is also contained within the Service User Guide. All people spoke to during the inspection said they were confident that they knew what to do if they wanted to make a complaint. The majority of staff have been trained in the area of Safeguarding Adults. All those staff spoken to during the inspection provided good evidence that they were aware of their roles and responsibilities within this process. Care Homes for Older People Page 16 of 25 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are provided with an environment that suits their needs. Evidence: An ongoing programme of redecoration has created a well lit welcoming appearance to the corridors. The corridor doors had been widened to allow easier access for wheelchairs. Handrails have been fitted to either side of the corridors for the benefit of service users and to provide some protection to the walls from passing wheelchairs. Most of the rooms seen were spacious in size allowing plenty of space for personal belongings. The home was clean and tidy on the day of the inspection. The domestic staff on duty had a clear understanding of infection control and COSHH (Control of Substances Harmful to Health) The garden areas have been landscaped and and a new garden summerhouse has been built for people to enter for quiet time if they wish. A new conservatory has also been built. Care Homes for Older People Page 17 of 25 Evidence: All bedrooms were fitted with locks, which allowed staff to access the rooms in an emergency. Health and Safety check records were examined. The records showed that the maintenance person inspected bedrails monthly and the pressure relieving mattress pumps. Care Homes for Older People Page 18 of 25 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People receive their care from a staff group that is well recruited and trained. Evidence: There is a staffing rota in place that identifies the staff that are on duty for each shift. People spoken to said they were busy most times but that they do have time to spend with people on an individual basis and this was observed during the day. The recruitment files for the two most recent employees were checked and the evidence seen showed that all information needed before a person could commence work was obtained. Staff said that they enjoyed the training that is offered within the home. There is an identified trainer in the home and she has developed a training matrix that highlights the training needs of the staff group. There were gaps in the mandatory core training that must be provided to all care staff. This includes moving and handling, fire training and safeguarding vulnerable adults. Two people had received no mandatory training. Staff said the provider is supportive of their training needs. Care Homes for Older People Page 19 of 25 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The overall management of the home is good. However, the systems and processes for monitoring the quality of the care provided must be improved. This will help improve the quality of care people receive in the home. Evidence: The manager has worked in the home for several years and is well respected by all groups. She has not yet completed the Registered Manager Award which is a recommended for all registered managers. The home is not responsible for any persons monies but they do look after some small amounts for individuals. The records for money transactions were recorded correctly. The home does not have any recognised quality assurance cycle in place to assist the quality performance. There are no audits of documentation such as falls, accidents, care plans and medication. This means that there is little evidence in place that shows Care Homes for Older People Page 20 of 25 Evidence: quality of care for people is monitored and improved. The provider does not complete Regulation 26 visits. The omission of these visits again indicates the home is not appropriately monitored. The accident book contained a number of incidents where the CSCI should have been informed. Discussion was held with the manager and deputy regarding action taken as a result of people sustaining minor head injuries. Inappropriate observations were being taken to ensure people were properly protected. This was discussed with the manager and deputy manager who were very clear that this information would be correctly recorded in future and that the CSCI would be informed of any serious incidents that occurred. The health and safety records were correct and up to date. Care Homes for Older People Page 21 of 25 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 22 of 25 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 30 13 All staff must be provided with training that supports them with performing their roles. This must include areas such as moving and handling, safeguarding vulnearble adults and fire training. This will ensure people receive appropriate care packages. 31/05/2009 2 33 26 Regulation 26 visits must be completed monthly. This will ensure the quality of care is regularly monitored. 31/05/2009 3 33 13 The home must ensure ther are apporpriate systems in place to monitor care provision. This will help ensure peoples care is monitored and improved. 31/05/2009 Care Homes for Older People Page 23 of 25 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 8 The care documentation should show clear evidence that people receiving the care package have consented to the process. Care Homes for Older People Page 24 of 25 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 25 of 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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